Sweeping changes to health policy under the incoming Trump administration, and at the likely direction of vaccine denier Robert F Kennedy Jr, will bring disruption and uncertainty to an agency currently “at peak performance”, the outgoing head of the federal Food and Drug Administration (FDA) has warned.
Robert Califf, speaking at the Friends of Cancer Research annual meeting in Washington DC on Tuesday night, said he was personally disappointed by the election result, and that FDA staff were “putting their heads down and doing their work” as they await the upheaval Trump has indicated.
The president-elect has promised to allow RFK Jr, a conspiracy theorist with a range of radical and unorthodox views on public health, to “go wild” on food and medicines in an as-yet unspecified role in his second administration.
Kennedy has claimed Trump assured him control over a broad range of public health agencies including the FDA, and Reuters reported that he has already been reviewing résumés and making recommendations for top health jobs.
Califf, who has served separate terms as FDA commissioner under Barack Obama and Joe Biden, did not mention Kennedy by name, but said he expected Trump to follow through on his promise to shake up public health policy.
“It’s not correct of me to make any specific comments about exactly what will happen,” he said.
“But I do think it’s pretty clear that the gist of this administration, from everything that’s been said, is to change a lot of things, and how it gets changed depends on who gets appointed into key positions and how the various policies play out.
“I’m biased, but I feel like the FDA is sort of at peak performance right now, and we’ll just see what happens as a new team comes in.”
Califf was asked if he expected a mass exodus of staff following Kennedy’s promise to “clear out” entire departments of the FDA that he has claimed, without evidence, are ridden with corruption, conflicts of interest and ties to the pharmaceutical industry.
“People are waiting to see,” he said. “From things that have been said, the change could happen internally, or external, decisions made by the administration. We have to wait and see and have some faith that hard-working, high-quality people are going to still be in place, and will have support, I hope, from the external regulated community.
“Getting into a back-and-forth about hypotheticals is not productive for anyone. I would just say I want to stand by the people who work at FDA, they’re good people. They’re hard working and they want what’s best for the American public. I have no question about that.”
Kennedy, whose own independent presidential campaign was sunk in part by bizarre tales including having part of his brain eaten by a worm, has risen to prominence inside Trump’s transition team. The Republican president-elect has chosen not to distance himself from Kennedy’s promise to remove teeth-strengthening fluoride from drinking water or to resurrect investigations into debunked theories over the supposed dangers of childhood vaccines, to which he has long been opposed.
Califf listed essential qualities he said the next FDA commissioner needed to have. “Ability to function as an executive is going to be a very important one, the ability to listen to people with disparate points of view and take in and learn in a new environment, and then make executive decisions,” he said.
“But right up with that, I would say hopefully it will be someone who understands the really critical role of high-quality evidence in everything we do, and a confidence that there is such a thing as expertise.
“Because I feel like a lot of what’s in question right now in our society is, should we make decisions based on how we feel at any given moment in time, versus analyzing things and coming up with an opinion?
“Not having experts, I think historically in every society, has been a case for demise of that society.”
