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Senior leaders across the Department of Health and Human Services were put on leave and countless other employees lost their jobs Tuesday as the Trump administration began a sweeping purge of the agencies that oversee government health programs. Top officials at the National Institutes of Health, the Centers for Disease Control and Prevention, and the Food and Drug Administration were put on administrative leave or offered reassignment to the Indian Health Service. Other employees began receiving layoff notices or learned they had lost their jobs when their entry badges no longer worked Tuesday morning. (Johnson, Roubein, Achenbach, Sun and Weber, 4/1)

Newly confirmed National Institutes of Health director Jay Bhattacharya told staff that they face challenges amid large-scale cutbacks and that he will try his best to "implement new policies humanely," according to an all-staff email sent [Monday] and shared with Axios by the agency. (Goldman, 4/1)

Marty Makary’s first official day as commissioner of the Food and Drug Administration began with employees in tears, learning from security guards that they were losing their jobs. The news release announcing the start of his tenure points readers to a press office that, after large-scale layoffs, basically no longer exists. His first email to staff summarized his resume. (Lawrence and Todd, 4/1)

Directors of five National Institutes of Health institutes and at least two other members of senior leadership have been placed on administrative leave or offered new assignments since Monday, topping a list of hundreds of employees notified in the last 24 hours that they had lost their jobs as part of sweeping layoffs across federal health agencies. (Molteni, Wosen and Mast, 4/1)

The Food and Drug Administration’s chief tobacco regulator was removed from his post Tuesday, part of sweeping cuts to the federal health workforce that have cleared out many of the nation’s top experts overseeing food, drugs, vaccines and products containing nicotine. The agency’s tobacco director, Brian King, notified his staff in an email: “It is with a heavy heart and profound disappointment that I share I have been placed on administrative leave.” (Perrone, 4/1)

As part of the sweeping layoffs that rocked the Department of Health and Human Services on Tuesday, the entire staff that oversaw an annual survey to better understand infant and maternal health — and that was considered the gold standard in the field — was placed on administrative leave. (Oza, 4/1)

The layoffs at the Department of Health and Human Services slashed the staffs of major federal aging, disability and anti-poverty programs, leaving the future of those programs uncertain. At least 40% of staff got layoff notices and many were turned away at the front door Tuesday when they showed up for work at the Administration for Community Living, or ACL, which coordinates federal policy on aging and disability. (Shapiro, 4/1)

The Department of Health and Human Services made major cuts to teams across its agencies that handle communications, media relations, and Freedom of Information Act requests as part of mass layoffs Tuesday, a move that workers say will impair the department’s ability to relay critical health information to the public and run counter to secretary Robert F. Kennedy Jr.’s vow to promote “radical transparency.” (Chen, Lawrence and Cueto, 4/1)

Thousands of federal workers are newly reeligible for a Trump administration offer paying them to quit as agencies prepare to shed up to half of their staffs, documents reviewed by The Washington Post show. The deal, extended across at least five agencies in recent days, resurrects an option to resign now and be paid through September that President Donald Trump and his adviser, billionaire Elon Musk, extended early in their push to shrink the workforce. About 75,000 employees took the deal in its first round, officials said then, as unions mounted legal challenges panning the program as arbitrary and coercive. (Davies, Natanson and Rein, 4/2)

Amid the layoff notices sent to stunned employees of the Department of Health and Human Services Tuesday was yet another surprise: some of them, including top National Institutes of Health officials, were offered the chance to transfer to the Indian Health Service. (McFarling, 4/1)

Some government health employees who were laid off Tuesday were told to contact Anita Pinder with discrimination complaints. But Pinder, who was the director at the Office of Equal Opportunity and Civil Rights at the Centers for Medicare and Medicaid Services, died last year. The inclusion of Pinder’s name in reduction-in-force notices reflects the chaos of the Trump administration’s ongoing efforts to shed federal workers and was a gut punch to employees who knew her, said Karen Shields, who worked with Pinder. (Weber, 4/1)

Elon Musk and his Department of Government Efficiency (DOGE) team created the new org chart for HHS, said Robert F. Kennedy Jr. during an interview on News Nation. The HHS secretary said when he arrived at the department, the org chart was "incomprehensible," and Musk "came in for the first time with a real org chart for the agency." Kennedy's statements were confirmed during a Fox News interview with Musk and the DOGE team. DOGE member Anthony Armstrong -- a former Morgan Stanley banker who is now a senior advisor to the Office of Personnel Management -- outlined the team's approach to agency reorganizations. "We literally go in -- and this is mostly at night and over weekends -- with the secretaries of those agencies, and their senior staff, and we're going line by line in the employee org charts ... from the bottom up, talking about every function," Armstrong said. (Fiore, 4/1)

Drugmakers made a calculated risk during HHS Secretary Robert F. Kennedy Jr.’s confirmation process in choosing not to publicly criticize a nominee who called their products dangerous. They’re starting to reconsider. After the firing of thousands of Department of Health and Human Services employees on Tuesday, industry trade groups that have mostly sought to curry favor with the new administration began to express alarm. “While we support improving FDA efficiency to deliver more affordable generic and biosimilar medicines to patients faster, many of the reported cuts appear to do the opposite,” said John Murphy, CEO of the Association for Accessible Medicines, which represents generic drugmakers. (Lim, 4/1)