“Our public health system has squandered the trust of our citizens,” President Donald Trump said on February 13, 2025, the day his nominee to run the nation’s health businesses, Robert F. Kennedy Jr., was sworn in. “They don’t trust us. They don’t trust anybody, frankly. They’ve gone through hell.”
Trump promised that Kennedy would “lead our campaign of historic reforms and restore faith in American health care.”
A year later, polling exhibits that RFK Jr.’s tenure atop the US Department of Health and Human Services has had the other impact. Trust in authorities health businesses has plummeted, according to health coverage and analysis group KFF, with declines throughout the political spectrum. And consultants instructed NCS that they concern issues may worsen.
“Today, the federal government’s public health agencies and leaders represent the greatest threat to efforts to prevent measles, whooping cough and other vaccine-preventable diseases,” mentioned Dr. Jason Schwartz, an affiliate professor at Yale School of Public Health. It’s “a scenario that would have been inconceivable a few years ago.”
HHS spokesperson Andrew Nixon mentioned that trust in public health was broken by the Biden administration’s “inconsistent guidance and a message to Americans to ‘trust the experts’ without showing the evidence.”
“Secretary Kennedy’s mandate is to restore transparency, scientific rigor, and accountability to restore the trust the Biden administration squandered,” Nixon continued. “Secretary Kennedy is leading the most transparent HHS in history, with unprecedented disclosure and openness aimed at restoring public trust in federal health agencies.”
Kennedy’s technique has at occasions concerned gutting organizations; after he fired all 17 consultants on the US Centers for Disease Control and Prevention’s vaccine advisory panel in June, he printed an opinion piece in the Wall Street Journal headlined, “HHS Moves to Restore Public Trust in Vaccines.”
And he’s moved to dramatically reshape the make-up of HHS.
The day after Kennedy’s swearing-in, Valentine’s Day, thousands of staff have been fired from their jobs on the CDC, the US Food and Drug Administration, the US National Institutes of Health and different health businesses, a part of a Department of Government Efficiency purge. It would precede an excellent larger reorganization of HHS simply six weeks later that aimed to shrink its ranks by almost 1 / 4 – a complete of about 20,000 staff.
Meanwhile, public health emergencies have been already on his doorstep.
Two weeks after Kennedy was sworn in, health officers in Texas introduced {that a} school-age little one had died in the fast-growing measles outbreak centered in the western a part of the state. Kennedy, requested about it in a Cabinet assembly later that day, referred to as measles outbreaks “not unusual.” It was the primary demise in the US from measles in a decade.
The year that adopted would convey two more deaths from measles, an excellent bigger outbreak in South Carolina and extra simmering in different states. Kennedy’s first year additionally introduced dramatic upheavals of vaccine policy and expert panels, the cancellation of thousands of scientific research grants and a continued purge of management from federal health businesses.
“I worry that there are entire domains of knowledge that are no longer well-represented at CDC,” mentioned Dr. Caitlin Rivers, an affiliate professor on the Johns Hopkins Bloomberg School of Public Health.
She identified that the company has been a supply of experience that native health departments depend on.
“If you are facing a case of pneumonic plague or a hemorrhagic fever virus, you’re not going to have that in most state or local health departments,” Rivers mentioned. “You’re going to look to CDC to provide that expertise and support. And a lot of those people aren’t there anymore.”
The CDC can also be nonetheless and not using a confirmed director; the White House withdrew its nomination for Trump’s first choose, Dr. David Weldon, a former Florida congressman and Kennedy ally, hours earlier than his affirmation listening to in March amid issues that he wouldn’t win adequate votes.
Weldon subsequently launched a prolonged assertion in which he attributed the scuttling of his nomination to his previous concentrate on vaccine security, together with the preservative thimerosal, which was faraway from most childhood vaccines a long time in the past regardless of no proof of hurt. He additionally defended Andrew Wakefield, the British doctor who made debunked claims of a hyperlink between the measles-mumps-rubella vaccine and autism in 1998.
Trump’s subsequent choose, Dr. Susan Monarez, was confirmed and sworn in in July, solely to be ousted lower than a month later after a clash with Kennedy over what she described as her refusal to log off on vaccine coverage no matter scientific proof and to dismiss profession vaccine officers with out trigger. Kennedy later told Congress that Monarez was mendacity. Several high-level veteran CDC officers additionally resigned after Monarez’s departure.
All of this occurred simply weeks after a shooter fired almost 500 rounds at CDC headquarters in Atlanta, killing an area police officer and leaving home windows pockmarked with bullet holes. The Georgia Bureau of Investigation said the shooter had expressed discontent with the Covid-19 vaccine in written paperwork and “wanted to make the public aware of his public distrust.”
In a letter after the taking pictures, a whole bunch of present and former HHS staff implored Kennedy to “stop spreading inaccurate health information,” noting that the assault at CDC “was not random.”
In response, an announcement from the division mentioned that Kennedy was “standing firmly with CDC employees” and that “for the first time in its 70-year history, the mission of HHS is truly resonating with the American people.”
Polling means that’s not the case.
In April 2025, trust in the CDC as a supply of dependable health info stood at 59%, based on KFF. There was a big divide between political events: 70% for Democrats and 51% for Republicans.
Now, general trust in the CDC has fallen to 47%, based on KFF ballot results launched final week. Trust was down 15 share factors to 55% amongst Democrats and down 8 share factors to 43% amongst Republicans, though that’s a slight rebound from a low in September.
Trust in Kennedy himself as a supply of health info was additionally low, with 37% of these polled in January saying they trust him an incredible deal or a good quantity. Only Trump scored decrease, at 30%.
The ballot was carried out weeks after HHS introduced an overhaul of the US vaccine schedule for youngsters to align it extra carefully with different nations’, and in explicit, Denmark’s – a rustic with a inhabitants of about 6 million and free common health care. The outcome was a discount in routinely really useful vaccines from 17 to 11, a transfer decried by public health consultants as missing proof and placing kids in danger.
“HHS has largely abandoned the process of evidence gathering and evaluation that guided the recommendations process for decades and helped save countless lives,” mentioned Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy on the University of Minnesota. “In its place, decisions are being made based on ideology and politics.”
Osterholm cited the overhaul of the vaccine schedule in addition to the CDC’s determination to cease universally recommending a dose of the hepatitis B vaccine at beginning, a transfer that modeling suggested may result in extra infections, long-term health problems and deaths.
“The doubt and distrust federal health authorities continue to sow in vaccines will result in fewer people being vaccinated and more people getting seriously ill from vaccine-preventable diseases,” Osterholm mentioned. “We’re already seeing the results of declining measles vaccinations, as measles outbreaks in the U.S. grow larger and larger.”
In December, Kennedy swore in Dr. Ralph Abraham as principal deputy director of the CDC. Abraham had served as surgeon basic in Louisiana, the place he reduced support for some mass vaccination campaigns.
Last month, confronted with the prospect that the US may lose measles elimination standing after 26 years, Abraham told reporters that it would be “the cost of doing business” with the nation’s porous borders.
On Sunday, Dr. Mehmet Oz, administrator of the US Centers for Medicare and Medicaid Services, told NCS’s Dana Bash that he didn’t consider US health officers’ posture towards vaccines was contributing to the rising outbreaks, an announcement that beggared perception amongst many who’ve heard Kennedy equivocate on vaccine security and champion unproven treatments for measles.
“We’ve advocated for measles vaccines all along,” Oz instructed Bash. “Secretary Kennedy’s been at the very front of this.”
Supporters of Kennedy, after all, argue that he’s remodeling health look after the higher.
Dr. Kevin Roberts, president of the conservative assume tank the Heritage Foundation, final week celebrated “one year of winning at the Department of Health and Human Services,” calling Kennedy “the most consequential public health official leading that agency in modern American history.”
He cited strikes together with the discharge of recent dietary tips “that are going to get Americans eating real food again,” together with “a revolution in protein”; “increasing transparency and ensuring scientific integrity across all health agencies”; and the overhaul of the CDC’s childhood immunization suggestions.
“You’re a popular guy at Heritage, Mr. Secretary,” Roberts mentioned.
Nixon, the HHS spokesperson, mentioned the company “is exercising its full authority to deliver results for the American people,” citing elimination of the “black box” warning from hormones used to deal with menopause signs, efforts to decrease drug costs and streamline prior authorization, and elevated scrutiny of organ transplants, amongst different efforts.
The White House is leaning into points like Trump’s “most favored nation” offers that goal to decrease drug costs, in addition to its concentrate on more healthy consuming, because the midterms strategy.
That contains personnel moves announced Thursday that restructure Kennedy’s senior-most ranks, enabling the White House to train tighter management over key areas of HHS, an administration official instructed NCS.
And although diet and drug pricing are broadly extra widespread points, outdoors health consultants mentioned that even strikes in these areas can’t compete in affect with the harm achieved in the previous year to public health programs.
“Everything else pales in significance,” mentioned Dr. Marion Nestle, an emerita professor of diet, meals research and public health at New York University.
Nestle had initially expressed optimism about a few of Kennedy’s meals coverage objectives as he laid them out earlier than the presidential election. And she famous a number of accomplishments: a promise from meals corporations to take away synthetic dyes by the top of 2027, a definition of ultraprocessed meals being labored on on the FDA, and on reforming the process for chemical substances to be thought of GRAS, or Generally Recognized as Safe.
But she wished extra progress had been made there, too.
“One big disappointment is the lack of progress on removing industrial and agricultural chemicals from the food supply, as promised,” Nestle mentioned. “MAHA,” Kennedy’s Make America Healthy Again motion, “has so much momentum behind it; it’s a shame more couldn’t be accomplished.”
Last month’s release of the brand new US Dietary Guidelines did garner assist from teams together with the American Medical Association, notably for spotlighting issues about extremely processed meals and sugar-sweetened drinks.
And Dr. Jerold Mande, an adjunct professor of diet on the Harvard T.H. Chan School of Public Health who labored in meals coverage underneath Presidents George H.W. Bush, Bill Clinton and Barack Obama, pointed to efforts to enhance food regimen high quality by Supplemental Nutrition Assistance Program, or SNAP, advantages as doubtlessly notably impactful.
But he provides HHS an F grade in terms of investing in diet analysis, which he argues has been traditionally considerably underfunded by the NIH and hasn’t improved underneath Kennedy. Moreover, he mentioned, the administration’s messaging even on widespread points is unlikely to meet its promise to revive trust.
Last month, Kennedy posted a clip to his social media feeds of a model of a “South Park” episode from 2014. In the original, the joke is that the meals pyramid has been upside-down the entire time; flipping it put butter, meat and dairy in the largest locations on the high.
“Nutrition is stabilizing!” a scientist on the US Department of Agriculture declares, and the then-secretary of agriculture says the president must be instructed to “have some steak with his butter.”
In Kennedy’s version, he’s the one declaring that the pyramid is upside-down. When it flips, it reveals HHS’s new version, which does certainly characteristic steak and cheese on the high.
And although it’s humorous, Mande mentioned, “It’s kind of this scene where what was right was wrong, what was wrong was right – this whole thing that somehow we’ve been all told the wrong things all along.”
It’s a typical theme in messaging from Kennedy and his health officers. But, Mande mentioned, “that is not a way to regain trust, to suggest that everything you’ve been told your whole life was somehow a conspiracy, and now you should trust us.”
“Obviously,” he mentioned, “most people will take from that: ‘Gee, we shouldn’t trust anybody.’”