(Updated at 4:55 p.m. ET)
Ethics wonks hope that the latest high-profile resignation from HHS will spur the Trump administration to be more aggressive in addressing conflicts of interest among top policymakers.
Nearly every major healthcare leader picked by the administration has raised Washington insider concerns about whether they can effectively do their jobs despite major ties to various industries. Dr. Brenda Fitzgerald could not escape a growing chorus of questions about conflicts of interest, including stock purchases she made since taking over as head of the Centers for Disease Control and Prevention. She resigned from her post following a meeting Wednesday morning with HHS Secretary Alex Azar.
"Something needs to change," said Kathleen Clark, a Washington University law professor with a focus on government ethics. "The Trump administration needs to get its act together on ethics."
In a statement, HHS spokesman Matt Lloyd said, "Dr. Fitzgerald owns certain complex financial interests that have imposed a broad recusal limiting her ability to complete all of her duties as the CDC director."
Virginia Canter, executive branch ethics counsel at the government watchdog Citizens for Responsibility and Ethics in Washington said she hopes the departure serves as a call to action from the Trump administration.
Fitzgerald, who was appointed to her post last July, didn't file an ethics agreement in which she identified her conflict interests until September and she didn't divest from companies until October. She was required to sell a range of stocks she owned, including beer and soda companies, the tobacco company Philip Morris International and a number of healthcare companies such as vaccine manufacturers.
She may have had a conflict of interest if she interacted with tobacco or healthcare companies or participated in matters affecting them before she formally divested her interests, Canter said.
Further, it put Fitzgerald in a position in which she may have had access to nonpublic information before she divested from these industries.
Ongoing ethical questions prevented Fitzgerald from testifying before congressional committees several times, most recently during a hearing on the nation's ability to respond to a public health emergency.
Her resignation came one day after reports surfaced that Fitzgerald bought shares in a tobacco company one month into her tenure at CDC.
Those purchases included between $1,001 and $15,000 of Japan Tobacco, one of the largest tobacco companies in the world, according to a response to a public information request sent by Politico.
"It is fairly reckless," said Canter, a former White House associate counsel for Presidents Bill Clinton and Barack Obama. "This is one of the only administrations to have these kinds of difficulties with divesting conflicting assets. The fact that she held stocks until the end of October is very concerning."
Moving forward, the Trump administration should push potential appointees to fully disclose their conflicts at or around the time of appointment or confirmation and have them lay out an aggressive plan to divest from those conflicts on a transparent time line, Canter said.
Conflict of interest worries have dogged other Trump appointees. Prior to being confirmed, former HHS Secretary Dr. Tom Price raised concerns about his decision to introduced legislation that benefited a health company he had invested in when he was a member of Congress.
FDA Commissioner Scott Gottlieb is believed to have had more financial conflicts of interest with the industry he regulates than any previous FDA commissioner. He raked in hundreds of thousands of dollars in consulting and speaking fees from drug and device companies before taking his post, according to the federal OpenPayments database. Even Azar came under fire during his confirmation hearings. He served as head of U.S. operations for drug manufacturer Eli Lilly & Co.
More recently, Sen. Ron Wyden (D-Ore.) accused CMS Administrator Seema Verma of breaking her conflict of interest waivers by weighing in on several Medicaid waivers.
HHS responded that the Verma had received permission from ethics official to have some contact with leaders from these states, which were at one point her clients when she was an industry consultant, and beyond that, the administrator does not have a recusal obligation for former state clients under the Trump Ethics Pledge.
Richard Painter, who served as Presidnt George W. Bush's chief ethics lawyer, said that the Trump administration has a low standard in how it handles a conflict of interests.
The Trump administration may be having troubles with appointed officials because the president himself has yet to do a full divestiture from his investments, experts argued.
"If the boss isn't willing to divest from of conflicts of interests, that sets the tone for everybody else," Painter said.
Former CDC Director Tom Frieden tweeted out after hearing about Fitzgerald's departure that he believed her when she said she was unaware a tobacco company investment had been made while she was in office and that she understands that any affiliation between the tobacco industry and public health is unacceptable.
"Fitzgerald impressed me as someone committed to supporting public health and protecting Americans," Frieden tweeted.
"I repeatedly raised concerns about Fitzgerald's conflicts of interest and broad recusals from work impacting public health issues like cancer and opioids," Sen. Meg Murray (D-WA) said in a tweet. "This is yet another example of this Administration's dysfunction and questionable ethics."
