To say the agency has taken a step back in Trump’s first year would be an understatement. On Wednesday, the new secretary of Health and Human Services, Alex Azar, announced the resignation of CDC Director Brenda Fitzgerald, citing “complex financial interests that have imposed a broad recusal limiting her ability to complete all her duties.” According to a recent report from Politico, some of those holdings included eyebrow-raising investments in companies directly related to Fitzgerald’s work, including thousands of dollars in drug and insurance companies.

Close ties with these industries aren’t unusual among Trump administration officials: Former Health Secretary Tom Price had stock in biotech and pharmaceuticals companies, and Azar is a former executive with pharmaceutical giant Eli Lilly. But Fitzgerald’s financial activity went even beyond this new norm. Politico reported that she’d held stock in tobacco companies Reynolds American, British American Tobacco, Imperial Brands, Philip Morris International, and Altria Group before she took office in July. As director, she purchased over $1,000 worth of stock in Japan Tobacco. That means that before she dumped the stocks in October, Fitzgerald held ownership in four of the “Big Five” tobacco companies in the world.

Now, there are no accusations of wrongdoing against Fitzgerald—no indication her stake made a difference in her leadership—and it’s unclear if she was aware of the stock purchases made in her name. But even the most generous interpretation for Fitzgerald is a scandal for the CDC. One of the centers’ chief public-health objectives is to end smoking. In fact, the only real public-health position on tobacco usage is that it should be eliminated entirely, a line that the CDC has held for years now. The CDC’s chief holding even a penny of tobacco stock, let alone a portfolio that includes almost all the major companies, runs counter to that goal.

This particular fiasco comes during a time when the agency is facing a growing number of public-health threats. Smoking rates have dipped significantly in the past year, but the disparities in smoking rates between rich and poor have actually increased—differences that threaten to further entrench income inequality. Antibiotic resistance is on the rise, and more than likely portends a new wave of infectious threats that will test the American public-health system, including the imminent threat of a resurgence of sexually-transmitted diseases. The country is in the grip of one of the worst flu seasons in years, and the unprecedented opioid crisis decreasing the lifespans of millions of Americans shows no signs of relenting.

Facing that rising tide, the mothership of the country’s public-health system is floundering, in no small part because of a Republican effort to reduce its funding. In 2017, the GOP’s attempts to repeal Obamacare often proposed raiding or eliminating the Prevention and Public Health Fund, which constitutes a major piece of the CDC’s budget. While repeal never passed, it put CDC on the defensive, where it’s likely to remain: Trump has also targeted the fund for cuts.