Analysis Law and Policy

Will Trump’s Next FDA Head Push Anti-Choice Agenda?

Ally Boguhn

“The FDA should be about science and public health, not politics and anti-abortion obstruction."

Scott Gottlieb last week announced his departure as head of the Food and Drug Administration (FDA), creating an opening to be filled as President Trump has used increasingly inflammatory language in pushing his opposition to abortion rights.

Gottlieb, FDA commissioner since May 2017, will depart from the agency in one month, according to a copy of his resignation letter. U.S. Department of Health and Human Services Secretary Alex Azar on Tuesday announced that Norman (Ned) Sharpless, director of the National Cancer Institute, will step in as acting commissioner of the FDA.

Reproductive rights and health advocates feared the repercussions of Gottlieb’s installment at the FDA when his nomination was announced. Groups such as the National Latina Institute for Reproductive Health, the National Women’s Health Network (NWHN), and NARAL Pro-Choice America opposed his nomination.

Then a resident fellow at the conservative American Enterprise Institute, Gottlieb had served as the deputy commissioner for medical and scientific affairs at the FDA under President George W. Bush. Gottlieb had made no secret of his anti-choice views.

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Among his published writings was a 2015 op-ed for the Wall Street Journal calling on the U.S. Congress to “tighten” laws on fetal tissue, citing propaganda videos created by a discredited anti-choice group. In the piece, Gottlieb dismissed the medical advancements enabled by fetal tissue research. In other pieces, Gottlieb criticized the Affordable Care Act’s (ACA) birth control benefit.

Sarah Christopherson, policy director at the National Women’s Health Network, told Rewire.News last week that there is “circumstantial evidence” of Gottlieb’s anti-choice positions since he was nominated for and confirmed to his spot at the FDA. She pointed first to when Sens. Patty Murray (D-WA) and Maggie Hassan (D-NH) questioned Gottlieb during his confirmation fight in April 2017 about his role in the Bush administration’s decision to delay the approval of emergency contraception, or Plan B, for over-the-counter use.

Christopherson said Gottlieb’s tenure in the FDA under Bush came when the administration “very controversially stymied access to Plan B, not because of the science but because of the politics.” The Bush administration had refused to make emergency contraception available over the counter, though evidence showed it was safe to do so.

Under Gottlieb’s leadership during the Trump administration, the FDA began an investigation into a self-managed abortion care website in October 2018. Earlier that year, Gottlieb “announced that he planned to reorganize and downgrade the Office of Women’s Health (OWH),” according to an NWHN report card on Gottlieb’s work.

“The Office of Women’s Health at the FDA has been around since 1994, but it was actually codified into law by the [ACA] and the law is very clear—it must report directly to the commissioner and it has its own staff it has its research budget,” Christopherson said. The office has been “very active in trying to improve clinical trials so that drugs and devices actually get tested in women before they get approved for women …. It’s got this great track record of being really successful for women.”

Then Gottlieb issued “this long, boring, [bureaucratic] memorandum about how he’s going to organize all of the different offices that report directly to him and he’s going to take women’s health out of that direct-command structure and put it and a bunch of other offices and showed it under,” Christopherson continued.

“If he’d been successful that would have meant losing with autonomy, losing its dedicated staff, losing its control of the scientific research project, it would have become much less visible to sort of women consumers … and it would have had much less sort of general little influence in standing up for women’s health,” she said. “And he just tried to do it very quietly, you know, sort of tucking it away into this, into this memo.”

But in July of that year, “Gottlieb bowed to pressure from the Network, our allies, and Congressional champions of women’s health and backed off on his plans,” according to the NWHN report card.

Gottlieb’s resignation comes at a time when Trump has been vociferous about his opposition to abortion rights. The president in recent months has pushed false anti-choice talking points, and the administration last month finalized its domestic “gag rule” restricting Title X family planning funds.

Christopherson—speaking prior to the acting FDA commissioner being named—noted that in the search for an FDA head in 2017, “some of the people that had been proposed before [Gottlieb] was ultimately selected were extreme,” and that other members of the Trump administration have shown how many offices can be used to promote an anti-choice agenda.

“We look at people like Scott Lloyd and some of the other folks who’ve taken positions and really stretched in sort of insane ways how they can impose their religious views,” she said. “You know, you wouldn’t think of refugees as immediately the position where someone is going to be mandating their religious views on abortion. And yet these nominees have proven very creative in taking whatever power they can and pushing through this really anti-science, anti-reproductive health, anti-women agenda.”

Erin Matson, co-director of reproductive justice direct action organization Reproaction, told Rewire.News that advocates will keep an eye on what happens next at the FDA. “The FDA should be about science and public health, not politics and anti-abortion obstruction. Activists around the country will be watching closely to see how a new FDA head handles medication abortion in particular—a safe and effective method of ending a pregnancy that shouldn’t be singled out for unfair, burdensome restrictions that purposefully make it harder for people to access the care they need,” she said.

“In our self-managed abortion work, we regularly reference how women in countries where abortion is extremely restricted or banned have for years safely and effectively self-managed abortion with pills obtained outside the medical system. It’s a shame that our country is effectively becoming one of those legislatively backward places as well; in any case, medication abortion and the people who use it are here to stay no matter what the Trump administration tries to pull,” Matson said.

Christopherson said NWHN would watch the FDA for “a handful of things potentially moving down the pipeline, like moving an oral contraceptive over the counter with no restrictions on age or other sort of politically motivated limitations.” The organization thinks “the science backs that up. We’re strong supporters of that we do not want to see that fall victim to a Plan B-style sort of ideological attack.”

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