That of President-elect Donald Trump appointment of Robert F. Kennedy Jr. as head of the Department of Health and Human Services (HHS) provokes a lot moaning and gnashing of teeth in Atlanta and suburban Maryland. For what? Because the Centers for Disease Control and Preventionthe Food and Drug Administration and the National Institutes of Health are headquartered in these locations. As HHS secretary, RFK Jr. would be able to set the priorities of these agencies.

In fact, the CDC, FDA, and NIH have long been in need of drastic reform. But is putting RFK Jr. in charge of HHS the right way to address these dysfunctions in public health agencies?

First, let’s take a quick look at what’s wrong with each agency. THE timid bureaucrats at the FDA suffocate medical innovation At detriment of patient health. These regulatory gaps have prompted calls to abolish agency and adoption competitive systems to ensure the safety and effectiveness of medical treatments and diagnostics.

The NIH is the world’s largest public funder of biomedical and public health research, with a budget of $47 billion, most of which is used to support research at universities and academic medical centers. The agency has long been criticized for being too risk aversion when it comes to choosing which research projects to fund. “NIH extramural research is systematically biased toward conservative research,” concluded a 2022 Emerging companies analysis of the agency’s research grant process. “The NIH could cripple progress in the biosciences, despite the enormous amount of funds it distributes, because its sheer hegemony directs the entire industry in setting standards for scientific work and priorities.”

The CDC, as a federal agency whose primary mission is to detect and manage public health responses to infectious diseases, failed during the COVID-19 pandemic. Distracted by the fight against “epidemics” of obesity, smokingAnd violencehe massively botched his response to a real epidemic when it hit.

So what does RFK Jr. plan to do with each agency? Like all politicians, RFK Jr. tailors his remarks to his audience, but here are some of his statements regarding how he plans to manage these three agencies.

In 2017, RFK Jr. spoke with then-President Trump about creating a vaccine safety review commission. During a Science interview on the future commission, he declared that the CDC “is the home of many of the most serious problems with the immunization program, the two divisions of the CDC: the Advisory Committee on Immunization Practices and the Office of Immunization Safety, where the scientists are located “.

During a NBC News interview, RFK Jr. stated: “I’m not going to take vaccines away from anyone. If vaccines work for someone, I’m not going to take them away. People should have (a) choice, and that choice should be informed by the best information.”

Being informed with the best information is definitely the right goal. But RFK Jr. long story The anti-vaccination agitation suggests that it is not a source of the best information on the safety and effectiveness of modern vaccines. This includes false claims that vaccines cause autism; they are not tested using placebo controlled tests; and contradicting the previous assertion, COVID-19 vaccines killed more people than the placebo.

Again, the CDC needs fixing, but RFK Jr.’s skepticism about the safety and effectiveness of modern vaccines would further undermine what should be the CDC’s primary goal: preventing the spread of disease dangerous infectious diseases.

“The FDA’s war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean food, sunshine, exercise, nutraceuticals and everything else that advances human health and cannot be patented by industry. pharmaceutical,” he said. job the X in October. “If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records and 2. Pack your bags.”

First, there’s nothing on the list that a libertarian would ban, but you take it at your own risk. However, in August, the FDA denied to approve the use of the psychedelic MDMA to treat post-traumatic stress disorder. The FDA also has a role to decide which controlled substances should fall under the jurisdiction of the Drug Enforcement Administration. To his credit, RFK Jr. said in 2023 that as president he legalize psychedelics and marijuana while regulating their access and taxing them.

By peptides, RFK Jr. probably means substances ranging from growth hormones and steroids to new semaglutides which successfully treat diabetes and obesity. Interestingly, semaglutides appear to be peptides that disdains. Although some stem cell therapies show promisemost have not undergone clinical trials for safety and effectiveness. Pasteurized milk is public health triumphbut if you want to risk various foodborne illnesses diseasesknock yourself out.

Four years into the post-COVID era, most research has shown that ivermectin and hydroxychloroquine provide no therapeutic benefit for the infected. In April, the Infection log published a report on a randomized controlled trial that concluded“Ivermectin for COVID-19 is unlikely to provide clinically meaningful improvement in recovery, hospitalizations, or longer-term outcomes.” For the most part, the FDA does not regulate vitamins, clean foods, sunshine, exercise, or nutraceuticals.

The main reform the FDA needs is to speed up its drug and treatment approval processes. Given his deep skepticism of the modern enterprise of pharmaceutical research and development, RFK Jr.’s demands for more safety testing and his opposition to FDA user fees risk even more. delays in provide new treatments to patients.

“I’m going to go to NIH my first week and I’m going to call all the division heads and I’m going to call all the office heads and I’m going to say, ‘We’re going to give drug development and infectious diseases a break – a little break , a little break – for about eight years and we’re going to study chronic diseases,” he said. said before suspending his presidential campaign.

Giving an eight-year break to drug development and infectious diseases does not seem wise. After all, the mortality rate cancer has continued to decline from 2016 to the present, partly due to lower incidence resulting from lifestyle changes, but also from better and more widely available pharmaceutical treatments. Recent calculations show the value of drugs to patients so far take away the profits earned by pharmaceutical companies. And, as always, infectious diseases hide in the background, waiting for us lower our guards or while searching just the right mutation to allow them to launch into the human population.

RFK Jr. is correct that the incidence of chronic diseases among Americans is increasing. A 2023 analysis of chronic disease trends note“Cardiometabolic causes of multimorbidity were highly prevalent, particularly obesity, hyperlipidemia, hypertension and diabetes.” In other words, much of the increase in chronic disease is linked to the increase in obesity. This week again, another study The Lancet reported that nearly three-quarters of American adults are overweight or obese. As a result, the prevalence of type 2 diabetes has doubled over the past 20 years.

RFK Jr.’s solution to stemming the tide of chronic disease is best diets And physical fitness. History suggests that government interventions will have little effect on either. After all, the federal government periodically publishes dietary guidelines since 1979 and promoting physical fitness since 1956. The Lancet The authors agree with RFK Jr.’s aspirations but suggest in the meantime that “regulations must be put in place to remove barriers to access to next-generation clinical treatments for obesity, thereby ensuring availability and the affordability of these options for the general population.”

Let’s hope RFK Jr. doesn’t model his public health efforts to combat chronic disease after those of New York City Health Commissioner Thomas Frieden. “When someone dies at an early age from a preventable cause in New York, it’s my fault,” declared Frieden in 2006. To protect New Yorkers from themselves, he required mandatory electronic reporting of glycosylated hemoglobin A1c values ​​of all diabetics tested by all city laboratories to the Department of Health and Welfare. ‘Mental Hygiene (DOH). Those whose results were too high received notifications and educational materials and were reported to their doctors. Frieden then served as head of the CDC for nearly eight years under President Barack Obama.

Analyzing Trump’s announcement of RFK Jr.’s nomination to HHS, Cato Institute Director of Health Policy Studies Michael Cannon posted on X that he amounts to “a call for more regulation. For the government to make even more decisions in health matters”.

The FDA must be streamlined to accelerate biomedical innovation, the NIH must take more risks in research, and the CDC must focus on preventing infectious diseases. None of these items appear to be at the top of the agenda for a potential new Secretary of Health and Human Services.