By Adam Cancryn, CNN
(CNN) — The Trump administration is racing to fill a widening leadership vacuum within the US Department of Health and Human Services, amid months of upheaval that have shaken Americans’ trust and stoked GOP fears of a backlash at the ballot box in November.
Senior health officials plan to settle on a new nominee to run the Food and Drug Administration within the next few weeks, in hopes of rapidly stabilizing an agency whose prior leader had alienated several elements of President Donald Trump’s political coalition, a senior administration official told CNN.
They are also plotting a broader shakeup of senior FDA staff meant to reset the agency’s strained relationship with its vast workforce and ease deepening concerns across the health care industry, two senior officials said.
And as it works to contain the hantavirus outbreak, the White House is also pushing for the quick confirmation of more conventional picks to head the Centers for Disease Control and Prevention and serve as surgeon general, after failing repeatedly to advance candidates closely aligned with HHS Secretary Robert F. Kennedy Jr.’s “Make America Healthy Again” movement.
“It needs a lot of sorting out,” GOP pollster Whit Ayres said of the turmoil across HHS. “It’s not exactly a well-oiled machine.”
The fresh urgency surrounding the health department comes as Trump tries to shore up key political weaknesses ahead of midterm elections that could cost him control of Congress, stall his agenda and open his administration up to a raft of Democratic investigations.
White House officials earlier this year decided that HHS under Kennedy required an overhaul following a tumultuous period marked by controversial vaccine policies, constant personnel problems and messaging missteps that had dented its standing with voters and a swath of frustrated GOP lawmakers.
The White House since then has grown more deeply involved in the department’s decisionmaking, Trump officials and others familiar with the matter said, working with Kennedy to shift away from controversial issues like vaccines and toward more mainstream affordability issues like drug pricing and health insurance.
It’s a move that has irked many in Kennedy’s MAHA movement, who aligned with Trump in hopes he would embrace radical changes to the nation’s health system. Some prominent MAHA influencers have cautioned in recent weeks that Republicans are at risk of alienating their voters ahead of November — a warning that only grew louder after FDA commissioner Marty Makary resigned earlier this week under pressure from Trump and his close aides and allies.
“Marty Makary was one of the few people inside Washington willing to challenge the corporate capture of our health agencies,” Vani Hari, a wellness influencer known for her “Food Babe” blog, wrote on X. “If reformers who challenge the system keep getting pushed out, it only proves how deeply entrenched these special interests really are.”
But Trump officials have largely brushed aside those concerns in favor of refocusing HHS and its leadership, overseeing a restructuring of Kennedy’s senior staff in February that set the stage for a broader revamp.
Top White House and HHS officials subsequently spent several weeks assembling new leadership at the CDC, which had been mired in crisis since Kennedy’s abrupt ouster last August of then-Director Susan Monarez over vaccine disagreements. Trump’s new CDC nominee, Erica Schwartz, is a public health veteran and former deputy US surgeon general.
The White House then abandoned an effort to install close Kennedy ally Casey Means as surgeon general after determining she could not be confirmed, in favor of a new nominee who has been more openly supportive of vaccines.
Senior health officials are now planning similar changes atop the FDA — although restructuring the agency is likely to be a more daunting challenge, some officials acknowledged, as they try to balance competing pressures.
Though still early in the search process, officials are privately hoping to whittle down their list of FDA nominee candidates over a matter of days and ultimately recommend a permanent replacement to Trump by early June, the senior administration official said.
“The Trump administration is actively searching for strong candidates for key leadership positions across HHS, including the FDA, with a focus on experienced individuals who can strengthen agency operations, continue to advance significant reforms, and maintain public trust,” HHS spokesman Andrew Nixon said in a statement, adding that the department continues “to operate under solid leadership.”
Trump officials nevertheless cautioned that the FDA is expected to face additional turbulence in the coming days, with more of Makary’s leadership team likely to exit by the end of the week following a sweeping reevaluation of the agency’s functionality.
Rich Danker, a top HHS spokesman who had worked alongside Makary on his communications strategy, resigned on Wednesday amid that review, citing opposition to an administration push to allow sales of flavored e-cigarettes that had put Makary and other Trump officials at odds. HHS Director of Public Strategy Mitchell Hailstone also departed in recent weeks, three officials said, though he had left the department prior to Makary’s resignation.
The White House and HHS declined to address specific departures or any plans for future personnel changes, and Hailstone could not be immediately reached.
Senior HHS officials plan to eventually fill the growing list of vacancies with a slate of new appointees that can be rolled out alongside a nominee for FDA commissioner, replicating the approach used to stabilize CDC that was largely well-received.
Those hiring efforts are likely to similarly focus on more conventional, experienced candidates who have credibility within the FDA and among the broader public, the senior official said — marking a further shift away from the MAHA-aligned outsiders favored by Kennedy.
But that won’t be easy. Senior HHS officials leading the search need to find a qualified candidate who gets along with both Trump and Kennedy. But they also need someone who can balance the demands of GOP lawmakers and pharmaceutical companies who fiercely criticized Makary’s approach to the drug industry against an energized MAHA movement still pushing Trump to take a harder line against the deep-pocketed health lobby.
And crucially, they’ll need to manage those pressures while keeping the drama to a minimum.
“The job is still impossible,” said Steven Grossman, a former HHS official and current health policy and regulatory consultant. “The most we can hope for is it won’t be badly done.”
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