DDonald Trump may be president for four more years, but the effects of his administration on public health could be catastrophic in the long run. While we do not know for sure what will happen, there is no doubt that the next four years will see attempts to reduce the authority and independence of health agencies such as the US Food and Drug Administration (FDA) and US Centers for Disease Control and Prevention. (CDC) – something the President-elect tried during his first term. However, despite Trump’s audacity to let RFK Jr. “show up” and “do what he wants” with health, there is no chance of a massive shutdown or rebuilding of government agencies. it can happen. More important is the possibility that one of Trump’s statements could undermine regulators — reversing the public-trust tactics that his first administration helped create in real trouble.
The concern is not only about what the Trump Administration 2.0 will do, but also about what it will say. RFK Jr., one of the so-called “Disinformation Dozen,” had become the most influential figure in the anti-vax movement. Now, it looks like he will have the ear of the president. The trend of conspiracy may continue throughout the government and outside of the government, there are rumors of famous people falsely reporting that they are in high health. For example, Dr. Joseph Ladapo, Florida’s Surgeon General, is rumored to be in the running to lead the United States Department of Health and Human Services. The fact that people who support ideas that deviate from mainstream science are considered to be the head of the most respected institutions is an indication of how controversial or radical the Trump administration 2.0 can be when it comes to health. public good. Instead of promising to “Make America Healthy Again,” the new Trump administration may end up leaving America—and the world—sicker than ever.
Reluctance to vaccinate
Vaccines are among the most successful public health interventions in history, saving at least 154 million lives over the past 50 years. If Trump’s record is any indication, he himself may not be the problem when it comes to vaccines. During the years of his first administration, vaccine coverage was higher than – or in some cases the highest – it had ever been (although this was a major development rather than following Trump’s policies). Childhood vaccination rates have dropped in America And with Trump’s second statement and the worrying prospect of people like Kennedy and Lapado directing or at least influencing policy, it’s hard to imagine that vaccination rates won’t drop. . Of course, vaccine hesitancy will increase — an intensification of the trend we’ve seen, in the US and around the world, since the outbreak began.
There may be no specific vaccination restrictions. Kennedy recently said: “I’m not going to take away anyone’s vaccines.” The problem is the doubt that Kennedy sows. The misinformation continues. It has been over 25 years since Andrew Wakefield published his fraudulent paper linking the MMR vaccine to autism. However, his shadow looms large, and the US has already had a recent outbreak of measles, with vaccine reluctance driven by misinformation being a factor. Around the world, the unfounded fear of autism is being cited as a reason why some parents refuse vaccinations for their children. Kennedy has made false claims that vaccines cause autism, and his misinformation has even been linked to a deadly measles outbreak in Samoa in 2019 (for which Kennedy has denied responsibility).
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The US is currently recommending updated COVID-19 vaccines for everyone. In this sense, the US likes to maintain a more widespread immunity than other countries around the world. But it is difficult to imagine that this level of official support for other vaccines for COVID-19 will continue next year.
One of the most dangerous vaccines is probably HPV. Kennedy has spread lies about the Gardasil HPV vaccine, including unfounded claims that it is linked to autoimmune conditions. The fallout of the HPV vaccine ban could be dangerous to public health, as it helps reduce the risk of cervical cancer by 90%.
Wild West of the “good life”
Kennedy and his followers claim, falsely, that many vaccines and drugs have not been adequately tested for safety. Let’s be clear: COVID-19 vaccines, HPV vaccines, and all the others approved and recommended in the US and around the world are safe and effective. But more research and testing is never a bad thing—so cutting agencies like the CDC and NIH (as Kennedy wants) wouldn’t help make the market for pharmaceuticals and health products be safe.
Then there is fluoride. Trump said that Kennedy’s idea to ban the addition of fluoride to some public water supplies—a long-term practice that improves dental health—”sounds good.” Although there has been controversy, organizations including the CDC and the World Health Organization have said that fluoride in drinking water can help prevent cavities and is safe within certain limits. But this issue can indicate which legally recommended public health measures can be removed or undermined, and which other remedies can replace them.
Kennedy suggested that he would stop the FDA’s “war” on substances including ivermectin, hydroxychloroquine, psychedelics, nutraceuticals and even sunlight. Like Kennedy, Ladapo recommended the use of ivermectin (an antiparasitic treatment widely used by veterinarians) and hydroxychloroquine, both of which were dismissed by the medical community. Like his former partner, Nicole Shanahan may follow Kennedy in playing a prominent role in shaping Trump’s health plans. Like Kennedy, Shanahan has been known to promote unscientific claims, including dangerous claims that sunscreen is harmful and that unprotected sun exposure can cure many conditions.
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There could be positive public health outcomes during the coming Trump years. The desire to reduce processed foods in the US diet, especially the amount of additives and artificial ingredients in baby food, is important. However, there are better ways to achieve this than undermining public trust in the FDA and other health agencies. Better regulation of the junk food industry, investing in health education, and making healthy, natural alternatives accessible, especially to those with low incomes, could be a better way.
It is possible that the high-profile advocacy of unproven scientific treatments, could mean that the Trump administration sees a further increase in “neo-quackery” and “conspirituality” (when conspiracy meets spirituality) under the banner of ‘good health’. Misinformation spreads like a virus, and perhaps it’s no surprise that some of those who have been seen as part of Trump’s success are at the forefront of the media’s vulnerability to misinformation, from X of Elon Musk to Joe Rogan’s podcast. .
Ignoring the next plague
In an interview with TIME, Trump indicated that he may disband the Office of Pandemic Preparedness and Response Strategy, a large office established by the Biden Administration to prepare for future disasters. Doing so can be a dangerous move. Several countries, including the UK and Australia, are conducting epidemiologic studies and finding that better, not less, preparedness is needed.
H5N1 continues to spread among cattle in the US, and with each infection the risk of spillover to humans increases. The current system is still very deficient in its control of the virus among dairy cattle, and in ensuring that those around infected herds have protective equipment. However, things are unlikely to improve in the coming years.
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Kennedy recommended drinking raw milk—a dangerous practice for all kinds of reasons, including being a potential risk factor for H5N1 infection. Of particular concern is the fact that the Trump Administration could undo some of the recent Biden-Harris efforts designed to deal with the growing threat of H5N1.
The broader problem is that America’s security-centric MAGA ethos can only go so far in protecting the country from global death threats. Whether it’s H5N1, mpox, Middle East Respiratory Syndrome (MERS), or a highly mutated and resistant strain of COVID-19, the best way for any country to protect its people is to try to deal with and epidemics at the source. This requires support, resources and cooperation around the world through organizations such as the World Health Organization, which Trump will cut.
These are just three of the areas of public health that may exist in the next four years. There are many more. Although it may not have been as electoral an issue as initially thought, abortion and reproductive health are concerns for many. So is the prospect of another four years for Trump to pick up where he left off in trying to destroy the Affordable Care Act and cut Medicare and Medicaid funding.
There is much to look forward to as Trump, Kennedy and their acolytes sink their teeth into public life.
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