At a recent rally held at Madison Square Garden, former President Donald Trump declared his intention to empower Robert F. Kennedy Jr. with significant influence over health policies, stating, "I'm going to let him go wild on health, on food, and on medicines." Trump's increasing promise to involve Kennedy in his administration, should he be re-elected, has raised concerns among public health experts. The apprehension is not due to Kennedy's specific policy proposals under his "Make America Healthy Again" initiative, but rather his notable silence on the topic of vaccines, a subject he has been historically vocal about.

Dr. Jason Schwartz, an associate professor at Yale School of Public Health, commented on Kennedy's rebranding efforts, suggesting that they should not be taken seriously. Kennedy, who established the nonprofit Children’s Health Defense that disseminates anti-vaccine content, has shifted his focus to chronic diseases in recent public appearances and writings, steering clear of his previously emphasized anti-vaccine stance. Instead, he has been advocating for the regulation of chemicals in food, proposing ideas such as replacing seed oils with tallow fat in McDonald’s fries to enhance their healthiness, and limiting the availability of soda and processed foods in schools and through assistance programs.

Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, acknowledged Kennedy's avoidance of the vaccine debate, stating, "He knows that [vaccines are] a contentious issue and that it doesn't help his cause." However, Osterholm warned of the potential damage Kennedy could inflict on vaccine programs and their utilization.

In a livestreamed event, Kennedy revealed that Trump had pledged to grant him "control" over several public health agencies, including the US Department of Health and Human Services (HHS), the US Department of Agriculture (USDA), the CDC, FDA, NIH, and others. Kennedy emphasized the importance of these agencies in his mission to improve public health in America.

A spokesperson for Kennedy responded to inquiries about his potential role in a Trump administration by stating that Trump had asked Kennedy to eliminate conflicts of interest and corruption within federal health agencies and to revert them to a tradition of evidence-based science. Additionally, Kennedy has been tasked with addressing the chronic disease epidemic, which impacts over 50% of Americans and has severe implications for the nation's health, economy, and global security.

Kennedy has been highlighting issues such as obesity, diabetes, kidney disease, autoimmune conditions, cancer, and addiction. In the Wall Street Journal, he expressed his desire to reform the US Food and Drug Administration's funding system, which relies on user fees from the pharmaceutical industry, to cap drug prices at European levels, and to review guidelines for direct-to-consumer pharmaceutical advertising on television. He also proposed prohibiting members of the USDA's Dietary Guidelines Advisory Committee from profiting from food or pharmaceutical companies, ensuring NIH funding does not go to researchers with conflicts of interest, and reviewing standards for pesticides and chemicals.

Kennedy wrote, "Americans are becoming sicker, grappling with illnesses that our medical system is not effectively addressing." In an appearance on Joe Rogan's podcast, Trump presented a chart comparing life expectancy and health expenditures globally, with the US standing out as an outlier in both negative aspects. Trump mentioned his intention to send this information to Kennedy, to which Rogan responded positively about their collaboration.

Dr. Jerome Adams, who served as surgeon general under Trump, warned of the potential impacts on the party and the country if the campaign were perceived as anti-science, and the potential for a resurgence of measles and polio outbreaks. Adams expressed concern that Kennedy could spread misinformation and set back progress in vaccine-preventable diseases, but he hoped Kennedy would focus on promoting overall well-being.

Joe Grogan, who served as director of the Domestic Policy Council in the Trump administration, acknowledged the need for improvement in the US health-care system, citing mental health, obesity, chronic disease, and addiction crises. He argued that any attention drawn to these issues by Kennedy should be welcomed, regardless of political affiliation.

Kennedy's focus on food policy has resonated with some health experts. Food policy researcher Marion Nestle wrote on her blog, "They are calling for fixing the food system, addressing diet-related chronic diseases, curbing corporate power, eliminating conflicts of interest between industry and government, removing toxic chemicals from the food supply, and refocusing the food environment and dietary advice on health." Nestle referred to a roundtable discussion on nutrition and policy led by Sen. Ron Johnson, which included Kennedy and others described as "mainly influencers."

Nestle expressed skepticism when contacted via email, stating that while she shares some goals with Kennedy, there is no evidence that he "can or will" achieve them, and plenty of evidence from Trump's presidency that public health, education, and health care will suffer.

Kennedy's exclusion of vaccines from his recent policy discussions has not alleviated the fears of public health experts. Dr. Paul Offit, director of the Vaccine Education Center and an infectious diseases physician at Children's Hospital of Philadelphia, criticized Kennedy for making misleading or false statements about vaccine safety, even as evidence disproves them. Offit labeled Kennedy as a "science denialist" when it comes to vaccines.

Dr. Schwartz described Kennedy's shift away from discussing vaccines as an "eleventh-hour attempt to sanitize his reputation and rebrand himself as a reasonable advocate for chronic disease prevention, presumably to secure a position in a potential Trump administration," which he deemed "not credible." Osterholm, a self-described "nonpartisan public health soldier" who has served in health policy roles in every presidential administration since Reagan's, felt compelled to speak out publicly about potential Trump policies and what he called Kennedy's "pseudoscience."

Osterholm concluded with a dire warning, stating, "Everything that we see and know about what a Trump administration would look like would devastate public health in this country. Devastate it."