President-elect Donald Trump candidacy Robert F. Kennedy Jr.’s tenure as head of the Department of Health and Human Services (HHS) has a lot going for it crying and grinding teeth in suburban Atlanta and Maryland. From where? Because Centers for Disease Control and PreventionThe Food and Drug Administration and the National Institutes of Health are headquartered in these locations. RFK Jr. as HHS secretary. would be able to shape the priorities of these institutions.

In fact, the CDC, FDA, and NIH have long needed radical reform. So is putting RFK Jr. in charge of HHS the right way to fix these dysfunctional public health agencies?

First, let’s take a quick look at what’s wrong with each agency. timid bureaucrats at FDA suppress medical innovation to damage patient health. These regulatory deficiencies eliminate agency and adoption competitive systems To ensure the safety and effectiveness of medical treatments and diagnoses.

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 acting too much. risk averse When it comes to choosing which research projects to fund. “NIH’s exurban research is systematically biased in favor of conservative research.” concluded 2022 Urgent Initiatives Analysis of the agency’s research grant process. “NIH may be hindering progress in bioscience despite the massive funds it distributes, because its sheer hegemony directs the entire industry by setting standards for scientific work and priorities.”

As the federal agency whose primary mission is to detect and manage public health responses to infectious diseases, the CDC is entirely defective During the COVID-19 pandemic. distracted by the fight against “epidemics” obesity, smokeAnd violenceIt largely failed its response to a real epidemic when it hit.

Well RFK Jr. What does it plan to do with each agency? Like all politicians, RFK Jr. He also shapes his words according to his audience, but here are some of his statements about how he plans to manage these three institutions.

In 2017, RFK Jr. met with then-President Trump about establishing a vaccine safety review commission. during a Science interviewed about the prospective commission, declared The CDC said “many of the most serious problems in the vaccine program are central to two divisions at the CDC: the Advisory Committee on Immunization Practices and the Office of Immunization Safety, which houses scientists.”

during a NBC News interview, RFK Jr. It was claimed that: “I’m not going to take away anyone’s vaccines. If vaccines work for someone, I’m not going to take them away. People should have (a) choice, and that choice should be made with the best information.”

Staying informed with the best information is definitely the right goal. However, RFK Jr. long history His anti-vaccine agitation shows that he is not the best source of information on the safety and effectiveness of modern vaccines. This includes false claims that it is caused by vaccines. autism; Them not tested using placebo controlled essays; and, contradicting the previous claim, COVID-19 vaccines killed more people than placebo.

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

“The FDA’s war on public health is about to end. It’s banning psychedelics, peptides, stem cells, raw milk, hyperbaric treatments, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunlight, exercise, nutraceuticals, and everything else.” “It involves aggressively suppressing something that improves human health and cannot be patented by Pharma,” he said. sent In October at X. “If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Protect your records and 2. Pack your bags.”

First, there is nothing on the list that a libertarian would prohibit, but you do so at your own risk. But in August, the FDA rejected Approving the use of psychedelic MDMA to treat post-traumatic stress disorder. FDA also has a role When deciding which one? controlled substances It should fall under the jurisdiction of the Drug Enforcement Administration. As president in 2023, RFK Jr. said: legalize psychedelics and when regulating and taxing access to cannabis.

By peptides, RFK Jr. probably refers to growth hormones and steroids to new semaglutides that successfully treat diabetes and obesity. Interestingly, semaglutides appear to be peptides. belittles. While some stem cell treatments show promiseMost have not undergone clinical trials for safety and effectiveness. Pasteurized milk is public health victorybut if you want to avoid various foodborne risks diseasesput yourself out there.

Four years into the post-COVID era, most studies have found that ivermectin and hydroxychloroquine provide: There is no treatment benefit for those infected. in April, Journal of Infection published a report on a randomized controlled trial. concluded“Ivermectin for COVID-19 is unlikely to provide clinically meaningful improvement in recovery, hospitalization, or long-term outcomes.” The FDA mostly does not regulate vitamins, clean foods, sunlight, exercise, or nutraceuticals.

The fundamental reform the FDA needs is to get out of the way by speeding up drug and treatment approval processes. Given his deep skepticism of the modern pharmaceutical research and development enterprise, RFK Jr.’s demands for more safety testing and opposition to FDA user fees further raise the stakes delays providing new treatments to patients.

“In my first week, I’m going to go to NIH and I’m going to call all the department heads and I’m going to call all the bureau chiefs and I’m going to say, ‘We’re going to take a break from drug development and infectious diseases for about eight years, take a break, and we’re going to study chronic diseases,'” he said. in question before suspending his presidential campaign.

An eight-year pause in drug development and infectious diseases seems inadvisable. Ultimately the death rate cancer It has continued to decline from 2016 to the present, partly as a result of lower incidence resulting from lifestyle changes, but also as a result of better and more widely available pharmaceutical treatments. Latest calculations show the value of drugs to patients outweigh profits made by pharmaceutical companies. And as always, infectious diseases hide waiting for us in the background lower our guards or wanted the right mutation to allow them to mix with the human population.

RFK Jr. that the incidence is correct chronic diseases It’s on the rise among Americans. 2023 analysis of chronic disease trends noted“Cardiometabolic causes of multiple diseases were quite common, particularly obesity, hyperlipidemia, hypertension, and diabetes.” In other words, much of the increase in chronic diseases is linked to the increase in obesity. Another study just this week Lancet reported It turns out that almost three-quarters of adults in the US are overweight or obese. As a result, the incidence of Type 2 diabetes has doubled in the last 20 years.

RFK Jr.’s solution to stem the tide of chronic disease: better diets And physical fitness. History shows that government interventions will have little impact on either. After all, the federal government periodically publishes nutrition rules Since 1979 and promotion physical fitness Since 1956. Lancet The authors agree with RFK Jr.’s wishes, but suggest that in the meantime, “regulations must be put in place to eliminate barriers to accessing next-generation obesity clinical treatments, ensuring the availability and affordability of these options for the broader population.”

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

Michael Cannon, Director of Health Policy Studies at the Cato Institute, who reviewed Trump’s announcement of RFK Jr.’s HHS nomination, shared the following on X: amounts “a call for more regulation. To enable the government to make even more decisions about our health decisions.”

The FDA needs regulation to accelerate biomedical innovation, the NIH needs to take more risks in research, and the CDC needs to be laser-focused on infectious disease prevention. None of this seems likely to be high on the potential secretary of Health and Human Services’ agenda.