Top federal health leaders across the Department of Health and Human Services were effectively ousted Tuesday from their posts, with many reassigned to positions at the Indian Health Service, or IHS,

Drug and medical device makers didn’t oppose Robert F. Kennedy Jr.’s confirmation as health secretary, but are speaking up in opposition to the agency downsizing he ordered.

Layoff notices began Tuesday, impacting workers across multiple agencies. The FDA will lose 3,500 jobs, the CDC 2,400, the National Institutes of Health 1,200, and the Centers for Medicare and Medicaid Services 300, according to figures released by HHS.