RFK, Jr. at HHS

An unserious man would be a figurehead a HHS, giving industry free rein to further reduce regulations that ensure our food is safe and new drugs and devices are effective.

Given what Robert F. Kennedy, Jr. said while campaigning for Donald Trump, who nominated him to head the Health and Human Services Department today, here’s what he might declare on “day one.”

1. He’d order the Centers for Disease Control and Prevention to withdraw every one of its vaccine recommendations since vaccines “are known” to cause autism in children.

The idiocy of the claim aside, would it change a thing? That would be up to 50 state legislatures and public health departments, who hold the power to use (or not) CDC recommendations. Ditto for withdrawing fluoride from the water supply. Watch what the states do, not what Kennedy and whomever Trump appoints to head the CDC says.

2. He’d order the head of the Food and Drug Administration to abolish its nutrition department, which employs about 8,000 people in its recently reorganized Human Food Program.

That would require an act of Congress, which is possible given its current make-up. However, the GOP would then be responsible for abolishing federal efforts to protect Americans from foodborne illnesses; ensure the accuracy of food labels; promote healthier food options (which Kennedy claims to want); educate consumers about diets that promote disease (excess sugar and salt in processed and restaurant foods being high on the list); and oversee the safety and nutritional content of “critical foods” like infant formula.

3. He would order the FDA’s drug and biologics divisions to back off policing sale of drugs, therapies and supplements whose makers falsely claim they are safe and effective.

Here’s what he tweeted on October 25th: “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 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.”

Such an order would be against the law. When it comes to drugs, biologics, and medical devices, the nation’s food and drug laws clearly state the agency must first evaluate the safety and efficacy of such products before they are let loose on the market. Industry wants that imprimatur. How else to convince the nation’s physicians to prescribe?

Neutraceuticals already have a free pass thanks to the late Republican Senator Orrin Hatch of Utah, who was the chief architect of the 1994 Dietary Supplement and Health Education Act. That law mandates the FDA treat dietary supplements like food and allows their makers to make amorphous health claims that have no scientific backing.

As for clean foods, sunshine and exercise, I wish the agency would do more to promote these proven approaches to better health (wear sunscreen). But, as I noted above, his plan (to the extent you can call a tweet a plan) is to put an end to the department in charge of promoting those activities.

4. Finally, he’d order the National Institutes of Health to spend half of its $47 billion budget on studying alternative medicines and therapies.

The budget for the NIH's alternative medicines program, officially called the National Center for Complementary and Integrative Health (NCCIH), stood at $170.3 million in 2023, or about three-tenths of one percent of the total budget. Moving that up to half would require cutting the budgets of every other research institute (there are 22 at the agency) in half.

Or, it would dramatically change the priorities of half the nation’s researchers who are funded by those other institutes. About 90% of the NIH budget is spent on “extramural” grants to major universities, non-profit research institutes or researchers pursuing opportunities identified by patient advocacy groups like the American Cancer Society, the American Heart Association and the American Diabetes Association.

Those scientists’ science-based research budgets would be cut in half. The peer-review panels that approve research would have their hands tied or would be directed to fund studies of, say, using hydroxychloroquine and ivermectin to cure COVID (which along with bleach were Trump’s preferred cures during his last year in office).

In other words, the research system that generates virtually all the basic and early-stage applied science that goes into developing new drugs and biologics, a research system that is the envy of the world, would be left in shambles. Industry, bereft of the new insights that can lead to breakthrough therapies, will be encouraged to do what it already does way too much of: focus on research that a) extends patent life; b) encourages off-label prescribing with little evidence of efficacy; and c) duplicates existing drugs (so-called me-too drugs). NIH would become an innovation desert.

Kennedy as smokescreen

The brutalist Hubert H. Humphrey Building in Washington, D.C., home to the Health & Human Services Department.

The New York Times, in its flash report on Trump naming his HHS designee, pointed out Kennedy has no medical or public health degree. That’s irrelevant. Neither did the four previous HHS heads: Kathleen Sebelius, Sylvia Matthews Burwell, Alex Azar and Xavier Becerra, three of whom, like Kennedy, were lawyers. (Burwell had two bachelor’s degrees.)

No, the reality in the diarrhea that came out in Kennedy’s tweets during the campaign is that he has no chance of enacting nine-tenths of what he talked about. The drug, biotech and medical device industries, the food processing industries, the patient advocacy groups (most of them already in bed with the pharmaceutical industry), and the nation’s research universities — plus all the politicians in whose districts these major players reside (the FDA regulates 78% of the nation’s food supply and 20% of every dollar consumers spend) — will make sure none of his more ridiculous claims come to pass.

What those industries want, and what they’ll get should Kennedy be approved by the Senate, is a figurehead at HHS mouthing idiocies, while Trump has a free hand to appoint experts recommended by the special interests to key positions at the FDA, CDC, NIH and other agencies. Their goal will be to further reduce regulations already under assault by industry lobbyists.

Trump will also order Kennedy to install people with a Christian Nationalist agenda to agencies that affect women’s access to abortion and birth control. That’s his base. That’s what the GOP wants. And that is what they’ll get with a non-entity like Kennedy in charge.