Tag: public health

The first MAHA report, released in May and titled “Make Our Children Healthy Again,” mentioned ultra-processed foods more than 40 times, blaming them for negative health outcomes in children. 

The just-released follow-up action plan, which outlines the Trump Administration’s strategy for fixing the problems identified by the first report, mentions ultra-processed foods only once, pledging that government agencies would continue to try to develop a definition for them.

It’s just one way that the MAHA Strategy Report, released on Sept. 9, disappointed many public health advocates—including some MAHA supporters—who had hoped that Robert F. Kennedy Jr.’s maverick approach to science might upend decades of slow progress on improving nutrition among American children. 

“The first MAHA report was revolutionary in a good way,” says Jerold Mande, an adjunct professor of nutrition at the Harvard T.H. Chan School of Public Health who was a senior policy official for nutrition in the Bush, Clinton, and Obama administrations. It suggested that the root cause of chronic disease in the U.S. was the food industry, a renegade position for the federal government to take. This action plan backed off significantly from that position. 

“What this says to me is that the first report was written by MAHA,” he says, “and the second one, the White House let industry lobbyists write it.”

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Trump Administration figures defended the action plan at a press conference on Sept. 9, praising the report and its 128 action points that it says will be achieved through innovative approaches to research, increased public awareness, private-sector collaboration, and realigned incentives.

“A lot of these 128 recommendations are things that I’ve been dreaming about my whole life,” said Robert F. Kennedy Jr., the Secretary of the Department of Health and Human Services, at the press conference. “There’s never been an effort like this.” 

The MAHA Commission—made up of Kennedy and more than a dozen other administration officials, including the USDA secretary and the EPA administrator—met with hundreds of stakeholders, including doctors, teachers, parents, and farmers, Kennedy said, outlining the many complex interests that the Administration had to balance in coming up with the report. 

But observers still contend that MAHA’s strategy lacks teeth. For example, the first report said that pesticides, microplastics, and dioxins are found “at alarming levels” in the blood and urine of American children. It mentioned that some studies have drawn links between pesticides and adverse health outcomes, and that glyphosate may lead to cancer and liver inflammation. 

The September report, though, only says that the EPA will ensure that the public has “awareness and confidence in EPA’s robust pesticide review procedures” and that USDA and EPA will launch a partnership with the private sector to use precision technology for pesticides. It does not mention any pesticides by name. 

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When a draft of the MAHA strategy report was leaked in mid-August, Moms Across America, a nonprofit that promotes awareness about toxins in the food supply, expressed disappointment. “This MAHA Commission Report’s section on pesticides was clearly influenced by chemical corporations,” the group said in a post on its website. “It is not a depiction of Robert F Kennedy’s commitment; it is a display of many people whose names are on the report, pandering to pesticide company profits and catering to the convenience of agrochemical farmers.”

Some of the group’s concerns include that the EPA’s pesticide review process does not require long-term animal studies or studies that show multigenerational effects of pesticides. The group has called on the Trump Administration to ban 86 pesticides that have been banned in other countries. 

When a reporter asked at the press conference why the report was not more critical about pesticides, as some people had expected, the administration defended its position, saying that the government already had a strong pesticide-review process in place.

“The EPA is arguably the most rigorous, most data backed, the most scientifically backed deep review process in the world,” USDA secretary Brooke Rollins said. “To approve any product that is used by our farmers, it will have gone through years upon years upon years of research.” 

EPA Administrator Lee Zeldin added that the EPA was “aggressively confronting” the threat of banned pesticides that had been imported or smuggled into the U.S. 

Another criticism of the leaked report came from Marion Nestle, a renowned nutritionist and professor of food studies at New York University. She lambasted the report for having too few actual plans to change the system, and too many calls for more research. 

“When it comes to policy, it has one strong, overall message: more research needed. Regulate?  Not a chance,” Nestle wrote, on her website. “Everything else is waffle words: explore, coordinate, partner, prioritize, develop, or work toward.”

The final strategy plan says it will address the chronic disease crisis “through advancing research,” that it will launch a new vaccine injury research program, that it will “conduct research as appropriate” on prescription patterns for mental health drugs, and will “expand research on dietary patterns,” to name a few. 

There are, of course, some groups that will be happy with the MAHA strategy report, including those in the food industry who were spared the regulation that the initial report seemed to hint was coming. The strategy report largely eschews industry regulation and instead calls for industry guidelines, which are often determined and developed by companies, not by the government. 

Rather than regulating the direct marking of food to children, for example, the strategy report says it will explore the development of potential industry guidelines.   

That approach to industry is not so different from what Michelle Obama did in her Let’s Move campaign, says Mande, of Harvard, who served in the USDA at the time. Obama’s government-wide effort to combat childhood obesity highlighted companies that were making their own efforts to meet the goals she had set in Let’s Move. Though she would name specific companies and hold events with them to celebrate their commitments, a lot of those commitments have fallen by the wayside, he says.

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At the press conference, Rollins highlighted companies that had voluntarily agreed to remove petroleum food dyes from their food products, calling them out by name.  

Some food industry groups also seemed to be pleased with the report, especially those in the dairy industry. 

They include the National Milk Producers Federation (NMPF), which celebrated a line from the strategy report that suggests that the Trump Administration will push to get whole milk back into schools. For decades, scientific evidence has suggested that because whole milk contains high levels of saturated fat, consumers should favor lower-fat versions. The MAHA report, on the other hand, says it wants to remove restrictions on whole-milk sales in schools. 

“The MAHA Commission’s Make Our Children Healthy Again Strategy recognizes what the latest science indicates and what we’ve long been saying: that getting whole milk back into schools and boosting dairy in diets helps meet America’s nutritional needs,” said NMPF president and CEO Gregg Doud on the group’s website, “and that it is critical to improving the health of our nation’s children.”

As head of the U.S. Department of Health and Human Services (HHS), Robert F. Kennedy Jr. has promised to lead with “radical transparency,” follow “gold-standard science,” and maintain vaccine access. But top officials at the U.S. Centers for Disease Control and Prevention (CDC) tell TIME that Kennedy has done only the opposite—prompting them to resign in late August from the agency. Their accounts include previously unreported details about the turmoil unfolding at one of the nation’s leading health agencies.

Kennedy has repeatedly sidelined CDC officials, ignored established research, circumvented scientific protocols, and pushed a vaccine agenda rooted in ideology and not science, say Dr. Debra Houry, CDC’s former chief medical officer; Dr. Demetre Daskalakis, the agency’s ex-vaccine chief; and Dr. Daniel Jernigan, who led the department that oversees vaccine safety.

Kennedy has stacked a key vaccine-advisory committee with vaccine opponents and granted special status to a vaccine skeptic allowing him unhampered access to part of a sensitive CDC vaccine database, they say. His office has, without explanation, held up a data project that CDC scientists say would make the agency’s data more transparent. And he has made major policy decisions, including changing vaccine recommendations, without consulting top CDC scientists, the former officials say. 

Houry, Daskalakis, and Jernigan resigned on Aug. 27, the same day the White House fired CDC Director Susan Monarez. Jennifer Layden, another top CDC official, also resigned. The four former officials spoke to TIME this week.

“You get to the point where if you stay, you’re complicit,” Daskalakis says. “I couldn’t just sit there and not say this is horribly wrong.” In his resignation letter, the former director of the National Center for Immunization and Respiratory Diseases wrote that he could no longer serve “in an environment that treats CDC as a tool to generate policies and materials that do not reflect scientific reality and are designed to hurt rather than to improve the public’s health.”

Monarez wrote in an op-ed published in the Wall Street Journal on Sept. 4 that she was instructed by Kennedy in a recent meeting to rubber-stamp all recommendations from the Advisory Committee on Immunization Practices (ACIP), an independent group that is supposed to advise the CDC director on vaccines, even though the director isn’t required to accept its recommendations. In an unprecedented move, Kennedy fired all ACIP members in June and replaced them with his allies, including several vaccine opponents. 

Monarez wrote that she was fired because she refused to compromise science.

“I hit my line when it became clear that Susan was being totally sidelined on the topic of vaccines,” Daskalakis says. “ACIP is being led by ideologues that don’t have regard for science. I know how this story ends. It will limit the ability of people to get vaccines.” 

Kennedy defended the CDC shakeup during a Senate Finance Committee hearing on Sept. 4, saying that the changes were necessary to “restore the agency to its role as the world’s gold-standard public health agency.” He said Monarez lied about the factors that had led to her firing and that he didn’t have a private meeting with her.

HHS did not respond to TIME’s request for comment.

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Monarez had earlier tried to appoint a new designated federal official for ACIP, but had been blocked by Kennedy’s office, Houry says. The official attends committee meetings and ensures members are complying with federal law and the correct protocols. Monarez had wanted to appoint someone with more legal and policy experience to the role given the inexperience of most current ACIP members, Houry says. “The final straw for me was when Susan couldn’t make that change. Any hope I had in scientific integrity was gone.”

At its first meeting in June, the new ACIP committee heard a presentation on the risks of thimerosal, a preservative that anti-vaccine activists have claimed is linked to autism. CDC scientists prepared a document for the meeting that showed, based on multiple studies, no link between thimerosal in vaccines to autism or other neurodevelopmental disorders. (For more than two decades, thimerosal has not been used in childhood vaccines except for flu vaccines in multi-dose vials. Most flu vaccines in the U.S. are given in single-dose vials that don’t contain thimerosal.) The document was initially posted online but was taken down on the day of the meeting at the behest of Kennedy’s office, Daskalakis says.

“They were cherrypicking what they wanted the American public to see,” he says. 

ACIP recommended that thimerosal be removed from all vaccines. HHS said in July that it was adopting the committee’s recommendation.

One of the key roles of the CDC is to provide scientific data and analyses to the Health Secretary and others, including ACIP, to help guide public-health policy and recommendations. But Daskalakis, Houry, and Jernigan say Kennedy barely engaged with CDC staff and disregarded CDC data that was provided, particularly related to vaccines. 

Daskalakis and Houry say they offered to brief Kennedy on a variety of public-health issues but were never invited to do so. Jernigan, former director of the National Center for Emerging and Zoonotic Infectious Diseases, says members of his staff were invited to a single scientific meeting with Kennedy, which took place in August and focused on Lyme disease. Jernigan says HHS staff told his team to avoid discussing the Lyme disease vaccine, which is under development for people.

Jernigan, Houry, and Daskalakis say they were in a meeting in May with other top CDC officials when they learned, via the social-media platform X, that Kennedy had announced a change to the CDC’s recommended vaccine schedules. 

“Radical transparency? Well, that’s not how you want to find out about COVID vaccine guidance,” Houry says. 

Layden, a fourth CDC official who resigned last week, said she left the agency because recent budget and staffing cuts, coupled with a lack of leadership support, had made it impossible for her to do her job. Layden was the director of CDC’s Office of Public Health Data, Surveillance and Technology, which oversees the agency’s data-modernization efforts. She says her group had recently completed a new website that centralizes data of all reportable infectious diseases. The CDC currently has separate websites for each disease, which can be hard to navigate.

“The idea was to create a one-stop shop,” Layden says. 

But Kennedy’s office needs to greenlight the website before it can be made public. “We never got the approval to release it,” Layden says. “No reasoning has been given.” 

Not publishing a website that provides clearer data is “inconsistent with being transparent,” she says.

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As of last week, no one at CDC had seen the agenda for the next ACIP meeting, scheduled to take place later this month, Daskalakis says. CDC scientists are usually involved months ahead of such meetings and provide guidance and data to the committee.

The agenda has since been posted online and lists respiratory syncytial virus (RSV) as one of the issues up for discussion. “No one at CDC has any idea what that topic is about,” Daskalakis says.

CDC staff are also in the dark about what David Geier, a longtime vaccine opponent who Kennedy tapped earlier this year to conduct vaccine-safety research, is up to, says Jernigan.

Kennedy has granted Geier special access to part of the CDC’s Vaccine Safety Datalink (VSD), Jernigan says. Scientists use the VSD to monitor vaccine safety and conduct studies about adverse events following vaccination. 

The VSD is a collaboration between the CDC and about a dozen large health care networks. The CDC only owns VSD data collected before 2000, and that is the data Geier has been given access to, Jernigan says. Unlike other researchers, however, Geier hasn’t been required to provide information to the CDC about what he is using the data for or explain what steps he is taking to protect the private health information contained in the VSD, the former official says. 

“We asked him to present a study question and protocol. We have never seen those documents,” Jernigan says. “That’s not transparent. That’s not gold-standard science.” 

Geier is expected to produce a report based on his research soon, Jernigan says. 

Geier, whose highest credential is a bachelor’s degree in biology, has built his career attempting to show a link between vaccines and autism. Large studies conducted over decades have shown no such link. 

In the 2000s, Geier, together with his late father and collaborator, Mark Geier, were barred from accessing the VSD at least twice by CDC officials who said they had misused it. Jernigan says he had misgivings about providing VSD access to Geier, but was told by an HHS attorney that Geier had been designated as a direct agent of Kennedy’s. “Our engagement with David was equivalent to engaging with” Kennedy himself, Jernigan says.

Jernigan, Houry, and Daskalakis say that Kennedy’s vaccine moves are already harming Americans. After changes to federal COVID-19 vaccine guidance were announced, CVS and Walgreens said last week they would restrict access to COVID-19 shots in several states.

It’s been a tumultuous week for U.S. Health and Human Services Secretary Robert F. Kennedy Jr. He and the Trump Administration fired Susan Monarez, director of the U.S. Centers for Disease Control and Prevention (CDC), just a month after she was confirmed, which triggered a series of high-profile resignations within the agency. Days later, nine former CDC leaders called on Kennedy to resign. Underlying this tumult is Kennedy’s vaccine-skeptical agenda, and on Sept. 4, Kennedy defended his controversial actions at HHS during a Senate hearing—in which he also maintained his skepticism about vaccines.

“When were you lying, Sir: when you told this committee that you were not anti-vax, or when you told Americans that there’s no safe and effective vaccine?” Sen. Tina Smith, a Democrat from Minnesota, asked Kennedy, referring to a podcast appearance in which he questioned the safety of vaccines.

“Both are true,” he replied.

Kennedy’s time as HHS secretary has been marred with controversy. In June, he fired all of 17 members of the Advisory Committee for Immunization Practices (ACIP), which develops vaccine recommendations for the CDC to consider, and then replaced them with new members, some of whom have expressed skepticism about vaccines. In early August, he canceled $500 million in funding for mRNA vaccine development, even though that technology led to the development of the COVID-19 vaccine.

Under his watch, the U.S. Food and Drug Administration (FDA) decided to limit approval for COVID-19 shots to adults 65 and older or those at high risk for severe COVID-19 outcomes. And in late August, he fired Monarez, the CDC director,  for refusing to rubber-stamp ACIP’s vaccine recommendations in advance, she wrote in her Sept. 4 opinion piece in the Wall Street Journal. 

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Sen. Elizabeth Warren directly asked Kennedy about his interaction with Monarez in the hearing.

“Did you tell the head of the CDC that if she refused to sign off on your changes to the childhood vaccine schedule, that she had to resign?” Warren said.

“No, I told her that she had to resign because I asked her, ‘Are you a trustworthy person?’ and she said, ‘No,’” Kennedy responded. 

“So you’re saying she’s lying?” Warren said.

“Yes,” Kennedy replied. 

Warren also questioned Kennedy about the FDA’s decision to recommend the updated COVID-19 vaccine only for people 65 or older and children and adults with risk factors for developing severe disease. Those recommendations have caused much confusion, and both CVS and Walgreens have limited access to the vaccines in some states to people with a prescription.

“Last November, while you were under consideration to become Secretary of Health and Human Services, Mr. Kennedy, you said, ‘If vaccines are working for somebody, I’m not going to take them away,’” Warren said. “Then last week, you announced the COVID-19 vaccine is no longer approved for healthy people under the age of 65. Obviously, both things cannot be true at the same moment.”

“Anybody can get the booster,” Kennedy said. 

“So you’re saying that is now the official rule of HHS: anybody is eligible to get a booster by just walking into the pharmacy?” Warren asked.

“It’s not recommended for healthy people,” he said. “No.” 

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Almost all Republican members of the Senate voted to confirm Kennedy earlier this year. But in the Senate hearing, some challenged Kennedy’s recent actions on vaccines. They included Sen. Bill Cassidy, a physician from Louisiana who had said he had “reservations” about Kennedy’s past positions about vaccine safety at the confirmation hearing, but who ultimately supported Kennedy’s nomination.

Cassidy began by saying he believed that President Trump deserved a Nobel Prize for Operation Warp Speed, the public-private partnership that accelerated the development of the COVID-19 vaccine. He then asked Kennedy if he agreed; Kennedy said he did. 

That “surprises me,” Cassidy said. “You canceled—or HHS did, but apparently under your director—$500 million in contracts using the mRNA vaccine platform that was critical to Operation Warp Speed—again, an accomplishment that I think President Trump should get a Nobel Prize for.”

Cassidy also read letters he had received from friends and doctors who expressed concern about the confusion surrounding who was able to get a COVID-19 vaccine. One friend said that his wife, who has Stage IV lung cancer, was unable to get the vaccine at CVS “thanks to the mess at HHS.” Another wrote Cassidy that doctors are confused about who can get the COVID-19 vaccine, and that they are turning to attorneys to get opinions. 

“I would say, effectively, we’re denying people vaccines,” Cassidy concluded. 

“You’re wrong,” Kennedy said. 

Sen. John Barrasso, a physician and Republican from Wyoming, said that he, too, had gotten messages from concerned doctors he used to work with.

“There are real concerns that safe, proven vaccines like measles, like Hepatitis B and others, could be in jeopardy, and that would put Americans at risk and reverse decades of progress,” he said. 

Kennedy’s clearest statements about where he stands on vaccines came during an exchange with Sen. Michael Bennet, a Democrat from Colorado, who questioned one of the new members Kennedy appointed to the vaccine advisory panel, Dr. Retsef Levi. “Are you aware that another one of these new members, Dr. Levi, wrote that ‘Evidence is mounting and indisputable that mRNA vaccines cause serious harm including death, especially among young people’?” Bennet asked. 

“I wasn’t aware that he said it, but I agree with it,” Kennedy answered. 

It’s not true,” Bennet said. “It wasn’t true when he said it. It’s not true when you said it.”

Thom Tillis, a Republican Senator from North Carolina, brought up the exchange later in the hearing, seemingly surprised that Kennedy so blatantly called into question a technology that had been lauded by President Trump.