The Senate narrowly confirmed President Joe Biden’s pick to head the Food and Drug Administration amid political controversies that threatened to derail his confirmation.

A vote of 50-46 confirmed Dr. Robert Califf, a cardiologist and prominent medical researcher, as the FDA’s leader, a position he briefly held during the Obama administration.

Several Republicans crossed party lines to support Califf’s confirmation, including Sens. Mitt Romney (UT), Mitch McConnell (KY), and Richard Burr (N.C.).

“He has the robust agency and private sector experience needed to help build on the success of the FDA in helping Americans get back to normal life with the approval of tests, vaccines and therapeutics that are bringing the pandemic to an end,” Burr said of Califf.

“He’s the leader we need today, but also for the future.”

Conversely, several Democrats opposed Califf’s appointment, citing his ties to Big Pharma and handling of the opioid crisis under former President Barack Obama.

“What started as an OxyContin prescription for back pain became full-blown dependence on heroin for countless Americans,” said Sen. Ed Markey (D-MA), who voted against the confirmation.

“The FDA continued to approve powerful new opioids either over the express objections of its own advisory committees or without convening an advisory committee at all. The FDA became the country’s biggest pill pusher [and] Big Pharma made billions in profits,” he continued.

“We cannot forget how we reached this epidemic in the first place, or we are doomed to repeat it for those families.”

“Those failures started at Big Pharma and were aided and abetted by the Food and Drug Administration,” Markey concluded.

Moderate Democrat Sen. Joe Manchin (W.VA.) was one of Califf’s most outspoken detractors, railing against the pharmaceutical industry for its role in the opioid crisis.

“We have insight into how he will lead the agency. [During] Dr. Califf’s previous tenure, drug-related overdoses went up. Five years later, they’re up again, and this time at record numbers,” Manchin said ahead of the vote.

“In fact, despite his pledge to overhaul the FDA policy, during his tenure and immediately following it, the FDA approved five new opiates for the market, and at the same time, they removed only one.”

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Senate confirms Biden’s FDA pick despite political divisions