The Trump administration has a cheat code for thinning the ranks of America’s health agencies.
In a little over a month, the Trump administration has started to hollow out America’s federal health agencies. Roughly 2,000 probationary workers have been fired en masse, by virtue of the fact that they were relatively new to their jobs. But the long-term impact of those terminations could pale in comparison to a lesser-noticed spate of departures that has recently roiled the health agencies. In the past two months, the FDA, CDC, and NIH second in commands have all resigned or retired. So have several other prominent officials, including the FDA’s chief operating officer as well as the heads of both its food center and its drug center.
There is always some churn in a new White House, but it typically affects “political staff” who are appointed to serve in a specific administration. Civil servants, meanwhile, are far more likely to stay in their positions regardless of who is president. The continuity of these career officials ensures that agencies can still function as their newly appointed political leaders map out their agendas. As in any other industry, career officials—who dramatically outnumber political staff—do sometimes leave. But many of the top staffers who voluntarily abandoned their positions had previously not shown any sign of being ready to do so. Nirav Shah, the principal deputy of the CDC, is reportedly resigning tomorrow, despite telling a Politico reporter in January that he did not have any “current plans to leave government.” And Jim Jones, the head of the FDA’s food center, was just getting started on a long-term plan to revitalize that office. Shah and Jones, like all the other recently departed health officials mentioned in this story, declined to comment.
[Read: Inside the collapse at the NIH]
The level of attrition happening in the health agencies right now is unprecedented, Max Stier, the head of the Partnership for Public Service, a nonpartisan group that aims to strengthen the federal bureaucracy, told me. “We’re watching a complete sweep of those most senior career experts,” he said. President Donald Trump campaigned on a promise to “demolish” the so-called deep state, which he believes is out to sabotage his agenda, and has repeatedly declared his intent to gut the health agencies. To an extraordinary degree, his administration has already succeeded.
The administration has offered plenty of incentive for government workers to head for the exit. One of the Trump administration’s first moves was offering a buyout to any federal worker willing to abruptly leave their position. Trump has also mandated that all federal workers, including those who live more than 50 miles from their office, work in office five days a week. It’s unclear how many rank-and-file workers have quit because of these efforts, but prominent instances of attrition have not been limited to just the health agencies. A top Treasury Department official recently retired after reportedly refusing to give DOGE access to the government’s system for doling out trillions of dollars each year. So did 21 staffers at the United States Digital Service who had been drafted into working for DOGE.
Jones, the former director of the FDA’s food center, is instructive in understanding what is fueling the public-health exodus in particular. He joined the agency in 2023, and had spent the past several months staffing up areas of the food center that were faltering. But when 89 newly hired probationary employees were fired by the Trump administration earlier this month, he had enough. He did not want to be involved in “dismantling an organization,” he told the health publication Stat. The health agencies were upended by DOGE cuts just as Robert F. Kennedy Jr. was confirmed by the Senate as their boss. The health secretary has his own desires to fire bureaucrats. Had Jones not resigned, it is reasonable to assume that he would have been pushed out of his position: Kennedy had previously implied that everyone at the center Jones ran should be given pink slips.
That’s easier said than done. Although bureaucrats on their probationary period—because they’re either newly hired or recently promoted—can be fired with relative ease, career officials generally cannot be let go without actual cause. But none of that matters if officials resign—whether as a result of their own dissatisfaction or being pressured out. Attrition is a cheat code for thinning the federal workforce. In just a month, the Trump administration’s assault on the federal workforce has managed to push even an ardent reformer like Jones to surrender.
These departures will likely be a cause célèbre for MAGA world. As I wrote in November, public-health officials historically have been the firewall against the political whims of the White House. That is what happened during Trump’s first term. Early in the pandemic, Janet Woodcock, then the head of the FDA’s drug center, reportedly sprang into action to prevent widespread distribution of the unproven COVID treatment hydroxychloroquine over the orders of top Trump officials. What makes the recent resignations so consequential is that they suggest that Trump and RFK Jr. will face less resistance from inside the agencies as they attempt to overhaul public health. Already, Jones has been replaced by Kyle Diamantas, a food and drug lawyer (and hunting buddy of Donald Trump Jr.) who has no previous experience working in the federal government.
Still, these resignations may not be to the Trump administration’s benefit. Very few individuals have the type of specialized knowledge that comes with decades in government service. “These are the people that you want to do everything possible to hold on to,” Stier, of the Partnership for Public Service, said. Consider Lawrence Tabak, the outgoing principal deputy director at the National Institutes of Health. He served in that role for more than a decade, punctuated only by a short stint running the entire agency. That experience could have been channeled into delivering Kennedy’s promised reforms to the agency, like revisiting the government’s standards on conflicts of interests in research. Jones, though new to the FDA, had previously spent nearly two decades at the EPA regulating the safety of pesticides and other chemicals, which made him one of the few people prepared to deliver on Kennedy’s promise to ramp up the regulation of food chemicals. Indeed, Jones’s resignation from the FDA has shaken the agency’s staff. One employee who works at the food center described the mood to me as “pissed and scared and coping and numb and confused and demoralized.” (I agreed not to name the employee, because they’re not allowed to speak to the press.)
The federal health agencies have real problems: They’re often slow, bureaucratic, and cloistered, as Trump and Kennedy have been quick to point out. That some of the nation’s top health officials have decided to head for the exit may only make matters worse.
