“The US is facing a sicker and poorer future!”
Exclusive: Two experts paint a shocking picture of US health policy under President Donald Trump and his Health Secretary Robert F. Kennedy Jr. The consequences could be dire.
Dear Readers,
The past week has once again clearly demonstrated how radically backward-looking Trump’s politics can be. Two reports underscore that the Republican Party under US President Donald Trump is waging a campaign against science and women’s rights.
On Wednesday, the New York Times reported that the state of Florida plans to abolish all forms of mandatory vaccination, including for schoolchildren. Florida’s Surgeon General, Dr. Joseph A. Ladapo, a well-known vaccine skeptic, cited a confusing mix of god and slavery as his reasoning.
In his words:
“Who am I to tell you what your child should put in their body? Your body is a gift from God.” He added that the administration would be “working to end” all vaccine mandates. “Every last one of them is wrong and drips with disdain and slavery.”
At the same time, Florida’s Republican governor, Ron DeSantis, announced the establishment of a commission to bring the state into line with the goals set by US Health Secretary Robert F. Kennedy Jr. The commission will be headed by Casey DeSantis, the governor’s wife.
Health Secretary Kennedy is also a long-standing vaccine skeptic. He recently fired independent advisors at the important Centers for Disease Control and Prevention (CDC) and replaced them with proven vaccine critics. Kennedy also dismissed the director of the CDC after less than a month in office.
In the meantime, the state government of Texas is working to ensure that anyone can soon sue doctors and distributors of abortion pills if they are involved in the delivery or import of the pills into the state.
As reported by the Washington Post, the bill, which is supported by anti-abortion activists, would allow private individuals, companies, and individuals to sue those who manufacture abortion pills or distribute them to patients in Texas.
What does this mean?
But why speculate about these issues when you can ask the experts?
I had the opportunity to speak with an experienced epidemiologist from the US who has been working with and for the CDC (Centers for Disease Control and Prevention) for over ten years.
I also spoke with a rising epidemiologist who specializes in women’s and minority rights. Both agreed to be interviewed on condition of anonymity, as they would otherwise fear for their jobs and careers.
As a journalist, it is important for me to tell you that both individuals have a great deal of expertise on the subject. Of course, I can also assure you that both individuals exist and that they answered my questions based on their many years of experience.
The first two questions were answered by the experienced CDC expert (source 1). The third question was answered by both the CDC expert and the aspiring epidemiologist (source 2). Questions four and five were answered by source 2.
“The US is completely hamstrung in terms of global health security”
What is Health Secretary Kennedy’s goal? What impact and consequences will his policies have not only for the CDC, but also for the US healthcare sector in general?
I’m not entirely sure I understand what the goal of Health Secretary Kennedy is. He claims that he aims to combat the disproportionately high (compared to other OECD countries) rates of chronic disease in the United States and yet dismantled many of the centers at CDC that work to do just that.
He claims that those efforts will instead move to a new AHA agency, except there is no funding for that agency or any known plans to get it started to speak of – if that agency ever comes to fruition it is years away - so in the meantime much of the work related to surveillance of chronic disease, evaluation of policies and programs to inform decision-making, and provision of evidence-based guidance for the American public and medical practitioners has been greatly diminished.
Kennedy, in my opinion, sells magic bullets to appease his Make American Healthy Again (MAHA) base. He’s made a big spectacle of getting junk food companies to eliminate food dyes or switch high fructose corn syrup for sugarcane. But we public health experts know those little changes will have no measurable impact on chronic disease because he is doing nothing to address root causes – prevalence of food deserts, which limit access to healthy foods, soaring costs of healthy foods, lack of insurance coverage and access to healthcare (particularly among the rural poor), and the list of social determinants impacting chronic disease goes on… and yet Kennedy does not address these pervasive underlying issues with his MAHA agenda.
And that’s just chronic disease. As he does nothing effective to address those, he is having an even more profound (negative) impact on our ability to control infectious diseases.
Not only did he stoke vaccine hesitancy in the country for many years before he became Secretary, but he is also now single-handedly dismantling our entire vaccine infrastructure. He has cancelled $500 million in mRNA research, severely hampering our ability to respond to the next pandemic. He has removed well-respected experts from the external advisory committees that inform FDA’s regulatory process and CDC’s recommendation process and replaced them with unqualified anti-vax grifters.
Already, the FDA has limited the COVID-19 vaccine approval for the upcoming season to adults ≥65 years and those with high-risk conditions. Earlier this year, Kennedy unilaterally revoked the COVID-19 vaccine recommendation for pregnant people – he did not consult with anyone at CDC on this decision, and he has yet to provide the “evidence” he used to make this decision.
It’s important to note that in the United States, most insurers will not cover a vaccine if the person receiving it does not belong to a group that FDA has authorized for use and/or the CDC has included in their recommendation. Despite Kennedy stating in no uncertain terms during his Senate confirmation hearing and again a couple of days ago at another Senate hearing that “anyone who wants to get a vaccine can get one”, his actions have effectively restricted access to the vaccine from millions of people who want them. What’s more alarming, is that currently there is scheduled for later this month an ACIP meeting that has not just COVID-19, but also MMR, RSV, and HepB on the agenda – notably vaccines that have been top of the anti-vaxxer agenda for years. If they move to remove recommendations for children, insurers will not cover these vaccines and millions of families will lose access – despite Kennedy’s promises to the contrary.
Further, in addition to the mRNA cuts, federal research funding across just about every health and biomedical field is in critical danger. Labs all over the country have already suspended research, universities have fewer spots (if any) for new PhD candidates – our biomedical research complex will be severely curtailed for years to come.
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How dangerous is it that Florida plans to get rid of all vaccination requirements? What consequences could this have?
In two words – very dangerous!
Let’s take measles for example – we can look at the Southwest U.S. measles outbreak this year, which originated in a vaccine hesitant community with low vaccination coverage. As of today, there have been at least 1,431 cases across 45 states - the largest outbreak since 1992 – with 3 deaths, 2 among children. Measles had been eliminated in the U.S. since 2000, although every year we experience a small number of imported cases. It should be noted we have had more importation-related cases (n=137) this year than any other year since 2000. If that increasing importation trend continues coupled with more pockets of low coverage, we have a recipe for disaster. Florida, in particular, is a major entry point for international travelers into the United States.
An interesting thing about this plan to eliminate the mandate is that parents in Florida have had the right to claim a non-medical exemption for school vaccination (e.g., religious or philosophical) for more than a decade. But there is an unintended consequence I think many people aren’t thinking about right now. In my work, I see that school entry vaccination requirements often serve as an important reminder for parents and caregivers to get their children the final booster doses of DTaP, IPV, and MMR. Most of the childhood vaccination schedule is completed by age 18 months, a period when parents and caregivers are primed by their pediatricians to schedule regular “well-baby” visits, at which point they receive those first few doses of the vaccine series.
However, after babies turn two years old, there aren’t many scheduled routine check-up or vaccination visits. Those final booster doses are recommended at ages 4 – 6 years, and in those intervening years, busy parents simply forget – until they go to enroll the child in school. Without the mandates in place, I suspect many parents who are otherwise in support of vaccination for their child will miss those last doses. I suspect we’ll see coverage for the second dose of MMR drop a few more percentage points (it’s already <90% and for measles herd immunity it needs to be 95%), particularly as the news dies down and parents start to forget about that second dose, which is so important for increasing effectiveness and maintaining immunity.
What consequences will the change in disease control policy in the US have for smaller countries with less money and fewer resources?
Source 1: This is a great question. I haven’t been hearing it talked about in the U.S. media much. First and foremost, the United States had been the largest contributor to developmental assistance for health (DAH) for the past few decades – and obviously this year much of that funding has been swiftly cut off at the source and agencies like USAID completely dismantled. This will have far-reaching consequences for decades to come. The U.N. and WHO have been advocating, particularly this decade, for countries with less resources to begin to diversify their health funding mechanisms and to work towards becoming independent of DAH – which was good foresight.
However, that is a complex policy and resource generation challenge that will take time to implement effectively – and instead of slowing the funding flow in a sustainable way to allow countries to adjust, this administration “took a sledgehammer” to our funding and assistance mechanisms.
We are completely hamstrung in terms of global health security.
Not only that, but our federal public health researchers are no longer permitted to engage with WHO in any capacity, which is significantly impacting our ability to interact with countries on important activities like disease surveillance and outbreak response. We are flying blind in our attempts to monitor the spread of various infectious diseases globally; even if we are alerted by a country, we are less able now to provide technical support in-country if requested due to newly imposed travel restrictions and a host of new approval processes that slow down our capability to respond quickly and effectively.
That’s not to mention the fact that we’ve lost thousands of experts this year through reduction in force – even if a team is called to respond, there’s a good chance a world leading expert that would have led the team nine months ago is no longer here. We are completely hamstrung in terms of global health security.
I have only touched on the tip of the iceberg for all of these questions – there is more to be said about the millions of Americans who are likely to lose healthcare access with the passage of the “Big, Beautiful Bill”, deregulation of environmental policies that will contribute to more pollutants in our air and waterways, and on and on. Given the many regulatory and policy actions implemented during this administration across the whole of government, the United States is poised to be poorer, sicker, and less ready for the next pandemic. Seems like thoughts and prayers are really all we have at this point.
Source 2: Oh, where do I begin? For these smaller countries that have limited resources, the US stepping back from Global health and global Disease Control has been like pulling the floor out from under them. Defunding USAID, which is named “the United States” and “AID,” has had catastrophic impacts on individuals around the world.
Several health programs, including HIV treatment clinics, vaccine campaigns, maternal health services, and services for preparedness / surveillance / treatment of emerging infectious diseases, were built on and by U.S. support – “The United States,” whose job is to “AID.” When 83% of funding was essentially cut overnight, the funding completely disappeared; it was not a slow decline by any means. Clinics shut down, vaccinations were not available, and food programs vanished overnight.
Diseases that have been controlled and managed will come roaring back.
Defunding USAID is estimated to cause 14,000,000 preventable deaths in the next five years, and 300,000 deaths have occurred so far due to the defunding.
These diseases that have been controlled and managed will come roaring back. People living with HIV who can’t get their meds end up sick again, malaria causes a surge when bed nets aren’t distributed, and preventable outbreaks like cholera or measles spread, because immunization drives completely stop. Wealthier countries can occasionally cushion these blows, but smaller nations don’t have a backup stockpile or a rainy-day budget. Progress that took decades is unraveling quickly.
It’s not just about the money, either. USAID has also trained doctors, nurses, public health professionals, and lab staff. They have kept diagnostic labs running. Without that, health systems lose both people and tools.
On top of all of this, there is the diplomatic side. For decades, the United States global health programs weren’t just humanitarian, they were a form of soft power. They built goodwill, strengthened alliances, and gave the US influence in regions where China, the EU, Russia, or other emerging superpowers were not as eager to step in.
Smaller countries have no choice but to turn elsewhere for support, and that reshapes who they partner with and trust. What used to be a symbol of American leadership in global health is now seen by many as a retreat, and that damages the US credibility and moral standing on the world stage.
On another note: Texas wants to make it possible for anyone to sue doctors and retailers of abortion pills. What consequences will this have for women’s health?
The move of Texas to let private citizens sue abortion pill prescribers and distributors is nothing short of disgusting. This bill will be signed into law by the Texas governor soon. And of course, it will crawl its way through the court system to see if it’s “constitutional.” But we all know what game this is. It is another round of red light, green light in America, where rights are dangled and ripped away depending on the political season. And yes, I assume the Supreme Court will eventually rule in favor of Texas, hiding behind the excuse “letting the states decide.”
One of the most disturbing aspects of this Texas law is its lack of territorial boundaries. It allows Texans - in fact encourages them - to sue doctors, providers, pharmacists and telehealth providers in other states who prescribe or ship abortion pills to patients in Texas. This means a provider in states like California, Illinois, or New York who is acting entirely within the law of their own state can suddenly find themselves dragged into lawsuits in Texas because the patient sought care. Think about that, Texas has decided its authority stretches beyond its borders, punishing people who are legally providing medical care in their own states. This is not just overreach; it's unconstitutional.
Women will bleed out, women will become septic, and women will die, because politicians are too cowardly to look at the actual data.
This tactic creates chaos and fear in the medical community. Providers across the country are left wondering if treating their patients will expose them to lawsuits in hostile states hundreds of miles away. Some clinics have already cut off telehealth access to patients in Texas because they can’t risk the financial and legal fallout. That means women in Texas are being isolated even further, cut off not only from local options but also from doctors who want to help them from afar.
So what does this mean on the ground?
It means fewer safe abortions, not fewer abortions. The reality is that abortions will not stop. It will just become more unsafe. Women will bleed out, women will become septic, and women will die, because politicians are too cowardly to look at the actual data. Texas has outright stated to dismiss and ignore its own maternal mortality reports from 2022 and 2023, which showed rising deaths among pregnant women. Instead of fixing that crisis, they've chosen to deepen it.
I personally know physicians in Texas emergency rooms who are already living under this cloud of fear. They see patients miscarrying and know precisely what care to give, but they stay silent, because one prescription could cost them their license. Imagine being forced to let your patients suffer while you watch, because politicians have put shackles on your medical judgment. That's not medicine, that's control and cruelty.
And the divide only grows. Wealthy women will travel to other states for care, no problem, period. Still, women with lower incomes, women in abusive relationships, and women with no one to turn to will be trapped. They will be silenced. They will be forced to risk their lives for basic health care.
This should never be a public debate. It should never be in the hands of lawmakers, bounty hunters, or courts. This decision belongs only between a patient and their doctor. What Texas is doing is not about “life,” it’s about power, it’s about control, it’s about religion. And it’s a direct attack on women’s autonomy, safety, and dignity.
When you consider and evaluate all these developments, in which direction is the US currently heading?
When you step back and look at everything happening in the United States right now, the direction is nothing short of disastrous. It isn’t just the assault on health care and public health, it’s the chaos at the borders, the cruelty and migration policy, the alienation of long standing allies, and the dismantling of international partnerships that once made America a global leader. Layering on top of that the open hostility towards science, the spread of misinformation, the complacency of the people and politicians who are supposed to represent the people, and the erosion of democratic norms - you see a country actively undermining itself on every front. These aren’t isolated policy decisions, they’re interconnected failures that create a picture of a nation that is eating away at its own credibility and stability.
This country is moving in a direction of isolation. America is not moving forward; it’s moving backward and dragging its people with it. America is not first. America has not only lost its credibility, but it has lost its soul.
The health of the public is just one piece of this larger collapse, but it’s an important one. Public health works best when the people are unaware of its existence or its effectiveness. Public health doesn’t only affect people who “believe” in science – it affects everyone. Viruses, maternal mortality, and epidemics don't ask about politics. Yet the United States is choosing a specific ideology of the few over evidence, allowing misinformation to shape laws and policy. That’s the truly frightening part, this is a general attack on science and truth itself, and once that is lost, every other system, education, healthcare, economics, security, all begin to fall.
This country is moving in a direction of isolation. America is not moving forward; it’s moving backward and dragging its people with it. America is not first. America has not only lost its credibility, but it has lost its soul.
Philipp Sandmann