How RFK Jr. is quickly changing U.S. health agencies

NBC News

a day ago

WASHINGTON — In just a few short months, Health and Human Services Secretary Robert F. Kennedy Jr. has begun to transform U.S. health policy: shrinking staff at health agencies, restructuring the focus of some regulators and researchers, changing Covid vaccine regulations and reshaping the mission of his department to focus more on alternative medicine.
The directives are all part of the same issue set that drove a slice of health-conscious, left-leaning Americans to eventually vote for a Republican president whose favorite meal is from McDonald's, Trump and Kennedy catered to a type of voter who has grown distrustful of America's health care establishment — but possibly fomented a new type of distrust in federal health policy along the way.
Bernadine Francis, a lifelong Democrat who backed Joe Biden for president in 2020 before supporting Donald Trump in 2024, told NBC News in an interview that she approves of Kennedy's efforts so far, despite his 'hands being tied' by entrenched forces in the administration and in Congress.
'From what I have seen so far with what RFK has been trying to do,' she said, 'I am really, really proud of what he's doing.'
Francis is among the voters who left the Democratic Party and voted for Trump because 'nothing else mattered' apart from public health, which they — like Kennedy — felt was going in the wrong direction.
Concerns about chemicals in food and toxins in the environment, long championed by Democrats, has become a galvanizing issue to a key portion of Trump's Republican Party, complete with an oversaturation of information that in some cases hasn't been proven. It's wrapped up, as well, in concerns about the Covid vaccine, which was accelerated under Trump, administered under Biden and weaponized by anti-vaccine activists like Kennedy amid lockdowns and firings in the wake of the devastating pandemic.
'We knew in order to get RFK in there so he can help with the situation that we have in the health industry, we knew we had to do this,' said Francis, a retired Washington, D.C., public school administrator, who said she left her 'beloved' career because she had refused the vaccine.
'It seemed to me, as soon as [Biden] became president, the vaccine was mandated, and that was when I lost all hope in the Democrats,' Francis told NBC News, referring to vaccination mandates put in place by the Biden administration for a large portion of the federal workforce during the height of the pandemic. There are not currently any federal Covid vaccine mandates.
There have been 1,228,393 confirmed Covid deaths in the United States since the start of the pandemic, according to data from the Centers for Disease Control and Prevention.
How RFK Jr.'s picks are changing public health agencies
Dr. Marty Makary, Kennedy's hand-picked commissioner of the Food and Drug Administration and a John Hopkins scientist and researcher, told NBC News in an interview that he wants to transform the agency, which he said faced 'corruption' over influence from the pharmaceutical and food industries.
'I mean, you look at the food pyramid, it was not based on what's best for you, it was based on what companies wanted you to buy,' he said, referring to the 1992 and later iterations of official government nutritional guidance. He said there would be 'entirely new nutrition guidance' released later this year, as soon as this summer.
He praised the FDA's mission of research and regulation, saying the agency is 'incredibly well-oiled, and we've got the trains running on time.'
He also highlighted the 75-page 'Make America Healthy Again' commission report — which focused on ultraprocessed foods and toxins in the environment — as having set 'the agenda for research' at the FDA, HHS and agencies overseeing social safety net programs such as Medicare and food stamps moving forward. (The MAHA report initially cited some studies that didn't exist, a mistake that Kennedy adviser Calley Means said was a 'great disservice' to their mission.)
'I think there's a lot we're going to learn. For example, the microbiome, which gets attention in the MAHA report, needs to be on the map. We don't even talk about it in our medical circles,' Makary said. 'The microbiome, food is medicine, the immune response that happens when chemicals that don't appear in nature go down our GI tract.'
Pressed on other areas of the administration, like the Environmental Protection Agency, making decisions that run counter to the pro-regulatory ideas presented in the MAHA report, Makary said he can 'only comment on the FDA' where they are 'committed to Secretary Kennedy's vision.'
But Kennedy's public health agenda goes beyond looking at the food supply and chemicals. Recently, Kennedy said in a video posted on X last month that the Covid vaccine is no longer recommended for healthy children and pregnant women, a change in CDC guidance that skipped the normal public review period.
Days later, after critics questioned the decision and raised concerns over a lack of public data behind the move, the administration updated its guidance again, urging parents to consult with their doctors instead.
Pressed about the confusion and whether Americans are now trading one side of public distrust in the health system for another, Makary defended Kennedy, who has been criticized for spreading misinformation.
'My experience with Secretary Robert F. Kennedy is that he listens. He listens to myself, he listens to Jay Bhattacharya, listens to Dr. Mehmet Oz, he listens to a host of scientists that are giving him guidance,' Makary argued, referring to the director of the National Institutes of Health and the administrator for the Centers for Medicare & Medicaid Services, respectively. 'So he may have big questions, but the questions he's asking are the questions most Americans are asking.'
The intersection of medicine and healthy lifestyle choices
Dr. Dawn Mussallem, a breast cancer oncologist and integrative medicine doctor — a physician who combines conventional treatments with research-based alternative therapies — has tried to help her patients wade through medical misinformation they encounter online and in their social circles.
Mussallem has an incredible story of personal survival: While in medical school, she was diagnosed with Stage IV cancer and, after conventional therapies like chemo saved her life, was diagnosed with heart failure. After undergoing a heart transplant, Mussallem ran a 26-mile marathon just one year later.
'I learned a lot in medical school, but nothing compared to what I learned being a patient,' said Mussallem, who dedicates, on average, 90 minutes each in one-on-one sessions with her patients. 'This is not about any one political choice. But we know lifestyle matters.'
For example, a new study from the American Society of Clinical Oncology that finds eating food that lowers inflammation in the body may help people with advanced colon cancer survive longer.
Mussallem's mission, along with her colleagues, is to elevate the modern medicine that saved her life, as well as encouraging her patients to live healthy lifestyles, including regular exercise, minimally processed foods, less screen time, more social connection and better sleep.
But politics do get in the way for millions of Americans who are inundated daily with social media influencers and 'nonmedical experts,' as Mussallem puts it, who stoke fear in her patients.
'Patients come in with all these questions, fears,' she said. 'I've heard this many times from patients, that their nervous system is affected by what they're seeing happening in government.'
Mussallem acknowledges that 'a lot of individuals out there' have questioned traditional medicine. For her, it isn't one or the other — it's both.
'We have to trust the conventional medicine,' she said. 'With the conventional care that marches right alongside more of an integrative modality to look at the root causes of disease, as well as to help to optimize with lifestyle, is where we need to be.'