Experts Warn of Threats to Public Health If RFK Jr. Plays Big Role Under Trump

President elect Donald Trump says he plans to give Robert F. Kennedy Jr. a “big role” in health care in the new administration and let him “go wild” on health, food and medicine. Although Trump hasn’t confirmed what that role would be or what precisely “going wild” means, Kennedy could potentially be elected to any number of leadership positions in the administration, including as the commissioner of the Food and Drug Administration (FDA).

Kennedy — an environmental lawyer with no scientific degrees — has made multiple false or misleading claims about vaccines and once relied on a fringe far-right supporter base. But he is rapidly inching closer toward influencing the federal response to infectious disease, vaccines and public health — which many scientists say would be detrimental to the nation.

“If RFK has a significant influence on the next administration, that could further erode people’s willingness to get up to date with recommended vaccines,” Dr. Jerome Adams, who served as Surgeon General during Trump’s first administration, said at a public health conference in Minneapolis last week, as reported by The New York Times. “I am worried about the impact that could have on our nation’s health, on our nation’s economy, on our global security.”

In the last weeks before Trump won the 2024 election, he made an alliance with Kennedy in a final campaign push under the slogan and super PAC, “Make America Healthy Again.” MAHA is largely centered around the so-called medical freedom movement, which operates on a platform that values personal liberties above the medical establishment and opposes government public health and regulatory agencies.

In an interview with NPR on Wednesday, Kennedy said Trump had already assigned him three tasks: to reduce the “corruption and conflicts” in regulatory agencies like the FDA, return those agencies to the “evidence-based science and medicine that they were once famous for,” and to end chronic disease with measurable impacts within two years.

“FDA’s war on public health is about to end,” Kennedy posted on X, formerly Twitter, in October. “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.”

Should Kennedy be appointed to a role like the FDA commissioner, he could influence whether the agency withdraws approval for vaccines or reduce expanded access to drugs like mifepristone, which is used to end pregnancies, said Lawrence O. Gostin, an expert in public health law at Georgetown University. Previously, Kennedy said he would redirect half of the national medical research budget to go toward “preventive, alternative and holistic approaches to health” and threatened to prosecute Dr. Anthony Fauci “if crimes were committed.” Fauci was formerly the director of the National Institute of Allergy and Infectious Diseases and during the COVID-19 pandemic became the center of multiple conspiracy theories. Kennedy did not respond to Salon’s request for comment.

“There are entire departments, like the nutrition department at the FDA that have to go,” he said in an NBC interview. “They are not doing their job.”

Kennedy also said he wants to reform the Prescription Drug User Fee Act, which regulates the funding the FDA receives from pharmaceutical companies when they apply for new drugs to be approved. This has long been a point of contention, but removing this funding would likely hobble the agency. These fees account for nearly half of the FDA’s budget used to pay its employees and sustain the process of approving and evaluating the medicines the country relies on.

“The pharmaceutical industry certainly doesn’t do everything right and I have a lot of criticisms about it, but nonetheless, we need a strong pharmaceutical industry to develop the vaccines and medicines we need,” Gostin told Salon in a phone interview.

While several scientists agree that parts of Kennedy’s platform like reducing chronic illness and obesity are important issues that should be getting attention, some criticize Kennedy for not laying out a clear plan on how to tackle these major health crises and using conspiracy theories to back up his claims.

“There could be certain areas where he would be beneficial, but to be very honest, I don’t trust him, because he shoots from the hip,” Gostin said. “He’s influenced by conspiracy theories on social media, and he has no fidelity to science and evidence.”

On the weekend before the election, Kennedy said the new administration would remove fluoride from public water systems, making several false claims about its health effects. Although adding fluoride to water is generally hailed as one of the greatest achievements in public health in recent history, Trump replied by saying it sounded “OK” to him.

Similarly, the Trump-Kennedy alliance has alluded to taking certain vaccines off the market. Both have made claims that vaccines are linked to autism, despite the fact that this has been repeatedly debunked in scientific studies across several decades. Nevertheless, Trump didn’t rule out the possibility of banning some vaccines in an interview with NBC News on Sunday — worrying many public health experts who are closely monitoring reduced uptake for routine childhood vaccinations and declining life expectancy in the U.S. largely driven by the million-plus lives lost to COVID.

It’s unclear whether these policies can even be enacted. Adding fluoride to water is a policy under local, not national jurisdiction, and vaccine mandates are regulated at the state level. Nonetheless, a position of leadership central to the administration could give Kennedy a new platform to spread misinformation, which is of increasing concern amid emerging threats like bird flu and any future infectious disease outbreaks or pandemics.

“This would be the most damaging appointment for public health and science in living memory,” Gostin said. “Trump would be appointing someone who is openly hostile to public health and life-saving public health interventions like vaccinations and fluoridation of water — and both of those issues affect children primarily, who did not participate in this election and can’t vote.”

Some of the policy changes Kennedy has proposed would need to be passed through other branches of government before enacted. For example, any withdrawals of vaccines would likely be challenged by the Supreme Court, Gostin said. Any decision to shrink agencies like the FDA would have to go through Congress, and changes in mifepristone regulations could also face legal challenges.

“I have doubts whether or not the Trump Administration, even influenced by RFK Jr. would be able to accomplish this,” Gostin said. “Nonetheless, I think there’s a great deal of damage that a Trump administration can and will have on public health and safety.”

Both the Senate and the Supreme Court are now ruled by a majority of Republicans, so there is a greater chance of both of these branches supporting the Trump Administration’s initiatives, noted Wendy Parmet, the co-director of the Center for Health Policy and Law at Northeastern University.

“The judges Trump appointed in his first term have done a lot of damage to the health of Americans, from limiting the EPA to striking public health powers to all kinds of things,” Parmet told Salon in a phone interview. “I’m very scared about where this is going to go with health.”

In addition to a role at the FDA, Kennedy could be elected as the secretary of the Health and Human Services (HHS) or the director of the Centers for Disease Control and Prevention (CDC). These roles, in addition to an FDA commissioner appointment, would require confirmation from the Senate.

“I would be surprised if he were confirmed by the Senate given his record of science denialism and anti-vaccine activity,” said Dr. Paul Offit, a vaccine expert at the Children’s Hospital of Philadelphia. “I would be surprised if he was appointed to either of those two positions because these are science agencies, and he’s a science denialist.”

Nevertheless, the left’s perception of public opinion in the U.S. has repeatedly been challenged by the Trump Administration, which continues to push the boundaries on health and science. Although the administration’s Operation Warp Speed is generally lauded for delivering millions of life-saving COVID vaccines, Trump and his acolytes also sowed deep seeds of distrust in public health that seem to be sprouting in a renewed vigor for science denialism and anti-establishment MAGA — or MAHA — sentiments.

“Given Trump’s track record, I think one can say it’s unpredictable,” Offit told Salon in a phone interview.

Even if Kennedy does not secure a spot in one of these agencies, he has said he could potentially serve as a “health czar,” where he could have plenty of influence regardless.

“Remember that during the COVID-19 pandemic, the Trump Administration censored the CDC website,” Gostin said. “So as an unofficial advisor at the White House that doesn’t require Senate confirmation, he could really do damage at critical public health agencies like the FDA and the EPA.”