RFK nomination disturbs health scientists

Life sciences research in the US could look very different come 2025 if Robert F. Kennedy Jr., a former presidential candidate and noted vaccine conspiracy theory peddler, takes the helm of the Department of Health and Human Services (HHS).

President-elect Donald J. Trump nominated Kennedy to the Cabinet position late Thursday. Kennedy will need Senate confirmation to become HHS secretary. The Senate will have a Republican majority in January.

HHS oversees several sub-agencies that either fund or regulate the biotech and pharmaceutical industries, as well as health research and policy more broadly. The Centers for Medicare and Medicaid Services handles federal insurance reimbursement and negotiates with manufacturers on drug pricing. The Food and Drug Administration (FDA) approves new drugs and regulates food products. The Centers for Disease Control and Prevention (CDC), the nation’s largest public health agency, formally recommends vaccines and treatments based on age and underlying medical conditions. The National Institutes of Health (NIH) funds early-stage research that often forms the foundation of new drugs.

Kennedy seeks to unravel those agencies. Recently, he’s said he would eliminate entire departments from the FDA— although he has focused more on food than drug regulation—and fire 600 NIH employees.

“For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health,” Trump said in a statement announcing Kennedy’s nomination. “The Safety and Health of all Americans is the most important role of any Administration, and HHS will play a big role in helping ensure that everybody will be protected from harmful chemicals, pollutants, pesticides, pharmaceutical products, and food additives that have contributed to the overwhelming Health Crisis in this Country.”

Many biotech and pharmaceutical executives were immediately alarmed by the news. Although Kennedy has been involved in conversations around Trump’s approach to public health, most industry insiders did not believe Kennedy would be seriously considered to run the HHS; Trump’s transition cochair told Stat News only last week that Kennedy would not be HHS secretary.

“I can say that the entire scientific and medical community must now work hard to have this nomination rejected,” says one biotech executive who spoke on the condition of anonymity “to preserve public health.”

Kennedy has repeatedly pushed ideas that are antithetical to basic science. He campaigned prominently on the debunked notion that vaccines cause autism, and he has suggested that governments should not add fluoride salts to water supplies, despite their relative safety and usefulness in preventing tooth decay.

The Standard & Poor’s Biotechnology Select Industry Index (XBI), one measure of the health of the life sciences industry, fell more than 3% over the day Thursday, well more than the 0.47% the Dow Jones Industrial Average dropped. The Nasdaq Biotechnology Index fell more than 2%.

Jeffrey Flier, an endocrinologist and Harvard Medical School professor, called Kennedy’s nomination “completely insane” in a post on X. “Completely independent of politics, this must be seen as unacceptable in 2024,” Flier wrote.

If confirmed, Kennedy would oversee the distribution of roughly $1.7 trillion in HHS funds. Project 2025, a policy document authored by the conservative Heritage Foundation that’s meant to serve as a blueprint for Trump’s second term, proposes a complete overhaul of federal research infrastructure and the implementation of policies like term limits on NIH leaders and block grants to states “to fund their own scientific research.”

NIH funds are critical to the biopharmaceutical industry. A Bentley University study last year (J. Am. Med. Assoc. 2023, DOI: 10.1001/jamahealthforum.2023.0511) found that the agency’s funding had played a role in all but two drugs approved over the course of a decade, with around $1.4 billion spent on each drug — comparable to the amount of private investment each drug received.

“We very much ascribe to the idea that the government is the lead investor in innovation,” author Fred Ledley, founding director of Bentley’s Center for Integration of Science and Industry, told C&EN last month. “Whether it’s computers or life sciences or anything else, that’s the lifeblood that fuels the industry.”