There’s a saying that Robert F Kennedy Jr is very fond of. He used it on the day he was confirmed as US health secretary. \u00ab\u00a0A healthy person has a thousand dreams, a sick person only has one,\u00a0\u00bb he said as he stood in the Oval Office. \u00ab\u00a060% of our population has only one dream \u2013 that they get better.\u00a0\u00bb<\/p>\n
The most powerful public health official in the US has made it his mission to tackle what he describes as an epidemic of chronic illness in America, a catch-all term that covers everything from obesity and diabetes to heart disease.<\/p>\n
His diagnosis that the US is experiencing an epidemic of ill health is a view shared by many healthcare experts in the country.<\/p>\n
But Kennedy also has a history of promoting unfounded health conspiracies, from the suggestion that Covid-19 targeted and spared certain ethnic groups to the idea that chemicals in tap water could be making children transgender.<\/p>\n
And after taking office, he slashed thousands of jobs at the Department of Health and Human Services and eliminated whole programmes at the Centers for Disease Control (CDC).<\/p>\n
\u00ab\u00a0On the one hand, it’s extraordinarily exciting to have a federal official take on chronic disease,\u00a0\u00bb says Marion Nestle, a retired professor of public health at New York University. \u00ab\u00a0On the other, the dismantling of the federal public health apparatus cannot possibly help with the agenda.\u00a0\u00bb<\/p>\n
Kennedy is reviled by parts of the medical and scientific communities. He was described to me as an \u00ab\u00a0evil nihilist\u00a0\u00bb by Dr Amesh Adalja, an infectious disease doctor and senior scholar at Johns Hopkins University.<\/p>\n
But even some of Kennedy’s critics accept that he is bringing drive and ambition to areas of healthcare that have been neglected. Is it possible that the man who attracts so much criticism – and in some quarters, hate – might actually start making America healthy again?<\/p>\n
There’s one industry that Kennedy had set his sights on long before joining the Trump administration: multinational food companies have, he has said, poisoned American children with artificial additives already banned in other countries.<\/p>\n
\u00ab\u00a0We have a generation of kids who are swimming around in a toxic soup right now,\u00a0\u00bb he claimed on Fox News last year.<\/p>\n
His first target was food colourings, with a promise to phase out the use of petroleum-based dyes by the end of 2026.<\/p>\n
Chemicals, with names like ‘Green No. 3’ and ‘Red No. 40’, have been linked to hyperactivity and behavioural issues in children, and cancer in some animal studies.<\/p>\n
\u00ab\u00a0What’s happening in this administration is really interesting,\u00a0\u00bb says Vani Hari, a food blogger and former Democrat who is now an influential voice in the Make America Healthy Again (MAHA) movement. \u00ab\u00a0MAHA is all about how do we get people off processed food, and one way to do that is to regulate the chemicals companies use.\u00a0\u00bb<\/p>\n
There are some signs this pressure may be paying off.<\/p>\n
The food giant PepsiCo, for example, said in a recent trading update that Lays crisps and Tostitos snacks \u00ab\u00a0will be out of artificial colours by the end of this year\u00a0\u00bb.<\/p>\n
Kennedy struck a voluntary agreement with the food industry but it only came after individual states from California to West Virginia had already started introducing their own laws.<\/p>\n
\u00ab\u00a0In the case of food dyes, companies will have to act because states are banning them [anyway] and they won’t want to have to formulate separate products for separate states,\u00a0\u00bb says Prof Nestle, an author and longtime critic of the industry.<\/p>\n
More recently Kennedy has signalled he backs a radical food bill in Texas that could target additives in some products ranging from sweets, to cereals and fizzy drinks<\/p>\n
Packets may soon have to carry a high-contrast label stating, \u00ab\u00a0WARNING: This product contains an ingredient that is not recommended for human consumption by the appropriate authority in Australia, Canada, the European Union, or the United Kingdom.\u00a0\u00bb<\/p>\n
The Consumer Brands Association, which represents some of the largest food manufacturers, opposes this, saying the ingredients used in the US food supply are safe and have been rigorously studied.<\/p>\n
It’s difficult to imagine that kind of regulation could ever be signed off in a state like Texas without the political backing of Kennedy and President Trump.<\/p>\n
\u00ab\u00a0He can’t change everything in a short amount of time, but I think the issue of food dyes will soon be history,\u00a0\u00bb says Ms Hari, who testified before the Senate on this subject last year.<\/p>\n
But others worry that the flurry of announcements on additives is tinkering around the edges of what is a much wider problem.<\/p>\n
\u00ab\u00a0While some of these individual actions are important, they are a drop in the ocean in the larger context of chronic disease,\u00a0\u00bb argues Nicola Hawley, professor of epidemiology at Yale School of Public Health. \u00ab\u00a0There is a focus on personal choice and access to natural food, but that completely ignores the big, systematic and structural barriers [to healthy eating] like poverty and really aggressive marketing of junk food to children.\u00a0\u00bb<\/p>\n
The US government, for example, still heavily subsidises crops including corn and soya beans, key ingredients in processed foods.<\/p>\n
Kennedy is now updating the US national dietary guidelines, an important document used to shape everything from school meals to assistance programmes for the elderly. A reduction in added sugars and a switch to more locally-sourced whole foods is expected. Plus he has called on states to ban millions of Americans from using food stamps, a welfare benefit, to buy junk food or sugar-sweetened drinks.<\/p>\n
He has also backed local officials who want to stop adding fluoride to drinking water, describing it as a \u00ab\u00a0dangerous neurotoxin\u00a0\u00bb. It is used in some countries, including in parts of the US, to prevent tooth decay, and whilst there is still debate about the possible health effects, the NHS says a review of the risks has found \u00ab\u00a0no convincing evidence\u00a0\u00bb to support any concerns. Other fluoride research has found the mineral only has detrimental health effects at extremely high levels.<\/p>\n
Prof Hawley also argues there is a tension between Kennedy’s \u00ab\u00a0important message\u00a0\u00bb on food and chronic disease, and what she feels is a lack of policies backed by solid scientific evidence.<\/p>\n
\u00ab\u00a0You’ve got this challenge of him drifting into misinformation about the links between additives and chronic disease, or environmental risk factors,\u00a0\u00bb she argues. \u00ab\u00a0And that really just undermines the science.\u00a0\u00bb<\/p>\n
That tension is even clearer when it comes to another of Kennedy’s big concerns.<\/p>\n
Vaccines are still listed on the CDC website as one of the great public health achievements of the last century, alongside family planning and tobacco control. They prevent countless cases of disease and disability each year, and save millions of lives, according to the American Medical Association.<\/p>\n
Kennedy, though, is the best known vaccine sceptic in the country. The activist group he ran for eight years, Children’s Health Defense, repeatedly questioned the safety and efficacy of vaccination.<\/p>\n
In 2019 he described the disgraced British doctor Andrew Wakefield as the \u00ab\u00a0most unfairly maligned person in modern history\u00a0\u00bb and told a crowd in Washington that \u00ab\u00a0any just society\u00a0\u00bb would be building statues of him.<\/p>\n
Wakefield was struck off the UK medical register in 2010 after his research falsely linked the MMR (measles, mumps and rubella) vaccine to autism, leading to a spike in measles cases in England and some other countries.<\/p>\n
Over the last year, Kennedy has repeatedly insisted he is not \u00ab\u00a0anti-vax\u00a0\u00bb and will not be \u00ab\u00a0taking away anybody’s vaccines\u00a0\u00bb. Faced with a deadly measles outbreak in unvaccinated children in west Texas, he posted that the MMR was \u00ab\u00a0the most effective way to prevent the spread of the disease\u00a0\u00bb.<\/p>\n
In other comments though, he described vaccination as\u202fa \u00ab\u00a0personal choice\u00a0\u00bb and emphasised alternative treatments such as vitamin A supplements.<\/p>\n
A huge deal with the drugmaker Moderna to develop a vaccine to combat bird flu in humans was scrapped, and new rules were brought in which could mean some vaccines need extra testing before they can be updated each winter.<\/p>\n
In May, Kennedy posted a video on social media saying the government would no longer endorse Covid vaccines for healthy children and pregnant women.<\/p>\n
However, some doctors point out that reducing eligibility would simply bring the US into line with other countries, including the UK, where free Covid boosters are restricted to those over 75 or with weakened immune systems.<\/p>\n
\u00ab\u00a0They are really just aligning themselves with everyone else, which is not in any way outrageous,\u00a0\u00bb says Prof Adam Finn, a paediatric doctor and one of the UK’s leading experts on vaccines.<\/p>\n
Then in June, Kennedy suddenly sacked all 17 members of the influential expert committee, which advises the CDC on vaccine eligibility. He accused the panel of being \u00ab\u00a0plagued with persistent conflicts of interest\u00a0\u00bb and rubber-stamping new vaccines without proper scrutiny.<\/p>\n
A new, much smaller, committee handpicked by the administration now has the power to change, or even drop, critical recommendations to immunise Americans for certain diseases, as well as shape the childhood vaccination programme.<\/p>\n
\u00ab\u00a0It underscores just how much we are backsliding now,\u00a0\u00bb says Dr Amesh Adalja, the infectious disease doctor and senior scholar at Johns Hopkins University. \u00ab\u00a0I think increasingly the panel will become irrelevant if RFK Jr is able to shape it the way he wants to.\u00a0\u00bb<\/p>\n
The new panel made its first decision last week, voting to stop recommending a small number of flu vaccines that still contain the preservative thimerosal, something Kennedy wrote a book about in 2015.<\/p>\n
His critics say that a new era of vaccine policy has arrived in the US. Whilst his supporters say no subject, including vaccine safety, should be considered off-limits.<\/p>\n
\u00ab\u00a0Everything has to be open to discussion and Bobby Kennedy is not anti-vaccine, he’s anti-corruption,\u00a0\u00bb argues Tony Lyons, who co-founded the political action committee that supported his independent presidential campaign.<\/p>\n
\u00ab\u00a0It’s about being pro-science, pro-capitalism, and believing you have an obligation to the public to do a thorough job of researching any product that is put in the arms of 40 million children.\u00a0\u00bb<\/p>\n
Weeks after Kennedy took office news emerged that the CDC would open a research project into the link between vaccines and autism.<\/p>\n
Since Wakefield’s now-discredited Lancet paper in 1998, which linked autism to the MMR vaccine given to children, there have been numerous international studies that have looked at this in detail and found no reputable link.<\/p>\n
\u00ab\u00a0There is nothing to debate any more, it has been settled by science,\u00a0\u00bb says Eric Fombonne, an autism researcher and professor emeritus at Oregon Health & Science University.<\/p>\n
Kennedy, though, has hired David Geier, a noted vaccine sceptic, to look again at the data.<\/p>\n
Today autism is widely understood to be a lifelong spectrum condition. It can include those with high support needs who are non-speaking, and those with above-average intelligence who might struggle with social interaction or communication.<\/p>\n
Most researchers believe a rise in cases over decades is down to a broadening in the way children with autism are defined, as well as improved awareness, understanding and screening.<\/p>\n
But in April, Kennedy dismissed that idea, describing autism as \u00ab\u00a0preventable\u00a0\u00bb. He blamed a mysterious environmental trigger for the increase in eight-year-olds being diagnosed.<\/p>\n
\u00ab\u00a0This is coming from an environmental toxin\u2026 [in] our air, our water, our medicines, our food,\u00a0\u00bb he said.<\/p>\n
He pledged a massive research effort to find that cause by September and \u00ab\u00a0eliminate those exposures\u00a0\u00bb.<\/p>\n
Dr Fombonne strongly disputes this. \u00ab\u00a0It is nonsensical and shows a complete absence of understanding,\u00a0\u00bb he says. \u00ab\u00a0We have known for many years that autism has a strong genetic component.\u00a0\u00bb<\/p>\n
In the same speech, Kennedy said that many autistic children will never \u00ab\u00a0pay taxes, never hold a job. They’ll never play baseball. They’ll never write a poem. They’ll never go out on a date. Many of them will never use a toilet unassisted.\u00a0\u00bb<\/p>\n
Many in the autism community are angry. \u00ab\u00a0What we’re seeing here is a fear-based rhetoric and [a] misleading narrative that is causing harm and perpetuating stigma,\u00a0\u00bb says Kristyn Roth from the Autism Society of America.<\/p>\n
But some parents of autistic children are more supportive.<\/p>\n
Emily May, a writer who is the mother of a child with autism, wrote in The New York Times that she found herself \u00ab\u00a0nodding along as Mr Kennedy spoke about the grim realities of profound autism\u00a0\u00bb.<\/p>\n
\u00ab\u00a0His remarks echo the reality and pain of a subset of parents of children with autism who feel left out of much of the conversation,\u00a0\u00bb she wrote.<\/p>\n
The administration has since watered down that promise to find the reasons for autism by September but it is still promising detailed findings of its research by March 2026.<\/p>\n
Ultimately, Robert Kennedy has only been in the job a matter of months. Already though he’s asking some big questions \u2013 particularly about chronic disease \u2013 which have never been asked in the same way by a health secretary before.<\/p>\n
For the first time that issue has both political attention and bipartisan support in the US.<\/p>\n
He is clearly not afraid to take on what he perceives to be vested interests in the food and drug industries, and he is still firmly supported by President Trump.<\/p>\n
Tony Lyons, who has published books by Kennedy, calls him \u00ab\u00a0uniquely qualified\u00a0\u00bb for the most powerful job in US public health. \u00ab\u00a0He’s a corruption fighter. He has seen what all these kinds of companies do, not just pharmaceutical companies but food companies, and he wants them to do a better job,\u00a0\u00bb he says.<\/p>\n
Robert Kennedy’s background as an environmental lawyer taking on big business and the establishment has clearly shaped the views he holds today.<\/p>\n
But Jerold Mande, a former federal food policy advisor in three administrations, worries that Kennedy’s own views and biases will mean some of the solutions he’s reaching for are predetermined and unsupported by the evidence.<\/p>\n
Now a professor of nutrition at Harvard, Prof Mande describes Kennedy as an imperfect messenger and says he has \u00ab\u00a0great concerns\u00a0\u00bb about the administration’s approach to aspects of public health, from tobacco control to vaccination, where there is \u00ab\u00a0no question that what he’s doing is going to result in enormous harm.\u00a0\u00bb<\/p>\n
\u00ab\u00a0At a high level, I’m optimistic but you still need to come up with the right answers, and those answers can only be found through science,\u00a0\u00bb says Prof Mande.<\/p>\n
\u00ab\u00a0We now have a shot and he’s provided that by making it a priority. But it’s how you use that shot that’s going to determine whether it’s a success or not. And that is where the jury is still out.\u00a0\u00bb<\/p>\n
Top image credit: Chip Somodevilla \/ Staff via Getty<\/p>\n
BBC InDepth is the home on the website and app for the best analysis, with fresh perspectives that challenge assumptions and deep reporting on the biggest issues of the day. And we showcase thought-provoking content from across BBC Sounds and iPlayer too. You can send us your feedback on the InDepth section by clicking on the button below.<\/p>\n","protected":false},"excerpt":{"rendered":"
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