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WASHINGTON — A growing number of senators are threatening to block Dr. Robert Califf’s nomination to head the Food and Drug Administration, including one who is promising an old-style filibuster on the Senate floor.

Although the White House insists that President Barack Obama still has confidence in his pick to head the agency, the steady increase in the opposition — which includes Democratic presidential candidate Bernie Sanders — suggests that Califf’s prospects for becoming the permanent head of FDA are getting weaker, not stronger.


The latest threat comes from Senator Joe Manchin of West Virginia, who said in a statement Wednesday that Califf has too many ties to the pharmaceutical industry to address the prescription opioid abuse crisis throughout the country.

Other senators, including Sanders, have said they’ll put a “hold” on Califf, a procedural step that just prevents his nomination from coming to the Senate floor. But Manchin said he will read letters on the Senate floor from West Virginia families that are dealing with opioid abuse, a statement that suggests he’d actually hold up the proceedings if Califf’s nomination ever gets to the floor.

“We need to change the culture of the FDA, and that will not happen if the person at the helm is not a champion who is committed to pushing back against the pressure to continually approve new opioid medications given the significant risks to public health,” Manchin said, noting that opioid abuse has “ravaged” West Virginia.


“Dr. Califf’s past involvement will have an impact on his effectiveness and leadership capabilities, and I cannot, in good conscience, allow his confirmation,” he said.

The complaints about Califf’s pharmaceutical industry ties might be one of the only issues Sanders and Manchin have ever agreed on. Manchin is one of the most conservative Democrats in the Senate, about as far from Sanders’ “democratic socialism” as one can get.

But Califf is also drawing other opponents from across the political spectrum. Senator Edward Markey, a Massachusetts Democrat, has said he’ll block Califf over the opioid addiction problem. Senator Kelly Ayotte, a New Hampshire Republican, told Bloomberg she’ll join Markey over the same issue. And Senator Lisa Murkowski, an Alaska Republican, says she’ll hold up the vote unless the FDA changes its position on the voluntary labeling of genetically modified fish.

Califf, who helped establish Duke University’s clinical research center, has acknowledged that his studies have received funding from pharmaceutical companies. But he insists that they had no ability to change or hide the results, and the Senate Health, Education, Labor and Pensions Committee approved his nomination with no dissenting votes earlier this month.

For now, at least, the White House isn’t backing down — and says Califf will be able to manage any conflicts once he’s in the job.

“Obviously, the president and the administration have full confidence in the ability of our nominee to make the kinds of decisions that are in the best interest of the health and safety of the American people,” White House press secretary Josh Earnest said at a briefing Wednesday. “The president would not have nominated him to the job if he didn’t think that he would be able to effectively look out for the interests of middle-class families in that role.”