Alex Azar

Alex Azar – Life, Career, and Public Leadership

A comprehensive look at Alex Azar: from legal and pharmaceutical executive to U.S. Health and Human Services Secretary. Learn about his background, policies, controversies, and guiding beliefs.

Introduction

Alex Michael Azar II (born June 17, 1967) is an American attorney, business executive, and political appointee. During the Trump administration, he served as the 24th U.S. Secretary of Health and Human Services from 2018 to 2021. His career spans government service, the pharmaceutical industry, and healthcare regulation. Azar has been a controversial figure, praised by allies for his organizational drive and criticized by opponents for his industry ties.

His life reflects tensions between public service and private sector influence, especially in debates over drug pricing, healthcare policy, and pandemic responses.

Early Life and Education

Alex Azar was born on June 17, 1967, in Johnstown, Pennsylvania, to Alex Michael Azar Sr. and Lynda (née Zarisky). His father was an ophthalmologist and taught at Johns Hopkins Hospital. Azar’s family heritage includes Lebanese roots (his grandfather emigrated from Lebanon).

He was raised in Salisbury, Maryland and graduated from Parkside High School.

For undergraduate study, Azar attended Dartmouth College, graduating summa cum laude in government and economics in 1988. He then earned a Juris Doctor (J.D.) from Yale Law School in 1991, where he served on the executive committee of the Yale Law Journal.

Following law school, he clerked for Judge Alex Kozinski (U.S. Ninth Circuit) and Judge J. Michael Luttig (U.S. Fourth Circuit), and briefly for Supreme Court Justice Antonin Scalia.

Early Career: Law & Government Service

After clerking, Azar worked as part of Kenneth Starr’s independent counsel team in the Whitewater investigation. He then joined the Washington, D.C. law firm Wiley Rein (later as partner).

In 2001, the George W. Bush administration appointed Azar as General Counsel of the U.S. Department of Health and Human Services (HHS). In 2005, he was elevated to Deputy Secretary of HHS, a role he held until 2007. During his tenure, he was involved in regulatory, operational, and legal oversight across health programs and emergency preparedness.

He resigned in January 2007 and moved to the private sector.

Private Sector: The Pharmaceutical Years

Soon after leaving government, Azar joined Eli Lilly & Company, a major pharmaceutical firm, in 2007 as Senior Vice President for Corporate Affairs and Communications. He later took leadership roles in Lilly’s U.S. operations, including overseeing managed healthcare divisions and the Puerto Rico affiliate.

By 2012, Azar became President of Lilly USA, LLC, responsible for all domestic operations. His time there coincided with controversies over drug pricing—critics allege that under his leadership, the price of insulin (among other drugs) increased significantly. He also served on the board of the Biotechnology Innovation Organization, a major industry trade association.

Azar resigned from Lilly in 2017, at which point he declared his intention to return to public service.

Secretary of Health and Human Services (2018–2021)

In November 2017, President Donald Trump nominated Azar to lead HHS. He was confirmed by the Senate on January 24, 2018, with a vote of 55–43, and sworn in on January 29.

Major Responsibilities & Actions

• Azar oversaw a department with over 85,000 employees and a budget exceeding $1.4 trillion.

• As HHS Secretary, he launched or supervised initiatives including the National Biodefense Strategy and Global Health Security Strategy.

• He was also briefly the Chairman of the White House Coronavirus Task Force from late January 2020 to February 2020, before being succeeded by Vice President Mike Pence.

• In August 2020, Azar became the first sitting U.S. Cabinet official to visit Taiwan in years, signing a memorandum of understanding on medical cooperation.

• Late in 2020, under his watch, HHS purchased 500,000 treatment courses of remdesivir for COVID-19, at a cost of about $2,340 per course.

• In September 2020, Azar issued a memorandum asserting that no health agencies (like the FDA) could make new rules related to foods, medicines, or devices without his approval—sparking concerns about overreach and politicization.

Controversies & Criticism

• His appointment drew scrutiny over his ties to the pharmaceutical industry and past drug pricing record. Critics asked whether he would prioritize public health or industry profits.

• During the COVID-19 outbreak, some accused the HHS under his leadership of insufficient testing and delayed responses.

• He reportedly clashed with other Trump administration officials (e.g. the Centers for Medicare & Medicaid Services head) over policy and management.

• Some observers questioned his ability to obtain full security clearance, limiting his access to certain information.

On January 12, 2021, Azar submitted his resignation, effective January 20 (the day of presidential transition). In his resignation letter, he called for a peaceful, orderly transition following the January 6 Capitol events.

After leaving office, China placed sanctions on Azar and other former Trump officials.

Legacy & Influence

Alex Azar’s impact lies at the juncture of health policy, pharmaceutical business, and public management. His legacy will likely be evaluated through several lenses:

1. The public-private bridge
   Azar straddled roles in government and industry, which gave him insider access but also exposed him to charges of conflict of interest.

2. Pandemic leadership under pressure
   His time as HHS Secretary during COVID-19 places him in the spotlight for decisions and preparedness measures—both praised and criticized.

3. Drug pricing and regulation
   Because of his past in pharma, Azar's stance on drug pricing, oversight, and regulatory reforms will be a lasting point of reference for observers.

4. Institutional centralization
   The 2020 memo centralizing rule-making authority in the HHS Secretary’s office may influence future debates about agency independence and political control of health policymaking.

5. Diplomacy and global health ties
   His Taiwan visit and engagement in global health security strategies reflect an ambition to situate U.S. health diplomacy on a more assertive footing.

Whether viewed as a reformer, industry insider, or political technocrat, Azar’s tenure illustrated the complexity of leading a massive federal health bureaucracy during crisis.

Personality, Style & Approach

• Azar is known for being organized, detail-oriented, and willing to assert authority within his agencies.

• His policy perspective often emphasizes regulatory balance—he has expressed interest in writing new rules (rather than simply striking old ones).

• He tends to frame debates in terms of tradeoffs: innovation vs. affordability, regulation vs. freedom, public health vs. market incentives.

• Coming from both law and business, his approach is technocratic, legalistic, and managerial.

Notable Statements & Views

While Azar is more often a policy actor than a quotable public intellectual, several remarks stand out:

• On drug pricing during confirmation:
  “I believe that the Department of Health and Human Services has the ability to, and should, make it work a little better [with regard to the Affordable Care Act].”

• On the mission of HHS and unborn life:
  As part of his confirmation responses, Azar stated that HHS’s mission includes enhancing the health and well-being of all Americans “and this includes the unborn.”

• On the coronavirus challenge:
  During early COVID coverage, he emphasized that disease “does not respect borders” and that all governmental authorities needed flexibility to act.

These statements reflect his inclination to balance direction, policy, and ideological commitments within his roles.

Lessons from Alex Azar’s Journey

1. Expertise across sectors comes with both strength and scrutiny
   Moving between government, law, and industry affords broad insight—but also invites conflict-of-interest challenges.

2. Leadership is tested in crisis
   Azar’s time during a pandemic underscores how reputation in stable times may be overshadowed by performance under pressure.

3. Rule-making is a key lever of power
   His decision to centralize regulatory rulemaking shows how procedural authority can shape long-term institutional direction.

4. Transparency and public trust matter
   In health policy, public confidence depends heavily on clear communication, accountability, and perceived integrity.

5. Public service demands responsiveness and adaptation
   The shift from industry to public leadership requires sensitivity to stakeholder interests, shifting norms, and emergency governance.

Conclusion

Alex Azar’s story is a study in contrasts: lawyer and executive, regulator and advocate, crisis manager and controversial insider. He led one of the largest U.S. federal departments during a historically turbulent period, with decisions that will be debated for years.

His legacy will be viewed through how effectively he balanced health imperatives, agency authority, and public accountability. As events unfold—especially in the wake of the pandemic—Azar’s place in the pantheon of health administrators will continue to evolve.