Is MAHA influencing health policy?

0:00Earlier this month, Secretary of Health Robert F. Kennedy Jr. and Vice President Vance met in Washington, D. for a Make America Healthy Again, or MAHA Summit. The summit's agenda showed a shift towards alternative medicine, wellness and nutrition, and away from conventional medications. Here's Vance speaking at the summit. We should only be taking stuff. We should only be giving our kids stuff if it's actually necessary, safe and effective. This was the only public event. All the other sessions were invitation-only private events. Politico did, though, acquire a copy of the summit's agenda, which included topics like psychedelics, food as medicine, anti-aging, and biohacking.

0:40Notably, most of the speakers were not academic researchers and doctors. Vance also criticized the medical establishment. They tried to silence the people who were saying things that were outside the Overton window. And as we found out the hard way over the last few years, it was very often the people who were outside the Overton window who were actually right, and all the experts were wrong. And this week, the Food and Drug Administration's top leaders said the agency is vowing stricter vaccine rules, which alarmed numerous experts that NPR spoke with. Consider this. The Trump administration is sidelining scientists and researchers.

1:17What does that mean for the health of Americans? From NPR, I'm Miles Parks.

1:36It's Consider This from NPR. Vice President Vance had strong criticism for the medical community in the Maha Summit earlier this month. Those views are now affecting the administration's guidelines on vaccines, medication, and wellness. So what happens when government guidance moves away from scientific consensus? We pose this question to Dr. Sandro Galea, a distinguished professor in public health and dean of the Washington University School of Public Health in St. Louis, Missouri. I want to start by having you respond to the vice president. Is the health system too rigid or bureaucratic to actually allow for innovation?

2:11Well, I think in general, I would like to think it's not. You know, there's much that the vice president said that one agrees with. I mean, he said that we should not take medications unless they're necessarily safe and effective. And I agree with that completely. I think the extension of that that the vice president implied, certainly in his clips that he just aired and in other comments, is that as a result of these challenges, we should discard science and discard what medicine has to offer. I mean, that extension is not really grounded in fact. Well, he also brought up this idea of overprescription.

2:45And there are peer-reviewed studies that note that some medications, things like antibiotics and in some cases, antacid medications, they have been found to be overprescribed. There's been other cases where people have said that business incentives motivate doctors to overprescribe things like CPAP machines for sleep apnea. I guess I wonder, can you explain that a little bit? Or do you think there is a tendency to overprescribe some medications. Yeah, I think the issue of overprescribing in the Maha Agenda is an interesting one. And it is a little bit of a piece of the larger Maha Agenda, meaning that it is correct.

3:23There is overprescribing. There is overprescribing of a number of medications. There's overprescribing of antibiotics. These are really complex systems that embed incentives for practitioners, incentives for prescribing. And what we need to be doing as society is doing the science to document you were prescribing, to work in partnership between science and government agencies to make sure that the incentives are not for prescribing, but for prescribing accurately. So the Maha Agenda, which is founded on a number of important and correct observations, ends up being taken too far to suggest that science has nothing to offer and that we should move to some other alternate way of embracing things like psychedelics and biohacking that is not grounded in rigorous evidence that can make sure that medications or approaches that you and I use are indeed safe, they're effective, and can do what they're supposed to be doing, which is helping us live longer, healthier lives.

4:25It is correct that we should invest in making America healthy again. It is not correct that the way to do that is by throwing away science, by disinvesting from the most successful partnership between the science establishment and government of anywhere in the world that has allowed us to advance by leaps and bounds in this country. What we need to be doing is exposing these challenges, writing about these challenges, and it's going to take science to determine what is beneficial and what is harmful. Do you think that we are entering a new political normal here where basically every time a new party enters power or takes over the presidency that scientific guidance is just going to shift radically?

5:08You know, I really hope not. I really hope that we as a country refine our equilibrium, meaning that we recognize that there are some core values that we hold as a country. I mean, these principles have been at the core of the advance of the republic of the American experiment for the past 250 years, that we use data and not belief to inform what we do and how we do what we do. But that process, if it's challenged or if it's dismantled, leaves us with no data, no evidence, and leaves us only with belief and opinion and perspective. And belief, opinion, perspective can lead us down the road to perdition.

5:48We can make a lot of mistakes and we can affect a lot of people's lives. When people in your own life ask you where they should go for information on decisions they have to make, I'm thinking specifically as somebody with a child in terms of vaccines and the potential risk reward of getting those vaccines. A lot of people have a lot of questions about that right now. What do you tell people about where to go for good information? Is it still the CDC or what do you tell them? I would first of all start with one's doctor, one's physician. Physicians should have the wisdom to be able to guide patients, all of us, in what the best available evidence is.

6:30Outside of that, our public health agencies are really among the best in the world. Now, I think we all recognize that there has been some sweeping up of those agencies and some of these political divides of the moment. And there have been some challenges to the data that are being presented by those agencies. and conversely the data that are no longer being presented. So I think one has to be careful there. But the scientists inside the Centers for Disease Control, the National Institutes of Health, the Food and Drug Administration, these are outstanding people who have spent a career in the pursuit of truth.

7:03I do not want us to lose sight of that in the heat of this political moment when these issues have really become used to advance partisan agendas. That was Dr. Sandro Galea, a distinguished professor in public health. Thank you for being here. Thank you for having me on. This episode was produced by Jordan Marie Smith and Avery Keatley, with audio engineering by Hannah Glovna. It was edited by Ahmad Dahman. Our executive producer is Sammy Yenigan. It's Consider This from NPR. I'm Miles Parks.