HHS HOT SEAT — At his Senate confirmation hearings next week, Robert F. Kennedy Jr., President Donald Trump’s pick to lead the Department of Health and Human Services, will get plenty of scrutiny for his anti-vaccination activism (and recent attempts to distance himself from it). Ditto for his finances and potential conflicts of interest, which intersect with his vaccine stances. But the HHS secretary has a really big job, with an expansive mandate that reaches well beyond vaccines. The department touches on abortion policy and substance abuse treatment and global health and climate change and medical privacy and health care costs. It oversees — along with its Centers for Medicare and Medicaid Services — the Affordable Care Act, Medicaid, Medicare and the Children’s Health Insurance Program. And the National Institutes of Health, the Food and Drug Administration and the Centers for Disease Control and many smaller agencies fall under its purview. Then, there’s Kennedy’s personal health protocols that are ripe for questioning — he has said he takes supplements by the “fistful ” without knowing what they do. To date, though, arguments over vaccines have crowded much of that out. So Nightly asked health and public health leaders — what questions do they want senators to ask Kennedy at the hearings? Responses have been lightly edited. Tom Frieden , President and CEO of Resolve to Save Lives and former Centers for Disease Control director. “President Trump announced on the first day of his presidency his intent to withdraw from the WHO. Through WHO governance and World Health Assembly resolutions, the U.S. has enormous influence over global health policy that applies to all countries, including those countries with which the United States does not have productive (or in some cases any) bilateral relations. What is your strategy for ensuring we can protect Americans from global health threats that do not respect borders if the U.S. separates itself from the international health community? You have discussed addressing America’s unhealthy food systems, which contribute to chronic diseases, which you say you want to combat. Will you commit to promoting and implementing evidence-based measures, such as mandatory sodium reduction targets set by the FDA, even in the face of industry opposition and lawsuits?” Dave Chokshi , former New York City health commissioner, chair of the Common Health Coalition and a practicing primary care physician. “Someone needs to pin him down on whether or not he believes that germs cause disease. The germ theory of disease was established in the late 19th century and all first year medical students are well-versed in it. Does he believe in it? Medicaid should also be the focus because that’s where there’s going to be the most policy foment in a Trump administration. What does he believe about work requirements, about whether the F map [the federal share of costs] should be lowered? About whether there should be block grants?” Sherry Glied, a health economist who served under George H.W. Bush, Bill Clinton and Barack Obama and who is now dean of the NYU Robert F. Wagner Graduate School of Public Service. “The ‘healing farms ’ for substance abusers [that Kennedy has praised] cost $10,000 a month [per person]. Is Congress going to spend $120,000 a year for people who use heroin? The HHS Secretary doesn’t run the other health agencies but what is your experience of getting all of these different agencies to work together? Your job is to actually create a coherent whole out of a bunch of unrelated parts. What’s your vision?” Peter Lurie , the head of the Center for Science in the Public Interest and the former FDA associate commissioner for public health strategy and analysis. “Have you communicated your intention for NIH to ‘give … infectious diseases a break … for about eight years’ to the relevant pathogens [like the virus that causes bird flu] so they know not to attack during that period? Drugs come to market on the basis of controlled, clinical trials, while the FDA doesn’t even know what dietary supplements are on the market, much less whether there is any substantiation for the claims they make. Such clinical trials have also disproven the effectiveness of ivermectin and hydroxychloroquine for COVID-19. Please explain the analytical approach that has led you to conclude that vitamins, ivermectin and hydroxychloroquine are effective for COVID-19 but that Ozempic, backed by clinical trials showing reductions in weight, cardiovascular disease and total mortality, is being sold by pharmaceutical companies ‘counting on selling it to Americans because we’re so stupid and so addicted to drugs.’” Georges C. Benjamin, executive director of the American Public Health Association. “Does he believe in preventing diseases, and if so should the administration support the preventative health services task force [at the center of the latest court battle over the Affordable Care Act]? Should women have control over their own bodies?” Andrea Baccarelli, dean of the faculty, Harvard T.H. Chan School of Public Health. “Dietary supplements are a huge business, largely unregulated. How would you ensure that science informs policy around supplement manufacture and marketing? How will you balance the right to free speech against the reality that all people, but especially those facing a serious illness, are vulnerable to manipulation by individuals peddling harmful or ineffective ‘cures’?” Welcome to POLITICO Nightly. Reach out with news, tips and ideas at nightly@politico.com . Or contact tonight’s author on X (formerly known as Twitter) at @JoanneKenen .
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