In March 2022, when President Joe Biden needed a COVID-19 response coordinator to help lead the largest vaccination campaign in American history, he tapped a blue chip public health expert: Dr. Ashish Jha. Jha had spent years ascending the summits of evidence-based medicine. He attended Harvard medical school, worked as a practicing physician, and served as the faculty director of the Harvard Global Health Institute. Today, he’s the dean of Brown University’s School of Public Health.
That’s the kind of résumé that has traditionally led to a major federal appointment. Now, however, a different kind of credentialism is taking hold as the incoming Trump administration develops its transition plans to govern American medicine and public health. The new must-haves are: a disdain for the medical establishment, vaccine skepticism, personal branding skills, and—above all—loyalty to the MAGA cause and its standard-bearers.
On Thursday, Donald Trump announced his intention to appoint Robert F. Kennedy Jr. as secretary of Health and Human Services, overseeing a vast public-health bureaucracy that encompasses the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institutes of Health.
As Trump’s friend and political ally, RFK Jr.’s sway could extend even beyond the department he’ll oversee (if he can get past the Senate). Five sources involved in the transition discussion told VF that Kennedy had previously been in talks to take on a White House health czar role overseeing not just HHS but the United States Department of Agriculture and the Environmental Protection Agency as well.
Sid Miller, the current Texas agriculture commissioner, who is helping the Trump team vet USDA candidates, and has been mentioned as a possible USDA secretary, described his interviewing approach to Vanity Fair. “First thing, I ask them: ‘Are you 110% behind Donald Trump? The second question is: ‘Do you think you could work with Bobby Kennedy and his plan to Make America Healthy Again?’”
In RFK Jr.’s telling, he would battle chronic disease in America by breaking the stranglehold of the processed food lobby, exposing the flaws in vaccine science, and moving forcefully to “clear out corruption” at America’s health agencies, which could involve eliminating entire departments.
Under a MAHA banner of radical reform, he says, he would empower Americans to make their own health decisions, among them whether to vaccinate their children. For years, Kennedy’s organization, Children’s Health Defense, has made spurious claims suggesting that certain ingredients in vaccines can cause autism and other harms. He has inveighed against legal protections for vaccine makers, viewed as essential to continued manufacturing and development of new vaccines. He has linked the rise in school shootings to the increased use of antidepressants, and stated that COVID-19 may have been engineered to minimize harm to Chinese people and Ashkenazi Jews.
Dr. Gregory Poland, trade editor of the journal Vaccine and president of the Atria Academy of Science and Medicine, says that Kennedy’s “untrue” claims and fire-all-the-experts approach puts at risk “the health, the welfare of an entire population.”
Faced with what could be a radical transformation or even a dismantling of the federal public-health apparatus, some observers are cautiously optimistic that cooler heads will prevail. “Campaign rhetoric is different from governing,” says Richard Besser, CEO of the Robert Wood Johnson Foundation, who served as acting director of the CDC in the early days of Barack Obama’s presidency. “I am on the side of wanting to see what the administration does, now that it is going to be in charge.” He added, “I would be very surprised if the federal government took a stand that led to increased spread of infectious diseases in our country.”
Others are far less sanguine. “My fear is that children and the public will be harmed by an assault on science,” says Sean O’Leary, chair of the committee on infectious diseases for the American Academy of Pediatrics. If vaccination rates decline, “We will see more measles, more pertussis,” also known as whooping cough. “We will have preventable deaths based on politics and misinformation.”
