How could the accession of RFK Jr. impact public health?
It’s a historic first: A direct scion of the Kennedy clan could serve as a cabinet member in a Republican administration. On Thursday, President-elect Donald Trump announced that Robert F. Kennedy Jr., a one-time Democratic candidate for president, would be his nominee for secretary of the Department of Health and Human Services (HHS).
RFK Jr. is, to put it mildly, a controversial selection. Long associated with the quackery of the anti-vax movement, the son of Robert F. Kennedy Sr. was a bit of a black sheep even before he hopped aboard the Trump train following his exit from the 2024 presidential race. And his possible accession could be disastrous for a public health system already wrought with institutional decline.
“The U.S. public health system is a critical driver of progress in improving the nation’s health, from reducing infant mortality and controlling infectious diseases to increasing life expectancy and promoting healthier lifestyles,” a recent report by the nonprofit Trust for America’s Health found.
“However, for decades, chronic underfunding has limited the system’s capacity
to fully address the complex health challenges facing the nation today.”
Kennedy’s track record as a public health “advocate” would suggest he’s not up for the task outlined above. Take his venture to Samoa in 2019, wherein an improperly administered measles vaccine tragically killed two children. The projected HHS secretary pounced on the opportunity and used his non-profit Children’s Health Defense — which traffics vaccine pseudoscience — to exploit the tragedy. His visit to the small island nation was detrimental in undermining trust in the public health system, and soon large swaths of parents were declining to vaccinate their kids. This resulted in a measles outbreak which would go on to take some 83 lives, many of them children.
“They amplified the fear and mistrust, which resulted in the amplification of the epidemic and an increased number of children dying. Children were being brought for care too late,” Helen Petousis-Harris, a vaccinologist, later said to the Associated Press.
This is to say nothing of his other confounding assertions, like that the herbicide atrazine is responsible for gender dysphoria and that psychiatric medication is linked to mass shootings.
And while the federal systems that govern public health will not allow Kennedy to act in a carte blanche fashion, he’ll have plenty of tools at his disposal to pave the way for his idiosyncratic ideology. For example, because HHS oversees Medicare and Medicaid, the secretary nominee could use his power to influence vaccine requirements.
“In both programs, the amount of money disbursed by the federal government is in part determined by how good of a job the states and private insurers do in vaccinating children and older adults enrolled in these programs. Kennedy could pressure the [Centers for Medicare & Medicaid Services] administrator to eliminate that vaccination requirement…,” a recent piece in Vox explained.
And according to Howard Lutnick, a co-chair of Trump’s transition team, Kennedy is deeply invested in accessing federal data so he can demonstrate the supposedly “harmful” effects of vaccination.
“He says, if you give me the data, all I want is the data and I’ll take on the data and show that it’s not safe. And then if you pull the product liability, the companies will yank these vaccines right off of the market. So that’s his point,” Lutnick said.
But the most damaging impact may come from Kennedy’s boss. During his first term, Trump flirted with imposing austerity measures on the National Institute of Health. Should he follow through on that, federal infrastructure for disease prevention would be in dire straights.
"Why would you want to dismantle an institute that is the leading research institute in the world?" one scientific researcher told NPR. “It would be like saying, 'Let's undo our national defense and block grant it.' There's no reason to take a successful institution and dismantle it."