President-elect Donald Trump appointment of Robert F. Kennedy Jr. to lead the Department of Health and Human Services (HHS) causes many wailing and gnashing of teeth in Atlanta and suburban Maryland. Why? Because Centers for Disease Control and PreventionThe Food and Drug Administration and the National Institutes of Health are based in those places. As HHS secretary, RFK Jr. could shape the priorities of these agencies.

In fact, the CDC, FDA, and NIH are long overdue for drastic reforms. But 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. The shy bureaucrats to the FDA choke medical innovation TO to the detriment of the patient’s health. These regulatory shortcomings have prompted calls for abolition agency and adoption competitive systems to ensure the safety and effectiveness of medical treatments and diagnoses.

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 as well risk aversion when it comes to choosing which research projects to fund. “NIH extramural research is systematically biased in favor of conservative research,” concluded a 2022 Emerging venturi analysis of the agency’s research grant process. “The NIH can affect the progress of bioscience, despite the huge amount of funding it distributes, because its total hegemony drives the entire industry by setting the standards for scientific activity and priorities.”

CDC, as the federal agency whose primary task is to detect and manage public health responses to infectious diseases, fully failed during the COVID-19 pandemic. Distracted from fighting “epidemics” of obesity, smokingand violencemassively 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 on how he plans to handle these three agencies.

In 2017, RFK Jr. discussed with then-President Trump the creation of a vaccine safety review panel. During a Science interview about the future commission, he declared that CDC “is home to most of the worst problems with the vaccination program, the two divisions at CDC: the Advisory Committee on Immunization Practices and the Office of Immunization Safety, which is where the scientists are.”

During a NBC News interview, RFK Jr. stated: “I will not take anyone’s vaccines. If vaccines work for someone, I won’t take them. 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 the RFK Jr long history of anti-vaccination agitation suggests that it is not a source of the best information for the safety and efficacy of modern vaccines. This includes false claims that vaccines cause autism; them they are not tested USING placebo controlled test; and contradicting the previous statement, the COVID-19 vaccines killed more people than placebo.

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

“The FDA’s war on public health is about to end. This includes aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sun, exercise, nutraceuticals, and everything in between. which promotes human health and cannot be patented by Pharma,” he POSTED on X in October. “If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Keep your records and 2. Pack your bags.”

First, there is nothing on the list that a libertarian would ban, but you take them at your own risk. However, the FDA in August DENIED to approve the use of the psychedelic MDMA to treat post-traumatic stress disorder. The FDA also has a role in deciding 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 would legalize psychedelic and marijuana while regulating access and taxing them.

By peptides, RFK Jr. likely means substances ranging from growth hormones and steroids to the new semaglutides that successfully treat diabetes and obesity. Interestingly, semaglutides appear to be peptides that he despise. While 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 food DISEASESremove yourself

Four years into the post-COVID era, most research has found that ivermectin and hydroxychloroquine provide no treatment benefit for the infected. In April, The Journal of Infection published a report on a randomized controlled trial that concluded“Ivermectin for COVID-19 is unlikely to provide clinically meaningful improvements in recovery, hospital admissions, or longer-term outcomes.” For the most part, the FDA does not regulate vitamins, clean foods, sunlight, exercise, or nutraceuticals.

The main reform the FDA needs is to get out of the way by speeding up drug and treatment approval processes. Given his deep skepticism about the modern pharmaceutical R&D enterprise, RFK Jr.’s calls for more safety testing and his opposition to FDA user fees risk even more. delays in receiving new treatments for patients.

“I’m going to go to NIH in 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 take a break from drug development and infectious disease development — a little break, a little break – for about eight years and we will study chronic diseases,” he said before suspending his presidential campaign.

Giving drug and infectious disease development an eight-year hiatus seems inadvisable. After all, the death rate for cancer has continued to decline from 2016 to the present, partly as a result of lower incidence resulting from lifestyle changes, but also better and more widely available pharmaceutical treatments. Recent calculations show the value of medicines for patients far away EXCEEDING the profits that drug companies make. And, as always, infectious diseases watch in the background waiting for us to below our guards or SEEKING just the right mutation to allow them to enter the human population.

RFK Jr. is right that incidence chronic diseases among Americans was on the rise. A 2023 analysis of chronic disease trends RECORDED“Cardiometabolic causes of multimorbidity were highly prevalent, particularly obesity, hyperlipidemia, hypertension, and diabetes.” In other words, a good part of the increase in chronic diseases is related to the increase in obesity. Just this week, another study in The Lancet reported that nearly three-quarters of US 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 stem the tide of chronic disease is better diets and physical condition. History suggests that government interventions will have little effect on either. After all, the federal government periodically issued food guides since 1979 and promoting physical condition 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 obesity treatments, ensuring the availability and accessibility of these options to the wider population.”

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

Reviewing Trump’s announcement of RFK Jr.’s HHS nomination, Cato Institute director of health policy studies Michael Cannon posted on X that amounts to “a call for more regulation. For the government to make even more of our health decisions.”

The FDA needs streamlining to accelerate biomedical innovation, the NIH needs greater risk-taking in research, and the CDC needs to focus on preventing infectious diseases. None of that seems to be at the top of the agenda for the possible next Secretary of Health and Human Services.