Is America's health secretary RFK Jr a danger to public health?

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1:08Ones about science, about health, about disease, about medicine, and the role of public health in America, and particularly what has been happening recently with vaccines. At the center of all of this is Robert F. Kennedy Jr. He is the Secretary of Health in the Trump administration, and he has been promising a radical transparency in his department. We will scrutinize the chemical additives in our food supply. We will remove financial conflicts of interest from our agencies. We will create an honest, unbiased, gold standard science at HHS accountable to the president, to Congress, and to the American people.

1:53we will reverse the chronic disease epidemic and put the nation back on the road to good health. But critics say he has been delivering something very different. In fact, some of the main scientists in charge of public health in America have either been forced out or directly sacked by RFK Jr. in recent weeks. And they say that they are being forced out because RFK Jr. is making decisions based not on public health, on science, but on ideology. So are these criticisms valid? Or is RFK Jr. bringing this radical transparency and reshaping American public health and making America healthy again, as Donald Trump likes to say?

2:35Welcome to AmeriCast.

2:41AmeriCast. AmeriCast from BBC News. When Donald Trump calls, they say, yes, sir. Right away, sir. Happy to lick your boot, sir. We are the sickest country in the world. Oh, dear. Are you worried that billionaires are going to go hungry? Of course the president supports peaceful protests. What a stupid question. Are you still talking about Jeffrey Epstein?

3:06Hello, it's Anthony in the BBC Bureau in Washington, D.C. And it is Mariana, a.k.a. misinformation, not in the worldwide headquarters, but actually in San Francisco, where I'm doing this documentary for BBC Two about social media algorithms. So I am even further time difference back than Anthony, which is something I'm not used to. But closer to me on the same continent, although we're on opposite sides of it. Welcome to America. So we've got a really interesting topic today to cover, and we have a really interesting guest who is going to be joining us in a little bit, someone who has been at the center of this controversy surrounding American public health for more than a decade under both Republicans and Democratic presidents.

3:51Her name is Dr. Deborah Howery, and she was chief medical officer at the Centers for Disease Control, a government agency based in Atlanta, Georgia, until she resigned just recently, objecting to RFK Jr.'s leadership. This was last month. Yeah, and it feels like a very, very timely moment to be speaking to her, not least because we've had this news this week on Monday, this press conference that happened where Donald Trump and RFK Jr. were essentially telling women not to take Tylenol when they're pregnant, which is similar to paracetamol that we have here in the UK. here in the UK, we have there in the UK, because of links with what they say are links with autism.

4:38Now, that link is unproven. And there are lots of medics and scientists who have taken issue with the press conference and the suggestion of this kind of causal connection. Another interesting thing that came up as well was Donald Trump talking about the MMR vaccine. So that's the vaccine for measles, mumps and rubella. And normally when babies have that vaccine, it's given all in one go but basically Donald Trump was suggesting that it should be taken separately and that mixing it together could be a problem that is again completely unproven and contrary to the scientific evidence which suggests that having that combined vaccine is broadly pretty effective and this is what Donald Trump had to say about MMR and babies.

5:19But I think when you go for the shot you do it over a five-time period. Take it over five times or four times, but you take it in smaller doses and you spread it out over a period of years. And they pump so much stuff into those beautiful little babies. It's a disgrace. I don't see it. I think it's very bad. It looks like they're pumping into a horse. You have a little child, little fragile child, and you get a vat of 80 different vaccines, I guess, 80 different blends, and they pump it in. I mean, it sounds like Donald Trump was really going off script there. 80 different vaccines, that's obviously a gross overstatement.

6:04But it's something that Donald Trump has talked about in the past. I remember early on when he was running for president in 2015, and they were asking at a debate whether the candidates thought that vaccines cause autism, and Donald Trump expressed an openness to that. Autism has become an epidemic. 25 years ago, 35 years ago, you look at the statistics, not even close. It has gotten totally out of control. I am totally in favor of vaccines, but I want smaller doses over a longer period of time. So maybe it's not surprising then, Mariana, that Donald Trump would return to this again at this event, even though the event was kind of supposed to be focused, I think, on Tylenol and what they claimed were the risks of taking it while you're pregnant.

6:53Yeah, and it felt a little bit like a throwback to the kind of early days of the pandemic when you'd have the kind of president along with health officials or whoever standing alongside giving these briefings. Only in this case, you've got two political figures. And I think that's been the strong criticism, certainly from lots of the medical community and health professional scientists is, hang on, how much of this is about the science and what the facts tell us and what we do or don't know, e.g. a lot of this is unproven. and how much of it is ideological. It's actually about something else. It's about something around freedom of choice or this decision to, you know, that they'd said previously that there was going to be this announcement about autism in particular, and it feels a little bit like Donald Trump and RFK Jr.

7:35were kind of like, oh, okay, right, right, we need to crack on with this and come up with something. I think it's really worth saying that when we talk about a lot of the things that Donald Trump does or says, you know, his post on Truth Social or wherever it might be, it feels like we're down the serious end of things that Donald Trump says that aren't just sort of sideshows, but really matter. Yeah, exactly. The concerns that I think medical professionals have about this is that it's going to erode support and trust in vaccines full stop. And I guess we did kind of see this coming. I mean, RFK Jr.

8:08has a long history of so-called vaccine skepticism. He's expressed conspiracy theories about drug companies, pharmaceutical companies, motivated by a profit, not fully researching the drugs, the vaccines that they're rolling out. I mean, Mariana, you know, immersed in your world of social media and conspiracy theories, I'm sure you've seen a lot of this and a lot of what RFK Jr. in particular has been saying, huh? Yeah, RFK Jr. is a longtime vaccine skeptic. There are other elements of his health policies that people have not minded so much or quite liked. For example, around healthy eating and general wellness.

8:50But it's the vaccination stuff that has really caught people's attention. And during the pandemic in particular, he managed to grow a huge following essentially online by posting a lot of these alternative health ideas. It wasn't that he didn't hold them before, but rather that that was the time where they really became prominent. They came to the fore. He was accused of promoting disinformation about the pandemic, about COVID-19 vaccines. And he has remained adamant that he's not anti-vaccination, that that's not the stance that he takes. However, he has certainly, at the very least, not disavowed a lot of the very extreme anti-vaccine profiles, anti-vaxxers who promote him, support him, and share completely not true claims about vaccinations.

9:35And this goes way beyond legitimate questions about big pharmaceutical companies or, you know, examples of where vaccines can and do have side effects and people have lost their lives or there has been harm caused in a small minority of people. This goes past that. And actually, RFK Jr. has been crucial in legitimising, I think might be the right word, or mainstreaming some of those ideas, even though he's adamant that that's not his intention. It feels like there's, and I don't know what you think about this, Anthony, but this kind of gap between what he had, what he's been saying online and the kind of other ideological leanings that he's shown, and then what he said, and the actions that have subsequently followed, and then what he said during those confirmation hearings when he was being questioned about how he felt about vaccinations.

10:22It feels like there's sort of two parallel realities. Right. And I think that that's exactly it. There were very real concerns in the Senate and the Senate committee. And so what you saw were Democratic senators in particular, and a handful of Republicans, I'll say, focusing in on RFK Jr.'s past comments and warning quite publicly that while RFK Jr. was promising that he believed in vaccines, that he would not change things dramatically at the Health and Human Services Department when he took over, that that was just a cover. And there was one exchange we'll play here now with Senator Elizabeth Warren of Massachusetts that I think kind of illustrates the tenor of those questioning and the concerns that Democrats had.

11:06No one should be fooled here. As secretary of HHS, Robert Kennedy will have the power to undercut vaccines and vaccine manufacturing across our country. And for all of his talk about follow the science and his promise that he won't interfere with those of us who want to vaccinate his kids. The bottom line is the same. Kennedy can kill off access to vaccines and make millions of dollars while he does it. Kids might die, but Robert Kennedy can keep cashing in. Senator, I support vaccines. I support the childhood schedule. I will do that. The only thing I want is good science and that's it. And Anthony, it's probably worth us just going through.

11:56So since then, what has actually happened to this point about the kind of gap between what he said at that time and the actions he's subsequently taken? We've seen how he has essentially fired 17 members of the Vaccine Advisory Commission, the CDC's Vaccine Advisory Commission, and replaced several of them with vaccine sceptics, people who really do have a reputation for engaging with anti-vaccine sentiment ideas. And then in late August as well, the director of the CDC, Susan Menares, who had been confirmed by this bipartisan committee with having, quote, unimpeachable scientific credentials was fired less than a month into the job.

12:37I mean, Anthony, all of those things do not seem to match so much with what he was then what he was previously saying about. No, no, no, I'm not you know, I'm not anti-vaccine. That's not going to impact the way I do this job. Yeah, exactly. I mean, I think that this does show that RFK Jr., when he came in, was ready and willing to make pretty significant changes, and particularly to the CDC, the Centers for Disease Control, which is the sprawling government agency that oversees all sorts of disease management, research, protecting the American public from infectious diseases. Obviously, it played a major role in the COVID pandemic response.

13:20And Anthony, you explained the CDC there. What is ACIP as well? So it's the Advisory Committee on Immunization Practices. And it is a group that issues recommendations to the CDC director, as well as the health secretary on the safety of vaccines, the recommended uses of vaccine. It sets together that schedule that we heard talked about in that last clip about when to have vaccines, what order to have them in, the timing of it and the importance of them. And so it is a it's a key committee. It's an advisory committee, obviously, but it is an important place, an important role in determining the rules for vaccines that most Americans follow or certainly recommended, encouraged to follow.

14:06Yeah, and Anthony, it feels like those various changes we were just chatting about has been this kind of like drip, drip, drip of, oh, hang on a second. OK, why is RFK Jr. doing this? This feels like quite a big change. And then when in at the end of August, like I mentioned before, the director of the CDC, Susan Menares, was fired only a month, less than a month in. And then other people also working at the CDC resigned in protest of that. That felt like a kind of culmination of, oh, what's going on behind the scenes here? And why are these people who are really well respected and experts in their field suddenly turning around and saying, we don't want to do this anymore?

14:44This was what RFK Jr. said when he defended those changes, including that one, during a Senate hearing, which was a few weeks ago. Finally, I would like to address the recent shakeups at CDC. These changes were absolutely necessary adjustments to restore the agency to its role as the world's gold standard public health agency with the central mission of protecting Americans from infectious disease. CDC failed that responsibility miserably during COVID when its disastrous and nonsensical policies destroyed small businesses violated civil liberties, closed our schools caused generational damage in doing so masked infants with no science and heightened economic inequality and yet all those oppressive and unscientific interventions failed to do anything about the disease itself America is home to 4.2 % of the world's population, yet we had nearly 20 % of the COVID deaths.

15:49We literally did worse than any country in the world. And the people at CDC who oversaw that process, who put masks on our children, who closed our schools, are the people who will be leaving. So there's one term there that we keep seeing pop up again and again, and that's the idea of a gold standard of science, relying on science. RFK Jr. says that's what he wants to do. His critics say that he's not doing it. I mean, this does seem to be something that comes up time and time again, doesn't it, Mariana? What is good science? How do you define it? And it's a battle for defining that term. Yeah, and I think it's who you're relying on for that good science as well.

16:33I mean, what is interesting is that RFK Jr. in particular has quite frequently relied most heavily on scientists, doctors who have been quite criticised and are very much not aligned with the body of evidence. And I think what's difficult is sometimes it feels like you've got, you know, RFK Jr. inhabiting this particular world where the experts are, you know, that they're all the contrarians are the experts. And anyone who is in line with the mainstream body of science, like the mainstream consensus, they're perceived to be wrong only because they are supporting the mainstream. And that doesn't mean that they're wrong.

17:09And it feels like that's the difficult place that America has got to, which is that anything that's perceived to be part of the institutions or part of the establishment is somehow incorrect. But actually, that's just not how science works, is it? Right. So we've heard RFK Jr.'s defense of that shake up at the CDC and within the health department writ large, including the firing of Menardez. Well, here is Susan Menardez testifying for herself before that same committee. And she obviously has a very different take on whether RFK Jr. is following science and whether these shakeups were warranted.

17:44On the morning of August 25th, Secretary Kennedy demanded two things of me that were inconsistent with my oath of office and the ethics required of a public official. he directed me to commit in advance to approving every acip recommendation regardless of the scientific evidence he also directed me to dismiss career officials responsible for vaccine policy without cause he said if i was unwilling to do both i should resign i responded that i could not pre-approved recommendations without reviewing the evidence. And I had no basis to fire scientific experts. He told me he had already spoken with the White House several times about having me removed.

18:39Okay, now let's speak to someone who did resign in protest at the firing of the director we were talking about, the former director of the CDC, Susan Menares, and just the general running of public health under RFK Jr.'s leadership. She's the former chief medical officer at the CDC. Her name is Dr. Deborah Howery, and she worked there for 10 years under four different administrations. Hi, Deborah. Thanks for joining us. My pleasure. Talk me through the decision to resign. When did you first start thinking about that? So I actually first started thinking about it in March of this year. It was one of those things to where I was the transition lead for the agency.

19:20And so I was, I'd read RFK Jr.'s books, had developed some big ideas to really support his priorities, and was optimistic to try to find some areas of alignment. But as some of the staffing cuts were initially proposed, I couldn't support them. And at that point was going to resign, but was able to appeal and actually protect several of our programs and staff. But over time, things kept happening. Like in a measles toolkit, they wanted to put information on two medications that weren't evidence-based and not recommended for measles. And I couldn't do that. And I pushed back on that because I don't want to do harm.

19:57We have to do what's right in medicine. He also, the secretary, ordered the removal of a scientific document on thimerosal, which is an additive on vaccines. And to me, that felt like political interference and not radical transparency. If you want the public to know all the data, over time, those things began to happen. And I was looking forward to Dr. Menara's joining the CDC. I'd spoken to her in the interim, and she was excited to bring a rigorous approach to science and make some changes. Within her first week, she tried to make some changes to the committee y 'all were talking about, the Advisory Committee on Immunization Practices, and the department wouldn't let her.

20:35And I knew at that point she was going to be ineffective in trying to make change. And when the department called her in to terminate her, myself and two of my employees who work on vaccines knew that that was the time to sound the alarm. And we resigned at that time. Yeah, you know, we just listened to that clip of RK Jr.'s testimony. when he was being confirmed. I'm sure you heard him. You were listening to him. I'm sure you were paying a lot of attention to it. I mean, were you reassured by hearing him say those things? And how much of a shock was it as this was all kind of unfolding, seeing what he was doing?

21:11Did you feel like he misrepresented himself? Yes, I'm not so reassured is the right word, but, you know, I was hopeful when I heard this testimony. But he was quickly, you know, not acting in accordance with what he had said. During the height of the measles epidemic in the United States, we were hitting record numbers of cases. He was promoting vitamins over vaccines and saying misinformation on vaccines. And I had to send some talking points to our leadership team to share with the department to try to rectify that. But obviously that didn't help. And then he said he wasn't going to change the vaccine committee, and he did.

21:49And then he said he wasn't going to change access to vaccines, but he did. He changed the CDC COVID vaccine guidance, which, in fact, I learned about as the agency's chief medical officer on Twitter or X. I saw the video. And when asked to implement those changes, we replied back and said, we can't make changes to vaccine policy on a social media video. Like, we need a written directive. But very different from any other administration I worked with. You know, the prior Trump administration, much more collaborative, appreciated scientists. So this is really unprecedented is almost an understatement.

22:25Yeah, it's interesting you say that, right? I mean, this isn't the first Trump administration. There were four years that you worked with them, worked through those four years. I mean, obviously, it was a critical time because of the COVID pandemic. And here we are, it's different. I just wonder, because it's a question we have a lot. Why is this time different? What changed? and since you were kind of there in the middle of it, at what point did you realize, oh my gosh, this is a different game this time around? I would say probably within the first month or two of Secretary Kennedy starting.

22:58Under the prior Trump administration, we regularly had interactions with the secretary and their leaders. Under Secretary Kennedy, I never briefed the secretary and neither did my center directors. And you would think when the secretary has priorities on vaccines or there's a measles outbreak, He would want to hear from senior career scientists at the agency. And he did not. We had offered, but we were not picking up on those offers. So there was really no collaboration or even expert advice that we were able to provide with the secretary and completely different from any other administration I worked with.

23:36And, you know, one of the things that RFK Jr. has mentioned time and time again is his criticism of the CDC around the pandemic and kind of saying it didn't get anything right. And I think they handled it really badly. What's your response to that? Because I guess there's, you know, it's not the case that science will always get stuff spot on, particularly in an evolving situation where you don't quite know what's happening. No, totally. And, you know, some of that criticism is founded and some is certainly unfounded. unfounded. What I would say is during the pandemic, CDC learned a lot. This was a novel pathogen that we didn't have the science and the data on.

24:12And so as new things were learned, guidance changed. And I think the agency could have been more proactive early on saying what they knew and what they didn't know and explaining how science changes. But after that pandemic, I actually led a lot of our reorganization and moving forward efforts to look at how we could do things differently and better. And I wish that's what the secretary had listened to, is that CDC changed after the pandemic. Data is much more timely on dashboards. Lab quality had been addressed and working with the private sector. And we had staff trained to respond to outbreaks.

24:44So CDC, you know, did have missteps during the pandemic, but learned. And that's what's unfortunate is under Secretary Kennedy, many of the things that move forward and that were learned during the pandemic are now being completely dismantled. And so the United States will be less prepared now. Do you think it's had an impact that, I guess, a combination of that erosion of trust within some communities or some people when it comes to public health following the pandemic, and then the rise of someone like Robert F. Kennedy Jr., who appeals to people who do feel distrustful of health official scientists?

25:22Yeah, I think it was really the perfect storm. You know, certainly with social media and with distrust, you could see them, you know, people posting a lot more and misinformation continuing to spread. And then the secretary spreads misinformation, you know, and also spreads doubt and experts. It was really disheartening to me that the only time I met the secretary is when he came to our campus at CDC after the shooting. You know, there was a violent attack on CDC based on COVID misinformation. and the secretary came three days later to tour the campus. Later that afternoon, he did a media interview where he said, don't trust the experts.

26:01That's not what's needed during a time after a violent attack based on misinformation. That's where the secretary should be condoning violence and spreading correct information about what we know and what we don't know. Right, and that was your one time meeting him in person since you was secretary. You said you didn't brief him at all. I mean, what was it like being there with him and seeing him in person? You know, I had very little interaction with him. I thank him for coming. You know, he essentially did the tour of the campus, had a short briefing on the violent attack, and then he left. I was glad he came to see the damage, but I was very disappointed by the lack of engagement that he had with the staff and the lack of really support for Officer David Rose, who lost his life, and any follow-ups after the shooting with our staff.