In November 2024, shortly after President-elect Donald Trump announced his intention to nominate Robert F. Kennedy Jr. as Secretary of the Department of Health and Human Services, I penned an opinion piece entitled, “The Case Against RFK Jr.—A man who asserts nonsense about vaccines and HIV should not be at the helm of HHS.” Today, seven months since he assumed the role, I declare the case closed—his background, views, and actions as Secretary all offer overwhelming evidence of his manifest unfitness for this crucial job.

The position of HHS Secretary is important because of its broad scope and impactful role overseeing health care, biomedical research, drug approval, and public health. Prior Secretaries have had professional backgrounds in fields ranging from medicine to public administration, often making significant contributions to those fields. In the case of RFK Jr., neither his experience, accomplishments, nor prior beliefs provided a rational basis for his selection. On the contrary, they should have immediately disqualified him for this role.

He lacks any medical, scientific, public health, or administrative background, and is best known for having produced a continuous stream of demonstrably false statements on issues relevant to the fields he would oversee. These range from views on vaccine efficacy and safety, the cause of AIDS, the supposed harm caused by electromagnetic radiation from mobile phones, fluoridation, and many other topics. Placing a person with this track record atop HHS rewards ignorance of science and health and reflects disdain for the very biomedical community that has led the world in accomplishments and impact.

I say this as a physician scientist and medical administrator who, while proud of the many advances made by American biomedicine in recent years, is also aware of the many limitations and failures of ongoing efforts to improve the nation’s health. Many aspects of our medical and research system could and should be better. Indeed, the destabilisation of the status quo caused by Trump’s election in 2024 might have been leveraged to bring about beneficial changes that would not otherwise have been achievable. But, as predicted, by choosing RFK as HHS Secretary, Trump has squandered that possibility. RFK Jr. has carried out a series of actions that reflect his ignorance and flawed judgment. These will only make the country sicker, while further diminishing confidence in science, medicine, and public health.

A few examples of RFK’s bad judgement—out of many—will suffice to illustrate this. In a move that justified concerns about his irrational approach to vaccines, on 9 June 2025, RFK Jr. fired the entire seventeen-member CDC Committee on Immunization Practices (ACIP), falsely claiming pervasive conflicts of interest among this outstanding group. He replaced them with a smaller group that includes some longstanding vaccine sceptics as well as several people with no qualifications whatsoever for this role. He supported and implemented cancellation of all federal funding for research on mRNA vaccines, an area with tremendous potential for combating diseases including cancer, without providing any specific scientific justification. Under oath before Congress, he displayed ignorance about the estimated number of COVID 19 deaths in the US and doubted whether the mRNA vaccines rapidly developed under Operation Warp Speed had saved over a million American lives, despite overwhelming evidence that they did. There are many more examples of this kind.

Sanitising a Paranoid Crank

Misleading and irresponsible journalism is being used to launder the reputation of RFK Jr.

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Another area of concern is his promotion of the Make America Healthy Again (MAHA) agenda, which promises easy but unproven answers to very real and difficult problems. As Ezra Klein recently opined, “MAHA is a bad answer to a good question.” Though progress against disease has been made on many fronts, we Americans—including our children—are less healthy than we should be, and we should all want to know how best to address this. Chronic diseases like obesity and diabetes—which I have studied for over forty years—have increased in prevalence despite the fact that many new insights into their pathophysiology have been achieved and new treatments have become available. Changes in nutritional and other environmental exposures are certain to be important contributors, but the specific causes are vigorously debated, and new research insights are desperately needed to address these. But there is no chance of reaching the desired outcomes while RFK Jr. takes advice from MAHA health influencers profoundly deficient in scientific knowledge and reasoning—who peddle unproven advice and nutritional supplements—while simultaneously reducing or freezing NIH-funded research by many of the nation’s most accomplished scientists.  

There are similar concerns with regard to other disorders, including autism, about which RFK Jr. frequently speaks. Autism is a serious disorder that has been diagnosed with increased frequency in recent decades, though the extent to which this results from changing diagnostic criteria rather than increased disease prevalence remains uncertain. RFK Jr. has long supported thoroughly debunked claims that autism is linked to MMR vaccination. We should be extremely sceptical about both his plans to fund research to identify new causes of autism, and his statement that by the end of September he will announce “what has caused the autism epidemic.” As with obesity and diabetes, the problems with autism are real and require new insights, but RFK Jr. is clearly the wrong person to lead the charge.

Another way to judge executive leadership is by the quality of senior appointments, and the ability of these individuals to advance their areas of responsibility while effectively working with the leader who appointed them. The case of Susan Monarez, a PhD microbiologist and longstanding public health professional, raises serious questions in that regard. Monarez was Acting Director of the CDC from 23 January to 24 March 2025, when Trump nominated her as the organisation’s Permanent Director, apparently at RFK’s prompting. On 29 July, she was confirmed in that role by a Senate vote of 51–47. At the time, RFK Jr. commented, “I handpicked Susan for this job because she is a longtime champion of MAHA values, and a caring, compassionate and brilliant microbiologist and a tech wizard who will reorient CDC toward public health and gold-standard science.” Less than a month later, on 27 August, RFK Jr. demanded she be fired—and her dismissal was duly announced by the White House—after she refused “to rubber stamp unscientific directives” related to vaccine policy, a chain of events that triggered the resignations of multiple senior CDC officials. A group of former CDC directors has warned that the organisation is in danger of unravelling.

RFK’s other major appointments to lead the Centers for Medicare and Medicaid (Dr Mehmet Oz), the FDA (Dr Marty Makary), and NIH (Dr Jay Bhattacharya) are professionally qualified for their roles by normal standards, though major questions remain about how they will lead these critical agencies while reporting to RFK Jr. Dr Monarez’s very public dismissal from the CDC sends a clear message: Any refusal to fulfil the demands of Trump or RFK Jr.—however flawed—could result in removal from office. This is hardly a prescription for effective leadership of those important agencies.

In addition to these specific issues, the extremely negative views RFK Jr. frequently expresses about the health and science ecosystem that he oversees are highly damaging. He repeatedly blames the poor health of Americans on a corrupt alliance between physicians, scientists, administrators, and the food and pharmaceutical industries, accusing them of conspiring to harm the public in pursuit of power, fame, and profit. This deeply conspiratorial view at the core of RFK Jr’s MAHA movement is profoundly mistaken. A head of HHS who holds such a dangerously uninformed perspective will surely not Make America Healthy Again. On the contrary, he threatens to dismantle one of the greatest achievements our society has ever produced.

There are very real problems facing health and biomedical research in America. To successfully address these using the best talent and strategies at our disposal, RFK Jr. must be replaced as Secretary of HHS, and the sooner the better.