CDC director’s resignation shows new HHS chief Alex Azar won’t tolerate unethical behavior on his watch

It’s unknown whether newly appointed Health and Human Secretary Alex Azar simply accepted Brenda Fitzgerald’s resignation as the director of the Centers for Disease Control and Prevention on Wednesday or demanded it.

But her resignation came shortly after a meeting with CDC senior leadership, according to Politico, and a day after the publication reported Fitzgerald had purchased shares in a tobacco company one month after she took over leadership of the agency.

RELATED: CDC Director Brenda Fitzgerald resigns due to ‘complex financial interests’ over tobacco stock purchase

The publication reports that Azar has no tolerance for unethical behavior or the appearance of unethical behavior. As it is, he is taking over the HHS top spot from Tom Price, M.D., who resigned after controversy erupted over his use of private and military planes for government and personal travel. And CDC staffers and lawmakers were already frustrated that Fitzgerald had to recuse herself from hearings and decisions on the opioid epidemic and cancer detection because of her holdings in companies that posed a potential conflict of interest.

RELATED: CDC Director Brenda Fitzgerald recuses herself from health IT decisions because of financial conflicts

Politico reports that sources who were familiar with Azar’s plans said he expected he’d spend his first days at HHS cleaning house to rid the department of ethical and organizational problems. Azar will also evaluate the department to identify problem areas.

RELATED: Former colleague describes Alex Azar as 'methodical and reasoned' as HHS secretary nomination hearings begin

Azar is someone who doesn’t like drama, one of his former colleagues told FierceHealthcare shortly before his first confirmation hearing in November. Thomas Barker, partner and co-chair of the healthcare practice at Foley Hoag in the District of Columbia, was the deputy general counsel at HHS when Azar served as the general counsel in the early 2000s.

“From day one he’d be able to make sure HHS was moving forward operationally and that’s what you want to see," Barker told FierceHealthcare, adding that he expected Azar would lead the agency by taking a reasoned approach to problems and solving them without a lot of drama. 

But Fitzgerald’s departure comes at the height of a deadly flu outbreak and worries that the agency is vulnerable to budget cuts. Last year President Donald Trump proposed huge cuts to the agency. Tom Frieden, M.D., the former director of the CDC, said at the time that the 17% reduction to the budget, the lowest budget the CDC has had in 20 years, was “unsafe at any level of enactment.”

Although Anne Schuchat, M.D., has been named the acting director of the CDC, some public health advocates are concerned that there won't be a strong leader to defend the agency if Trump targets the CDC for cuts when the administration releases its budget proposal next month.

“This comes at an unfortunate time because the budget will soon be released by the administration, and we’re concerned that, as was the case last year, the CDC’s budget may be significantly reduced in the proposed administrative budget,” John Auerbach, a former CDC official who is now president and CEO of the Trust for America’s Health, told The Hill.