This post has been updated.
According to a statement from the Health and Human Services department, Secretary Alex Azar, who was sworn in just two days ago, accepted Brenda Fitzgerald's resignation because she could not divest from those interests “in a definitive time period.” Azar succeeded former Georgia congressman Tom Price, who was forced out in the fall following an uproar over his use of costly private charter aircraft for official travel.
Fitzgerald, 71, a physician who served as the Georgia public health commissioner until her appointment to the CDC post in July, said in an interview late last year that she already had divested from many stock holdings. But she and her husband were legally obligated to maintain other investments in cancer detection and health information technology, according to her ethics agreement, requiring Fitzgerald to pledge to avoid government business that might affect those interests.
In Congress, some lawmakers had become increasingly concerned over Fitzgerald's ability to do her job effectively.
“It is unacceptable that the person responsible for leading our nation’s public health efforts has, for months, been unable to fully engage in the critical work she was appointed to do,” Sen. Patty Murray (Wash.), the senior Democrat on the Senate committee that oversees the CDC, said in a statement Wednesday.
“Dr. Fitzgerald’s tenure was unfortunately the latest example of the Trump Administration’s dysfunction and lax ethical standards,” Murray continued. “I hope the incoming Secretary of Health — nominated because his predecessor resigned for using taxpayer dollars for his personal luxury travel — will encourage President Trump to choose a new CDC Director who is truly prepared to focus on families and communities.”
Murray repeatedly raised concerns about Fitzgerald’s financial investments and the broad recusals necessary to avoid conflicts of interest. In December, the senator sent Fitzgerald a letter saying those recusals prevented her from fully engaging on public health issues including cancer and the opioid epidemic.
Fitzgerald had dismissed those concerns, saying that she was following ethics rules laid out by HHS and that her recusals were “very limited.”
About three hours after HHS announced Fitzgerald's resignation, the CDC's chief operating officer, Sherri Berger, sent an agencywide email that announced Fitzgerald's resignation and said Anne Schuchat, the principal deputy, will be acting director effective Wednesday.
“The leadership team remains committed to CDC’s mission of saving lives and protecting people,” the email informed staff. Schuchat, an agency veteran who is highly regarded within the agency, on Capitol Hill and in the public health community, served as acting director after Fitzgerald's predecessor, Tom Frieden, stepped down a year ago.
A former HHS official, speaking on the condition of anonymity to discuss personnel matters, said that Azar and Schuchat overlapped at the department during the George W. Bush administration, when he was general counsel and she was already at CDC. “He knows her and interacted with her,” the former official said, noting that Azar was in touch extensively with the CDC during the creation of the department’s Office of Public Health Preparedness and Response shortly after the Sept. 11, 2001, terrorist attacks and the anthrax attacks.
The ethics issues were part of a broader set of questions about Fitzgerald's general leadership at the agency, which Trump has targeted for deep budget cuts. Since her appointment, she had made few public statements. She waited 133 days before holding her first agencywide staff meeting, on Nov. 17. And she was scheduled several times to testify before Congress — on opioids and other issues — but had to cancel each appearance. Deputies were sent instead.
On Tuesday, Politico reported that Fitzgerald had purchased shares in a tobacco company shortly after becoming CDC director. An HHS spokesman confirmed “the potentially conflicting” stock purchases. He said they were handled by her financial manager.
“During the divestiture process, her financial account manager purchased some potentially conflicting stock holdings,” spokesman Bill Hall said. “These additional purchases did not change the scope of Dr. Fitzgerald's recusal obligations, and Dr. Fitzgerald has since also divested of these newly acquired potentially conflicting publicly traded stock holdings.”
Longtime health policy experts said the official HHS statement suggested her ongoing financial conflicts of interest were so broad and indefinite that they were posing a problem for the administration and creating too much of a distraction.
The latest report about the tobacco stock was probably “the straw that breaks the camel’s back,” said one policy expert who has worked with both Republican and Democratic administrations. Referring to CDC’s acting director, this person said: “If you know you have a super-competent person who can immediately assume the reins as acting director, maybe you feel freer to make a move than you would have absent an Anne Schuchat.”
Former CDC director Frieden said in two morning tweets Wednesday that Fitzgerald had impressed him as “someone who was committed to supporting public health and protecting Americans.” He said he had spoken with her and believed her “when she says that she was unaware that a tobacco company investment had been made.”
He added: “She understands that any affiliation between the tobacco industry & public health is unacceptable, & that when she learned of it she directed that it be sold.”
Dr. Fitzgerald impressed me as someone committed to supporting public health and protecting Americans. I wish her well and hope the next director remains focused on using science to protect Americans from threats that arise in this country and anywhere in the world.— Dr. Tom Frieden (@DrTomFrieden) January 31, 2018
I have spoken with Dr. Fitzgerald & believe her when she says she was unaware a tobacco company investment had been made, she understands that any affiliation between the tobacco industry & public health is unacceptable, & that when she learned of it she directed that it be sold.— Dr. Tom Frieden (@DrTomFrieden) January 31, 2018
Fitzgerald's departure took nearly all of the agency's staff and the nation's public health leaders by surprise. She was scheduled to give the keynote address on Friday at the International Society for Disease Surveillance's annual meeting in Orlando.
Her sudden exit at CDC comes at a precarious time for the agency.
“CDC is on the front lines of the worst outbreak of flu in nearly a decade,” noted John Auerbach, president and chief executive of Trust for America's Health and a former CDC official. In addition, CDC personnel are still involved in hurricane recovery efforts in Texas, Florida, Puerto Rico and the U.S. Virgin Islands. And theirs is the lead agency working with hospitals and doctors nationwide to guarantee that opioids are appropriately prescribed and that opioid-related deaths are accurately recorded, he said.
CDC’s work helping countries detect and control outbreaks is slated to fall dramatically over the next two years because of lack of funding. Another big source of funding — a prevention and public health fund — was just cut by $100 million for fiscal year 2019 as part of the tax bill Congress passed in late December.
“Who is going to protect CDC so that CDC can protect Americans?” Frieden asked.
An obstetrician-gynecologist for 30 years, Fitzgerald served as a major in the Air Force and ran unsuccessfully for Congress twice in the 1990s. Named Georgia's public health chief in 2011, Fitzgerald championed early childhood development, tobacco control and obesity prevention. She has been criticized for accepting funds from the Atlanta-based Coca-Cola Foundation for a childhood obesity program.
Amy Goldstein contributed to this report.