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      How Robert F. Kennedy Jr. Could Destroy One of Civilization’s Best Achievements

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      Even among the chaos generated by Donald Trump’s recent cabinet picks, one stands out for the extensive suffering and lasting institutional damage it may cause: his choice of Robert F. Kennedy Jr. to lead the Health and Human Services Department.Modern public health is one of civilization’s great achievements. In 1900, up to 30 percent of infants in some U.S. cities never made it to their first birthday. Since that time, vaccines, sanitation and effective medications have eliminated many previously commonplace illnesses and consigned others to extreme rarity. It’s easy to take much of that for granted, especially as those days have receded from living memory, but those achievements are fragile and can be lost.The danger isn’t merely that Kennedy — who has almost no experience in government or large-scale administration, and who has shown a sometimes breathtakingly loose connection to the truth — would be incompetent or misleading. At the helm of a department with over 80,000 employees and a $3 trillion budget, one that oversees key agencies such as the Centers for Disease Control and Prevention, the Food and Drug Administration and the National Institutes of Health, he would have control over the nation’s medicines, food safety, vaccines and medical research. With that power he could inflict significant harm to the public health system — and to the public trust that would be needed to rebuild it once he’s gone.Kennedy has brought attention to some worthwhile public health concerns, such as the downsides of ultraprocessed foods and the value of exercise. But beyond those reasonable issues, he has filled the internet and the airwaves with views on vaccines, food safety, medicines and supplements that are a mix of grave misrepresentations and far-fetched conspiracies.His opposition to vaccines has attracted the most attention. He doesn’t say just that they merit closer scrutiny, as some “vaccine skeptics” claim. Last year he told a podcaster that “there’s no vaccine that is, you know, safe and effective.” When it later became expedient, he denied that he had ever said such a thing. The truth is that he has long promoted the lie that vaccines cause autism, and the extravagantly false claim that “researchers have done very little to study the health” of children after they get shots for once-common diseases.Outside of the medical community, few people still know about all the diseases whose safe and effective vaccines he is lying about, so let me remind you about one of them: diphtheria. Once known as “the strangling angel of children,” it causes its young victims to slowly and painfully suffocate, turn blue and gasp as a thick film fills their throat. They lie dying for many agonizing days. The disease has been all but wiped out, but in Spain a few years ago, it cost the life of an unvaccinated boy of 6. His distraught antivax parents promptly vaccinated their surviving child.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Kennedy’s Views Mix Mistrust of Business With Bizarre Health Claims

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      Seven years after Americans celebrated the licensing of Jonas Salk’s polio vaccine, President John F. Kennedy called on Congress to finance a nationwide vaccination program to stamp out what he called the “ancient enemies of our children”: infectious disease.Now Kennedy’s nephew, Robert F. Kennedy Jr., is the nation’s chief critic of vaccines — a public health intervention that has saved millions of lives — and President-elect Donald J. Trump’s pick to become the next secretary of health and human services. Mr. Kennedy calls himself a vaccine safety activist. The press calls him a vaccine skeptic. His detractors call him an anti-vaxxer and a conspiracy theorist.Whatever one calls him, Mr. Kennedy is a polarizing choice whose views on certain public health matters beyond vaccination are far outside the mainstream. He opposes fluoride in water. He favors raw milk, which the Food and Drug Administration deems risky. And he has promoted unproven therapies like hydroxychloroquine for Covid-19. His own relatives called his presidential bid “dangerous for our country.”If there is a through line to Mr. Kennedy’s thinking, it appears to be a deep mistrust of corporate influence on health and medicine. In some cases, that has led him to support positions that are also embraced by public health professionals, including his push to get ultra-processed foods, which have been linked to obesity, off grocery store shelves. His disdain for profit-seeking pharmaceutical manufacturers and food companies drew applause on the campaign trail.People close to him say his commitment to “make America healthy again” is heartfelt.“This is his life’s mission,” said Brian Festa, a founder of We the Patriots U.S.A., a “medical freedom” group that has pushed back on vaccine mandates, who said he has known Mr. Kennedy for years.But like Mr. Trump, Mr. Kennedy also has a tendency to float wild theories based on scanty evidence. And he has hinted at taking actions, like prosecuting leading medical journals, that have unnerved the medical community. On Friday, many leading public health experts reacted to his nomination with alarm.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Robert F. Kennedy Jr.’s FDA Wish List: Raw Milk, Stem Cells, Heavy Metals

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      Robert F. Kennedy Jr., one of President-elect Donald J. Trump’s advisers on health, is taking aim at the agency’s oversight on many fronts.Robert F. Kennedy Jr. has been unflinching in his attacks on the Food and Drug Administration in recent weeks, saying he wants to fire agency experts who have taken action against treatments that have sometimes harmed people or that teeter on the fringe of accepted health care practice.How much influence Mr. Kennedy will have in President-elect Donald J. Trump’s next administration remains unclear, with some suggesting that he could act as a White House czar for policy over several federal health agencies. Mr. Trump has voiced support for Mr. Kennedy in recent weeks, saying he will let him “go wild on health.” In his acceptance speech, Mr. Trump reiterated his support for Mr. Kennedy’s involvement on health matters.Some of Mr. Kennedy’s priorities are relatively standard, such as focusing on the health effects associated with ultraprocessed foods. Yet others threaten to undermine F.D.A. authority to rein in inappropriate medical treatments or to warn about products that can damage the public health.A spokeswoman for Mr. Kennedy did not respond to interview requests.Days before the election, in a post on X that has received 6.4 million views, Mr. Kennedy threatened to fire F.D.A. employees who have waged a “war on public health.” He listed some of the products that he claimed the F.D.A. had subjected to “aggressive suppression,” including ivermectin, raw milk, vitamins as well as therapies involving stem cells, and hyperbaric oxygen.Some items that he singled out had become flash points for conservative voters during the coronavirus pandemic, including ivermectin, which was found to be an ineffective treatment against Covid.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Robert F. Kennedy Jr. Says Trump Will Seek to Remove Fluoride From Drinking Water

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      Robert F. Kennedy Jr. said Saturday that among the first acts of a second Trump administration would be to “advise all U.S. water systems to remove fluoride from public water,” a stunning potential reversal of what is widely considered one of the most important public health interventions of the past century.The statement, posted on social media, is among the more concrete pledges made by Mr. Kennedy — a former independent presidential candidate who is now backing Mr. Trump — in his capacity as a top adviser on Mr. Trump’s transition team. It also raises the specter of an all-out assault on public-health expertise should Mr. Trump win next week’s election, a prospect that has already caused significant alarm among experts across the medical and environmental fields.As president, Mr. Trump would not have the power to order states and municipalities to remove fluoride from their water supplies; fluoridation is a matter of local control.But a presidential pronouncement would inject the White House into a debate that stretches back to the 1950s, when conspiracy theories swirled around fluoridation, with critics claiming it was a Communist plot to poison Americans’ brains — a view that was memorably parodied in Stanley Kubrick’s film “Dr. Strangelove.”More recently, however, there has been scientific debate around the practice, with some studies suggesting that excess exposure to fluoride — at levels twice the amount recommended by the Environmental Protection Agency — could harm infants’ developing brains. But scientists, including those at the federal government’s National Toxicology Program, say more research is needed to understand whether lower exposure to fluoride has an effect.The process of adding small amounts fluoride to drinking water, or fluoridation, began about 80 years ago to prevent tooth decay. That effort, public health officials say, has been extraordinarily successful. A majority of Americans today live in water systems that are fluoridated, according to the Centers for Disease Control and Prevention, which lists fluoridation as one of the 10 great public health achievements of the 20th century.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      From AI to Musk’s Brain Chip, the F.D.A.’s Device Unit Faces Rapid Change

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      The new director overseeing medical devices will confront criticisms about hasty approvals as she ushers in revolutionary technology.There are now artificial intelligence programs that scan M.R.I.s for signs of cancer, Apple AirPods that work as hearing aids and devices that decode the electrical blips of the brain to restore speech to those who have lost it.Medical device technology is now deeply entrenched in many patients’ health care and can have a stunning impact on their lives. As advancements become more tangible to millions of Americans, regulation of the devices has commanded increasing attention at the Food and Drug Administration.Dr. Michelle Tarver, a 15-year-veteran of the agency, is stepping into that spotlight at a critical time. She is taking the reins of the F.D.A.’s device division from Dr. Jeffrey Shuren, who forged deep ties with the device industry, sped up the pace of approvals and made the agency more approachable to companies. Some of those device makers were represented by Dr. Shuren’s wife and her law firm, posing ethical conflicts for him that continue to draw scrutiny.Dr. Michelle Tarver, an ophthalmologist and a 15-year veteran of the F.D.A.’s medical device division.U.S. Food and Drug AdministrationMore broadly, congressional lawmakers and consumer advocates have become increasingly concerned about the device industry’s influence over the sprawling division, which has a budget of about $790 million and a staff of 2,500. Device safety and standards for agency approvals of products as intimate as heart valves or neural implants will be at the forefront of the division’s mission in the coming years. Among the issues Dr. Tarver will encounter:Brains, computers and Elon MuskFew devices will require such intense oversight as one of the most breathtaking technologies in development: brain-computer interfaces that dip into the surface layers of the brain to decode its electrical noise — and return function to people who have lost it.Researchers from a number of teams have demonstrated the capability to restore the voice and speech of a California man with ALS, to enable a paralyzed man to walk and to help a man who is paralyzed below the neck to play Mario Kart by simply thinking about steering left or right.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      They Barter and Trade in Rural America. How Will They Vote?

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      Many rural Americans engage in cashless barter systems to get food and firewood for heating and cooking. They value self-sufficiency, making them wary of government intervention.When Miki Shiverick needs firewood to heat her home, or help clearing the rusted appliances and vehicles from her property, she doesn’t go to a store or pay for services. Instead, she trades for it.For instance, preparing her land in Bergholz, Ohio for livestock over the last four years required hauling away piles of salvage, old tools and antiques from the rundown property she bought from the family of an old tinker. The place, with its barn house and five outbuildings, resembled a 12-acre junkyard.Ms. Shiverick, 56, found local scrappers willing to keep the profits from selling the rusted cars, campers, tractor parts, buried gas tanks and aluminum ingots at the local scrap yard. She also found woodsmen willing to clear trees for her in exchange for most of the wood.On this newly blank canvas, she dreams of creating a clean, natural retreat for her family with gardens that support wildlife and livestock, which she raises to promote food self-sufficiency and land stewardship.Bergholz is a rural town with a population of fewer than 600. For centuries, rural communities like Bergholz have operated in cashless barter systems built on mutual trust and neighborly relationships — a culture of self-sufficiency that has also shaped political views toward a kind of bootstrap conservatism.“People around here don’t do welfare, it’s not who we are,” Ms. Shiverick said.Ms. Shiverick bartered a bolt of linen with an Amish neighbor for a chicken coop.Rebecca Kiger for The New York TimesWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      U.S. Study on Puberty Blockers Goes Unpublished Because of Politics, Doctor Says

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      The leader of the long-running study said that the drugs did not improve mental health in children with gender distress and that the finding might be weaponized by opponents of the care.An influential doctor and advocate of adolescent gender treatments said she had not published a long-awaited study of puberty-blocking drugs because of the charged American political environment.The doctor, Johanna Olson-Kennedy, began the study in 2015 as part of a broader, multimillion-dollar federal project on transgender youth. She and colleagues recruited 95 children from across the country and gave them puberty blockers, which stave off the permanent physical changes — like breasts or a deepening voice — that could exacerbate their gender distress, known as dysphoria.The researchers followed the children for two years to see if the treatments improved their mental health. An older Dutch study had found that puberty blockers improved well-being, results that inspired clinics around the world to regularly prescribe the medications as part of what is now called gender-affirming care.But the American trial did not find a similar trend, Dr. Olson-Kennedy said in a wide-ranging interview. Puberty blockers did not lead to mental health improvements, she said, most likely because the children were already doing well when the study began.“They’re in really good shape when they come in, and they’re in really good shape after two years,” said Dr. Olson-Kennedy, who runs the country’s largest youth gender clinic at the Children’s Hospital of Los Angeles.That conclusion seemed to contradict an earlier description of the group, in which Dr. Olson-Kennedy and her colleagues noted that one quarter of the adolescents were depressed or suicidal before treatment.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      ‘No Smoking’ Sign on Planes Won’t Need Off Switch After FAA Rule Change

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      The Federal Aviation Administration did away with a rule that had required an off switch for the sign even though smoking on U.S. flights ended years ago.The days of airplane cabins hazy with cigarette smoke are long gone, but a reminder of that era is still visible inside commercial jets.Smoking has been banned on commercial flights in the United States for decades, but the Federal Aviation Administration is only just updating an outdated rule to reflect that reality. Starting on Tuesday, the illuminated overhead “No Smoking” sign no longer requires an off switch.That obsolete requirement had become “time-consuming and burdensome” for airlines and airplane manufacturers to comply with, the F.A.A. said in a rule enacting the change. In February, for example, United Airlines was briefly unable to use a handful of new Airbus planes because the “No Smoking” signs on board couldn’t be shut off, causing the airline to delay a few flights. The issue was resolved after the F.A.A. granted United an exemption.Dozens of such exemptions have allowed that requirement to live on while the agency focused on more pressing matters. But the long life of the mandate also reflects how entangled smoking once was with commercial flights, which began in the 1910s.“The rise of aviation literally parallels the rise of the cigarette,” said Alan Blum, the director of the University of Alabama’s Center for the Study of Tobacco and Society.Pipes, cigars and chewing tobacco were once more popular than cigarettes, but that began to change in the early 20th century, according to Dr. Blum. During World War I, cigarettes were added to rations for American soldiers fighting abroad.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More