With President-elect Donald Trump’s selection of Robert F. Kennedy Jr. as his nominee to lead the Department of Health and Human Services, many public health leaders are expressing fears that the nation’s top health agencies will be weakened at a time when the country faces growing threats from infectious diseases, lobbyists from industry encourage and the dangerous consequences of medical misinformation.

If confirmed as HHS secretary, Kennedy — a supporter of fringe medical conspiracies and a self-described “poster child for the anti-vax movement” — would have oversight of agencies including the Centers for Disease Control and Prevention, the Food and Drug Administration, the Centers for Medicare and Medicaid Services, and the National Institutes of Health.

Like the two most recently confirmed HHS secretaries, Xavier Becerra and Alex Azar, Kennedy is a lawyer with no formal scientific or medical credentials. His purview would include programs and departments he has fiercely criticized in the past, often in ways opponents say misrepresent or ignore the facts and misinterpret the science.

Many of the issues Kennedy has said publicly he wants to address are concerns widely shared by healthcare providers, public health officials and members of the public. These include pervasive chronic disease, poor nutrition, and the ubiquity of processed foods containing artificial chemicals.

But his nomination has alarmed many public health and medical officials, who say they are concerned that the solutions Kennedy might see fit could undermine Americans’ long-term health.

Read more:Food, fluoride and funding: How a new Trump term could affect health in California

“Putting someone in charge who can’t tell the difference between good and bad science is really dangerous to the American people,” said Dr. Peter Luriepresident and executive director of the Center for Science in the Public Interest.

“Yes, there are some things that he supports that we would agree with, but they feel more like the stopped clock that is right twice a day,” Lurie said, citing food additives as an example. “There are opportunities for small victories. … But it’s generally dissolved into so many bad ideas that it’s absolutely not worth it.”

Kennedy declined to discuss his plans for HHS with The Times, but has indicated some priorities for the agency in previous public statements.

For example, he said Trump would advises water fluoridation on his first day in office. He he told NBC News he wouldn’t “take away” vaccines, but would “make sure there are scientific studies of safety and efficacy, and people can make individual judgments about whether that product is going to be good for them.”

More than half a dozen experts who spoke to The Times said Kennedy’s suggestions that science around vaccines is unhealthy would undermine public health.

The United States has “the best vaccine safety system in the world,” it said Dr. Richard Bessera former CDC acting director who now heads the Robert Wood Johnson Foundation. “RFK Jr. has done a lot to undermine confidence in that.”

Indeed, cases of measles has increased in the US because childhood vaccinations are behind schedule, especially after the COVID-19 pandemic. The CDC has identified 277 measles cases this year, up from 59 in 2023.

“I don’t want to have to see us go back to remind ourselves that vaccines work,” Dr. Mandy Cohendirector of the CDC, said this week at the Milken Institute’s Future of Health Summit in Washington, DC

Kennedy’s drive to remove fluoride from drinking water based on claims that the mineral causes neurodevelopmental disorders and other health conditions is another example of dodging the best science, he said. Dr. Walter Willettprofessor of epidemiology and nutrition at the Harvard TH Chan School of Public Health.

“This was carefully considered and it was there was no evidence of a linkWillett said. “On the other hand, there are serious problems with lead in water systems.”

Read more:A Trump victory could mean big changes for California’s drinking water, RFK Jr. says.

Vaccines and fluoride are just two areas where Kennedy will have the opportunity to implement ideas that lack strong scientific support.

Last month, he condemned the FDA’s “aggressive crackdown” on unproven health remedies such as dietary supplements and ivermectin. and warned: “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.”

But food safety advocates who shared many of Kennedy’s criticisms of lax regulations said eliminating the agency is not the answer. Any effort to reduce or eliminate chemical additives in food would require experienced staff to develop new rules and guide them through the necessary regulatory process, he said. Ken Cookchair of the Environment Working Group.

“If you got rid of all the bureaucrats, who’s going to write the rules?” Cook said.

Or consider the FDA’s reliance on user fees from companies that want the agency to approve its medical products. Such charges shall be offset almost half from the agency’s operating budget. Kennedy and others have criticized such taxes, but if those dollars were to disappear, Congress is unlikely to replenish them, Lurie said.

“Closing user fees is tantamount to starving the agency,” he said. “That would mean a food program that is limited in what it can do, drugs that come to market more slowly, and vaccines that are even less well monitored for safety.”

Lurie said he would not be surprised to see Kennedy researchers at the National Institutes of Health look for harmful side effects of vaccines and elusive benefits of potential therapies that have already been shown to be ineffective, such as chelation as a treatment for autism. and ivermectin and hydroxychloroquine for COVID-19.

“These appear to be very promising,” Lurie said. “Most of these ideas are sinkholes for government spending, which is ironic given the Trump administration’s purported devotion to efficiency.”

As significant as HHS’s role is, Kennedy would still find his powers limited by the agency’s coverage limits — and possibly by the whims of his boss.

Willett said he agreed with Kennedy that the nation’s health is in decline and that our food and health systems are “in many ways dysfunctional.” He would welcome efforts to restrict the amount of salt allowed in food and to reduce consumption of added sugars, refined grains and sugar-sweetened beverages.

But if Kennedy takes steps like these, “we know for sure there will be resistance from the industry,” Willett said. “It would be interesting to see if he’s ready to take on Coca-Cola.”

Read more:RFK Jr. says he had a dead worm in his brain. What are these parasites and how common?

While Kennedy is passionate about reducing pesticides and other chemicals in food, it’s up to the Department of Agriculture to regulate pesticide use on crops, and it’s up to the Environmental Protection Agency to determine what exposure levels are considered safe for humans, Cook said. Kennedy would also lack the power to reform farm subsidies to encourage organic and regenerative agriculture.

“He doesn’t have a lot of pesticide buys from his perch,” Cook said. “It’s not really an HHS or FDA thing.”

The FDA has the authority to regulate chemicals that come off food packaging and find their way into food, and Kennedy could prioritize that, Cook said.

Kennedy is also likely to protect budgets National Institute of Environmental Health Sciences and the Agency for Toxic Substances and Disease RegistryCook said.

To help him achieve his goals, Kennedy invited the public to weigh in on people who could fill important roles within the federal government’s health agencies.

Names that have garnered thousands of votes in “America’s Health” category. among its “Nominees for the People” site is Dr. Sherri Tenpenny, who has advocated for COVID-19 vaccines made people magneticand Dr. Simone Gold, the anti-vaccine doctor in Beverly Hills, who had his medical license suspended after the pleaded guilty for trespassing in the US Capitol on January 6, 2021. (Her license has since been restored.)

Kennedy’s accession to the post of HHS secretary is not yet certain. Cabinet positions must be confirmed by the Senate, although Trump has suggested he could use recess appointments to bypass the need for lawmakers’ approval.

Dr. Georges Benjaminexecutive director of the American Public Health Association, said that even if Kennedy wins the confirmation, he is not sure how long he will remain in Trump’s good graces.

“I remind people that his first health secretary didn’t last a year,” Benjamin said. “We’ll see what happens here.”

This story originally appeared in Los Angeles Times.