Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. wasted no time in launching into an agenda that was widely reported on even before his confirmation hearings, including restoring HHS to evidence-based science and medicine. Those working in the public health arena strongly opposed his nomination, however, fearing his lack of knowledge and experience and his past reliance on conspiracy theories would bring devastating outcomes for the patients, families and communities we serve.
Kennedy has been working at unprecedented speed to decapitate and gut the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), recognized as the premier agencies for biomedical research and the promotion and protection of public health, respectively. Hundreds of the country’s brightest and most-renowned scientists and researchers have been fired or put on leave, disrupting clinical trials that Americans count on to promote health. At the Food and Drug Administration (FDA), Thomas Corry, who handled the agency’s communications, and Peter Marks, the top official who oversaw regulation of vaccines, resigned under pressure when they both refused to advance vaccine misinformation.
Kennedy was confirmed at the onset of the worst measles outbreak in the U.S. in decades, and he has stumbled immediately. His failure to use the platform to promote a national vaccination campaign for the measles, mumps, rubella (MMR) vaccine, that has been established to be among the safest vaccines available, is nothing short of irrational. Currently, there are more than 600 cases reported in this multi-state measles outbreak now occurring in 22 jurisdictions. Sadly, two children and one adult have died.
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We commend Kennedy’s participation in the weekend funeral in Texas for one of the deceased children, surely a comfort to the family, and his belated endorsement of MMR vaccination as the most effective way to prevent the spread of measles. However, on X he took the opportunity to refer to two unorthodox therapies for measles that are unproven treatments for the disease, budesonide and clarithromycin. In addition, just as President Donald Trump encouraged hydroxychloroquine and ivermectin to treat COVID-19, both unproven therapies, Kennedy claims that vitamin A supplementation using cod liver oil will prevent and treat measles despite no scientific basis for this intervention. Some parents are unfortunately heeding his guidance. Pharmacists in Lubbock County, Texas, the epicenter of the epidemic, report that cod liver oil has been “flying off the shelves.” Apparently, the secretary is unaware that vitamin A is fat soluble and not easily excreted, with any excess stored in the liver. The New York Times reported that several children have been hospitalized with liver failure.
Equally disconcerting is that we are hearing from epidemiologists and immunologists like Dr. Michael Mina, whose essay appeared in The New York Times on April 2, theorizing that the U.S. is barreling towards a measles epidemic. Mina supported his warning with data from a 2018 European epidemic. As in our country, in Europe measles was on the road to elimination, but low vaccination rates contributed to more than 80,000 cases, tens of thousands of hospitalizations and more than 70 preventable deaths. Vaccine hesitancy has spiked in our country making this same scenario highly plausible. Optimistically, due to media attention and the increase in cases, some parents in Texas are choosing to vaccinate their children after an initial reluctance to do so.
Secretary Kennedy has long held the belief that vaccines cause autism, even though his own children are fully vaccinated. He refuses to acknowledge that more than 200 studies in 2004 and more than 1,000 studies in 2011 were re-evaluated to thoroughly examine the data on this question. The reviews were conducted by the National Academy of Medicine, an impartial group of the world’s leading experts, and they concluded that there is no evidence for a link between autism and vaccines. In an attempt to revisit this settled issue, Kennedy has assigned a vaccine skeptic, David Geier, to lead a government study of immunizations and autism. Geier has also propagated this long-debunked theory on autism and vaccines, thus we expect that he will enter this endeavor with a pre-determined conclusion. Geier’s research background is limited, but it is notable that he was disciplined for practicing medicine without a license.
Making good on his promise to “give infectious disease a break for about eight years,” Kennedy began his tenure by firing more than 1,000 workers at the National Institute of Health (NIH). More than 1,000 clinical trials have come to a halt across the country and world, ranging from cardiovascular disease treatment to HIV prevention, to childhood and adult cancer treatment. Also on the chopping block were 40 grants focused on vaccine hesitancy and ways to increase vaccine acceptance. According to their memo, the NIH said these no longer align with agency priorities.
Prevention is a big part of Kennedy’s platform, and we would not argue that it is crucial when tackling chronic disease. Chronic diseases are the leading causes of death and disability, costing $4.5 trillion in annual health care expenditures. The United States lags behind other high-income countries in average life expectancy, with heart disease, stroke, lung diseases, and cancer shortening millions of lives per year. However, the presumption that HHS has neglected evidence-based policies and failed to address the “epidemic” of chronic disease is flawed. Additionally, decreasing the workforce of the HHS by another 10,000 full-time specialized workers will not “Make America Healthy Again.”
If we want real change in America’s health, we must invest in the people who make it possible. A healthier future depends on a public health workforce that is prepared, trained, and empowered—not just to respond to crises, but to lead lasting change. It’s time to build the systems, not cut them and the support that let public health professionals do what they do best: create the conditions where everyone, everywhere, has a real chance to be healthy.
Dr. Timothy Holtz is a professor at the Milken Institute School of Public Health at George Washington University.
Teri Mills, MSN, RN Emeritus, Adult Nurse Practitioner (retired) is the Former president of the National Nursing Network Organization.
The views expressed in this article are the writer’s own.