[IMPORTANT: Make this 4 times longer with much more detail]
Argument An expert’s point of view on a current event. Make America Highly Pathogenic Again If RFK Jr. gets to helm HHS, global health is at risk. By Angela Rasmussen , a virologist at the Vaccine and Infectious Disease Organization (VIDO) at the University of Saskatchewan. Robert F. Kennedy Jr. testifies during a Senate Finance Committee hearing on his nomination to be secretary of the Department of Health and Human Services, on Capitol Hill in Washington, D.C. Robert F. Kennedy Jr. testifies during a Senate Finance Committee hearing on his nomination to be secretary of the Department of Health and Human Services, on Capitol Hill in Washington, D.C., Jan. 29. Alex Wroblewski/AFP via Getty Images My FP: Follow topics and authors to get straight to what you like. Exclusively for FP subscribers. Subscribe Now | Log In Health Pandemics United States January 30, 2025, 11:05 AM Comment icon View Comments ( 1 ) For years, Robert F. Kennedy Jr., U.S. President Donald Trump’s pick as secretary of the Department of Health and Human Services (HHS), has spread conspiracy theories and factually incorrect information about vaccination, drug regulation, epidemiology, and biomedical science in general to advance his skepticism of evidence-based science and medicine. The anti-vaccine organization Kennedy helped found, Children’s Health Defense, has conducted extensive disinformation campaigns, including funding propaganda films such as Plandemic , the Vaxxed trilogy, and Medical Racism: The New Apartheid , which specifically targeted Black Americans to discourage vaccination. The scale of the destruction Kennedy could wreak at the helm of HHS is immense. For years, Robert F. Kennedy Jr., U.S. President Donald Trump’s pick as secretary of the Department of Health and Human Services (HHS), has spread conspiracy theories and factually incorrect information about vaccination, drug regulation, epidemiology, and biomedical science in general to advance his skepticism of evidence-based science and medicine. The anti-vaccine organization Kennedy helped found, Children’s Health Defense, has conducted extensive disinformation campaigns, including funding propaganda films such as Plandemic , the Vaxxed trilogy, and Medical Racism: The New Apartheid , which specifically targeted Black Americans to discourage vaccination. The scale of the destruction Kennedy could wreak at the helm of HHS is immense. Trending Articles Congolese President Skips Crisis Meeting With Rwanda The emergency regional leaders’ summit aimed to address ongoing fighting between Rwandan-backed rebels and Congolese… Powered By Advertisement Congolese President Skips Crisis Meeting With Rwanda X HHS is tasked with overseeing government efforts to take care of the American people, and its 10 component agencies, from the Food and Drug Administration (FDA) to the National Institutes of Health (NIH), play different specialized roles to do so. Kennedy has already floated some of his ideas that would harm public health in the United States, including ending water fluoridation; rescheduling or withdrawing regulatory approval for numerous vaccines; reshaping the drug approval process and removing lifesaving drugs from the market; giving infectious disease research a “ break ”; and lifting food safety regulations on some products , such as unpasteurized “raw” milk, while imposing new regulations on others. Even small changes to these essential functions of HHS would have catastrophic consequences without Kennedy needing to ban vaccines. Prior to the COVID-19 pandemic, Kennedy used the tragic deaths of two infants from mis-formulated measles vaccines in Samoa to advance his theories . Kennedy flew to Samoa to support a campaign that falsely suggested that vaccination was unsafe and potentially deadly. Several months later, a massive measles outbreak sickened nearly 6,000 people and left 83 dead, most of them young children. Curtailing routine childhood immunizations would conservatively result in more than a million preventable deaths in the United States. Highly pathogenic emerging viruses—such as the Ebola virus, avian influenza viruses, and coronaviruses such as SARS-CoV-2, the cause of the COVID-19 pandemic—often appear unexpectedly and, if not effectively contained, cause epidemics and pandemics. Imagining worst-case scenarios about outbreaks is essential for preparing for, responding to, and ideally preventing pandemics altogether. As a virologist who specializes in such outbreaks, having Kennedy at the helm of HHS during an outbreak of a lethal virus is the worst pandemic scenario I can conceive—and it’s a worryingly real possibility. A massive outbreak of H5N1 highly pathogenic avian influenza has impacted nearly a thousand herds of dairy cattle across 16 states. The cattle outbreak began in late 2023 with a single spillover from an infected bird in Texas because of the global H5N1 panzootic (a pandemic in animals) that has been ongoing since 2021. Because H5N1-infected cows were not detected for several months, animal transport and milking operations allowed the virus to spread throughout the United States. More than a year later, the full scope of the cattle outbreak remains unknown. Spillovers from wild birds into domestic poultry have continued and necessitated culling millions of birds. As the tally of infected dairy herds and poultry flocks has risen, human cases have also increased at an alarming rate. Currently, there are more than 70 confirmed or probable cases , including the first cases with severe disease and the first fatal case in the United States. Multiple studies show that a substantial number of H5N1 cases in dairy workers are likely going undetected. More troublingly, three cases of H5N1 have occurred in children in California, one of which is linked to consumption of raw milk , and spillovers directly from birds also continue with increasing frequency. Although there is no evidence that human-to-human transmission has occurred, the biological reality is that with enough opportunities to adapt to a human host and potentially reassort with seasonal influenza viruses, H5N1 could gain this ability. If that happens, a rapid and effective response will be imperative for containment. If efforts to detect and contain a human outbreak fail, an influenza pandemic is a very real possibility. Nobody can say with certainty when or if this will happen, but we can anticipate what might happen if it does under Kennedy’s leadership. Although the COVID-19 pandemic response in the United States was replete with mistakes , the first Trump administration did manage to execute some critical interventions that were largely attributable to HHS agencies’ actions. The initial research on COVID-19 vaccines was conducted at the Vaccine Research Center at NIH in collaboration with NIH-funded academic investigators. The immediate action of these scientists that hastened the research into a development pipeline comprising pre-clinical studies and clinical trials was essential to producing mRNA vaccines at national scale within a year. Operation Warp Speed—which was a joint effort among multiple HHS agencies including the Centers for Disease Control and Prevention (CDC), NIH, and FDA, the Department of Defense, and the private sector—allowed for nationwide distribution of the vaccines and saved millions of lives. In the event of a bird flu pandemic, millions of lives will again depend on the urgent actions taken by HHS and its component agencies. However, unlike the COVID-19 pandemic, these responses would be orchestrated by someone who promotes conspiracy theories, questions established tenets of science and medicine, and has significant financial interest in pseudoscientific profiteering. Given that Aaron Siri, the lawyer reportedly vetting Kennedy’s picks to lead HHS agencies, has previously petitioned FDA to withdraw or suspend the licenses on the polio and hepatitis B vaccines, it is likely these putative leaders would be equally unsuited to effectively lead essential pandemic responses. Read More A cat (L) is seen inside the hazmat suit sleeve of a health worker taking swab samples from residents in Shanghai on June 6, 2022. Blocking a Fair WHO Pandemic Accord Endangers Humanity Without an equitable agreement, including wealthy nations sharing IP with poorer ones, the world is doomed to repeat its COVID-era mistakes. Analysis | Luke McDonagh Trump’s putative CDC director, Dave Weldon, is celebrated by anti-vaxxers for his consistent vaccination opposition. He rejects basic facts about vaccines, has appeared in several anti-vaccine documentaries, and is willing to dismiss reliable population-level data in favor of anecdotes . The nominated FDA commissioner, Marty Makary, has stated that he may rethink current policies for approving diagnostics and medications, including vaccines. Until recently, Makary, a gastrointestinal surgeon who has indicated willingness to loosen food safety regulation and block essential medicines, also sat on an advisory board for Biosafety Now, an organization that opposes research on pandemic viruses , called for the prosecution of virologists , and whose founders have allegedly conducted harassment campaigns against virologists (including myself ). Makary’s track record of COVID-19 pronouncements includes his prediction in early 2021 that America would reach “ herd immunity ” by April. Sign up for Editors’ Picks A curated selection of FP’s must-read stories. Sign Up By submitting your email, you agree to the Privacy Policy and Terms of Use and to receive email correspondence from us. You may opt out at any time. Enter your email Sign Up ✓ Signed Up You’re on the list! More ways to stay updated on global news: FP Live Enter your email Sign Up ✓ Signed Up World Brief Enter your email Sign Up ✓ Signed Up China Brief Enter your email Sign Up ✓ Signed Up South Asia Brief Enter your email Sign Up ✓ Signed Up Situation Report Enter your email Sign Up ✓ Signed Up View All Newsletters The nominated NIH director, Jay Bhattacharya, has been an outspoken opponent of critical research priorities . In early 2020, he co-authored a profoundly flawed study underestimating the severity of COVID-19 to bolster economic arguments for ending pandemic mitigation measures. Bhattacharya co-authored the Great Barrington Declaration (GBD), an anti-lockdown policy proposal recommending mass infection as a path to herd immunity, which studies estimate would have significantly increased deaths in the United States beyond the estimated 1.2 million Americans who died from COVID-19. The GBD gave rise to the Brownstone Institute, where Bhattacharya was a regular content contributor . He has also appeared in a Falun Gong-produced documentary promoting anti-vaccine ivermectin conspiracy theories . He is deeply antagonistic to virology, vaccinology, and public health research, and, like Makary, was also affiliated with Biosafety Now, serving on the board of directors . Finally, the nominee for the Centers for Medicare and Medicaid Services, Mehmet Oz, is a cardiothoracic surgeon and failed U.S. Senate candidate who used his television show as a vehicle for promoting unproven supplements to promote weight loss and has a long history of distributing medical misinformation . During the pandemic, he opposed masking and vaccination in favor of hydroxychloroquine and supplements he sold through social media . The damage these figures could do would be exponentially magnified during a pandemic. Early identification of human cases is essential to isolate and contain a growing outbreak. This depends on CDC and state public health officials identifying human cases using sensitive, specific molecular diagnostic tests in combination with standard epidemiological approaches such as contact tracing. This would trigger critical containment measures and medical countermeasures—such as antivirals and vaccines—rapidly. For H5N1, we are already failing to detect human cases thanks in part to a sluggish response from the CDC, the CDC’s self-imposed monopoly on confirmatory testing, and continued incompetence at developing effective tests. If the FDA delays or withholds authorization for diagnostic tests, we will be powerless to contain the spread, particularly for very mild or asymptomatic cases that are less likely to be identified clinically but may still be contagious. At the beginning of the COVID-19 pandemic, the CDC and FDA’s technical ineptitude , poor quality control , and bureaucratic paralysis resulted in a nearly two-month period of undetected virus spread. Containment failed, and the virus established itself in the American population. In early 2024, the CDC and FDA under the Biden administration repeated many of these errors with H5N1 diagnostic tests, although fortunately no human-to-human transmission has occurred to date. Still, delayed implementation of diagnostic testing further hampered elimination from dairy cattle and delayed diagnosing some human cases. It’s hard to imagine improvement in the Kennedy HHS. A failure to contain a human H5N1 outbreak will be disastrous over the long term if there is no biomedical research occurring to understand it. Some of the greatest successes of the COVID-19 response were led by NIH-funded investigators, both within NIH itself and by academic scientists supported by extramural NIH grants. Such research can drastically accelerate the timeline for developing and deploying effective countermeasures and inform us where the virus is spreading, who is at the greatest risk, and what treatments work best to save lives. Kennedy and Bhattacharya have proposed radically reorganizing NIH and reducing funding for infectious diseases and vaccine research. Ultimately, this would create a situation in which we know little about the virus, how it spreads, how it causes disease, or how to treat it. Vaccines would be unavailable, we’d have no information on resistance to antiviral drugs or a pipeline for developing other therapies, and we won’t know where cases are primarily occurring until the hospitals are overwhelmed with H5N1 patients. Our options for intervention would be limited to supportive care and unproven remedies embraced by Kennedy: thoughts, prayers, raw milk, and roadkill. The devastating impacts of such failures across HHS will not be limited to America, since pandemics transcend national borders. Any suppression of effective public health policy by Kennedy will exacerbate economic, agricultural, ecological, and medical ruin at home and abroad. Anywhere from thousands to millions could die as a direct result. Angela Rasmussen , PhD is a virologist at the Vaccine and Infectious Disease Organization (VIDO) at the University of Saskatchewan. Read More On Health | Pandemics | U.S. Government | United States Join the Conversation Commenting on this and other recent articles is just one benefit of a Foreign Policy subscription. Already a subscriber? Log In . Subscribe Subscribe View 1 Comments Join the Conversation Join the conversation on this and other recent Foreign Policy articles when you subscribe now. Subscribe Subscribe Not your account? 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