Public health in the United States has faced significant turmoil during the first year of Robert F. Kennedy Jr.’s tenure as Secretary of Health and Human Services. Promising to “Make America Healthy Again,” Kennedy’s administration has seen a series of controversial decisions that have undermined trust in health agencies. Recent surveys indicate that less than half of Americans now have confidence in the ability of these agencies to make science-backed decisions.
Kennedy’s most notable actions include the dismissal of key personnel within the Centers for Disease Control and Prevention (CDC) and the replacement of its advisory panel on vaccines with individuals who have a history of promoting misinformation. In June 2024, he removed CDC director Susan Monarez after she resisted his attempts to eliminate career staff and endorse his newly appointed advisory panel’s recommendations. The CDC subsequently altered its childhood vaccine schedule, raising concerns among health professionals and parents alike.
The ripple effects of Kennedy’s approach have not only impacted the CDC but have also reverberated throughout the broader health landscape. Under his leadership, the Department of Health and Human Services has witnessed a staggering loss of talent. An analysis by Science revealed that nearly 2,400 Ph.D. scientists departed from three major health agencies in 2024, a number significantly higher than in previous years. At the National Institutes of Health (NIH), over half of its 27 institutes currently lack permanent directors, disrupting vital research activities.
Financially, the NIH and the National Science Foundation have seen a substantial decline in funding, with researchers losing an estimated $1.4 billion due to grant terminations and reinstatements following court rulings. In 2025, new grant awards from the NIH to academic laboratories fell by approximately 24%, potentially stalling critical medical discoveries.
The Food and Drug Administration (FDA), which plays a crucial role in regulating pharmaceuticals, has also faced instability. Last year, five different individuals served as acting directors of the Center for Drug Evaluation and Research, which oversees new drug approvals. Some departures occurred amidst scrutiny over a new voucher program, raising concerns about the motivations behind policy decisions that appear more politically driven than patient-focused.
Beyond these upheavals, the CDC’s core functions have been hindered. An analysis published in the Annals of Internal Medicine highlighted that much of the agency’s traditional data releases have been delayed or omitted entirely. In the past year, the CDC issued only a few health alerts, in stark contrast to the dozens typically released annually. This lack of communication has left local health departments uninformed about emerging threats in their communities.
Following the firing of Monarez, Jim O’Neill, the interim director, was also removed from his position last week. Given the tumultuous year, it remains uncertain whether a qualified candidate with scientific credibility would be willing to lead the CDC, particularly if chosen by Kennedy.
Kennedy’s actions have eroded public trust in scientific expertise. His frequent admonitions to the public, particularly parents, to “do your own research” have further fueled skepticism about the professionals working within health agencies. As the CDC’s credibility wanes, various states and medical associations are beginning to create alternative public health groups that aim to fill the void, offering coordinated responses during outbreaks and disseminating reliable information.
Looking ahead, the future of public health under Kennedy remains uncertain. His administration is reportedly planning a remaking of the National Vaccine Injury Compensation Program, a fund that compensates individuals who experience rare side effects from vaccinations. The removal of half of the panel that determines compensation has raised alarms about potential changes that could include non-scientific claims, which may jeopardize the fund’s sustainability.
While Kennedy may shift focus to more politically appealing issues, such as nutrition, his track record raises questions about his commitment to evidence-based changes. His overhaul of dietary guidelines, which has drawn criticism for its emphasis on red meat and saturated fats, underscores the complexities surrounding his policies.
Ultimately, Kennedy’s legacy will likely be judged by the public health crises that have unfolded during his administration. The consequences of his decisions may continue to escalate, exacerbating the challenges facing the American healthcare system.
