President-elect Donald Trump has begun making appointments to his future cabinet, and many are waiting to see what Trump will do for President and current ally Robert F. Kennedy Jr. Will play a role.
After all, Trump announced at a rally in late October that he would let Kennedy “run wild” on health care in the country. “I’m going to let him go wild on health. I’m going to let him go wild on food. I’m going to let him go wild on medicine,” Trump said.
Kennedy later said that Trump “asked me to end the chronic disease epidemic in this country. And he said, ‘I want to see results, measurable results of chronic disease reduction in two years.’ And I said, ‘Mr. President, I’ll do it.’
Kennedy is a longtime anti-vaccine activist who has repeatedly expressed health views that contradict scientific evidence. He has created a Trump-endorsed plan called “Make America Healthy Again” (MAHA), a broad set of proposed policies that the politician claims online will “make Wall Street, Big Tech is more powerful than Big Pharma, Big Food, and a war machine.”
It’s unclear what official role Kennedy will have in a second Trump administration, if any. But there have been rumors of him being nominated for a top job at a federal health agency, such as the Department of Health and Human Services (HHS), the Food and Drug Administration (FDA), or the Centers for Disease Control and Prevention. (CDC). The latter two roles are usually held by someone with a medical degree, which Kennedy does not have.
What might her health leadership mean for the future of American health care and health policy? Four health policy experts explain.
It can target fluoride in drinking water.
Kennedy has repeatedly spoken about his concerns about the public health implications of adding fluoride to drinking water. Fluoride, a mineral that strengthens teeth and reduces the risk of cavities, has been added to drinking water since 1945 to promote good dental health in children. Statistics show that adding fluoride to water can reduce the amount of tooth decay in young children by 35 percent. This practice is currently listed by the Centers for Disease Control and Prevention (CDC) as one of the greatest public health achievements of the 20th century.
A government report released in August found that fluoride in drinking water At twice the recommended limit Associated with low IQ in children. The report found with “moderate” confidence that there is a link between high fluoride levels and lower IQ in children. But the CDC said in a statement that panels of experts in the U.S. and abroad have “not linked community water fluoridation to any potential adverse health effects or increased risk of systemic disorders such as cancer, Down syndrome, heart disease, osteoporosis, and osteoporosis.” There is no convincing scientific evidence for bone fractures, immune disorders, reduced intelligence, kidney failure, Alzheimer’s disease, or allergic reactions.”
Kennedy said in an interview with NPR that he thinks fluoride should be removed from drinking water. “Now we have fluoride in toothpaste,” he said. In another interview with NPR, Kennedy said, “We don’t need fluoride in our water. This is a very bad way to get it into our systems.”
But public policy experts say they’re unlikely to make much of a difference with fluoride in the water. “The issue has been made by state and local officials as to whether water is fluoridated—it’s a federal issue,” says Leighton Coe, PhD, MPH, professor and director of the Center for Health Policy Research at George Washington University’s Milken Institute. No.” School of Public Health. Ku says it’s possible the federal government could create new standards around water fluoridation, “but it’s going to take a long time.”
To prevent water fluoridation from a federal perspective, “Congress would have to pass a law outlawing the use of fluoridation or perhaps the EPA would have to add water fluoridation to the hazardous chemical list,” says Gerald Kominsky. are D., senior fellow at the UCLA Center for Health Policy Research. But Kominsky says Kennedy “could be influenced through public persuasion and the authority of any position to encourage municipalities to step up and stop using fluoride.”
He is likely to try to influence vaccination policies.
Kennedy is a longtime anti-vaccine advocate. “There is no such vaccine that is safe and effective,” he said on the Lex Friedman podcast in 2023. Among other things, Kennedy has linked vaccines to autism, a claim rejected by the scientific community. Kennedy also said in 2021 that giving the COVID-19 vaccine to children was “criminal medical malpractice.”
In an NPR interview, Kennedy said he would work “immediately” on changing vaccine regulations and research. “Of course, we’re not going to take the vaccine from anybody,” he said. “We’re going to make sure Americans have good information about vaccines and vaccine safety.”
Kennedy said there are “huge gaps” in the science surrounding vaccine safety, and we’re going to make sure those scientific studies are done and people can make informed choices about their vaccines and their children’s vaccines.
Their claims are for experts. “He claims vaccine safety data is ‘hidden’ — it’s not — and that no placebo-controlled studies have been done on vaccines. They have,” Kathryn Wallace, Ph.D. , an epidemiologist and adjunct assistant professor at the University of Illinois at Chicago School of Public Health. “He also spread misinformation about COVID-19 and sowed skepticism about vaccines during the pandemic. He does not change course when presented with real evidence, or when the flaws in his logic are explained.”
Wallace says he worries about what would happen if Kennedy were to be put in a position of power with authority over vaccines. “An administration that supports anti-science rhetoric and misinformation will only further reduce vaccine coverage, and we will see more vaccine-preventable disease, death and disability,” she says. She says
Ku says Kennedy would have some influence around vaccines if he were in charge of the FDA, which approves vaccines, or the CDC, which recommends how the public uses vaccines. Approved vaccines are provided free by the government to low-income children, and have the potential to make an impact, says Cue. “But there are a lot of principles that are well-accepted at the FDA and the CDC about how they do their business,” he says. “It’s not entirely clear that even the president himself can make changes to things like this on an immediate basis.”
If Kennedy was appointed head of HHS, Kew says, he might try to use pressure and influence to remove some substances from vaccines that he finds harmful. do “But I would suspect that people would push back, if there was data that he was trying to remove,” he says.
Kominsky pointed out that Kennedy “proposed the idea” that schools with vaccine requirements should be defunded, although it’s unclear whether he could actually do so. “This is not an intelligent, evidence-based way to protect childhood and improve childhood health,” he says. “He has some dangerous ideas and appears to be largely anti-science, which is scary when it comes to appointing someone who has authority over public health.”
He may try to change how things are done at the FDA.
Kennedy has been very clear about his dissatisfaction with the way things are run at the FDA. In late October, he wrote on X that “the FDA’s war on public health is coming to an end.”
“This includes psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean diets, sunshine, exercise, nutraceuticals, and anything else that promotes human health. And it can’t be patented by Pharma,” he continued. “If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Keep your records safe, and 2. Pack your bags.”
But for all his threats against the FDA, Kennedy is unlikely to change that much, whether he is appointed head of the FDA or HHS, said Dan Troy, former FDA chief counsel and B.R. Says GK Managing Director. “It’s difficult for a single individual to drive seismic change in the context of a law-enforced bureaucracy like the FDA,” he says.
Troy explains that it “takes years” to change a rule, adding that “a notice of proposed rulemaking is dozens, if not hundreds, of papers. It requires an economic analysis. It’s a team sport. And it requires a lot of support.
“One cannot just sit in the White House and issue proclamations and expect that policy is going to change,” Troy continues. “That’s not the way it works. It takes time, energy, effort, and work with staff and systems to make really dramatic changes.
When it comes to approving products like vaccines or antidepressants, which Kennedy has linked to mass shootings, Kennedy is unlikely to be able to remove existing products. “You can’t revoke an approval just because you don’t like it or you don’t think there was a reasonable basis for it,” says Troy.
“It’s hard to think of any earthquakes that were done there,” Troy said, referring to the FDA under the previous Trump administration. “There’s only a limited amount you can really do,” he adds.
He may try to ban some foods and promote others.
Kennedy said at a virtual event in late October that Trump had promised him he would take control of “public health agencies,” including HHS, CDC, FDA, and NIH. “And then the USDA is also, you know, the key to making America healthier because we have to get off of seed oil and we have to get out of pesticide agriculture,” he added.
He has said that what he would like to see Americans consume more of is raw milk, which proponents say has more nutrients and healthy enzymes because it is unpasteurized. But it’s something that’s often linked to disease outbreaks, including a potentially deadly strain of E. coli, and now it’s even more dangerous because of bird flu outbreaks in dairy cows. . The New York Times.
But Cue says it’s “less clear” what Kennedy wants to do in the food sector. “He certainly has some interest in trying to get people to eat a healthier diet, and that might involve moving away from certain additives in foods and trying to change the way people eat,” he said. say “These government recommendations have some effect, but there are still people who eat whatever they want, regardless of what the government recommends.”
Even if Kennedy was appointed secretary of agriculture, Ku says it’s a “divisive” role. “On the one hand, that person has a duty to support agriculture and the food industry in general. On the other hand, they have to support the dietary habits of Americans, such as school meal programs,” he says. Ku cites the example of encouraging Americans to eat more plant-based foods, which can upset producers. “And they’re a big part of the Department of Agriculture,” says Ku. “Some of these things are a little harsh.”
Overall, Kaminsky says it will be a “challenge” to keep Kennedy in a position of power at the federal health agency. “Science and facts are under attack,” he says. “We need to develop science and data that will guide policy in the future.”
But while Keough says it’s “reasonable to be concerned” about a future with Kennedy in charge of the health agency, he stresses that the medical and scientific community should keep talking if the proposed policies are without merit. will
They also emphasize that the government has a system of checks and balances for a reason. “It’s not like if RFK Jr. was appointed to a high office, he could wave his magic wand and change policy,” he says. Even Trump couldn’t do that when he was president.
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