WASHINGTON (AP) — President-elect Donald Trump has assembled a team of medical contrarians and health care critics to fulfill an agenda aimed at remaking how the federal government oversees medicines, health programs and nutrition.
On Tuesday night, Trump nominated Dr. Jay Bhattacharya to lead the National Institutes of Health, tapping an opponent of pandemic lockdowns and vaccine mandates to lead the nation's top medical research agency. He is the latest in a string of Trump nominees who were critics of COVID-19 health measures.
Bhattacharya and the other nominees are expected to play pivotal roles in implementing Robert F. Kennedy Jr's sprawling "Make America Healthy Again," agenda, which calls for removing thousands of additives from U.S. foods, rooting out conflicts of interest at agencies and incentivizing healthier foods in school lunches and other nutrition programs. Trump nominated Kennedy to head the Department of Health and Human Services, which oversees NIH and other federal health agencies.
The new health priorities bear little resemblance to those of Trump's first term, which focused on cutting regulations for food, drug and agriculture companies.
"You're hearing a very different tune as we head into this new Trump administration," said Gabby Headrick, a nutrition researcher at George Washington University's school of public health. "It's important that we all proceed with caution and remember some of the public health losses we saw the first time."
Trump's choices don't have experience running large bureaucratic agencies, but they know how to talk about health on TV.
Centers for Medicare and Medicaid pick Dr. Mehmet Oz hosted a talk show for 13 years and is a well-known wellness and lifestyle influencer. The pick for the Food and Drug Administration, Dr. Marty Makary, and for surgeon general, Dr. Janette Nesheiwat, are frequent Fox News contributors.
Some of them have ties to Florida like many of Trump's other Cabinet nominees: Dave Weldon, the pick for the Centers for Disease Control and Prevention, represented the state in Congress for 14 years.
Here's a look at how the nominees may carry out Kennedy's plans to "reorganize" agencies, which have an overall $1.7 trillion budget, employ 80,000 scientists, researchers, doctors and other officials:
National Institutes of Health
The National Institutes of Health, with a $48 billion budget, funds medical research through grants to scientists across the nation and conducts its own research.
Bhattacharya, a health economist and physician at Stanford University, was one of three authors of the Great Barrington Declaration, an October 2020 letter maintaining that lockdowns were causing irreparable harm.
The document — which came before the availability of COVID-19 vaccines — promoted "herd immunity," the idea that people at low risk should live normally while building up immunity to COVID-19 through infection. Protection should focus instead on people at higher risk, the document said.
"I think the lockdowns were the single biggest public health mistake," Bhattacharya said in March 2021 during a panel discussion convened by Florida Gov. Ron DeSantis.
The Great Barrington Declaration was embraced by some in the first Trump administration, even as it was widely denounced by disease experts. Then- NIH director Dr. Francis Collins called it dangerous and "not mainstream science."
His nomination would need to be approved by the Senate.
Kennedy has said he would pause NIH's drug development and infectious disease research and shift its focus to chronic diseases. He also would like to keep NIH funding from researchers with conflicts of interest. In 2017, he said the agency wasn't doing enough research into the role of vaccines in autism — an idea that has long been debunked.
Centers for Disease Control and Prevention
The Atlanta-based CDC, with a $9.2 billion core budget, is charged with protecting Americans from disease outbreaks and other public health threats.
Kennedy has long attacked vaccines and criticized the CDC, repeatedly alleging corruption at the agency. He said on a 2023 podcast that there is "no vaccine that is safe and effective," and urged people to resist the CDC's guidelines about if and when kids should get vaccinated. The World Health Organization estimates that vaccines have saved more than 150 million lives over the past 50 years, and that 100 million of them were infants.
Decades ago, Kennedy found common ground with Weldon, who served in the Army and worked as an internal medicine doctor before he represented a central Florida congressional district from 1995 to 2009.
Starting in the early 2000s, Weldon had a prominent part in a debate about whether there was a relationship between a vaccine preservative called thimerosal and autism. He was a founding member of the Congressional Autism Caucus and tried to ban thimerosal from all vaccines.
Since 2001, all vaccines manufactured for the U.S. market and routinely recommended for children 6 years or younger have contained no thimerosal or only trace amounts, with the exception of inactivated flu vaccine. Meanwhile, study after study found no evidence that thimerosal caused autism.
Weldon's congressional voting record suggests he may go along with Republican efforts to downsize the CDC, including to eliminate the National Center for Injury Prevention and Control, which works on topics like drownings, drug overdoses and shooting deaths.
Food and Drug Administration
Kennedy has been extremely critical of the FDA, which has 18,000 employees and is responsible for the safety and effectiveness of prescription drugs, vaccines and other medical products, as well as overseeing cosmetics, electronic cigarettes and most foods.
Makary, Trump's pick to run the FDA, is a professor at Johns Hopkins University, a trained surgeon and a cancer specialist. He is closely aligned with Kennedy on several topics.
Makary has decried the overprescribing of drugs, the use of pesticides on foods and the influence of pharmaceutical and insurance companies over doctors and government regulators.
Kennedy has suggested he'll clear out "entire" FDA departments and also recently threatened to fire FDA employees for "aggressive suppression" of a host of unsubstantiated products and therapies, including stem cells, raw milk, psychedelics and discredited COVID-era treatments like hydroxychloroquine.
Makary's contrarian views during COVID-19 included questioning the need for COVID-19 vaccine boosters in young kids.
Centers for Medicaid and Medicare Services
The agency provides health care coverage for more than 160 million people through Medicaid, Medicare and the Affordable Care Act, and also sets Medicare payment rates for hospitals, doctors and other providers. With a $1.1 trillion budget and more than 6,000 employees, Oz has a massive agency to run if confirmed — and an agency that Kennedy hasn't talked about much.
While Trump tried to scrap the Affordable Care Act in his first term, Kennedy has not taken aim at it yet.
The Biden administration on Tuesday revealed a new plan to force Medicare and Medicaid to cover weight-loss drugs like Wegovy and Zepbound for many Americans who are obese. Kennedy has opposed the idea, saying government-sponsored insurance programs should instead expand coverage of healthier foods and gym memberships.
Trump said during his campaign that he would protect Medicare, which provides insurance for older Americans. Oz has endorsed expanding Medicare Advantage — a privately run version of Medicare that is popular but also a source of widespread fraud.
Surgeon general
Kennedy doesn't appear to have said much publicly about what he'd like to see from the surgeon general.
The nation's top doctor has little administrative power but can influence what counts as a public health danger and what to do about it — suggesting things like warning labels for products and issuing advisories. The current surgeon general, Vivek Murthy, declared gun violence as a public health crisis in June.
Trump's pick, Nesheiwat, is employed as a New York City medical director with CityMD, a group of urgent care facilities. She also has appeared on Fox News and other TV shows, authored a book on the "transformative power of prayer" in her medical career and endorses a brand of vitamin supplements.
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Associated Press writers Mike Stobbe, Amanda Seitz, Carla K. Johnson, Matthew Perrone and Erica Hunzinger contributed to this report.
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