Biden’s FDA Pick to Prioritize Workforce Retention, Trust

President Biden’s pick to lead the Food and Drug Administration testified on Tuesday that, if confirmed, he will prioritize workforce retention and rebuilding trust in the agency.

Biden tapped Dr. Robert Califf, most recently a professor of medicine at the Duke University School of Medicine, on November 12 to be Food and Drug Administration commissioner. He previously served as FDA commissioner from 2016 to 2017 and was confirmed by the Senate 89-4, with bipartisan support. However, a lot has changed in the past five years—most critically, the emergence of the coronavirus pandemic. 

With each of his priorities for the agency––such as emergency preparedness, consumer and patient protection, and modernization––“a common thread is my commitment to ensuring the agency is more inclusive, diverse, equitable and accessible in the work it does for the American public,” Califf testified before the Senate Health Education, Labor and Pensions Committee. “As I work to implement these priorities, attracting and retaining FDA’s scientific workforce may be even more important than any particular policy because it is the agency’s day-to-day decision making that protects the public.” 

He added in his prepared remarks that “the scientific and technical world is moving quickly—the FDA needs the talent to keep up and protect the public while supporting scientific innovation.”

The nonprofit Partnership for Public Service issues annual rankings of agencies titled “Best Places to Work.” The FDA, within the Health and Human Services Department, was ranked 80 out of 411 for overall engagement for agency subcomponents. 

FDA ranked higher than the sub-agency median for employee skills-mission match, effective leadership, teamwork, innovation and recognition; it ranked below the median for pay, and was about even for work-life balance. Due to a change in the Partnership’s calculation methodology for 2020, results could not be compared to previous years. 

As for the coronavirus-specific questions, which were new, FDA ranked 87 of 383 for COVID-19 response overall for agency subcomponents. For specific COVID-19 topics, the FDA ranked 110 of 393 for supportive leaders, 119 of 393 for employee well-being, 71 of 393 for job resources and 139 of 393 for agency performance. 

If confirmed, Califf said he will understand the critical need to work with Congress and other parts of the executive branch. “I will also be a commissioner who can hit the ground running because of my past experience as a civil servant and in leading the agency,” he said. 

The FDA had 19,614 employees, as of June, which is the most current data available online from the Office of Personnel Management. About 47% identified as minorities and 59% as women. For comparison in September 2006, about 30% were minorities and about 51% women. 

Califf thanked “[acting FDA Commissioner] Dr. Janet Woodcock, the rest of the FDA leadership team and the entirety of the FDA workforce for their exemplary service over the years and especially during the COVID-19 pandemic.”

In response to a question from Sen. Roger Marshall, R-Kan., about distributing an abortion pill, Califf said: “I do trust the FDA staff to make good decisions,” based on the latest data and scientific policies. 

The FDA has also been challenged over the last almost two years with the public’s trust between allegations of political interference by the Trump administration in the public health agencies and distrust in coronavirus vaccines and now booster shots. 

“‘Trust once lost is hard to regain.’ That’s an old statement and I think it’s true,” said Califf. “We’re going to have to be much more aggressively outgoing and work on every single aspect of transparency that we can.”

Sen. Bernie Sanders, I-Vt., raised concerns about Califf’s connections to the drug industry, as have other lawmakers and other observers since he was nominated. 

Califf said he has a history of standing up to special interest groups, but also “this administration has the most stringent ethics pledge in the history of administrations. They reviewed my status; I’ve agreed to the ethics pledge and FDA and HHS have excellent staff whose job it is to make sure that those ethics pledges are adhered to.” 

Sen. Richard Burr, R-N.C., ranking member of the Senate Health, Labor and Pensions Committee, thanked Califf during the hearing for his willingness to return to the FDA.

“This administration has left the FDA commissioner position open since January 20th – almost a full year – in the middle of the pandemic,” Burr said. “I’m disappointed that it took them so long, but I am glad to see you again sitting before this committee.”

Both President Trump and Obama’s first FDA commissioners were confirmed in May of their first years in office. 

While it is unclear if Califf will receive the same bipartisan support in the Senate as he did last time, six former FDA commissioners who served under presidents of both major political parties submitted a letter of support for Califf’s confirmation, Sen. Patty Murray, D-Wash., chairwoman of the Senate Health, Education, Labor and Pensions Committee, noted at the beginning of the hearing.