Many thought they misunderstood. Imagined that Donald Trump would change his mind. Or that he would anticipate a refusal from Congress. And yet, the facts are there: the future 47th President of the United States has confirmed his intention to appoint Robert Kennedy Jr as head of the American Department of Health. This sulphurous character, a lawyer specializing in the environment but above all an anti-vax and notorious conspiracy theorist, would thus have all powers over institutions as important as the FDA (food and drug administration, the agency responsible for medicines and food safety), the NIH (National Institutes of Health, in charge of biomedical research, like Inserm in France), or the CDC (Centers for Disease Control, equivalent of regional health agencies).
We must understand the scale of the explosion caused by this announcement: in 2021, John F. Kennedy’s nephew was ranked among the 12 biggest propagators of false information online about Covid by Countering digital hate, an NGO specializing in the fight against digital obscurantism. He continually trampled on science throughout his campaign. “RFK” considers that vaccines cause autism, that giving antidepressants to adolescents increases the risk that they will engage in mass killings, or even that the CIA killed his uncle.
Once the shock has passed, we must ask ourselves: what would be the concrete effects of this nomination if it were to be validated by Congress? To answer this question, we should do with Robert Kennedy as many analysts do on other subjects with Donald Trump himself: take him at his word. By dissecting his announcements and his declarations, we find the catastrophic, the very worrying, the very bad, but also, surprisingly, some interesting ideas. He would still have to implement them: the character promises to be just as unpredictable as Donald Trump.
Upsurge in infectious diseases
Let’s start with the worst: Kennedy, skeptical about the benefit of certain drugs, is above all a fierce opponent of vaccination. If he says he is in favor of “free choice”, he notably called for resist recommendations in matters concerning children. Adherence to vaccination being a permanent battle for health authorities around the world, we can well imagine the consequences that an anti-vax Minister of Health would have, and many experts are already anticipating a resurgence of infectious diseases in the United States. United. Should we recall the benefit of these injections? According to a study by The Lancetvaccinating children helped save 100 million infants around the world over the last fifty years.
Just as worrying, Robert Kennedy Jr declared on social networks that he was committed to “liberating the agencies” (healthcare, Editor’s note), in particular from the “suffocating cloud of corporate control”. If this consists of dismiss, as he has suggested on numerous occasions, any personnel unfavorable to his theses, the measure promises to be dramatic, as the opinions of these agencies are scrutinized throughout the world, in their respective fields of competence. Bringing them into line, ensuring that they are won over to an ideology, would profoundly degrade the quality of their evaluations. If this involves strengthening the “independence”, “transparency” and “efficiency” of research, which he promises at the same time, some improvements could however see the light of day.
Stewardship would still have to follow: if Kennedy, for example, wants to put an end to the dependence of these institutions on private money, this “corruption” that he sees everywhere, he does not say where to find the missing money, which sometimes represents 50% to 75% of their budgets. And if he wants to simplify the organization of research, rid it of its paperwork, by reducing for example the number of institutes run by the NIH, from 27 to 15, nothing says that it is not, above all, for ideological purposes. For example, Kennedy never hid the fact that he found it pointless to work on infectious diseases. Without these laboratories, there will be no vaccine against Covid-19, at least not as quickly. The entire world public health would suffer from this decision, and not just that of Americans.
Towards a reduction in the price of medicines?
Conversely, and very surprisingly for supporters of uninhibited liberalism like Robert Kennedy and Donald Trump, the two men seem determined to tackle certain very real abuses. “RFK” wants to ban advertising for medicines on television, which would be a major step forward in a country flooded by pharmaceutical products, and in particular painkillers, once distributed en masse and responsible for the opioid crisis. With it, he said, 50% of research budgets would go to prevention or “alternative” approaches, such as the study of the effect of certain diets, or the development of generic drugs.
Even more surprising is its position on the question of the price of medicines, and in particular innovative medicines, which are particularly expensive. At the end of his first term, Donald Trump attempted to pass a text to cap the prices of health products covered by Medicare and Medicaid at the level of those charged in other world markets. His own camp had opposed it, but RFK recently revived the idea in an op-ed at wall street journal. Such a proposal, if it ends up being adopted, could initially have favorable effects for Europeans.
Today, in fact, pharmaceutical laboratories (whose prices fell after Donald Trump’s announcement) are first launching their drugs on the American market, at prices that are not or barely negotiated, which then serve as a basis for discussion in the rest of the world, and particularly in Europe. The starting point being very high, the bills remain high on this side of the Atlantic, including after negotiation. A change in policy in the United States could therefore indirectly have a positive effect on the social accounts of the Old Continent. But there would undoubtedly also be undesirable effects: as the Americans today largely finance pharmaceutical innovation, this could in the medium term be slowed down by such a decision.
Chronic disease epidemic
Another campaign promise, Kennedy promises to “reverse the epidemic of chronic diseases” (obesity, diabetes, etc.) from which Americans suffer. Hence this slogan, which he constantly repeated after allying himself with Donald Trump: “Make America Healthy Again”. In words, the project is ambitious: “I am going to press President Trump so that we make these pathologies a national emergency, as we did for Covid-19,” he declared on September 26 last. The politician is this time, generally in agreement with the scientific consensus: Kennedy wants to put America back into sport, rid it of junk food, make it taste the joys of daylight again, and “all these health benefits which cannot be patented.
If we leave aside the most eccentric, like “fire […] all scientists specializing in nutrition” working for the federal state, we must recognize some interesting proposals. Kennedy, for example, proposed aligning with certain much more precautionary European standards, particularly in terms of additives or ingredients potentially harmful. He would like to ensure that food aid cannot be used to buy sodas or drinks. junk food and ban processed food from canteens. A desirable precaution, according to scientists: processing damages nutrients, and increases the absorption of sugar or fat, present en masse in this type of food.
Kennedy also promised to making junk food manufacturers pay for the costs of obesity and diabeteswhose care is particularly expensive. Unlike France, for example, the United States taxes very sugary products very little. Gold several local experiments seem to show that in addition to allowing money to be recovered, such measures could have a deterrent effect for the consumer. In Seattle, for example, where the system was implemented, soda consumption fell by 22%. Yet slayer ofWHO in many respects, this time he is aligned with his recommendations… However, it is not certain that this is enough to counterbalance the disastrous effects of the rest of his program.
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