What could Trump's health pick RFK Jr. mean for patients and drug makers?

Donald Trump has made a clear promise about who could help take the government's health reins if he wins the presidency: Robert F. Kennedy Jr., the vaccine skeptic and conspiracy theorist.

The former president said last week that Kennedy, who ended his independent campaign for the White House earlier this year and supported Trump, would have a “big role” on health care in his administration. Last month, Trump said he would let Kennedy “freak out” on health, food and drug regulation.

It's not clear what exactly Kennedy's role will look like, but the prospect is already raising alarm bells in the broader health community. Some health experts said that promoting Kennedy, even to an unofficial position in the Trump administration, could have dire consequences for patients, drug makers and the country's public health overall.

“I think it's going to be an upside-down world,” Dr. Paul Offit, a vaccine expert at Children's Hospital of Philadelphia who has been an outspoken critic of Kennedy, told CNBC. “Things will not be based on scientific fact, they will only be based on what he or his collaborators believe. It will be up for grabs. There will be uncertainty and instability. It will be chaos.”

He said the “chaos” could look like declining vaccination rates, an increase in preventable diseases, and increasing distrust of federal health agencies, such as the Food and Drug Administration and the Centers for Disease Control and Prevention.

Some experts say this could exacerbate the country's existing public health challenges, such as low rates of childhood vaccination against many preventable diseases. The United States also has the lowest life expectancy at birth, the highest rate of people with multiple chronic diseases, and the highest maternal and infant mortality rates among other high-income countries, according to a 2023 report by the Commonwealth Fund, an independent research group. .

Kennedy, who has no medical or scientific credentials, believes that drug companies and the federal health agencies that regulate them are making Americans less healthy. He suggested taking some vaccines off the market — a position Trump did not rule out on Monday.

The former environmental lawyer may also bring uncertainty to the pharmaceutical industry, which relies on federal health agencies to greenlight new products, keep old ones on the market and, in some cases, fund research and development. It will likely be difficult for Kennedy to change the drug approval process, but experts said he could gain a new platform to politicize certain treatments he opposes and promote others that have not been proven safe and effective.

Top leadership roles, such as Food and Drug Administration commissioner, require Senate confirmation, which some experts have suggested could be an obstacle for Kennedy. But Kennedy has met with Trump's transition officials and could take over as a White House “health official” that would not need Senate confirmation, The Washington Post reported Saturday.

Whatever the position looks like, Kennedy will likely get “a new platform to spread his views,” said Drew Altman, president and CEO of the health policy organization KFF.

“It gives one of the chief architects of health misinformation a national platform that the president supports,” Altman told CNBC. “More people will hear what he has to say, believe it and act on it. This could pose a risk to their health.”

Kennedy's team did not immediately respond to CNBC's request for comment.

A second Trump term could allow Kennedy to raise the bar on anti-vaccine rhetoric, regardless of whether he holds a key role at a federal health agency.

Health experts said this could prevent more Americans from receiving Covid vaccines and routine immunizations against various diseases that have for decades saved millions of lives and prevented crippling diseases.

“By raising his message, he's making people and parents naturally opt out of the vaccination schedule,” said Genevieve Kanter, an assistant professor of public policy at the University of Southern California. “I think we can reasonably predict that there will be a decline in vaccination rates among children, and perhaps vaccination overall.”

Real-world data from the Centers for Disease Control and Prevention suggests that routine vaccination rates for kindergartners have declined during the pandemic and have not yet rebounded. Experts noted that if Kennedy can reduce these rates, vaccine-preventable diseases such as polio and measles will likely return.

For companies that make the doses, the increase in anti-vaccine rhetoric will likely translate into lower revenues. Pharmaceutical makers such as Pfizer and Moderna These companies are still recovering from low coronavirus vaccination rates in the United States, which has dragged down their profits over the past two years.

Some experts say Kennedy could also affect the drug industry's ability to respond to another pandemic if he is given the authority to decide how much federal funding should go to vaccine development. He told NBC News last year that he would not prioritize research, manufacturing or distribution of vaccines if we faced another pandemic, falsely adding that “vaccines have probably caused more deaths than they have avoided.”

Kennedy's record as a vaccine skeptic is extensive: He has long made misleading and false statements about the safety of the shots, such as claiming they are linked to autism despite numerous studies dating back decades that have debunked that link. Kennedy is the founder of the nonprofit Children's Health Defense, the nation's most funded anti-vaccine organization.

“He lies to the point that children are suffering or dying, and he also backs off and takes no responsibility for it,” Offit said.

He pointed to Kennedy's misinformation about the safety of the measles, mumps and rubella vaccine, which was linked to a severe measles outbreak in Samoa in 2019 that left dozens of children dead.

It will likely be difficult for Kennedy to change how vaccines and other treatments are approved, recommended and regulated, even in a leadership role at the US Food and Drug Administration, the Centers for Disease Control and Prevention, or the Department of Health and Human Services, which oversees both agencies.

This could be good news for both patients and drug makers.

“Approval processes are very well defined and managed by civil servants,” USC's Kanter said. “I don't see, in terms of day-to-day product approvals, that he's going to have a lot of influence because that's not the way the FDA is structured, that's not the role of the FDA commissioner. And so this process, I think we can trust to stay consistent.” ”

Recommendations regarding vaccine approval, use, and coverage under certain federal health plans are made by advisory committees to the FDA and CDC, which are composed of outside experts in public health and medicine. The same applies to other medical treatments and devices.

George Benjamin, executive director of the American Public Health Association, told CNBC that Kennedy might try to pack those committees with people with similar views on vaccination or other treatments to disrupt “the traditional regulatory oversight that protects us.”

But members of those committees must undergo a rigorous nomination process. Many states that rely on the advisory committee's recommendations on vaccination schedules and mandates could also choose to ignore them if people sympathetic to Kennedy's views join the committees.

Kennedy's other proposals to reform federal health agencies are likely to be difficult to implement. He has proposed cutting funding or staffing at the FDA, but those changes would have to come from Congress.

Last week, Kennedy warned in an X post that the FDA's “war on public health is about to end” and hinted at plans to revoke the agency for workers who disagree with his views.

He accused the agency of aggressively cracking down on drugs, peptides, stem cells, raw milk, hyperbaric therapies, chelators, ivermectin, hydroxychloroquine, vitamins, clean foods, sunlight, exercise, nutrients and anything else that promotes human health and can help improve human health. man. “The invention will not be patented by Pharma.”

Kennedy has previously claimed that hydroxychloroquine and ivermectin work against Covid, although several studies say they do not. Hydroxychloroquine is an immunosuppressive drug, while ivermectin is used to treat infections caused by parasites.

“He has embraced a lot of treatments that have not been proven for some use and some of which have been discredited,” Kanter said.

Both Kennedy and Trump have been vocal about addressing the root causes of chronic diseases rather than spending resources on treating those conditions with drugs from the pharmaceutical industry. There are few details about what this might mean for drugmakers, but experts said Kennedy pushed misleading claims about the factors that cause chronic disease.

The prevalence of chronic diseases, which last for a year or more and require continuous medical care, is a real problem in the United States

A growing percentage of people in America have multiple chronic conditions, with approximately 42% having two or more, according to the CDC. More than 40% of school-age children and adolescents have at least one. Chronic diseases such as heart disease, cancer, diabetes and obesity are also a major driver of health care costs in the United States, accounting for about 90% of the $4.1 trillion in annual health care expenditures, the Centers for Disease Control and Prevention said.

Kennedy could lead “Operation Warp Speed ​​for pediatric chronic diseases” under the Trump administration, sources close to the former president's campaign told NBC News last week. This refers to the title of the project to develop and distribute a Covid vaccine during Trump's first term.

It's not clear what the new program or Kennedy's role will look like, but the focus on chronic diseases is consistent with his so-called “Make America Healthy Again” platform.

The initiative — a take on Trump's “Make America Great Again” slogan — aims to remove chemicals from food production, combat the “root” causes of chronic disease and eliminate conflicts of interest in medical research, among other priorities that have largely bipartisan support. Environmental factors, such as air pollution and diet, contribute to chronic health conditions, but Kennedy has pushed unsubstantiated claims about some food ingredients and minerals.

Last week, Kennedy also proposed advising all water systems in the United States to remove fluoride from drinking water, falsely claiming it is an “industrial waste” linked to numerous medical conditions, such as thyroid disease and neurodevelopmental disorders. Trump has since said that this idea sounds “okay to me.”

But fluoride is a natural mineral found in soil, water and plants. Adding low levels of fluoride to drinking water is considered one of the greatest public health achievements of the 20th century for its role in preventing tooth decay.

USC's Kanter also said: “There is a danger of oversimplifying complex health problems” and attributing them to a few “root causes,” especially when they are not backed by science. Chronic diseases are complex conditions that can be caused by multiple factors, such as genetics and the patient's socioeconomic status, according to Kanter.

Kennedy's nonprofit falsely links vaccines to chronic diseases, citing misleading articles and studies that show unvaccinated populations suffer fewer chronic conditions than their vaccinated peers.