Trump health vacancies offer chances to change course
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Multiple high-level vacancies at federal health agencies are giving the Trump administration a chance to pivot from contentious vaccine policies to a more mainstream public health strategy.
Why it matters: The anticipated nomination of a new Centers for Disease Control and Prevention director and selection of a top Food and Drug Administration vaccine regulator will be closely watched for signs the White House wants to break from the drama that characterized much of the past year.
Driving the news: The CDC pick could be imminent since acting director Jay Bhattacharya's appointment expires on Thursday unless a permanent nominee is named.
- That pick will have to be confirmed by the Senate — a potentially tall order in an election year after Health Secretary Robert F. Kennedy Jr. and other Trump health nominees antagonized some of the chamber's Republican centrists.
The FDA also is picking a successor for Vinay Prasad, a polarizing figure who oversees vaccines and biologics and picked fights with patient advocates and biotech investors. Many are pushing for a more mainstream choice.
- The upheaval is also reaching the CDC's vaccine advisory committee, whose work has been temporarily frozen after a federal judge invalidated Kennedy picks. It's unclear whether a new slate of advisers will be chosen.
- On Tuesday, the vice chair of the committee, Robert Malone, resigned, citing the time commitment and attendant drama, per Roll Call.
- Another question mark is surgeon general nominee Casey Means, a Kennedy ally and wellness influencer, who declined to fully urge vaccinations in her confirmation hearing. She remains in limbo, stalled by concerns from some GOP senators.
The big picture: The openings come amid signs the White House is eager to avoid further controversial health moves ahead of the midterm elections.
- Chris Klomp, a well-respected former health care investor who's now effectively chief operating officer of Health and Human Services, is involved in the sensitive personnel decisions.
- Some noted vaccine critics like former CDC deputy director Ralph Abraham have left the administration.
- Klomp said at a Stat event last week that he wants a CDC director with "unassailably high moral integrity who is deeply experienced and ... is qualified to lead a staggeringly complicated and essential government agency."
Yes, but: Any administration appointee will still have to work with Kennedy, who's recently tamped down some of his vaccine criticism to focus on less controversial topics like healthy foods.
- The CDC director will have to establish ties with a demoralized workforce that was particularly hard hit by Kennedy's personnel cuts and then targeted by a gunman in an attack on the agency's Atlanta headquarters.
What they're saying: David Mansdoerfer, a former HHS official in President Trump's first term, said the administration is in the midst of "a pretty significant shift to an emphasis on drug pricing overall," noting Klomp's elevation after he led negotiations with leading drugmakers.
- To replace Prasad at the FDA, he said he expects "a little bit more of a traditional Republican that goes into that position, someone who's a bit more comfortable working with the pharmaceutical industry, someone that will still challenge them."
- Richard Besser, a former acting CDC director under President Obama, said the Senate can act as a check in helping the administration opt for a more qualified CDC nominee.
- "Given the current state of affairs, I think that is a good thing that there's congressional oversight," said Besser, now CEO of the Robert Wood Johnson Foundation, noting there recently has been a "slowdown in the vaccine activity by the administration."
What we're watching: Whether the administration punts decisions past the elections by putting off a permanent CDC director pick and making policy decisions without input from the vaccine advisers.
