RFK’s Deputy: Saviour or Wolf in Sheep’s Clothing?

Look over there, not over here. While the internet was literally exploding on May 12 about Casey Means’ appointment as Surgeon General, a Senate confirmation hearing – a much more important one – quietly flew under the radar.

The hearing was for Jim O’Neill, who was announced in November 2024 as a Trump pick, at the same time as Jay Bhattacharya was tapped to lead NIH (so Bhattarcharya’s nomination largely overshadowed anything else.) The November 2024 news articles focus mainly on Bhattacharya and his controversial “fringe” views, while O’Neill is barely mentioned as the “biotech investor” who will serve as RFK Jr.’s deputy.

It’s not so much that we can’t figure out whether he is a good guy or a bad guy, it’s that his nomination and confirmation hearings were largely hidden from the public eye. In short, we never got to the good/bad argument, because we didn’t know about it. At all.

So who is he?

Bush Administration

It turns out O’Neill served in several HHS roles during the George W. Bush administration, including principal associate deputy secretary at the Department of HHS, a role known as PADS. This role is not confirmed by the Senate and is one of the most influential roles in government. The PADS is a senior policy advisor across several agencies, including HHS, CDC, FDA, NIH and CMS, even acting as a White House liaison. The PADS is usually tasked with large-scale reforms and initiatives and plays a central role in the response of HHS to public health emergencies, like natural disasters and pandemics. Interestingly, in 2007-2008, his primary focus was global health and emergency preparedness. He helped design and launch the Administration for Strategic Preparedness and Response (ASPR) to improve HHS response to emergencies and disasters.

Isn’t that interesting?

Even more interesting is that O’Neill was jockeying for the top HHS job prior to Trump nominating Kennedy. When RFK Jr. was nominated, O’Neill was totally onboard supporting both Kennedy and his MAHA (Make America Healthy Again) movement.

Jim O’Neill is touted as a public health policy expert, despite having no training in health or policy. He is described as having a “diverse career” spanning government service, venture capital, and biomedical research. Yes, that is certainly diverse.

The Private Sector with Peter Thiel

After his government role, O’Neill served as a close confidant of Peter Thiel. Yes, THAT Peter Thiel, the controversial billionaire cofounder of PayPal and Palantir, and the first outside investor for Facebook. O’ Neill’s first post-government private role was as managing director of Clarium Capital, a hedge fund founded by Thiel over 20 years ago. The fund peaked at $8 billion in 2008 but in a few years, the assets had dwindled to $700 million and the fund became inactive.

This is the role that made O’Neill part of Thiel’s inner circle. Both men are libertarians, both love minimal regulations in health, and both favor radical, disruptive innovation and government reform. Once part of the inner circle, O’Neill served as managing director at Thiel’s Mithril Capital Management, and CEO of the Thiel Foundation for three years, funding nonprofits to promote both technology and freedom. He also co-founded (with Thiel) the Thiel Fellowship, which provided $100,000 grants to young entrepreneurs to drop out of school and pursue their entrepreneurial interests. (Side question: are any of them working for DOGE?)

More recently, O’Neill has served as the CEO of the SENS Research Foundation, which has led the research and development of regenerative medicine solutions for age-related diseases including Alzheimer’s disease, cancer, and heart disease.

In short, O’Neill has tremendous ties to Silicon Valley.

Healthcare Philosophy and Connections

It is O’Neill’s government work, and his CEO and investor roles that tie him to healthcare. He abhors bureaucratic hurdles, particularly regarding drug approval. A decade ago, he made waves by proposing that the FDA should approve medications based solely on safety data, without requiring proof of effectiveness (efficacy.) “We should reform FDA so that it’s approving drugs after their sponsors have demonstrated safety and let people start using them at their own risk. Let’s prove efficacy after they’ve been legalized.” Interestingly, this is the polar opposite stance that RFK Jr. has.

Needless to say, O’Neill’s stance was very controversial. Experts voiced concerns, saying he demonstrated a lack of knowledge about the FDA’s review process and that separating the questions of safety and efficacy is impossible. But O’Neill saw it differently than most. He believes in accelerating access to potentially life-saving treatments, and to do that, the consumer must be empowered.

In his confirmation hearing, it was almost certain that US Senator Elizabeth Warren was expected to be front and center, and she was, calling out O’Neill’s ethics and asking him to recuse himself for four years from any decisions involving his former healthcare clients and employers. She also asked him not to accept any compensation for his HHS role, nor engage in lobbying, which is hilarious given that Warren herself has received significant Big Pharma contributions to the tune of over $1 million.

O’Neill did actually agree to recuse himself from specific matters related to ADvantage Therapeutics, a company developing an Alzheimer’s drug and other treatments for neurodegenerative conditions. Their leading Alzheimer’s drug, AD04™, is pending FDA approval. It is an immunotherapy that has been used as an adjuvant in both human and animal vaccination programs. AD04™ aims to modulate the immune system to reduce Alzheimer’s pathology. O’Neill is on the board of directors at ADvantage Therapeutics.

Many were surprised to hear, during the confirmation hearings, that O’Neill is a global health advisor to a vaccine company, Rational Vaccines, purported to be developing vaccines for herpes simplex virus infections.

What Trump Said

“I am very pleased to nominate Jim O’Neill to serve as the Deputy Secretary of Health and Human Services to work alongside RFK Jr. Trump went on to say that O’Neill will oversee all operations and improve Management, Transparency, and Accountability for HHS and be dedicated to ensuring every American, and especially our most precious resource — our children — will live long and healthy lives. Trump even considered him for the FDA Director role in 2016 during his first term.

It is difficult to say what is truly going on here. There are so many possibilities. Is O’Neill a good guy, waiting all these years to give humanity the gift of medical freedom? Or is he a wolf in sheep’s clothing? One thing is for certain…we were led completely away from this story.

As of May 13, 2025, Jim O’Neill has not yet been confirmed by the US Senate. It remains pending in the Senate Finance Committee.

Time will tell. But the lesson we’ve learned is this…keep your eye on the ball. Don’t fall for the shiny new object that is the major distraction.