Despite the skepticism and outrage over Robert F. Kennedy Jr.’s nomination to head the Department of Health and Human Services, there is a lot that he can do to reassure doubters in the medical community.
His continued focus on the need to improve our food quality and fight the obesity epidemic head-on is one major thing, especially if you see food as medicine (as I do) or recognize that a healthy person with a normal weight is much less likely to get sick and need expensive health care.
Kennedy needs to follow through on these ideas, not only because they are essential to decreasing health care costs and turning us from a sick-care to a health care system, but also because they are likely to garner bipartisan support. He will need to take on the food and agriculture lobbies, not just reform the Food and Drug Administration.
In the meantime, I would recommend supporting all tools we have to fight obesity and its consequences, including semaglutide and related drugs (Ozempic, Wegovy, Mounjaro, etc.) This is not an either-or situation, as we must get our weight down any way we can with over 40 percent of Americans obese.
When it comes to water fluoridation, I am hoping that RFK Jr. adopts a more moderate approach rather than a ban — raising a question rather than providing a quick answer. Clearly, water fluoridation has cut down dramatically on cavities over the years, but how necessary is it now that Fluoride is also in toothpaste? And what level is safe?
The Environmental Protection Agency, Centers for Disease Control and Prevention, American Academy of Pediatrics and the American Dental Association all say 0.7 mg per liter of water, but this is difficult to control and in certain areas, it can be higher.
Some observational studies have shown that more than double the recommended amount could possibly be associated with developmental issues in infants. Clearly, more research needs to be done as fluoridation has a big upside as well.
Another thing Kennedy can do is to reconsider some of his more controversial ideas on vaccines. It is one thing to question and ask for more data, it is another to express overt skepticism or cynicism.
Vaccination is an extremely important public health tool that alerts the immune system to a potential pathogen so it is thereby primed to fight it. If enough people take it, a community immunity against a pathogen develops.
Of course, vaccine effectiveness varies and alerting the immune system has side effects, but not generally more than the virus does itself. Deciding whether or not to give a vaccine is a risk-benefit analysis where the vaccine should generally win.
Unfortunately, because of fears of putting a needle into your arm versus the more theoretical risk of getting a virus, it is important not to fearmonger because it tips the scales away from useful immunizations. Kennedy could gain much more support in the medical community if he approached vaccines from this perspective.
Smallpox is a spectacular example of what a vaccine can do. That disease killed hundreds of millions of people over thousands of years before British physician Edward Jenner observed that milkmaids who had caught a cousin virus cowpox did not then develop smallpox. He had the brilliant idea of injecting patients with material from cowpox sores, which alerted the immune system to produce a response that generalized to smallpox as well.
Jenner’s vaccine in 1796 changed the world, but it wasn’t until 1801 that enough studies were done to convince people that taking the cowpox vaccine wouldn’t turn them into cows. Thanks to vaccination, smallpox was eradicated from the world by 1979.
During the 1918 flu pandemic, there was no effective vaccine or treatment, though there were many struggles to develop them. Over 50 million people died worldwide.
With the COVID pandemic, Operation Warp Speed helped save millions of lives here and around the world. When I interviewed President Trump in July 2020, his excitement about the vaccines and treatments being developed under Operation Warp Speed was palpable.
His excitement proved prophetic, as he himself was saved by a cocktail of treatments, including monoclonal antibodies in October 2020. Paxlovid emerged as an extremely effective antiviral treatment for influenza at the level of Tamiflu.
I think Kennedy can gain more support by acknowledging the success of Operation Warp Speed and the extreme importance of tools in the fight against emerging contagions and pandemics.
The COVID vaccines should not be disparaged. They have not only been useful in decreasing severity, especially in those at higher risk but also in decreasing the risk of long COVID.
Vaccines save and do not cost lives. Kennedy should acknowledge this. Big Pharma and Big Food need reform badly, as do our health care agencies, but acknowledging successes is the best first step toward reform and preventing future failures.
We have come a long way from the days when people feared becoming cows from the first smallpox vaccine. Kennedy should see into the biotechnological future with excitement rather than fear.
Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of “COVID; The Politics of Fear and the Power of Science.”
