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Following Rhodri Morgan’s appointment as First Minister in 2000, Drakeford became the Welsh Government’s special advisor on health and social policy, and later served as the head of Morgan’s political office. He had been close with Morgan for a number of years, having been Morgan's election agent when he was elected to the UK Parliament. In his role as a special advisor, Drakeford was one of the principal architects of the 'clear red water' philosophy, which made a distinction between Labour Party policy under Morgan in Wales and under Tony Blair in Westminster.

He was appointed as a Privy Counsellor on 10 January 2019.

Immediately following Carwyn Jones' announcement on 21 April 2018 that he intended to resign as party leader and First Minister, Drakeford told BBC Wales he was giving a leadership bid ‘serious consideration’. Two days later, he announced that he would seek to be a candidate in the ensuing leadership contest. He immediately secured the public support of seven other Labour AMs, taking him beyond the threshold of nominations needed to get onto the ballot. Prior to Jones giving written notice of his resignation on 26 September, a further nine Labour AMs announced they would be nominating Drakeford, meaning a majority of the Labour Group in the Senedd would be supporting his candidacy. He later received support from 10 MPs, eight trade unions and 24 Constituency Labour Parties.

At a special conference on 15 September 2018, it was decided that the voting system for Welsh Labour leadership elections would be changed to a variation of one member, one vote – a change for which Drakeford had been campaigning for over 20 years.

On 6 December 2018, it was announced that Drakeford had been elected as the leader of the Welsh Labour Party in succession to Carwyn Jones. He received 46.9% of the vote in the first round of the contest, and 53.9% in the second round compared to 41.4% for Vaughan Gething.

Drakeford is married with three children. In 2018, his adopted son Jonathan was jailed for a child sexual offence and rape.

In a reshuffle after the 2016 election, he became Cabinet Secretary for Finance and Local Government. His portfolio was later changed, as he assumed responsibility for the Welsh Government’s Brexit preparations and responsibility for local government was transferred to Alun Davies.

Drakeford is considered to be on the left-wing of the Labour Party, and is supported by some members of the grassroots groups Welsh Labour Grassroots and Momentum. He was the only sitting Cabinet member in any part of the UK to support Jeremy Corbyn in his bid for the national leadership of the Labour Party in 2015, while he was Minister for Health and Social Services.

In 2013, he was invited by First Minister Carwyn Jones to join the Government, replacing Lesley Griffiths as Minister for Health and Social Services. His appointment was welcomed by the British Medical Association and the Royal College of Nursing. As Health Minister, he guided both the Human Transplantation Act and the Nurse Staffing Levels Act through the Senedd.

Drakeford succeeded Morgan as the Assembly Member for Cardiff West when the latter retired at the 2011 election. Soon after, he became Chair of the Assembly’s Health and Social Care Committee and of the All-Wales Programme Monitoring Committee for European Funds.

Having been part of the successful Yes for Wales campaign in the 1997 Welsh devolution referendum, he was selected as the Labour candidate for Cardiff Central at the first Welsh Assembly election, as part of Labour's ‘twinned seats’ policy. The seat was won by the Liberal Democrats' Jenny Randerson.

From 1991 to 1995, he was a lecturer in applied social studies at the University College of Swansea (now Swansea University). He then moved to the University of Wales, Cardiff (Cardiff University from 1999) as a lecturer at its School of Social and Admin Studies. He was promoted to senior lecturer in 1999, and appointed Professor of Social Policy and Applied Social Sciences in 2003. He retained his academic post until his appointment as a Welsh Government minister in 2013. He has published a number of books and journal articles on various aspects of social policy.

From 1985 to 1993, Drakeford represented the Pontcanna ward on South Glamorgan County Council, with fellow future Welsh Assembly members Jane Hutt and Jane Davidson as his ward colleagues. He served as Chair of the Education Committee and took a particular interest in Welsh-medium education.

After university, he trained both as a teacher and as a social worker. He moved to Cardiff in 1979 and worked as a probation officer and a youth justice worker, including as a Barnardo's project leader in the Ely and Caerau communities. His experiences working with young people in deprived areas inspired him to help establish the Welsh youth homelessness charity Llamau in the late 1980s.

Drakeford has always been interested in politics, which he says was part of the fabric of life in 1960s Carmarthenshire. He has also stated that he was 'always Labour', believing that a person's ties to the economy are the great determining factor in their life chances.

Mark Drakeford (born 19 September 1954) is a Welsh politician serving as the fourth First Minister of Wales and Leader of the Welsh Labour Party since 2018. He served as Cabinet Secretary for Finance in the Jones Government from 2016 to 2018, Brexit Minister from 2017 to 2018 and Minister for Health and Social Services from 2013 to 2016. Drakeford was first elected Member of the National Assembly (AM) for Cardiff West in 2011.