President Trump has nominated Indiana’s health commissioner, Dr. Jerome Adams, to be the next surgeon general, the White House announced Thursday.

If confirmed, Adams would replace Dr. Vivek Murthy, who was ousted by the Trump administration in April.

Adams was appointed to his current post in Indiana by Vice President Mike Pence when he was governor. He would be at least the second top health official in the Trump administration who had previous connections to Pence. Seema Verma, who administers Medicare and Medicaid in the administration, was previously a health consultant who worked with Pence to reform Indiana’s Medicaid program.

Adams was trained as an anesthesiologist and has been an advocate for addressing the opioid epidemic — an issue Murthy took on when he was surgeon general. Adams also has had to face the public health consequences of opioid addiction head on as health commissioner, most notably when an HIV outbreak erupted in Scott County.

Read more: Who is Jerome Adams, the Indiana doctor Trump hosted this week?

The first cases were reported in November 2014 — just one month after Adams came to lead the health department — and within a year, health officials had identified at least 181 cases in the town of Austin, which had a population of fewer than 5,000 people.

The virus was being transmitted by people sharing needles to inject a prescription painkiller. The outbreak reached such a scale that Pence, overcoming his personal opposition to needle exchanges, authorized an emergency clean needle program, and the state later reversed its ban on such programs.

Critics of the response, however, have said Pence was too slow to launch a needle exchange program, which have been shown to reduce the spread of infectious diseases, allowing the virus to spread to more people.

“We don’t have all the answers, but we are learning as we go,” Adams wrote in May 2015. “We are building a model for prevention and response should this type of outbreak happen in other communities in the US. I would like nothing better than to tell you this unprecedented HIV epidemic will never happen anywhere else. But I can’t do that.”