By Jade Macmillan for the ABC
When Robert F Kennedy Jr was running as an independent candidate at this year’s US election, he attracted a series of bizarre headlines.
“RFK Jr says doctors found a dead worm in his brain,” screamed The New York Times.
“RFK Jr admits to dumping a dead bear in Central Park,” said NPR.
“Feds open probe into RFK Jr for allegedly decapitating a dead whale,” reported Fox News.
The 70-year-old had been seen as a potential spoiler in a rematch between Joe Biden and Donald Trump.
But by the time Kamala Harris replaced the president on the Democratic ticket, his campaign had faltered and was running out of money.
Opinion polls suggested he could still draw votes away from Trump, however, in what was then expected to be a very close contest.
And despite having previously described RFK Jr as the “most radical left candidate in the race”, the now president-elect sought – and received – his endorsement.
That support has now been rewarded with the promise of a major new job; Trump has nominated RFK Jr to be his secretary of the Department of Health and Human Services (DHHS).
I am thrilled to announce Robert F. Kennedy Jr. as The United States Secretary of Health and Human Services (HHS). For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it…
— Donald J. Trump (@realDonaldTrump) November 14, 2024
It is a sprawling federal agency tasked with overseeing everything from vaccines to Medicare to food safety.
So what exactly does RFK Jr mean when he promises to “Make America Healthy Again”?
And why are some public health experts so alarmed?
A ‘dangerous’ record on vaccines
RFK Jr is part of one of America’s most famous political dynasties.
He is named after his father, former US attorney-general Robert F Kennedy, and is the nephew of former president John F Kennedy.
He made his own mark as an environmental lawyer, focusing on issues such as water pollution.
But it is his vaccine activism that is generating the most attention now that he is in line for a role in Trump’s second-term administration.
RFK Jr has promoted disproven claims, including that childhood vaccines cause autism.
He has also been accused of fuelling vaccine scepticism in Samoa ahead of a deadly measles outbreak that killed 83 people there in 2019.
Vaccination rates had fallen after two babies died the previous year from incorrectly mixed and administered mumps, measles and rubella (MMR) shots.
RFK Jr visited the Pacific nation several months before the outbreak, writing later that the trip was organised by a local vaccination critic.
He has since denied bearing any responsibility for the measles outbreak in Samoa, telling a documentary that he “never told anybody not to vaccinate”.
“I didn’t, you know, go there for any reason to do with that,” he said.
But Helen Petousis-Harris, a New Zealand-based vaccinologist who worked to try to rebuild confidence in Samoa’s vaccination programme, said RFK Jr weakened an “already fragile trust”.
“A person who has the status of RFK Jr just I guess further amplifies what those local anti-vaccine advocates had been saying,” she said.
“And there’s a big price to pay, isn’t there? I mean, these were children’s lives.”
RFK Jr has rejected the assertion that he is an “anti-vaxxer” and he insisted shortly after Trump’s election victory that if vaccines were “working for somebody, I’m not going to take them away”.
“I’m going to make sure scientific safety studies and efficacy are out there, and people can make individual assessments about whether that product is going to be good for them,” he told NBC News.
Lawrence Gostin, a professor of global health law at Georgetown University, points out control over vaccines in the US resides with the states, not the federal government.
But he argues RFK Jr could try to change which vaccines can be accessed free of charge under health insurance. And he believes he will do “everything in his power to foment distrust in them”.
“I’ve never seen a darker day for public health than I have since the election,” he said.
“I just call this simply a poke in the eye of science.”
RFK Jr’s position on vaccines is partly behind a split in his famous family. His cousin and outgoing US ambassador to Australia Caroline Kennedy recently described his views as “dangerous”.
“I grew up with him so I’ve known all this for a long time and others are just getting to know him,” she told the National Press Club in Canberra.
An overhaul of America’s eating habits
Along with what he says will be a crackdown on big pharma, RFK Jr is promising to overhaul America’s food system.
He has called for new limits on food additives and dyes, highlighting differences between the artificial colours used in American-made breakfast cereals and those used in the same products produced in Canada.
“It’s literally poisoning our kids,” he told Fox News in September.
He has also pledged to remove ultra-processed foods from school lunches as part of an effort to end what he describes as the “chronic disease epidemic”.
“President Trump has told me that he wants to see measurable, concrete results within two years in terms of a measurable diminishment in chronic disease among America’s kids,” he told NBC earlier this month.
Some of RFK Jr’s stances on nutrition have found support across a broad political spectrum in the US.
Author Michael Pollan, who has spent decades advocating for healthier eating, told Politico he agreed with many of RFK Jr’s criticisms of the US food system.
“The way we’re eating is the biggest threat to public health,” he said. But he added that he did not support RFK Jr’s nomination.
“I think he’s completely unfit and that’s because of his stance on vaccines,” he said.
Richard Besser, a former acting director of the Centres for Disease Control (CDC) under Barack Obama, believes there is merit in some of the goals RFK Jr is pursuing.
But he also does not support his appointment as DHHS secretary.
“One of the challenges very frequently with people who are big spreaders of misinformation is that some of what they spread is good,” Dr Besser said.
“If we had a secretary who said, ‘Let’s take on childhood nutrition,’ that’s great.
“But you want to make sure that they’re coming in and saying, ‘Let’s bring in the best and the brightest around this topic,’ … not pulling in ideas that may not be based on science, may be based on fear or misleading information.”
The ‘MAHA’ movement
RFK Jr has called for fluoride to be removed from public drinking water, warned against seed oils, and criticised what he has called the “aggressive suppression” by federal regulators of unpasteurised milk and psychedelics.
He has attracted a social media following under the hashtag “Make America Healthy Again”, or “MAHA”, a spin on Trump’s famous slogan.
“How it feels knowing RFK Jr is about to go head to head with the food and pharmacy industries,” one TikTok user posted alongside the #crunchymom hashtag.
RFK Jr has also recently been linked to controversial Australian personality Pete Evans.
An advocacy group founded by RFK Jr is publishing a children’s cookbook with the former celebrity chef who has previously been accused of spreading medical misinformation.
Professor Gostin said there had long been some level of scepticism towards American public health institutions, but that distrust increased dramatically during the Covid-19 pandemic.
“I think perhaps science and public health lacked the necessary humility during the pandemic, and that’s part of the problem,” he said.
“But the solution isn’t to tear down science and evidence, because we have no alternative.”
‘Pretty wild ideas’
RFK Jr’s appointment will need to be confirmed by the Senate, and while Republicans are set to take control of the chamber, that does not guarantee approval.
Trump’s pick for attorney-general, Matt Gaetz, recently withdrew his name from consideration after senators demanded to see the detail of sexual misconduct allegations against him.
“The end of the Matt Gaetz nomination could play out in the form of the Senate willing now to confirm whoever is put in front of them,” said Sara Rosenbaum, professor emirata at George Washington University’s Milken Institute School of Public Health.
“Although, interestingly, the Senate was sort of able to ward [Gaetz’s appointment] off before it came to an actual ‘no’.
“So whether this, in fact, means that they are still rigourous and moving through the candidates in a meaningful way, considering the candidates in a meaningful way, remains to be seen.”
If he is confirmed, the president-elect has joked he will let RFK Jr “go wild for a little while”.
“Then I’m going to have to maybe rein him back,” Trump said in the lead-up to the election.
“Because he’s got some pretty wild ideas but most of them are really good, I think.”
– ABC