(CNN) — President Donald Trump’s strategy to ‘Make America Healthy Again’ includes investigating vaccine injuries and pharmaceutical practices but stops short of new regulatory action, for now.
US Health and Human Services Secretary Robert F. Kennedy Jr. unveiled the MAHA strategy on Tuesday, joined by Agriculture Department Secretary Brooke Rollins, Environmental Protection Agency Administrator Lee Zeldin, and other top Trump officials.
The report hews closely to a draft document circulated in August that cites earlier Trump administration announcements — developing a definition for ultraprocessed foods, educating the public about synthetic kratom — but largely bypassed industry crackdowns.
Language around pesticides strategy also remained unchanged. Environmental and food activists had rallied for the administration to include steps to reduce pesticide usage and probe potential health risks of commonly used chemicals such as RoundUp.
The report says that USDA, EPA and the National Institutes of Health will develop a framework to study cumulative exposures to chemicals including pesticides and microplastics. USDA and EPA will also invest in new farming approaches to reduce chemical use, and EPA will launch a public awareness campaign about the limited risk of approved products.
The commission’s first report this May suggested a broad range of factors driving chronic disease in the US, including ultraprocessed foods, environmental exposures, and overprescription of pharmaceuticals like antidepressants.
The report noted previous announcements that HHS, the NIH and the Centers for Medicare and Medicaid Services are studying the causes of autism. Kennedy had previously promised some answers on the root causes in September; NIH is expected to announce autism research grants this month.
Recent reports suggest that HHS will issue a report that links the development of autism to taking Tylenol during pregnancy.
Medicines and vaccines
Kennedy has drawn criticism for suggesting antidepressants, particularly those that are part of a family known as SSRIs are as addictive as heroin and can be dangerous. Following the August 27 shooting in Minneapolis, he told Fox News that HHS is launching studies “on the potential contribution of some of the SSRI drugs and some of the other psychiatric drugs that might be contributing to violence.”
SSRIs, or selective serotonin reuptake inhibitors, are the most prescribed class of antidepressants for depression, anxiety disorders and many other mental health conditions. Several SSRIs have been on the market in the United States since the 1990s, including Prozac, Zoloft and Celexa. Experts agree that there is no scientific evidence or correlation between these drugs and violence towards others.
Tuesday’s report states that HHS will assemble a working group of federal officials to evaluate SSRI prescribing patterns, specifically among children. HHS will also “evaluate the therapeutic harms and benefits of current diagnostic thresholds,” or the current common practices doctors use to diagnose patients with mental health disorders.
Dr. Theresa Miskimen Rivera, president of the American Psychiatric Association said access to care, not over-medication is the bigger problem when it comes to helping kids’ mental health in the country, and there is no mention of the issue in the report. The report said addressing a child’s nutrition, screen time, and exercise can improve their mental health, but can’t address everything. “Psychiatric conditions are complex in nature,” she said. Extreme poverty, post traumatic stress disorder, trauma-related factors should also be addressed, but there is no mention in the report of any of those issues either.
“In terms of over medication, that’s not what we do. We have a comprehensive evaluation and we are evidence based. We diagnose than create a comprehensive treatment plan, “ Miskimen Rivera told CNN. “Medication can save lives, not only in children, but in adults and elderly.”
When asked about whether or not the commission chose to consider gun violence – the leading cause of death for children – as one of the issues to be investigated, Kennedy doubled down on the issue of prescription drugs, saying “We are doing studies now, or initiating studies to look at the correlation and the connection, potential connection between over medicating our kids and this violence.”
HHS will also work with the White House Domestic Policy Council on a new vaccine framework that, the report said, will ensure “America has the best childhood vaccine schedule” and ensure “scientific and medical freedom.”
The report comes as Kennedy continues to defend his shakeup of the US Centers for Disease Control and Prevention over vaccine policy, including the ouster of CDC Director Dr. Susan Monarez.
The administration will also increase oversight of “deceptive” direct-to-consumer advertising of pharmaceutical products, including from social media influencers and telehealth companies, it said.
Food policy stays the course
FDA will continue work on developing a definition for ultraprocessed foods, but the report bypasses recommendations, like those of former FDA Director Dr. David Kessler, to essentially order certain additives off the market until they are reviewed.
Dr. Dariush Mozaffarian, director of Tufts Food is Medicine Institute said a definition of ultraprocessed foods would be “really important.” With more than half of calories in the food supply coming from ultraprocessed foods, addressing this and other issues involving the nation’s diet would mean a “massive fight with the industry and is going to be incredibly controversial, but is much needed.”
“Overall, this is really quite thorough, quite specific, and even if parts of this are accomplished, this could have tremendous positive impact for Americans,” Mozaffarian told CNN.
Other experts, like Marion Nestle, agreed the report was ambitious in scope, but noted it fell short on regulatory action. “What’s still missing is regulation. So much of this is voluntary, work with, promote, partner,” said Nestle, who is the Paulette Goddard professor emerita of nutrition, food studies and public health at New York University.
The report also nods to new, user-friendly dietary guidelines expected later this year. Kennedy has promised a vastly shortened set of recommendations that will emphasize whole foods.
The commission also cited ongoing work to reduce ultraprocessed foods in the Supplemental Nutrition Assistance Program (SNAP) and Head Start.
While the report also touches on agriculture deregulation with the aim of making it easier for small farms to get greater access to markets and schools, Ken Cook, co-founder of the Environmental Working Group, a health advocacy organization said the report abandons earlier MAHA promises to ban toxic pesticides and instead “echoes the pesticide industry’s talking points.”
“Secretary Kennedy and President Trump cynically convinced millions they’d protect children from harmful farm chemicals – promises now exposed as hollow,” Cook said in a statement.
There were minor changes from the draft document leaked in August. For instance, the August 6 draft stated that the FDA and other agencies will crack down on “Illegal Chinese Vapes,” while the final version promises enforcement on vapes more broadly.
“We support the goal of making children healthier and addressing and preventing chronic disease, but unfortunately, the recommendations fall short in some really critical ways,” Laura Kate Bender, vice president nationwide advocacy and public policy for the American Lung Association told CNN.
“They continue to cast doubt on vaccines, one of the most, important, proven public health interventions that we can have for kids health. They don’t address some major contributors to diseases in kids like pollution, tobacco use, beyond the mention of vaping, and this report is coming out at the same time that we’re continuing to see dramatic cuts in staff and funding of a lot of the programs that could make the good parts of the report a reality.”
The report’s emphasis on kids’ health can help overall, Dr. Michelle Macy, director of the Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center in Chicago told CNN. “I’m really trying to look for bright spots in this report, and I think that the focus on data and infrastructure for us to be able to answer big questions about what environmental and food exposures and medication exposures do to shape the trajectory of someone’s health and chronic disease across the lifespan is something that has promise and potential.”
Dr. Richard Besser, pediatrician and president and CEO of the Robert Wood Johnson Foundation said that having a focus on preventing chronic disease in children is a good thing, but he said, with Kennedy’s track record that includes firing thousands of federal health employees, slashing millions in health research funding, dismantling entire offices that managed important issues like smoking and chronic disease specifically, in addition to his “assault on vaccinations” will undermine any potential good of this kind of report.
“Neither RFK Jr.’s record, nor his policies outlined in the report give me confidence that he is going to make any difference whatsoever on chronic diseases in children,” Besser told CNN.
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