President-elect Donald Trump is considering nominating Jim O’Neill, an associate of billionaire investor and early Trump backer Peter Thiel, as HHS deputy secretary, three people familiar with the deliberation granted anonymity to discuss transition planning told POLITICO.

O’Neill held several roles at HHS during the George W. Bush administration including principal associate deputy secretary — but he does not have formal medical training.

The former acting CEO of The Thiel Foundation and former CEO of anti-aging nonprofit SENS Research Foundation, O’Neill has advocated for people to be able to take medicines once their safety, but not effectiveness, is reviewed by the FDA.

“We should reform FDA so that it is approving drugs after their sponsors have demonstrated safety ... let’s prove efficacy after they’ve been legalized,” O’Neill said in a 2014 talk.

Trump’s team considered O’Neill to lead the FDA in his first term before picking Scott Gottlieb. Eric Hargan, a Bush-era health official who Trump then nominated to fill the HHS deputy secretary role, won Senate confirmation by a 57-38 vote.

A longtime close adviser to Thiel with ties across Silicon Valley, O’Neill reentered the mix in recent days for the No. 2 HHS job, as transition officials race to fill out the remaining senior health roles.

One former administration official granted anonymity to discuss the transition argued that HHS Secretary nominee Robert F. Kennedy Jr. should enlist a deputy that knows how to navigate the sprawling health department and implement administration policy priorities. They pointed to Paul Mango, who served as HHS deputy chief of staff during Trump’s first term, who has also been floated as a potential deputy secretary.

“With a new cabinet secretary who has never had a managerial role in running a large organization, it’s even more important to have someone like Paul Mango as deputy secretary — one of the most important positions that most people have never even heard of,” the former official said.

It remains unclear how O’Neill would fit in with a Kennedy-led HHS team already stocked at key positions with senior officials who have expressed deep skepticism of mainstream health experts and those with ties to the pharmaceutical industry.

Trump on Friday named Johns Hopkins surgeon Marty Makary to lead the FDA, former Florida Rep. Dave Weldon to lead the CDC and Fox News contributor Dr. Janette Nesheiwat to be surgeon general.

The people familiar with the deliberations cautioned that the debate remains ongoing and that Trump could always take it in a sharply different direction.

“President-elect Trump has made brilliant decisions on who will serve in his second Administration at lightning pace,” said Trump transition spokesperson Karoline Leavitt. “Remaining decisions will continue to be announced by him when they are made.”

In recent weeks, O’Neill posted support for RFK Jr.’s Make America Healthy Again priorities on X. He recently described Stanford professor and Covid lockdown critic Jay Bhattacharya as a “courageous scientist” who “would be an excellent” NIH director.

But O’Neill has a pharmaceutical background, which is likely to count against him. O’Neill worked as a managing director at Thiel’s Mithril Capital and sits on the board of directors of ADvantage Therapeutics, a pharmaceutical company developing treatments for neurodegenerative conditions, according to his LinkedIn.

He also retweeted a post from Nov. 13 — a day before RFK Jr. was nominated — that stated “There is a clear choice for Secretary of the Department of Health and Human Services: Jim O’Neill.”