Hahn’s ‘Kitchen Cabinet’ Helped Protect FDA: The Hill

A lengthy article in The Hill details how former FDA commissioner Stephen Hahn got help from a group of outside scientists, known informally as his “kitchen cabinet,” to withstand political pressures on the agency from the Trump administration. Hahn, an oncologist with no experience running a government agency, took over at FDA weeks before the first Covid-19 cases were reported.

The Hill reports that as scientists around the country saw FDA approve an emergency use authorization for convalescent plasma, they feared the approval signaled a race to give final approval to a vaccine in the weeks before the November presidential election. “They worried that Hahn was overmatched and overwhelmed,” the article says.

The outside scientists came together in secret Zoom meetings disguised on their calendars to help Hahn withstand the political pressure, the report says. The article quotes former FDA commissioner Peggy Hamburg, a member of the “kitchen cabinet” that “all of us were deeply concerned about making sure that the vaccine research and development and review process could go forward as swiftly and smoothly as possible and that the integrity of the process wouldn’t be compromised by any political intrusions.”

Hahn recalled that after cardiologist and Medscape editor Eric Topol called for his resignation over the convalescent plasma decision, he reached out to University of Minnesota Center for Infectious Disease Research and Prevention director Michael Osterholm and asked him to convene an informal group of experts to provide advice and act as a sounding board.

“After a series of events, including plasma, I realized that in addition to the counsel I was getting from folks up to that point, both internal and external, I really would benefit from having more input,” Hahn told the online newsletter. “It always helps as a leader to get as much outside information as you can, and you have to sift through it.” Hamburg, Topol, and several others accepted Osterholm’s invitation to participate in the group.

The group’s work took on greater emphasis as the election neared at the same time as final decisions were likely to be made on vaccine emergency authorizations. The story says Hahn faced a choice of sticking to the rigorous process of analyzing and eventually approving a vaccine that would be both safe and effective or racing to deliver a political win to former president Donald Trump.

“He could take the path of political expediency or the path of a robust process to ensure the integrity of the agency, to ensure the efficacy and safety of the vaccine,” said Rollins School of Public Health emeritus professor of epidemiology Ruth Berkelman, another member of the “kitchen cabinet.” “It became clear that he had already in my mind made the decision to do what he thought was right for the agency and the country.”

Hahn told the newsletter there was no way the vaccine decision could be rushed. “To me, it was pretty straightforward,” he said. “We didn’t have the data in hand. The data came to us after the election.” He said there was huge pressure to deliver a vaccine, but Trump never demanded approval by a specific date.

Hahn said he considered resigning, but was concerned that someone more compliant politically might be appointed to follow him. His outside advisors urged him to stay with FDA and to force Trump to fire him, if it came to that, rather than resign.

“It’s a hard job balancing the different pressures coming in, and even more difficult in this national and international crisis,” Hamburg commented. “The toxic political environment in which he had to work certainly made everything more difficult.”

Trump tweeted at FDA or Hahn 25 times in the months between the beginning of the pandemic and the end of the year, The Hill reports. It says that each tweet sent a wave of trolls into Hahn’s social media timeline, although he says his background allowed him to ignore the attacks.

“I’m a cancer doctor. There are so many worse things in the world than getting tweeted about negatively by the president or someone calling for your resignation,” he said. “My kids are not in line getting chemotherapy for cancer. It’s a pretty damn good day.”