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Thursday, November 21, 2024

What is “Make America Healthy Again”? What to know about Trump and RFK Jr.’s wide-ranging platform


Robert F. Kennedy Jr. has outlined a number of promises to “Make America Healthy Again” under President-elect Donald Trump, vowing to combat an “epidemic” of chronic diseases that he has described as an “existential” threat to America’s future.

All are under the banner of fighting what Kennedy sees as a common thread behind a broad swath of ailments: that Americans have been “mass poisoned by big pharma and big food,” and that federal agencies have failed to stop it. In response, he has also floated a number of specific policy ideas to remake the federal government’s public health institutions. 

“[Trump] asked me to end the chronic disease epidemic in this country. And he said, I want to see results, measurable results in the diminishment of chronic disease within two years. And I said, Mr. President, I will do that,” Kennedy said on Nov. 2. 

Authority for a MAHA agenda

Kennedy’s allies say Trump’s election is also a mandate for their platform of health proposals, which they say delivered key votes for the president-elect. Trump has promised to let Kennedy “go wild” on health issues.

“The American people re-elected President Trump by resounding margins because they trust his judgement and support his policies, including his promise to Make America Healthy Again alongside well-respected leaders like RFK Jr.,” Karoline Leavitt, Trump-Vance Transition spokeswoman, told CBS News in a statement.

Some ideas in Kennedy’s wide-ranging platform have evolved since his original longshot presidential campaign. He has acknowledged Trump does not agree with him on every policy.

The president-elect has listed oil and gas as one off-limits issue for Kennedy. In the past, Kennedy has been critical of “big oil” and natural gas, over the fatal toll of fossil fuel pollution and climate change.

Several of Kennedy’s ideas would require presidential or congressional action to implement, though it is possible that they could be supercharged by emergency powers.

“I’m going to urge President Trump on day one to do the same thing they did in COVID, which is to declare a national emergency, but not for infectious disease, but for chronic disease,” Kennedy said on Sept. 26.

Staff changes at federal agencies

Kennedy claims a number of health issues have worsened due to federal inaction, including autism, attention-deficit/hyperactivity disorder, sleep disorders, infertility rates, diabetes and obesity.

He aims to address that by replacing many staff throughout the agencies, which Kennedy has accused of being too sympathetic to large food and drug companies. As a co-chair of Trump’s transition, Kennedy has been vetting a slate of staffers who could fill top positions throughout the Trump administration. 

Kennedy has said Trump tasked him with returning agencies “to their rich tradition of gold-standard, evidence-based science.” He has also said “medical expertise” is not the priority for all staff picks.

“What we don’t really need at HHS is more medical expertise. What we need is an expertise on decoupling the agency from institutional corruption. Because it’s the corruption that has distorted the science,” Kennedy said on Sept. 30. 

Kennedy has said he hopes “to have every nutritional scientist” across the Department of Health and Human Services and U.S. Department of Agriculture “fired on Day One.”

Kennedy himself has been floated to head the Department of Health and Human Services, though some allies say he could be more effective in a “czar” type role out of the White House.

“Get the chemicals out” of food

When talking about his platform, Kennedy often lampoons products like McDonald’s French fries or Fruit Loops cereal as examples of how foods sold in the U.S. are made with ingredients that are banned or discouraged abroad, or have changed for the worse.

“It’s easy to fix. We have a thousand ingredients in our foods that are illegal in Italy and other countries in Europe,” he said on Oct. 29.

Trump agrees with his plans to “get the chemicals out” of America’s food supply, Kennedy says, which also includes upending the use of common pesticides and herbicides by American farmers.

Kennedy has described the food in the U.S. as “just poison,” citing his own anecdotal experience with his son struggling with eczema while eating pasta in the U.S. 

“When he ate any kind of pasta in this country, he would get these terrible, terrible outbreaks, you know, really agonizing. And he moved to Italy and he lived off of pasta for a year and a half and he never got a case,” Kennedy said on Sept. 19.

Kennedy suspects that was caused by glyphosate, used in Roundup brand weed-killers, which Italy moved to start restricting in 2016. Italy’s decision was over worries that it could pose a cancer risk, and some advocacy groups in the U.S. have also voiced similar concerns.

Agricultural trade associations have defended glyphosate as “one of the safest, most effective” tools farmers have to manage weeds and support “important conservation practices.”

Kennedy’s plea to crack down on food additives and chemicals comes as the FDA is in the middle of launching its own new effort — and is calling on Congress to step up funding for — scrutinizing chemicals currently allowed in foods.

Food industry groups have generally voiced support for the FDA to step up its vetting of chemicals in food, in hopes that it “negates the ill advised and disruptive state by state patchwork” of legislatures drawing up their own restrictions.

Reducing unhealthy and processed foods in federal programs

Kennedy has also promised to “get processed food out of school lunch immediately” and voiced frustration over the amount of federal food assistance for low-income Americans that goes towards sugary drinks and processed food.

One way Kennedy could try to get at this issue is through the federal dietary guidelines process, jointly run by the USDA and HHS, which is in the final stages of crafting the next edition of recommendations that influence a broad range of government nutrition programs. 

“Kids shouldn’t be eating grains. They should definitely not be eating seed oils. And they for sure should not be eating sugar. And yet that is what we’re forcing them to eat,” he said on Sept. 26. 

On seed oils, Kennedy has claimed that the switch away from oils like beef tallow which were high in saturated fats in favor of vegetable oils was a mistake, and is to blame for a rise in obesity rates. That puts him at odds with longstanding recommendations to limit saturated fats.

“The guidance around this has been reviewed many times since, and has only become stronger in its conclusion for the role of saturated fat, particularly in its relationship with higher risks of cardiovascular disease,” Deirdre Tobias, a researcher on this year’s Dietary Guidelines Advisory Committee, said last month. 

Grains have been more divisive at this year’s committee and the broader scientific community, which has debated setting lower limits to overall grain consumption alongside recommendations to switch from refined to whole grains. 

Setting new limits is difficult, scientists on the panel have said, because the only source of some key nutrients for many Americans is cereals and breads fortified with vitamins.

Kennedy has also been critical of the panel of outside researchers put together to create the scientific report underpinning the recommendations, but acknowledges broader changes will also be needed to move the needle.

While Kennedy says he personally would “never eat anything in a package” as a rule of thumb, he acknowledges “most people don’t have access to the resources I have.”

“We need to start forcing these companies to internalize their costs. So the illusion of cheap food goes away, right? Because if you’re drinking Coke and it seems cheap and it gives you diabetes over the long run, that’s not very cheap,” he said on Sept. 30.

Curbing the influence of drugmakers

Kennedy has called for a “review” of guidelines that govern advertising by pharmaceutical companies.

The FDA currently regulates advertising about prescription drugs, going after drugmakers that misrepresent their products. Responsibility for some other medical products is shared between the FDA and the Federal Trade Commission. 

Kennedy has urged Trump to go further, saying he is advising the president-elect to “ban pharmaceutical advertising on TV” over concerns that it is influencing news coverage of health issues. 

He has also urged reform of the Prescription Drug User Fee Act, which charges pharmaceutical companies millions of dollars for the cost of the FDA vetting their applications to decide whether to approve new drugs.

“We need to end the corruption. 50% of FDA’s budget comes not from the taxpayer, but from the pharmaceutical industry,” he said on Sept. 26.

Kennedy has not said how Congress or the Trump administration would make up the difference from the fees if they were cut, which amount to around $3 billion out of FDA’s budget.

Undoing the fees could leave taxpayers effectively subsidizing a hefty bill previously paid for by drugmakers — or a return to the significant delays for new medications that initially spurred the creation of the fees.

Promoting alternatives to drugs

Kennedy has accused the FDA of waging a “war on public health” which he says includes “aggressive suppression” of anything “that advances human health and can’t be patented by Pharma.”

In his view, that includes treatments like psychedelics, which recently fell short of FDA approval, and foods like raw milk, which officials have stepped up warnings against amid this year’s unprecedented bird flu outbreak on dairy farms. 

Kennedy has also praised the dietary supplement industry for a court win against the FDA, after the agency tried to take action against what it said was an illegally marketed anti-aging drug.

Also on Kennedy’s list are things like “clean foods” and exercise, which he wants to allow Medicare and Medicaid to cover. 

The promise has echoes of the “food is medicine” initiative, which has called for the health care system to offer more financial support for healthier lifestyle habits.

“If a doctor’s patient has diabetes or obesity, the doctor ought to be able to say, I’m going to recommend gym membership, and I’m going to recommend, good food and Medicaid ought to be able to finance those things the same as they would Ozempic,” Kennedy said on Sept. 30.

Kennedy has also promised to promote healthier lifestyles in other ways, ranging from requiring nutrition classes in federally funded medical schools to reviving the presidential fitness test in schools.

“Informed choices” on vaccines

Kennedy has a long record criticizing the safety of vaccines, including recent misleading claims that shots have an “exemption from pre-licensing safety testing” before they are approved. 

In fact, the FDA requires new vaccines be studied for their safety and efficacy in large trials, results of which are published in peer-reviewed journals and publicly disclosed.

His activism on the issue dates back decades, including a now-retracted article he published in Rolling Stone in 2005 claiming a link between autism and an ingredient called thimerosal that had been used in vaccines before 2001 — which medical research has disproven. His focus has broadened since then. 

“This doesn’t mean vaccines is the only cause of autism. Our kids today are swimming around in a toxic soup coming mainly from their foods that operate along the same biological pathways. But some of it’s coming from pharmaceutical drugs,” Kennedy said on Sept. 19.

Kennedy has insisted that is not “anti-vaccine” and would not seek to ban them under Trump, instead saying he wants to “restore the transparency” around them — echoing lawsuits by the group he chaired, Children’s Health Defense, over its Freedom of Information Act requests.

“[Trump] doesn’t want me to take vaccines away from people. If you want to take a vaccine, you ought to be able to take it. We believe in free choice in this country. You ought to know the risks and benefits of everything you take,” Kennedy said on Nov. 2. 

But Kennedy has also asserted “there’s no vaccine that is safe and effective,” and encouraged people to “resist” CDC guidelines on vaccines for kids — raising concern among public health officials, who point to the success of vaccination in saving millions of children worldwide from debilitating illness or premature death from preventable diseases.

Opposing water fluoridation

Ahead of the election, Kennedy said one of Trump’s first acts in the White House would be to “advise all U.S. water systems to remove fluoride from public water.” 

While a number of health risks have been tied to higher levels of fluoride, most are extremely rare in the U.S. and involve far greater exposure than what is added to drinking water.

Fluoride has been incorporated into a majority of U.S. water systems for decades. The American Dental Association estimates that the practice has reduced tooth decay by about 25%, though some research suggests modern use of toothpaste with fluoride has reduced the policy’s benefits.

Kennedy’s announcement does come as the Environmental Protection Agency is now under a federal court order to take action over one specific risk: the concern that fluoride might lower children’s IQ “at dosages that are far too close to fluoride levels in the drinking water of the United States,” stemming in large part from a report published by the National Institutes of Health.

Beyond influencing what rule the Trump administration’s EPA ends up pursuing in response to the order, Kennedy could also take aim at fluoride through another route: changing the CDC’s widely-cited statement about the practice, which hails water fluoridation as one of the greatest “public health achievements of the 20th century.” 

Kennedy himself has described fluoride as “a poison” and praised the nonprofits for suing over the issue.

“The simple answer is I don’t like it,” Kennedy said on Sept. 30.





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