Make America Toothless Again

Robert F. Kennedy Jr's confirmation as health secretary is a dark day for America, and for public health generally. The question is, how far will the rot go?

So, in the end, a man whose own cousin described him as a “predator” and labelled his views on vaccines “dangerous and wilfully misinformed”, has been confirmed as America’s new health secretary.

And it wasn’t even close.

When push came to shove, every Republican Senator, save for Mitch McConnell – a survivor of childhood polio – voted to install Robert F. Kennedy Jr at the Department of Health and Human Services. Thus, at a stroke, a man who has questioned whether HIV causes AIDS (it does) and whether the Measles, Mumps and Rubella (MMR) vaccine causes autism (it doesn’t) has been gifted a $1.7 trillion agency with oversight of everything from medicines to food to programmes such as Medicare and Medicaid.

In a forthcoming article for Index on Censorship, I explain why even before his confirmation, Kennedy’s appointment was shaping up to be a disaster for public health. Now, with DOGE dismantling USAID programmes delivering life-saving treatments to people at risk of HIV, tuberculosis and malaria across the globe, I fear Kennedy will be even more emboldened. How bad it will be perhaps only his wife, Cherly Hines, who stood behind him at the swearing in on Thursday, can tell. Or perhaps not?

As I write in Index:

Ascertaining what Kennedy believes and understands by “science” is a fool’s errand. As the editorial board of the New York Post concluded when it met with Kennedy in May 2023, when it comes to medical issues Kennedy’s views are “a head-scratching spaghetti of what we can only call warped conspiracy theories”.

In retrospect, I suspect, it was Covid-19 that pushed Kennedy to the wilder fringes of the anti-vax movement. During the pandemic, he likened government efforts to contain the coronavirus to the Holocaust and compared vaccine refuseniks to Anne Frank, the Dutch Jewish girl who hid from the Nazis during the Second World War only to be captured and sent to Auschwitz at the war’s end. He also pushed unproven Covid treatments such as ivermectin and hydroxychloroquine.

Under pressure from Hines (who plays Larry David’s on-screen wife in Curb My Enthusiasm), Kennedy subsequently rolled back on his antisemitic comments - though, to my knowledge, he has yet to retract his claims that the coronavirus was “ethnically targeted” to spare Ashkenazi Jews and Chinese people – a view that is both offensive and scientifically highly implausible.

During the hearings, Kennedy also displayed a tenuous grasp of the Federal health care programs he is now charged with overseeing. In particular, he didn't seem to understand the role of community health centres, where many low-income Americans go to receive care, or that cuts to Medicaid would be particularly harmful to blacks and hispanics, who are more likely than whites to be uninsured.

But as I write in Index:

…perhaps the most revealing exchange came when Bernie Sanders, the Independent Senator for Vermont, asked Kennedy whether he agreed that healthcare was a fundamental human right. Kennedy’s response that heath care should not be treated the same way as free speech and that long-term cigarette smokers were “taking from the [insurance] pool” tells you everything you need to know about his eugenicist and libertarian mindset.

Listening to Kennedy’s stuttering and, at times incoherent replies during the confirmation hearings, it was hard not to conclude that he is someone who has studied a little science and medical history but failed to absorb the lessons of germ theory or the role of social and economic conditions in determining people’s health.

Except for antibiotics, vaccines have saved more lives than any other technology in medical history. And while Kennedy’s desire to wean Americans off processed foods would, if he succeeds, go some way to addressing chronic conditions such as obesity and diabetes, his plan to remove fluoride from community water would not. On the contrary, fluoridisation is one of the most beneficial public health interventions in history.

As I conclude my article, it is hard to imagine a more “rotten” policy”.

Prior to fluoridation in the 1940s, Americans, like other populations, suffered from high levels of tooth decay. For those who cannot afford fluoridated toothpaste or regular visits to the hygienist, de-fluoridation would likely result in a surge in dental cavities. Not so much MAHA then as MATA – Make Americans Toothless Again.