Remember ivermectin, the antiparasitic drug that right-wing media figures wrongly touted as a cure for COVID? How about hydroxychloroquine, the malaria treatment taken by thousands who then suffered side-effects after Donald Trump recommended it as a COVID treatment? And recall when the Trump White House pondered poisonous oleandrin as a COVID treatment on the advice of a pillow-maker campaign donor?
Now Trump says he will elevate to his Cabinet someone with a notable record of promoting pseudoscience and downright quackery: Robert F. Kennedy, Jr. A prominent vaccine skeptic, Kennedy promises to be a disaster for U.S. public health.
“For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health,” wrote Trump in a November 14 post on X (formerly Twitter) in which he announced that he will nominate Kennedy to head the U.S. Department of Health and Human Services.
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“Mr. Kennedy will restore these Agencies to the traditions of Gold Standard Scientific Research, and beacons of Transparency, to end the Chronic Disease epidemic, and to Make America Great and Healthy Again!” Trump added.
That, according to Kennedy, will include pushing for the removal of fluoride from drinking water, relitigating the already meticulous approval of vaccines and revisiting disproven treatments, such as chelation therapy, sometimes touted as a treatment for autism.
An environmental lawyer, Kennedy is a master at seeding doubt around public health. He employs the same distrust-sowing technique that worked for the tobacco industry for decades, “just asking questions” dissembling that threatens support for science and an already stumbling public health infrastructure.
Kennedy largely owes his prominence and income to his last name, not demonstrated scientific competence. As a senior writer on the NBC News medical unit in the 2010s, I fought more than once with senior producers who wanted to give airtime to Kennedy and his bogus health claims. These claims run the gamut from vaccine skepticism to advocating for raw milk and fears Wi-Fi might cause cancer. Now he’ll have the implied legitimacy of the White House. News outlets will have little choice but to report whatever nonsense he decides to spew.
“This is not his area of expertise. I am not quite sure why they would let him do any of this stuff,” says Georges Benjamin, executive director of the American Public Health Association.
The Senate will have to confirm Kennedy to head HHS, an enormous department with a nearly $2-trillion annual budget that oversees the U.S. Food and Drug Administration, the National Institutes of Health, the Centers for Disease Control and Prevention, and the Centers for Medicare and Medicaid Services.
But even if the Republican-led Senate balks at approving Kennedy, Trump could give him an unofficial “czar” position with extensive influence over fresh political appointees eager to please the fickle Trump.
“They take calls from the White House,” says Lawrence Gostin, a professor of global health law at Georgetown University. “Being able to whisper in the ear of the president, that brings enormous power and influence.”
HHS leads the agencies tasked with discovering new drugs, approving new treatments and vaccines, advising on public health and preparing against threats such as pandemics and biological attacks. COVID has killed more than 42,000 people in the U.S. so far this year alone. And with H5N1 avian influenza spreading among poultry, cattle and people, this is a perilous time to give free rein to an amateur.
Kennedy comes to the Trump administration with a track record of trying to thwart public health campaigns. His nonprofit Children’s Health Defense has produced films, such as Vaxxed III: Authorized to Kill, that feature testimonials by people claiming standard medical treatments or vaccines hurt them or killed loved ones. “We leave you to decide where the truth lies,” reads Vaxxed III’s introduction. A Facebook misinformation campaign funded in no small part by Kennedy’s organization helped fuel fear of measles vaccines in American Samoa. The resulting outbreak there in 2019 killed 83 people, mostly children, and sickened more than 5,700. This year alone, undervaccination has led to at least 277 measles cases in 32 cities and states, according to the CDC.
It’s unlikely Kennedy could directly limit state-decided approval of vaccines, Gostin said. But he can scare more people away from vaccines and help turn an already dubious public away from mainstream medicine. “On spreading mis- and disinformation, there are no guardrails. There are no restraints,” Gostin says.
“In my mind, he is the most influential and most well financed anti-vaxxer in the world. But he will now have the imprimatur of the White House and the organs of public health like the CDC to really amplify that deep distrust in vaccines and also deep distrust in public health agencies and science itself,” Gostin adds.
Already the CDC has struggled to gain the cooperation of state officials and dairy farms in collecting data on an outbreak of H5N1 in farm animals that has caused infections in humans. In the U.S., human cases have been confirmed in 53 people in seven states. So far all but one of them have been confirmed animal-to-human infections. (The source of the additional U.S. case is unknown.)
Having spread from poultry to dairy cattle, the virus also infects a range of other mammals, including pigs, the best-known mixing vessel for flu viruses. If the virus does start to spread from human to human, the federal government is already behind in preparing vaccines. “If we have an H5N1 outbreak, assuming we have a vaccine that works, how do we get people to take it?” Benjamin asks.
An HHS chief telling people to drink raw milk from possibly infected cows won’t help. While pasteurization kills the virus, raw milk offers no such protection, and it sickens several hundred people every year who catch Listeria, Campylobacter and other bacterial infections from it. The FDA has long been battling the raw milk movement. Howard Lutnick, Trump’s transition co-chair, told CNN in October that Kennedy’s plans include dismantling faith in vaccines. “He wants the data so that he can say that these things are unsafe,” Lutnick said, despite prodigious amounts of clinical trial data showing that vaccines are overwhelmingly safe.
“FDA’s war on public health is about to end,” Kennedy recently wrote on X. “This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented by Pharma.”
While few would argue against the benefits of exercise, psychedelic treatments have yet to make it through clinical trials, hydroxychloroquine and ivermectin don’t treat or prevent COVID, hyperbaric therapies are proven only to treat rare conditions such a decompression sickness, and the FDA is restricted by law from regulating the multibillion-dollar nutraceutical and supplement market. Many legitimate stem cell treatments exist, but thousands of clinics offer sham treatments at extortionate prices, exploiting desperate patients’ hope.
It’s ironic that Kennedy happily casts doubt on vaccines, which are meticulously tested and monitored and which have saved 154 million lives over the past 50 years, while promoting unproven or disproven products alongside treatments that only empty pockets with empty promises.
Benjamin says he despairs. “We already know [the FDA] is overburdened, underfunded and under stress to do things quickly,” he notes.
Strong leaders at HHS, the FDA and the CDC will have a hard time withstanding what the COVID experience has already promised: an onslaught of confusing, contradictory and chaotic health direction coming from a Trump White House. Weaker leaders may not even bother to try.
“Oh, God. Wouldn’t it be terrible for us to have another epidemic on [Trump’s] watch?” Benjamin asks. “I am not sure how much they learned from the first one.”
This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of Scientific American.