How to Navigate the White House's Search for a New FDA Commissioner: A Step-by-Step Guide

Introduction

Following the resignation of FDA Commissioner Marty Makary, the Trump administration faces the urgent task of finding a successor who can restore staff morale, sharpen the agency's focus on food policy, and sustain momentum in drug-approval reforms. This guide breaks down the search process as insiders expect it to unfold, from defining priorities to managing the Senate confirmation timeline. Whether you're a policy analyst, a stakeholder, or simply curious about the inner workings of presidential appointments, these steps outline what it takes to secure the next leader of the Food and Drug Administration.

What You Need

• A clear policy agenda – The administration must have a defined set of goals for the FDA, particularly around food safety, drug review speed, and rebuilding internal trust.
• A pool of vetted candidates – Although no shortlist exists yet, the search team needs access to potential nominees with FDA experience, regulatory expertise, and political viability.
• Senate confirmation calendar – The Senate is in session for a limited number of days, and other nominations (Erica Schwartz for CDC, Nicole Saphier for Surgeon General) are also pending.
• Acting leadership plan – If the search takes longer than expected, the administration must decide who will serve as acting commissioner, possibly Kyle Diamantas (former head of FDA's food center).
• Communication strategy – The official will need to rebuild trust with FDA staff and communicate priorities to Congress and the public.

Step-by-Step Process

1. Step 1: Define the Administration's Key Priorities for the FDA

   Before interviewing anyone, the White House must crystallize what it wants from its next FDA leader. Based on internal discussions, three areas stand out: restoring credibility with career staff who feel demoralized; advancing food policy reforms (e.g., labeling, nutrition, and safety); and continuing to streamline drug-approval pathways without compromising safety. These priorities will serve as a litmus test for every candidate. The search team should draft a one-page mandate that clarifies these goals, ensuring alignment across the administration.

2. Step 2: Conduct a Confidential Candidate Search Over Several Weeks

   According to an official with knowledge of the process, the search will unfold over the next several weeks. This stage involves identifying potential nominees from academia, industry, previous FDA roles, and medical practice. The administration values candidates who can navigate political crosswinds and who have a track record of regulatory leadership. Discretion is critical; leaks can derail negotiations. The search committee should quietly reach out to trusted advisors and professional networks to compile a long list, then refine it based on the priorities from Step 1.

3. Step 3: Vet Candidates on Policy Fit and Senate Viability

   Once a short list emerges, thorough vetting must begin. This includes scrutinizing past public statements, financial disclosures, and any potential conflicts of interest. The administration also needs to gauge how each candidate would fare during Senate confirmation. Given the tight legislative calendar and the presence of other pending nominees (Schwartz and Saphier), the FDA commissioner nominee must be someone who can attract bipartisan support or at least avoid a protracted battle. Background checks, interviews, and reference calls are essential before any formal announcement.

   

4. Step 4: Build Internal and External Support

   Rebuilding trust at the FDA requires early outreach to agency staff, patient advocacy groups, and industry stakeholders. The nominee-designate should meet (privately or virtually) with key FDA center directors and union representatives. Simultaneously, the administration should prepare talking points that emphasize continuity in drug-approval reforms and a renewed commitment to food policy. This step reduces the risk of a confirmation process derailed by opposition from within the public health community.

5. Step 5: Navigate the Senate Confirmation Process

   Confirmation is the final hurdle. The administration must coordinate with Senate leadership to schedule hearings and a vote. With limited session days, the nominee may be asked to commit to expedited proceedings. The administration should also prepare answers to expected questions on regulatory independence, food safety enforcement, and drug pricing. If delays persist, the acting commissioner (likely Kyle Diamantas) will remain in charge well into the midterm election cycle in November, as the official noted.

6. Step 6: Plan for a Smooth Transition

   Once confirmed, the new commissioner must hit the ground running. The administration should arrange briefings with outgoing staff, share a 90-day action plan, and establish clear communication channels. This step is crucial for maintaining morale and preventing policy drift. The commissioner should host an all-hands meeting early on to signal accessibility and a collaborative approach.

Tips for a Successful Search

• Act quickly but don't rush. A rushed selection can lead to a failed confirmation or a poor fit. Use the full several-week window to find the right person.
• Leverage acting leadership carefully. Kyle Diamantas’s experience with FDA food policy could provide stability, but the administration should avoid leaving a permanent vacancy too long.
• Prioritize communication skills. The next commissioner must rebuild trust both inside and outside the agency. Look for someone who can explain complex regulatory decisions clearly.
• Monitor Senate dynamics. Other nominations and the midterm calendar affect the FDA pick. Stay in touch with the Majority Leader’s office to secure a timely vote.
• Keep an eye on food policy. While drug-approval reforms are important, the administration has signaled a strong focus on food – choose a nominee with genuine interest in that area.