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. Adams 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.

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, allowing the virus to spread to more people. Needle exchanges have been shown to reduce the spread of infectious diseases.

“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 U.S. I would like nothing better than to tell you this unprecedented HIV epidemic will never happen anywhere else. But I can’t do that.”

Earlier this month, Adams highlighted the importance of needle exchanges and their role in helping people in Indiana.

“No matter how uncomfortable syringe service programs make us, they are proven to save lives, both by preventing the spread of diseases like HIV and hepatitis C, and by connecting people to treatment that can put them on a path to recovery,” he wrote.

Adams has also worked to expand naloxone, the overdose antidote, in Indiana.

In a tweet Thursday, Adams wrote that he was “honored” to be nominated and that he was “looking forward to working to improve health.”

Sara Johnson of Indiana University-Purdue University Indianapolis, who has worked with Adams, said in addition to opioids, his priorities have included reducing the use of tobacco and bringing down the state’s infant mortality rate. She said Adams brought a passion to the job and is a strong advocate for public health.

“He’s a trusted partner in working with clinicians and public health officials. He’s one of those people who’s easy to work with,” Johnson said. “This is a perfect fit for him.”

Trump met with Adams in November after the election, but the two have taken taken different positions in the past.

During the West African Ebola outbreak, for example, Adams provided measured information about the disease and tried to correct myths. Trump falsely stated that the virus was spreading all over Africa and called to block flights from the continent.

And while Trump is now backing a GOP effort to repeal and replace Obamacare — which would end the expansion of Medicaid that Indiana and 30 other states implemented — Adams has praised the expansion has a way to improve access and care. (Pence and Verma designed Indiana’s expansion with some conservative reforms, such as requiring some beneficiaries to pay monthly premiums, and Adams specifically highlighted the state’s model of the expansion, saying it would help residents “to be able to work and better themselves as opposed to trapping them in an income-based entitlement program.”)

The Medicaid expansion also helped stem the Austin HIV outbreak by extending coverage to people in the community, according to a New England Journal of Medicine paper. The authors of the paper included a number of officials from the state health department, but not Adams.

Republished with permission from STAT. This article originally appeared on June 29, 2017