Former FDA commissioner Robert Califf talks politics and future of health research at UIC Chair Chats

November 7, 2025

For decades, Dr. Robert M. Califf has been a national leader in health research and policy, including two stints as commissioner of the Food and Drug Administration, top positions at Duke University and roles at Google Health and Verily.

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But for Califf, the most meaningful part of his career has been his impact on the students, doctors and researchers he’s worked with as a teacher or mentor.

“For me, it’s always the people that came up through the system who went on to do better things than I could do,” he told UIC Chancellor Marie Lynn Miranda during Chair Chats on Oct. 28.

“I go through airports today, and people bump into me and say, ‘Hey, I rounded with you 25 years ago, and you said this thing, and it changed what I decided to do after that,’” Califf said. “That’s the kind of thing that makes me feel good.”

Califf reflected on his long career, the state of U.S. science today and other topics at the most recent installment of Chair Chats at the Retzky College of Pharmacy in partnership with UI Health’s Distinguished Scholar Series. The Chair Chats series, which launched last year with Dr. Anthony Fauci, brings well-known leaders to campus for illuminating conversations.

Miranda began the chat by relating how she met Califf years ago. It was during a presentation to academic health leadership at Duke University, where they both were on the faculty. Leaning over to the stranger next to her, Miranda explained that the problem being presented could be solved with geospatial methods, one of her specialties. That person, of course, was Califf, and the conversation they had after the meeting kicked off a long and fruitful research partnership, Miranda said.

“We co-authored together. We presented at various conferences. We’ve written grant proposals together. And I’m very proud of the fact that he still uses some of the maps that my research group produced,” Miranda said. “Rob has been a really highly valued colleague for a long time.”

Califf grew up in Columbia, South Carolina, where he was captain of his high school’s state championship basketball team. When his younger brother was born with ABO incompatibly, a condition where mother and baby have incompatible blood types, Califf’s parents asked doctors if he could be treated with transfusion. They were rebuffed, with devastating consequences, Califf said.

“My little brother died and could have easily been salvaged by this needed treatment,” he said.

In retrospect, Califf said, this tragic event seems like a clear motivation to pursue a career in medicine. But the experience broke the family’s trust in doctors, he added. “To them it was like, can you trust these people?”

Califf studied clinical psychology during his first years at Duke University, the institution that would become his home for the next half century. But after some formative experiences, including witnessing the use of an early defibrillator to treat cardiac arrhythmia, Califf became a cardiologist.

Dr. Robert M. Califf sits in a red chair wearing a dark grey suit, white shirt and blue bow tie while talking to UIC Chancellor Marie Lynn Miranda, who sits in the photograph's foreground in a red chair and blue suit. — Dr. Robert M. Califf talks with UIC Chancellor Marie Lynn Miranda at the Retzky College of Pharmacy during a Chair Chats event on Oct. 28, 2025. (Photo: Martin Hernandez/UIC)

In addition to years of practicing medicine and teaching at the Duke University School of Medicine, Califf is the founding director of the Duke Clinical Research Institute, the largest academic clinical research organization in the nation. He has been a steadfast advocate for ensuring greater diversity in clinical trials and fair access to health care, Miranda said.

“If you’re operating a system which is designed to produce inequity, then you say, we’re going to fix it by doing clinical trials that are equitable,” Califf said.

His clinical trial work led to many interactions with the FDA, and in 2015, he was appointed Deputy Commissioner of the FDA’s Office of Medical Products and Tobacco. Later that year, President Obama nominated him for the top job in the agency, and he reprised the role under President Biden from 2022 to 2025.

Miranda asked him about the most challenging decision he had to make at the FDA.

“It wasn’t the most difficult,” Califf said of his answer. But controversy arose when Califf, a political appointee, chose not to intervene in a decision made by a top civil servant in the agency chain of command to override disapproval for an intervention targeting Duchene’s muscular dystrophy.

“There were a lot of people who disagreed with what I did. But fast forward to today, I think it was a really important precedent that I hope we’ll go back to,” Califf said. “The minute political appointees start making decisions about individual products, where do you draw the line over political influence, over what gets on the market, and what doesn’t?” he said. “One reason that we have such great medical technology in the U.S. is that the FDA’s decisions about individual products have not been political.”

Califf also reflected on his failure to pass meaningful tobacco reforms.

“The FDA cannot outlaw nicotine, but it can set standards for what is allowed with nicotine, and it also can regulate the types of flavors used in tobacco,” he said. “But to get that through, you had to get through the whole of Health and Human Services and the executive branch and had to fend off all sorts of political tradeoffs that would have occurred had it gone through. And frankly, we just lost.”

Miranda and Califf also discussed the high costs of medicines in the U.S., the addictive properties of social media and the risks and benefits of integrating AI in medicine.

“The major use of AI right now in health care is to separate people from their wallets, to distinguish people in whom you make money versus people in whom you don’t,” he said. “Practicing clinicians tell me they’re under intense pressure to generate margin … We need to change that.”

Audience members gather around tables in a lecture hall. A woman wearing a blue sweater with curly hair is on the left and looking at her phone while a woman with a beige sweater and curly hair smiles and talks to a person in the foreground wearing a blue suit. — The audience gathers before the Chair Chats discussion with Dr. Robert M. Califf at the Retzky College of Pharmacy on Oct. 28, 2025. (Photo: Martin Hernandez/UIC)

Chancellor Marie Lynn Miranda is wearing a blue suit with a red shirt and sits to the left of Dr. Jerry Krishnan in a blue-green suit and blue tie. The two are on the bottom row in a lecture hall with tables. A woman sits on the other side of Dr. Krishnan and a man and a woman sit at the table behind them. — UIC Chancellor Marie Lynn Miranda sits in the audience before taking the stage at the Oct. 28, 2025, Chair Chats discussion with Dr. Robert Califf at the Retzky College of Pharmacy. (Photo: Martin Hernandez/UIC)

Dr. Robert M. Califf holds a red drink in a plastic cup while smiling and engaging with other people around a table in a reception room. One person at the table wears a flowered shirt and has curly hair, a man wears a white and blue-checked business shirt and a woman in a black coat has her back to the camera. — Dr. Robert M. Califf engages with attendees the reception after his Chair Chats discussion on Oct. 28, 2025 with UIC Chancellor Marie Lynn Miranda. (Photo: Martin Hernandez/UIC)

Dr. Robert M. Califf wears a suit and blue bow tie as he engages with attendees during the reception after his Chair Chats discussion at UIC. Women around the table have their backs to the camera and are wearing black, tan and red coats. — Chair Chats with Dr. Robert Califf at UIC’s Retzky College of Pharmacy. Dr. Califf engages with attendees during the reception. (Photo: Martin Hernandez/UIC)

Four people pose for a photograph at Chair Chats in a lecture hall at UIC. Dr. Jerry Krishnan stands to the far left in a blue-green suit and blue tie; Dr. Bob Barish is in a blue suit and blue tie; UIC Chancellor Marie Lynn Miranda is wearing a blue suit with a red shirt; and Dr. Robert M. Califf is wearing a grey suit with a white shirt and blue bow tie. — Dr. Jerry Krishnan, left, Vice Chancellor for Health Affairs Dr. Robert Barish, UIC Chancellor Marie Lynn Miranda and Dr. Robert M. Califf pose in the Retzky College of Pharmacy during the Chair Chats discussion on Oct. 28, 2025. (Photo: Martin Hernandez/UIC)

UIC Chancellor Marie Lynn Miranda is wearing a blue suit with red shirt and holds her phone camera high to take a selfie with Dr. Robert M. Califf and a crowd behind them in a UIC lecture room. — UIC Chancellor Marie Lynn Miranda takes a selfie with Dr. Robert M. Califf and the crowd at a Chair Chats discussion on Oct. 28, 2025. (Photo: Martin Hernandez/UIC)

UIC Chancellor Marie Lynn Miranda, wearing a blue suit with a red shirt, hands a crystal award to Dr. Robert M. Califf, who is wearing a grey suit and standing on the right side of the photo. Dr. Robert Barish stands behind them in front of the UIC circle mark. — UIC Chancellor Marie Lynn Miranda hands an award to Dr. Robert M. Califf during a Chair Chats discussion on Oct. 28, 2025, at the Retzky College of Pharmacy. UIC Vice Chancellor for Health Affairs Dr. Robert Barish (center) introduced Califf. (Photo: Martin Hernandez/UIC)

Attendees sit in lecture hall chairs and listen attentively during a UIC Chair Chats event. — Attendees listen to Dr. Robert M. Califf during a Chair Chats event at the Retzky College of Pharmacy on Oct. 28, 2025. (Photo: Martin Hernandez/UIC)

Chancellor Marie Lynn Miranda and Dr. Robert M. Califf sit in red chairs in front of the UIC circle mark on a stage in a lecture hall. — UIC Chancellor Marie Lynn Miranda talks with Dr. Robert M. Califf at a Chair Chats event at the Retzky College of Pharmacy on Oct. 28, 2025. (Photo: Martin Hernandez/UIC)

Chancellor Marie Lynn Miranda and Dr. Robert M. Califf sit in red chairs in front of the UIC circle mark on a stage in a large lecture hall. The audience can be seen in the foreground of the photograph. — UIC Chancellor Marie Lynn Miranda talks with Dr. Robert M. Califf at a Chair Chats event at the Retzky College of Pharmacy on Oct. 28, 2025. (Photo: Martin Hernandez/UIC)

Chancellor Marie Lynn Miranda laughs while sitting in a red chair on a stage. Chancellor Miranda is wearing a blue suit and red shirt while talking to Dr. Robert M. Califf, also sitting in a red chair in the foreground of the photograph. — Chancellor Marie Lynn Miranda laughs during a discussion with Dr. Robert M. Califf during a Chair Chats event on Oct. 28, 2025. (Photo: Martin Hernandez/UIC)

Dr. Robert M. Califf sits in a chair in front of a table listening to someone on a stage. He is wearing a dark grey suit, a white shirt and a blue bow tie. A placard on the table in front of him reads "Reserved Seat." — Dr. Robert M. Califf listens while being introduced at the Chair Chats discussion on Oct. 28, 2025. (Photo: Martin Hernandez/UIC)

UIC Chancellor Marie Lynn Miranda wears a lbue suit with a red shirt and begins walking toward the stage in a large lecture hall She is holding cards in her hands. — Chancellor Marie Lynn Miranda walks up to the stage to start the Chair Chats discussion with Dr. Robert M. Califf on Oct. 28, 2025 at the Retzky College of Pharmacy. (Photo: Martin Hernandez/UIC)

Dr. Bob Barish stands in front of a podium to introduce speakers at a Chair Chats event. Dr. Barish is wearing a blue suit, white shirt and blue tie. A computer screen and microphone sit on the lectern. — Dr. Robert Barish introduces the speakers at the Oct. 28, 2025 Chair Chats discussion at UIC’s Retzky College of Pharmacy. (Photo: Martin Hernandez/UIC)

Contact

Tess Joosse

joosse2@uic.edu