Health groups prepare for the unthinkable: Working with RFK Jr.

Robert F. Kennedy, Jr. speaks during the Libertarian National Convention at the Washington Hilton in Washington, Friday, May 24, 2024. (AP Photo/Jose Luis Magana, File)

WASHINGTON — When U.S. President Donald Trump tapped Robert F. Kennedy Jr. to become the nation’s top health official, his administration inherited a sprawling list of ideas to “Make America Healthy Again,” from banning TV drug advertisements to dropping restrictions on raw milk.

While those unorthodox proposals — and Kennedy’s discredited views on vaccines — have dominated recent headlines, a slate of more familiar ideas have attracted interest on Capitol Hill and across the U.S.: making school lunches healthier, banning certain food additives and cracking down on ultraprocessed foods linked to obesity and diabetes.

For decades, public health groups have called for similar steps, lobbying federal leaders and mounting public campaigns about the risks of American diets loaded with salt, sugar and fat.

As Kennedy faces Senate confirmation hearings Wednesday and Thursday, health advocates find themselves in an uncomfortable position: voicing cautious support for some of Kennedy’s ideas while warning of the catastrophic consequences of others.

“If there’s an opportunity to advance the public health, you have to seize it,” said Dr. Peter Lurie, a former FDA official who now leads the nonprofit Center for Science in the Public Interest. “So you can’t ignore the guy on everything because you oppose him on some things.”

Like many experts, Lurie says Kennedy’s record on vaccines should disqualify him from becoming health secretary. And he’s deeply skeptical Kennedy can deliver on his ideas for food and nutrition.

Kennedy’s confirmation is far from certain in the Senate, where he is expected to face pointed questioning from both Republicans and Democrats on the chamber’s health and finance committees. Kennedy has been downplaying his long history in the anti-vaccine movement, but experts say that’s where lawmakers should focus.

“The elephant in the room is vaccine policy,” said Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention under Barack Obama. “In medicine we say: ‘Above all, do no harm.’ I’m certainly not convinced that RFK Jr. wouldn’t do a lot of harm to our vaccine policy and to our kids.”

Still, such worries haven’t stopped some Democrats from finding shared interests.

Former Ohio congressman Tim Ryan penned an op-ed last month titled: “Hey Democrats: We should work with RFK Jr. on fixing America’s food system.”

Sen. Cory Booker, a vegan, told reporters that he and Kennedy are “talking out of the same playbook” when it comes to food reforms.

Booker’s office did not respond to a request for comment.

Trump and Kennedy are an unlikely alliance

Trump’s unlikely alliance with Kennedy, a lifelong Democrat until 2023, reflects a diverse segment of Americans who increasingly worry about chemicals in their food and water and distrust medical experts, government officials, and big food and drugmakers.

Supporters of Kennedy’s longshot presidential campaign included California parents concerned about food dyes in cereal and Midwestern factory workers resentful of COVID-19 vaccine mandates.

But the clash between Trump’s antiregulatory approach and Kennedy’s anticorporate stance has many observers skeptical that much of the so-called MAHA agenda will ever happen.

Requiring healthier foods in school lunches, for example, has long been opposed by food and agriculture companies that overwhelmingly backed Trump in the last election, donating to his campaign by a nearly four-to-one margin over Kamala Harris, according to records compiled by Opensecrets.org.

During Trump’s first term, political appointees weakened school nutrition guidelines introduced as part of Michelle Obama’s “Let’s Move” campaign. The rules required schools to offer more fruit and vegetable options.

Making major changes to the federal program involves coordination between the Agriculture Department, the Department of Health and Human Services and dozens of state educational programs.

“They don’t have the policy coherence to make that happen,” said Dr. Georges Benjamin of the American Public Health Association. “People have been talking about improving the quality of school lunches for many years, but it takes a lot of money and collaboration to do it at a national level.”

Even seemingly smaller goals like banning potentially harmful food additives would require new regulations and staffers at FDA — which Kennedy has vowed to “clear out.”

U.S. foods contain hundreds of ingredients that aren’t permitted in Europe because American companies aren’t required to seek FDA approval before introducing them. Companies can self-certify that new colors or chemicals are “generally recognized as safe.”

Efforts to reform the decades-old system have been rejected in court and defeated in Congress, with backing from industry lobbyists.

Seemingly popular ideas like discouraging ultraprocessed foods could also prove untenable.

“I don’t think most Americans know that when you talk about ultraprocessed foods you’re talking about ice cream, frozen dinners, fast food,” said Benjamin. “Are we really talking about changing the entire American food experience?”

Experts hope for the best, but prepare for the worst

If Kennedy is blocked from overhauling the nation’s food system he would still have many other ideas to pursue.

“What we have is a bunch of good things that are very unlikely to happen weighed against a bunch of bad things that are very injurious but are much more feasible,” Lurie said.

Kennedy has threatened to fire hundreds of employees at the National Institutes of Health and slash FDA regulations on a host of unproven treatments, including stem cells, psychedelics and discredited COVID-era treatments like ivermectin.

Even seemingly small changes on vaccines could have damaging consequences, experts say.

Kennedy could dissolve current federal vaccine committees and staff them with advisers who are hostile to vaccines. Currently, insurers must pay for children to receive shots recommended by those experts. But the requirement would lapse if Kennedy’s appointees declined to endorse updated shots and immunization schedules.

For now, Georgetown University’s Larry Gostin says he and other advocates are hoping for the best but preparing for the worst.

“If he comes up with ideas that are good and actionable, I will be the first one to applaud and put my back into helping them succeed,” said Gostin, a health attorney. “I’m just very skeptical that he will do that.”

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

Matthew Perrone, The Associated Press