‘Go wild, Robert’: Trump appoints RFK Jr – here’s what it could mean for health in the US… and beyond

President-elect vowed to untether Robert F Kennedy Jr to ‘go wild on health’. We explore what that might look like in the US and beyond

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Donald Trump’s election to a second term as president of the United States puts him at the helm of not only the world’s economic and military superpower, but also a global health superpower.
From its huge healthcare industry, to its world beating aid budget, powerful public health bodies, pharmaceutical industry and leading scientific institutions, the US has long set the pace and tone on global health.
Now the content and tone of US messaging on health could change – and change dramatically.
Robert F Kennedy Jr, Mr Trump’s appointed man on health, is on a mission to shake up the global health establishment in a bid to “Make America Healthy Again”.
He wants to tackle chronic diseases like obesity, diabetes, autism, cancer, and mental illness but tends to favour psychedelics over vaccines and raw milk over the pasteurised variety.
The former lawyer and nephew of JFK accuses big business, drug companies and conniving federal agencies of making the country more unhealthy with toxic chemicals and additives.
Last month, he told officials at the US Food and Drugs Administration (FDA) to “pack your bags” in the event of a Trump win.
While critics cast him as a conspiracy theorist, Mr Trump is a fan and has said he would appoint Mr Kennedy to “go wild on health”.
He told a rally last week: “I’m going to let him go wild on the food. I’m going to let him go wild on medicines.”
Trump staffers say Mr Kennedy will not be given the top health job, the chief of the Department of Health and Human Services (HHS), but he is expected to be given a powerful “health tsar” type role.
So what would a Trump and Kennedy double act mean for global health?
Mr Kennedy says he is not anti-vaccine, only that he wants them to be safer. But he is accused of being a prominent spreader of vaccine misinformation and is certainly a vaccine sceptic.
He has repeatedly claimed for example that childhood vaccines are linked to autism, despite numerous studies having debunked the association.
In an interview last week, Mr Trump appeared open to the possibility of banning some vaccines, in light of Mr Kennedy’s opinions.
Mr Trump told NBC: “Well, I’m going to talk to him and talk to other people, and I’ll make a decision, but he’s a very talented guy and has strong views.”
Legal experts say Mr Trump would in fact struggle to unilaterally ban vaccines in the US.
Public health is governed by states, not the federal government. Vaccines are also licenced by the Food and Drug Administration and the White House would not be able to simply remove a product from the market.
But having a charismatic senior figure in the White House raising fears about jabs would be likely to significantly strengthen vaccine hesitancy both in America and around the world.
His appointment, if it is confirmed, comes as Russia has launched a new campaign aimed at undermining western backed vaccines in Africa.
Fluoride in water has been another of Mr Kennedy’s campaign issues.
The chemical, which strengthens teeth, has been added to US water supplies since 1945 to protect against tooth decay. Its use is common across the west, including in the UK.
Health agencies accept that while prolonged high levels of fluoride exposure can actually damage teeth and cognitive development, there are no side effects at the levels recommended for drinking water.
Mr Kennedy has vowed a Trump White House would, on its first day, advise all US water systems to remove fluoride from public water.
He said: “Fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease.”
But advise may be all that Mr Kennedy can do, because drinking water is controlled at the local level, not federal level.
Mr Trump says he has unfinished business with the health establishment from his first term.
As the Covid pandemic raged through his presidency, he repeatedly clashed with domestic and international health organisations.
He has accused them of being corrupt, overbearing, unaccountable, self-interested and beholden to foreign powers.
At a recent rally, he appeared not to have mellowed. He told supporters: “We’ll take on the corruption at the FDA [Food and Drug Administration], the CDC [Centres for Disease Control], World Health Organization [WHO] and other institutions of public health that have dominated, and really are dominated by corporate power, and dominated really by China.”
In 2020, Mr Trump began the process of pulling America out of the WHO. Mr Biden reversed it as soon as he took power, but many expect Mr Trump to again consider a departure.
Mr Trump is also likely to torpedo any “pandemic treaty” which sets out nations’ obligations in the event of another global outbreak.
The Project 2025 blueprint drawn up by a right-wing think tank as a wish list for a Trump presidency, lists big reforms to the FDA, CDC and National Institutes of Health.
Mr Trump denies involvement in Project 2025, but its blueprint is expected to be influential in the new Republican administration.
The CDC for example, the main public health agency, would be broken in two, with its policy wings clipped. One part would publish data, the other would retain a “severely confined ability to make policy recommendations”.
Mr Kennedy recently said on social media the “FDA’s war on public health is about to end”.
“This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented by Pharma.
“If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack your bags.”
Mr Trump’s three appointments to the US Supreme Court shaped its 2022 ruling taking away the constitutional right to abortion. Since then, 17 states have banned abortion entirely or severely restricted it, according to the Centre for Reproductive Rights.
Mr Trump has said he is against a national ban, and it is up to states to decide.
Ten states had votes on Tuesday night on whether to cement reproductive rights in their state constitutions. Seven voted to protect access, Missouri voted to expand access, South Dakota upheld its ban and in Florida, a proposal to expand access failed.
Worldwide, Mr Trump is expected to reimpose the Mexico City Policy, known by its opponents as the “global gag rule”.
The rule prohibits foreign NGOs who receive US aid from providing abortion services or referrals, while also barring advocacy for abortion law reform – even if it’s done with the NGO’s own funds.
Mr Trump expanded the scope of the ban in his first term, decreeing that organisations taking any form of global health funding from the US had to adhere to it.
American aid largesse is so extensive that very few organisations refuse to sign up to the policy when it is in effect.
Republicans have repeatedly failed to overturn Barack Obama’s Affordable Care Act, known as Obamacare, which was introduced to widen access to health insurance.
Mr Trump has said in debates that he wants to replace the scheme, but has been vague on what would follow.
“Obamacare was lousy health care. Always was,” he said.
“It’s not very good today and, what I said, that if we come up with something, we are working on things, we’re going to do it and we’re going to replace it.”
“If we can come up with a plan that’s going to cost our people, our population, less money and be better health care than Obamacare, then I would absolutely do it.”
America is the biggest global health donor, with an annual spend of more than $12 billion (£9 billion) a year.
It provides a hefty chunk of the WHO’s core annual budget and is also a main funder of other UN agencies and international campaigns to combat disease, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria; and Gavi: The Vaccine Alliance.
Some in the global health world fear Mr Trump would freeze, or even try to cut aid spending entirely in his second term in office.
Project 2025 calls for a shake-up of American aid, taking aim at funding for climate change programmes and women’s empowerment in particular.
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