With President-elect Donald Trump's selection of Robert F. Kennedy Jr. as your nominee to lead the Department of Health and Human Services, numerous public health leaders are expressing fears that the nation's top health agencies will be weakened at a time when the country faces growing infectious disease threats, emboldened industry lobbyists and the dangerous consequences of medical misinformation.
If confirmed as HHS secretary, Kennedy, a fringe medical conspiracist and self-described “poster of the anti-vaccine movement,” would oversee institutions such as the Centers for Disease Control and Prevention and the U.S. Administration. Food and Medicine. , the Centers for Medicare and Medicaid Services, and the National Institutes of Health.
Like the two most recently confirmed HHS secretaries, Xavier Becerra and Alex Azar, Kennedy is a lawyer with no formal scientific or medical credentials. His competition would include programs and departments that he has fiercely criticized in the past, often in ways that his opponents say distort or ignore facts and misinterpret science.
Many of the issues Kennedy has said publicly he wants to address are concerns widely shared by health care providers, public health officials and the general public. They include widespread chronic disease, poor nutrition, and the ubiquity of processed foods containing artificial chemicals.
But his nomination has alarmed many medical and public health officials who say they are concerned that solutions Kennedy might see as appropriate could undermine the long-term health of Americans.
“Putting someone in charge who is incapable of discerning the difference between good science and bad science is really dangerous for the American people,” he said. Dr. Peter Luriepresident and executive director of the Center for Science in the Public Interest.
“Yes, there are some things that he supports that we would agree with, but they are more like a stopped clock that is right twice a day,” Lurie said, citing food additives as an example. “There are opportunities for small victories. … But overall, it dissolves into so many bad ideas that it’s not worth it at all.”
Kennedy declined to discuss his plans for HHS with The Times, but he indicated some priorities for the agency in previous public statements.
For example, he said Trump would advise against water fluoridation on his first day in office. He told NBC News He wouldn't “take away” vaccines, but he would “make sure there are scientific studies of safety and effectiveness, and that people can make individual assessments about whether that product will be good for them.”
More than half a dozen experts who spoke to The Times said Kennedy's suggestions that the science around vaccines is not sound would undermine public health.
The United States has “the best vaccine safety system in the world,” said Dr. Richard Besser, a former acting director of the CDC who now heads the Robert Wood Johnson Foundation. “RFK Jr. has done a lot to undermine confidence in that.”
In fact, cases of measles has been increasing in the US as childhood vaccines are delayed, especially since the COVID-19 pandemic. The CDC has identified 277 cases of measles this year, up from 59 in 2023.
“I don't want to see us go backwards to remind us that vaccines work,” Dr. Mandy Cohen, director of the CDC, said this week at the Milken Institute's Future of Health Summit in Washington, DC.
Kennedy's zeal to remove fluoride from drinking water on the grounds that the mineral causes neurodevelopmental disorders and other health conditions is another example of circumventing the best science, said Dr. Walter Willett, professor of epidemiology and nutrition. at the Harvard TH Chan School of Public Sciences. Health.
“This has been carefully looked at and there has been no evidence of a link,” Willett said. “On the other hand, there are serious problems with lead in water systems.”
Vaccines and fluoride are just two areas where Kennedy will have the opportunity to implement ideas that lack strong scientific backing.
Last month, he denounced the FDA’s “aggressive suppression” of unproven health remedies like dietary supplements and ivermectin, warning: “If you work for the FDA and are part of this corrupt system, I have two messages for you.” you: 1. Keep your records and 2. Pack your bags.”
But food safety advocates who have shared many of Kennedy's criticisms of lax regulation said dismantling the agency is not the answer. Any effort to reduce or eliminate chemical additives in food would require experienced staff to draft new rules and guide them through the required regulatory process, said Ken Cook, chairman of the Environmental Working Group.
“If you've gotten rid of all the bureaucrats, who will write the regulations?” Cook said.
Or consider the FDA's reliance on user fees from companies that want the agency to approve their medical products. Such fees constitute almost half of the agency's operating budget. Kennedy and others have criticized such fees, but if those dollars disappeared, Congress would be unlikely to replace them, Lurie said.
“Eliminating user fees is equivalent to starving the agency,” he said. “That would mean a food program that has limitations in what it can do, drugs coming to market more slowly, and vaccines being even more poorly monitored for safety.”
Lurie said he wouldn't be surprised to see Kennedy task National Institutes of Health researchers with searching for harmful side effects of vaccines and elusive benefits of potential therapies that have already been shown to be ineffective, such as chelation as a treatment for autism. and ivermectin and hydroxychloroquine for COVID-19.
“He seems to think they have a lot of promise,” Lurie said. “Most of those ideas are sinkholes for government spending, which is ironic given the Trump administration's supposed devotion to efficiency.”
As important as HHS's role is, Kennedy would still find his powers restricted by the limits of the agency's scope and, potentially, by the whims of his boss.
Willett said he agrees with Kennedy that the country's health is in decline and that our food and healthcare systems are “in many ways dysfunctional.” I would welcome efforts to reduce the amount of salt allowed in foods and reduce consumption of added sugars, refined grains, and sugar-sweetened beverages.
But if Kennedy takes steps like these, “we know for a fact that he will encounter resistance from the industry,” Willett said. “It would be interesting to see if he is ready to take on Coca-Cola.”
While Kennedy is passionate about reducing pesticides and other chemicals in food, it is up to the Department of Agriculture to regulate the use of pesticides on crops, and it is the job of the Environmental Protection Agency to determine what levels of exposure are considered safe for people. Cook said. Kennedy would also not have the power to reform farm subsidies to encourage organic and regenerative agriculture.
“From his position he doesn't have much interest in pesticides,” Cook said. “That's not really an HHS or FDA issue.”
The FDA has the authority to regulate chemicals that leak from food packaging and can get into food, and Kennedy could prioritize that, Cook said.
It is also possible that Kennedy could protect the budgets of the National Institute of Environmental Health Sciences and the Agency for the Registry of Toxic Substances and DiseasesCook said.
To help him achieve his goals, Kennedy has invited the public to comment on people who could serve in important roles within the federal government's health agencies.
Names that have garnered thousands of votes in the “America's Health” category of its “Nominees for the People” website include Dr. Sherri Tenpenny, who said COVID-19 vaccines made people magneticand Dr. Simone Gold, the anti-vaccine Beverly Hills doctor whose medical license was suspended after she pleaded guilty to unlawfully entering the US Capitol on January 6, 2021 (her license has since been canceled ). restored.)
Kennedy's own accession to the position of HHS secretary is not yet secure. Cabinet posts are supposed to be confirmed by the Senate, although Trump has suggested he could use recess appointments to avoid the need for approval from lawmakers.
Dr. Georges Benjamin, executive director of the American Public Health Association, said that even if Kennedy wins confirmation, it is unclear how long he will remain in Trump's favor.
“I remind people that their first health secretary didn't last a year,” Benjamin said. “We'll see what happens here.”
