Government (2017–2021)
President Donald Trump nominated Giroir for appointment as a commissioned officer, and appointment to the rank of admiral in the U.S. Public Health Service Commissioned Corps, while serving as the assistant secretary for health, on 25 May 2017. In August 2017, the Senate committee on Health, Education, Labor and Pensions held up Giroir's confirmation, due to skepticism over his testimony that he would support women's health programs. The Senate returned his nomination back to the President on 3 January 2018, without action. He was renominated on 8 January 2018, and confirmed via voice vote on 7 February 2018.
Giroir received his commission and four-star rank in the commissioned corps, a week after he assumed the office of assistant secretary on 15 February 2018. He was also appointed by the secretary to the additional role as mental health senior adviser on 29 March 2018.
In April 2018, Senator Ron Wyden (D-Oregon) criticized Giroir for neglecting to address the role of drug companies in sparking the opioid crisis. In September 2018, Senator Claire McCaskill (D-Missouri) wrote to Health Secretary Alex Azar: "At a hearing of the Senate Committee on Finance in April 2018, I asked Admiral Brett P. Giroir ... whether HHS had demanded explanations from pharmaceutical manufacturers that had raised prices for the opioid-reversal drug naloxone. Admiral Giroir stated he had not asked the companies to explain their dramatic price increases, but promised he would 'get back to [me] on whether [he] could write a letter.' I am not aware, however, of outreach from HHS to my office on this issue."
In November 2018, Giroir wrote a letter in which he said that the agency was seeking to end the use of fetal tissue in taxpayer-funded biomedical research involving developing vaccines and researching the Zika virus, and treatments for Alzheimer's disease and Parkinson's, if it can find "adequate alternatives", and said the HHS was "pro-life and pro-science". The National Institutes of Health at the time funded more than $100 million in research drawing on fetal tissue.
In May 2020, Senator Mitt Romney (R-Utah) criticized Giroir at a Senate health committee hearing for his participation in a White House event celebrating that the U.S. had conducted more coronavirus tests than South Korea. Romney said the difference was that South Korea tested early, and the U.S. was catching up—which could result in many more American deaths. Romney said: "I understand that politicians are going to frame data in a way that is most positive politically. Of course, I don't expect that from admirals. But you ignored the fact that they accomplished theirs at the beginning of the outbreak, while we treaded water during February and March.... The fact is their test numbers are going down, down, down now, because they don't have the kind of outbreak we have. Ours are going up, up, up...."
On 1 November 2019, HHS Secretary Alex Azar announced that Giroir would serve as Acting Commissioner of Food and Drugs until Stephen Hahn, whose nomination for the same position was announced on the same day, was confirmed by the U.S. Senate. Senator Patty Murray (D-Washington) said that she was "alarmed" by Giroir's "track record of letting ideology drive decisions at the expense of women and families." Giroir served as Acting Commissioner in November and December 2019, while Hahn's nomination was pending in the Senate.
On 15 November 2018, President Trump nominated Giroir to serve the additional role of representative of the United States on the executive board of the World Health Organization. The nomination was returned to the president on 3 January 2019, without action by the Senate. He was renominated on January 16, 2019, but that nomination was also returned to the president on 3 January 2020, without action. He was renominated for a third time on 18 March 2020. Giroir was finally confirmed by the Senate in a voice vote on 7 May 2020. He served on the executive board, for the remainder of the current three-year term cycle, which expired in January 2021.
Giroir resigned from his government positions on 19 January 2021, as expected from all appointed government leadership, in order to facilitate a smooth transition to the new Biden administration.