Robert F. Kennedy Jr. endorsed former President Donald J. Trump after ending his own independent presidential campaign.
Credit...Hiroko Masuike/The New York Times

Robert F. Kennedy Jr., Foe of Drug Makers and Regulators, Is Poised to Wield New Power

President-elect Donald Trump has encouraged him to “go wild on health” but has not made clear what role Mr. Kennedy will play.

by · NY Times

When 12,000 public health professionals gathered in Minneapolis last week for the annual meeting of the American Public Health Association, Dr. Jerome Adams, who served as surgeon general in the first administration of President-elect Donald J. Trump, issued a pointed warning about Robert F. Kennedy Jr.

“If R.F.K. has a significant influence on the next administration, that could further erode people’s willingness to get up to date with recommended vaccines,” Dr. Adams said. “I am worried about the impact that could have on our nation’s health, on our nation’s economy, on our global security.”

Now, Mr. Kennedy, a vocal skeptic of vaccines, is in a position to have significant influence, and over a broad range of policy. Mr. Trump’s sweeping electoral victory, with Mr. Kennedy at his side, is — in the eyes of their supporters — not only a mandate but also a repudiation of the public health establishment that has long kept Mr. Kennedy at bay.

As an independent presidential candidate and as a surrogate for Mr. Trump, Mr. Kennedy pledged to upend the nation’s agriculture system and public health bureaucracy, effectively gutting whole swaths of the regulatory state, under the rubric of rooting out “cronyism” and corruption.

After Mr. Trump was first elected in 2016, Mr. Kennedy told reporters that Mr. Trump promised to let him chair a vaccine commission, but it never came to pass. Now, Mr. Kennedy has a much stronger hand, having rallied his followers behind Mr. Trump. The president-elect has indicated that Mr. Kennedy will play a role in his new administration and recently said he would let Mr. Kennedy “go wild on health,” but he has not been specific about what that means.

Some have speculated that Mr. Trump will make him a “health czar” inside the White House, to guide the president on public health matters; a person familiar with the transition said Mr. Kennedy was at Mar-a-Lago on Wednesday and spoke with Trump insiders about the public health agenda.

Mr. Kennedy’s worldview is embodied in two of his most frequent refrains: “There is nothing more profitable for much of the health care system than a sick child” and “Public health agencies have become sock puppets for the industries they are supposed to regulate.”

Now that Republicans will control the Senate, Mr. Kennedy could theoretically win confirmation for any one of a number of top health jobs: secretary of Health and Human Services, commissioner of the Food and Drug Administration or director of the Centers for Disease Control and Prevention.

“There is a real mandate victory here, with many millions of people who are first-time Trump voters,” said Calley Means, a health care entrepreneur who has been an adviser to Mr. Kennedy and who was instrumental in connecting him to Mr. Trump. “It is a true mandate to take on broken health care institutions, and to deliver the change.”

Mr. Kennedy did not respond to requests for comment. In an interview with NPR on Wednesday, he said his role in the new administration had not yet been decided. But he said Mr. Trump had given him three instructions: to rid regulatory agencies of “the corruption and the conflicts,” to “return the agencies to the gold standard” of “empirically based, evidence-based science and medicine” and to “end the chronic disease epidemic with measurable impacts” within two years.

As for vaccines, he said, “We are not going to take vaccines away from anybody.” He said he wanted Americans to be able to make “informed choices” about vaccination — an idea that worries public health experts, who say that school vaccination requirements are especially important because vaccines are most effective in slowing the spread of infectious disease when entire communities are vaccinated.

As a presidential candidate, Mr. Kennedy moved away from his focus on vaccines to a broader theme: Americans, he argued, are suffering from an epidemic of chronic disease. And when he aligned himself with Mr. Trump, that theme got a name: “Make America Healthy Again.” It quickly caught on.

Today, he is the undisputed leader of a burgeoning “medical freedom” movement that marries fierce resistance to public health measures and deep suspicion of industry with an embrace of alternative medicine and natural foods. In a recent opinion essay in The Wall Street Journal, Mr. Kennedy called for half of the budget of the National Institutes of Health to be devoted to “preventive, alternative and holistic approaches to health.”

As a candidate for president, he vowed to prosecute the N.I.H.’s most prominent alumnus, Dr. Anthony S. Fauci, “if crimes were committed.” Dr. Fauci, who retired as the director of the National Institute of Allergy and Infectious Diseases in 2022, declined to comment on Wednesday.

Mr. Kennedy, an environmental lawyer and a scion of one of America’s most storied Democratic families, has no medical or public health degree. His work on the environment, and in particular mercury in waterways, led him to question the safety of vaccines, some of which contained a mercury-based preservative, thimerosal, until manufacturers removed it in 2001 at the C.D.C.’s urging.

Like Mr. Trump, Mr. Kennedy has in the past blamed childhood vaccines for autism — a discredited theory that has been repudiated by more than a dozen peer-reviewed scientific studies in multiple countries. He has decried childhood vaccination schedules and coronavirus vaccine mandates as government overreach and as a way to enrich drug makers.

He forecast his plans for the F.D.A. on social media two weeks ago.

“FDA’s war on public health is about to end,” Mr. Kennedy wrote. “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. 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.”

Experts in public health fear that even if Mr. Kennedy is not appointed to run a specific agency, his public assault on vaccines will depress vaccination rates.

Mr. Kennedy has also pledged that Mr. Trump will press to eliminate fluoride from the water supply, a promise Mr. Kennedy reiterated on NPR on Wednesday. Along with vaccines, the C.D.C. lists fluoridation, which prevents tooth decay, as one of the “10 great public health achievements” of the 20th century.

“I think it’s fair to say we’re in uncharted territory,” said Michael T. Osterholm, who directs the Center for Infectious Disease Research and Policy at the University of Minnesota and has advised presidents of both parties dating back to Ronald Reagan. “In my 50 years in the business, I never had to encounter, even in the first Trump administration, a callous disregard for science and facts.”

The C.D.C. is already recording what its experts view as a worrisome dip in measles vaccinations. There have been 13 measles outbreaks so far in 2024, compared with four in 2023, endangering those with immune disorders and those who cannot be vaccinated for medical reasons. And Mr. Kennedy is not the only leader raising doubts.

In Florida, Dr. Joseph Ladapo, the state’s surgeon general, has repeatedly contradicted the C.D.C.’s advice on vaccination. During a recent measles outbreak, Dr. Ladapo left it up to parents to decide whether to send their children to school, even if the children were unvaccinated.

Dr. Ladapo also recently advised Floridians to avoid mRNA vaccines for Covid-19, claiming — without evidence — that they posed an “unknown risk of potential adverse impacts.” Dr. Ladapo has been mentioned for a possible role in the second Trump administration, according to a person briefed on the discussions. Other people under consideration, this person said, include Jay Bhattacharya, a Stanford University economist and expert in health policy, and Dr. Martin Makary, a surgeon and professor at the Johns Hopkins University School of Medicine. Their opposition to lockdowns during the coronavirus pandemic came under attack from public health experts.

Mr. Kennedy has also taken aim at the food and agriculture industries. In his essay for The Wall Street Journal, he laid out proposals for a second Trump administration that included scaling back pesticide use and reforming subsidies that make corn and soybeans artificially cheap.

And he called on Mr. Trump to “stop allowing beneficiaries of the Supplemental Nutrition Assistance Program to use their food stamps to buy soda or processed foods.” Last year, about 42 million Americans received SNAP benefits each month, federal data shows.

Sid Miller, the Texas commissioner of agriculture, who has been part of Mr. Trump’s transition team — in particular, helping to select the leadership of the U.S. Department of Agriculture — said in an interview on Wednesday that he had asked potential candidates: “Can you work with Robert F. Kennedy Jr. to make America healthy again?”

Mr. Miller and Mr. Kennedy share some goals that would not be out of place in a liberal administration — for example, getting processed foods out of school cafeterias in favor of organic produce.

“This shouldn’t be a partisan issue,” Mr. Miller said. “Who doesn’t want healthy children?” But he acknowledged that getting some measures past the food lobby might be a “tough fight.” Mr. Kennedy also appears to have endorsed a proposal to abandon the current insurance-based system of health coverage in favor of individual health savings accounts — a plan that Republicans have proposed as an alternative to the program popularly known as Obamacare.

When Representative Chip Roy, Republican of Texas, proposed the idea on Monday as part of an opinion essay in The Hill, Mr. Kennedy wrote on social media that Mr. Roy “hits the nail squarely on the head.”

Dr. Thomas Frieden, the director of the C.D.C. under Barack Obama, wrote in a recent opinion essay that Mr. Kennedy was right to focus on chronic disease, environmental risks and dangerous and inappropriate corporate influence on health decisions. He suggested evidence-based policies to attack those problems, including “comprehensive tobacco and alcohol control policies” and taxes on sugary sodas.

But Dr. Frieden also wrote that Mr. Kennedy had “repeatedly spread falsehoods” about vaccines.

It remains to be seen how Mr. Kennedy’s stated goal of rooting out conflicts of interest in the federal government — such as getting pharmaceutical and agricultural interests out of federal policymaking — will jibe with Mr. Trump, whose first administration was stocked with executives from major industries.

Steven Brozak, the president of WBB Securities, a Wall Street investment firm that specializes in health care, said Mr. Kennedy had “put his thumb on the pulse of the dissatisfaction Americans feel with their health care,” and now had a “golden opportunity” to steer drug makers toward a path of more innovation.

“Every single large pharma company, large biotech company is beating a path to his door — they’re trying to figure him out,” said Dr. Brozak. “In this time of uncertainty, he can actually go out there and achieve more in challenging the system than anyone else has ever done in health care.”

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