American Public Health Association’s Opposition to RFK Jr’s HHS Nomination
The association’s Executive Director Georges Benjamin, MD, offers some commentary as to why they have concerns around him as Health and Human Services Secretary.
This is the third in a series around the intersection of government and public health and how the former can affect the latter.
Back on November 18, and shortly after the presidential election, the American Public Health Association (APHA) released a statement opposing the nomination of Robert F. Kennedy Jr for Health and Human Services Secretary. Within this statement, the association wrote: “To effectively lead our nation’s top health agency, a candidate should have the proper training, management skills, temperament and the trust of the public. Unfortunately, Mr. Kennedy fails on all fronts.”1
And, on January 23, APHA’s Executive Director Georges C. Benjamin, MD sent along a letter to the Senate’s chair and ranking members of the Senate Committee on Finance, and the Senate Committee on Health, Education, Labor and Pensions again expressing his and the APHA’s concerns around his nomination.2
“The plethora of health challenges currently facing the nation include the H5 bird flu outbreak, the epidemic of preventable maternal deaths, rising health care costs, drug shortages and rural hospital closures, just to name a few. We also have emerging and reemerging health threats on the horizon like growing numbers of people with dementia and increasing cases of vaccine-preventable infectious diseases like measles and pertussis. Addressing these and other challenges will require someone with the knowledge and experience to lead the agency who can hit the ground running. Mr. Kennedy has neither the training nor management experience nor judgment for such an important and complex position,” Benjamin wrote.2
HHS: A Significant Department in Size and Scope
HHS has a large footprint within government that has importance influence from the federal level down to the local levels as well as the private sector.
“The US Department of Health and Human Services is really a mega agency. It's about $1.7 trillion of our taxpayer dollars. It has over 80,000 employees, 13 operating divisions, and several offices that support those of targeted activities, numerous contracts with a range of private sector entities,” said Benjamin. “And of course, it works collaboratively with all the other agencies of government, and at the federal, state, and local level, and tribes as well. It houses the largest research enterprise in the world, the National Institute of Health. It houses the Food and Drug Administration, which, by the way, regulates almost 20% of our economy of all the things that have anything to do with health, food, drugs or materials.”
In addition, HHS oversees the Affordable Care Act (Obama Care) and manages the Centers for Medicare and Medicaid Services (CMS).
“It actually influences 100% of us, because when CMS decides something ought to be covered, or that something is appropriate on the healthcare priority list for policy, almost all the insurers follow,” Benjamin said. “So it is a driver of policy nationally for every single one of us. The impact that an HHS Secretary can have is quite substantial to all Americans.”
In terms of other specific concerns Benjamin and APHA have around RFK Jr’s candidacy it is both his lack of a medical background and limited management experience.
“This is a big, big management job. And this is not a job for an intern—someone to learn on the job. And Mr Kennedy has not had the kind of experience that is necessary. He's never run anything this complex,” Benjamin said.
RFK Jr’s Antivaccine Stance
One of the biggest criticisms against RFK Jr’s nomination is his long-time antivaccine stance through his organization, Children's Health Defense. He joined the organization in 2015 when it was the World Mercury Project. Its name was changed 3 years later.3
The organization has falsely stated that vaccines cause autism. Additionally, the Children's Health Defense has been involved in lawsuits to do away with vaccine requirements, and tried to get the FDA’s emergency use authorization of COVID-19 vaccines for children revoked.3
Read more: The Modern-Day Foundation of How Medical Disinformation Began
There has been a question around his time in Samoa where he espoused antivaccine views and several people on the island contracted measles. Back in 2019, he was invited to come to the island through someone who was an antivaxxer. Later on that year, 83 people died from the measles in a total population of 200,000. 4
As HHS Secretary, he could have a major influence on the childhood vaccine schedule, which has already been declining for a few years in the US. These vaccines guard against a number of diseases including measles and polio. Although the latter disease has not been an issue yet, measles, which is one of the most highly contagious respiratory diseases, have seen outbreaks among unvaccinated adults and children in recent years in many states.
Read More: Four Cases of Measles Confirmed in Texas
In its aforementioned statement, APHA wrote: “Kennedy’s past statements and views on vaccines alone should disqualify him from consideration. He has stated that “there’s no vaccine that is safe and effective” and touted misinformation claiming that vaccines cause autism. A serious candidate for this position would follow the decades of real-world evidence that shows that vaccines are safe and prevent as many as 5 million deaths each year.”
“We call him the 12 people in the country who've been most involved in disinformation—not just misinformation, where people are making mistakes and passing along bad information and they're not aware it is bad information—but his group has been purposely involved in sharing bad information...So we don't think he's the right guy for the job,” Benjamin said.
Two Senate committees voted to send his nomination to the floor of the Senate. The upcoming Senate floor vote is going to happen soon. It remains to be seen what that vote will yield, and if confirmed, how he will act as secretary.
According to the APHA’s website, the association, “speak(s) out for public health issues and policies backed by science. We are the only organization that combines a 150-year perspective, a broad-based member community and the ability to influence federal policy to improve the public's health. Our Mission Build public health capacity and promote effective policy and practice.”
