Here’s how Robert F. Kennedy Jr. has promised to reshape the country’s top health agencies

WASHINGTON – Robert F. Kennedy Jr.an anti-vaccine activist and environmentalist, for years he won a loyal and fierce following with his scathing condemnations of the way the country’s public health authorities do business.

And that put him on a direct collision course with some of the 80,000 scientists, researchers, doctors and other officials who work for the Department of Health and Human Services, especially with newly elected President Donald Trump. tap him to head the agency.

If confirmed, Kennedy will control the world’s largest public health agency, with a budget of $1.7 trillion.

The agency’s reach is enormous. It provides health insurance for nearly half the country: poor, disabled and older Americans. It oversees research into vaccines, diseases and treatments. It regulates the medications found in medicine cabinets and inspects the food that goes into the cabinets.

A look at Kennedy’s comments about some of the agencies that fall within the HHS arena, and how he has said he plans to shake them up:

Food and Drug Administration

– “The FDA’s war on public health is about to end,” he wrote on X in late October. “If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Save your details and 2. Pack your bags.”

The FDA’s 18,000 employees include professional scientists, researchers and inspectors responsible for the safety and effectiveness of prescription drugs, vaccines and other medical products. The agency also has broad oversight of a wide range of consumer goods, including cosmetics, electronic cigarettes and most food products.

HHS has the legal authority to reorganize the agency without congressional approval to maintain the safety of food, drugs, medical devices and other products.

And Kennedy has long criticized the FDA’s work on vaccines. During the COVID-19 epidemic, his nonprofit, Children’s Health Defense, petitioned the FDA to halt the use of all COVID vaccines. The group has argued that the FDA is dependent on “big pharma” because it receives much of its budget from industry fees and some employees who have left the agency have gone on to work for drugmakers.

His attacks have become more sweeping, with Kennedy suggesting he will clear out “entire departments” at the FDA, including the agency’s food and nutrition center. The program is responsible for preventing foodborne illness, promoting health and wellness, reducing diet-related chronic diseases and ensuring chemicals in food are safe.

Last month, Kennedy took to social media to threaten to fire FDA employees for “aggressively suppressing” a host of unsubstantiated products and therapies, including stem cells. raw milk, psychedelics And discredited COVID-era treatments such as ivermectin and hydroxychloroquine.

In the case of hydroxychloroquine, for example, the agency halted its emergency use after determining it was ineffective in treating COVID and increased the risk of potentially fatal heart events.

Consuming raw milk has long been considered risky by the FDA because it contains a high number of bacteria that can make people sick and has been linked to hundreds of disease outbreaks.

If confirmed, Kennedy could in principle overturn virtually any decision made by the FDA. There have been rare cases of such decisions in previous governments. Under both George W. Bush and Barack Obama, HHS ignored FDA approval decisions on the availability of emergency contraceptives.

Unwinding FDA regulations or withdrawing approval of long-standing vaccines and drugs would likely be more challenging. The FDA has longstanding requirements for removing drugs from the market, which are based on federal laws passed by Congress. If the process is not followed, drug manufacturers can file lawsuits that must be resolved through the courts.

Centers for Disease Control and Prevention

– “On January 20, the Trump White House will advise all U.S. water systems to remove fluoride from public water,” Kennedy wrote on social media in November.

The CDC’s fluoride guidelines are just one recommendation the organization has made as part of its mission to protect Americans from disease outbreaks and public health threats.

The agency has a core budget of $9.2 billion and more than 13,000 employees

Days before Trump’s victory, Kennedy said he would reverse the agency’s recommendations around fluoride in drinking water, which the CDC currently recommends at 0.7 milligrams per liter of water.

The recommendations have strengthened teeth and reduced cavities replacing minerals lost during normal wear and tear. Smudged tooth patterns have occurred at higher levels of fluoride, prompting the U.S. government to lower its recommendations from 1.2 milligrams per liter of water in 2015.

Local and state governments control water supplies, with some states mandating fluoride levels through state law.

Kennedy, who has said that “there is no vaccine that is safe and effective,” would be in charge of appointing the committee of influential expert panels that help formulate vaccine recommendations to doctors and the general public. These include polio and measles given to infants and toddlers to protect against debilitating diseases, to shots given to older adults to protect against threats such as shingles and bacterial pneumonia, as well as vaccinations against more exotic dangers for international travelers or laboratory workers.

National Institutes of Health

– “We have to act quickly,” Kennedy reportedly said at a rally in Scottsdale, Arizona event during the weekend. “So that on January 21, 600 people walk into the NIH offices and 600 people leave.”

The agency’s $48 billion budget funds medical research on cancers, vaccines and other diseases through competitive grants to researchers at institutions across the country. The agency also conducts its own research with thousands of scientists working at NIH laboratories in Bethesda, Maryland.

Advances supported by NIH money include a drug for opioid addiction, a vaccine to prevent cervical cancer, many new cancer drugs, and the rapid development of mRNA COVID-19 vaccines.

In the past, Kennedy has criticized the NIH because they are not doing enough to study the role of vaccines in autism.

Kennedy wants half of the NIH budget to go to ‘preventive, alternative and holistic approaches to health’ he wrote in the Wall Street Journal in September. “In the current system, researchers don’t have enough incentive to study generic drugs and root cause therapies that look at things like nutrition.”

Kennedy wants to prevent NIH from funding researchers with financial conflicts of interest, citing a 2019 report ProPublica investigation which found that more than 8,000 federally funded health researchers reported significant conflicts, such as taking equity stakes in biotech companies or licensing patents to drug makers.

Centers for Medicare and Medicaid Services

– “If a doctor’s patient has diabetes or obesity, the doctor should be able to say, I’m going to recommend gym membership, and I’m going to recommend good eating, and Medicaid should be able to fund those things. same as Ozempic, ‘Kennedy said during a town hall on September 30 in Philadelphia.

Kennedy has not focused so much on the agency that spends more than $1.5 trillion annually on health care coverage for more than half the country through Medicaid, Medicare or the Affordable Care Act.

Even as Trump and other Republicans have threatened some of that reporting, Kennedy has remained silent.

Instead, he was an outspoken opponent of Medicare or Medicaid, which covers expensive drugs designed to treat diabetes, such as Ozempic, which is now also sold for weight loss as Wegovy. Those drugs are not widely available covered by either programbut there is some bipartisan support in Congress to change that.

During a congressional roundtable in September, Kennedy cautioned some against supporting the effort, noting it could cost the U.S. government trillions of dollars. An exact price tag for the US government to reimburse for these drugs has not yet been determined.

Kennedy has said that Medicare and Medicaid should instead offer gym memberships and pay for healthier foods for those enrollees.

“For half the price of Ozempic, we could buy regeneratively grown, organic food for every American, three meals a day and a gym membership for every obese American,” Kennedy said.

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Associated Press writers Carla K. Johnson in Seattle and Mike Stobbe in New York contributed to this report.