Restore trust in public health weakened by Trump and Kennedy

For generations, the world has admired our nation's public health system. It has helped protect us from harm, responding quickly and forcefully to crises like tuberculosis and polio and educating us about the dangers of harmful habits like cigarette smoking.

But now our system is under attack. Trust in it is eroding. That is due in part to the growing rejection of institutions in general that festers among many Americans. But the lack of trust also stems from action — and inaction — within the public health system itself.

The current measles crisis is a case in point. In 2024, the nation reported 285 cases of measles. In less than four months this year, the once-eradicated disease is spreading through Texas, New Mexico and beyond, killing two unvaccinated children and infecting more than 700 people — nearly all of whom were unvaccinated.

Once upon a time, the message from the nation's health leaders would have been unequivocal: Get vaccinated. But after visiting Texas to assess the outbreak, Health and Human Services Secretary Robert F. Kennedy Jr. wrote on social media: "The most effective way to prevent the spread of measles is the MMR vaccine," which protects against measles, mumps and rubella.

Kennedy, a noted vaccine skeptic, didn't say the vaccine is safe — though it is. He didn't urge people to vaccinate themselves or their children — though they should. He didn't deliver the message aloud, in front of cameras, so it lacked the needed gravitas and urgency. Absent clear advice from a respected leader, a virus considered eliminated in 2000 continues to expand, mostly among victims under age 19.

Measles isn't the only battleground. Skepticism about pasteurization has increased incidents of illness from the consumption of raw milk.

STOKING DISTRUST

Public health has its flaws but the current level of distrust is out of proportion to those issues. And now the Trump administration is recklessly accelerating this lack of trust by firing respected scientists, dismantling the public health infrastructure, and starving it of funding. 

Skepticism spans the political spectrum. Energy currently is supplied by a group known as MAHA moms — nicknamed after the "Make America Healthy Again" slogan that President Donald Trump and Kennedy adopted during last year's presidential campaign. With a significant presence on Long Island, some MAHA moms oppose vaccination entirely, but all share a disdain for government and for traditional medicine and science.

Some of their concerns, like those regarding chronic disease, obesity and the outsize influence of Big Pharma, are legitimate. But for science and medicine to work, there must be a foundational confidence in facts and evidence-based public health measures. That's now broken.

Normally, people in the positions held by Trump and Kennedy would be working to repair that fissure. But they are more provocateurs than healers.

During his first term, Trump instituted Operation Warp Speed that quickly brought the COVID-19 vaccine to market and he was among the first to be vaccinated. But in his second term, he fired the person who was instrumental in making that happen — Peter Marks, the Food and Drug Administration's top vaccine official, who was forced out last month. 

The FDA, which is under Kennedy's purview, initially canceled its March meeting of independent vaccine advisers who help determine the composition of the next flu vaccine; the group finally began its work last week. The agency also delayed its approvals for the next COVID-19 vaccine, leading experts to worry about other prospective vaccines, including the combo flu-COVID shot that's awaiting FDA approval. Most recently, Kennedy and Trump again raised the debunked notion that vaccines cause autism, with Kennedy improbably promising to find the cause of autism by September.

DAMAGING OLD FICTIONS

Beyond sowing unfounded vaccination worries, Kennedy consistently fans the flames of old fictions, like saying it is "highly likely" that Lyme disease was developed as a bioweapon at a Plum Island lab. There's no truth to that. But the more people have faith in Kennedy, especially now that he is an authority figure in government, the more they may lose trust in broader scientific and research efforts that underpin public health.

There is much to worry about on that front. The Trump administration slashed staff and funding within HHS — a move that won't improve the nation's health and research network or people's trust in it. The National Institutes of Health, which fall under HHS, has been asked to cut nearly $2.6 billion from its budget. Long Island could lose up to $163.3 million in funding. Cold Spring Harbor Laboratory, Stony Brook University and other institutions could all feel the pain. Critical research into Alzheimer's disease, cancer, 9/11-related illnesses and other diseases relies on such seed money.

Earlier this month, a promising study showed the shingles vaccination cut older adults' risk of developing dementia by 20%. There's more work to do. But without the resources, staff, and support of public health officials, we might never get a definitive verdict.

Kennedy has promised the nation will have "good science." But science must be rooted in fact and reality. It needs leadership and funding to support its work and patience as it seeks results. Good science both requires and nurtures a vibrant public health system, one that cultivates people's trust so we all can benefit from the breakthroughs already accomplished — and the ones yet to come.