The appointment of a US health secretary with anti-vaccine views could cause deaths and have profound consequences around the world, global health experts fear.
Robert F Kennedy Jr, Trump’s pick for the position, has a history of spreading misinformation on vaccines and questioning the science of HIV and Aids.
His nomination has been greeted with both bemusement and alarm. One global health activist, speaking on background, said the move was akin to making the disgraced doctor Andrew Wakefield, who falsely claimed the MMR vaccine caused autism, the UK’s health secretary.
“That sound that you just heard was my jaw dropping, hitting the floor and rolling out of the door,” said Prof Sir Simon Wessely, regius professor of psychiatry at King’s College London.
Prof Sir Andrew Pollard, the director of the Oxford Vaccine Group, said there was “real concern” that RFK Jr might use the platform “to pursue the same anti-science positions on life-saving public health interventions that he has advanced previously”. He added: “If this makes families hesitate to immunise against the deadly diseases that threaten children, the consequence will be fatal for some.”
Prof Beate Kampmann of the London School of Hygiene and Tropical Medicine said the measles vaccine had averted more than 60m deaths worldwide in the last 25 years. “Progress will be rapidly lost in societies where vaccine hesitancy is promoted – as I fear will be the case in the US if Kennedy is appointed,” she said. Beyond US shores, the influence “could swing either way”, she said: “My worry is that polarisation on the topic will further increase.”
The US is a huge force in global health both as the largest funder and the home to many big pharmaceutical companies and leading health research institutes. The decisions of its regulators, such as the Food and Drug Administration, are closely watched by their equivalents elsewhere.
Some of those institutions are likely to be disrupted by RFK Jr’s pledge to “clear out corruption” at US health agencies and potentially eliminate entire departments. But the impact of a Trump administration on global health will be broader than any policies pursued by Kennedy alone. Trump could reinstate plans to withdraw from the World Health Organization and is almost certain to cut funding to UNFPA, the United Nations sexual and reproductive health agency that works in many poorer countries.
As under all Republican presidents since Reagan, NGOs expect there to be a “global gag rule” – banning recipients of US health funding from performing or promoting abortions anywhere in the world, which will potentially expand to cover even recipients of humanitarian aid.
Kennedy’s stance on vaccination is being watched warily. Globally, routine vaccination coverage has yet to return to pre-pandemic levels. Lower immunisation rates led to a 20% annual increase in measles cases in 2023.
He has previously made common cause with anti-vaccine groups overseas. In June 2019 he visited Samoa, where the measles vaccine was being blamed for the deaths of two babies a year earlier. It later emerged that the deaths had been caused by incorrect preparation of the vaccine mixture.
Immunisation rates halved to 31% and not long after his visit a measles outbreak ended up infecting more than 57,000 people and killed 83, including children. Even as the outbreak raged, Kennedy wrote to the Samoan prime minister suggesting it might have been caused “by a defective vaccine” rather than inadequate coverage. Kennedy said previously he bore no responsibility for the outcome.
His nomination was greeted with cautious civility in Berlin, where Kennedy made a name for himself as a coronavirus sceptic during the pandemic. The health minister, Karl Lauterbach, a qualified doctor, offered his congratulations, but couched it in language that made his scepticism clear. “Here’s to a constructive collaboration. Will certainly not be just easy. But the choice of the voters is to be respected,” he wrote on X.
Kennedy managed to enter Germany in 2020 despite tight travel restrictions in order to address coronavirus sceptics at a rally in the German capital. He became a hero of the so-called Querdenker anti-coronavirus conspiracy theorist group, speaking to a demonstration attended by about 18,000 people.
Kennedy drew parallels between his presence in Berlin, as a “fighter against totalitarianism”, and his uncle John F Kennedy’s appearance there in June 1963 during the cold war when he said the city had previously been a front against totalitarianism.
On Friday individuals and groups linked to the Querdenker movement welcomed the appointment, with some claiming Kennedy would “save the rest of the world”.
The Hartmannbund association of German doctors voiced its concern about the overall effect a Trump presidency might have on Germany’s healthcare system. Its chair, Klaus Reinhardt, warned about the potential impact of any trade war between the US and Europe on the supply of medicines, saying issues over tariffs could greatly increase health costs and the individual contributions currently required by Germany’s health insurers.
Scientific leaders say another pandemic is inevitable and that while during the Covid-19 pandemic Trump’s Operation Warp Speed aided the development, approval and mass manufacture of vaccines in record times, similar US leadership under RFK Jr appears less likely.
On other issues, experts are waiting for more detail on Kennedy’s plans. He has pledged to tackle chronic diseases and address the issue of overly processed foods. Leadership in those areas could be welcome in a world where diabetes rates have doubled in the past three decades.
Many global health activists said they would agree with RFK that big pharma has questions to answer, but that companies should not be falsely accused of making vaccines that harm people, rather they should be asked why so much of the world does not have access to affordable medicines.