The Shallow Iconoclasm of HHS Leadership

By Grayson Logue

Thursday, September 10, 2026

 

Robert F. Kennedy Jr. and his allies at the Department of Health and Human Services (HHS) are tired of talking about measles. In the weeks before and after the controversy over the recent measles-associated deaths in Lancaster County, Pennsylvania, HHS officials were characterizing the focus on the spread of the world’s most contagious disease as a campaign by media and Democrats to distract from the toll of chronic disease.

 

“The media and certain demagogic politicians are constantly trying to scare us about infectious disease,” Kennedy said in a town hall last month with Fox News. “And we take the attention away from the chronic disease that is being caused by powerful entities, by big food companies, by big pharmaceutical companies!” He referred to the two measles fatalities as “so-called” measles deaths. While there was uncertainty about whether one infant infected with measles had died due to complications from the virus, the Lancaster County coroner announced last Friday that a second infant, a 6-week-old baby, had died from the disease.

 

Despite leading a sprawling department responsible for overseeing the nation’s federal public health agencies, Kennedy continues to operate like an outsider, railing against the very system he administers. Faced with growing outbreaks, Kennedy and his allies alternate between claiming the spread is insignificant, solely the fault of their predecessors, or being sensationalized to distract from the MAHA agenda. They consistently fall back on amplifying institutional distrust, but the refrain betrays a lack of progress in fighting both infectious and chronic disease.

 

Downplaying outbreaks.

 

Calley Means, a senior adviser at HHS, is a prominent MAHA influencer who helped connect the Kennedy and Trump campaigns in 2024 prior to Kennedy’s endorsement of the GOP presidential candidate. Before the announcement of the Pennsylvania deaths, Means had spent recent weeks decrying any focus on measles outbreaks, comparing measles deaths to annual childhood drownings or the toll of chronic diseases. “[Zero] Americans have died this year of measles. 300 per year died before invention of vaccine. The U.S. is managing the current Fauci measles outbreak better than any other country. Over 1 million Americans will die this year of preventable chronic diseases tied to our food system. Any medical influencer only talking about measles and not talking about chronic disease is a political hack, not someone who cares about public health,” Means posted on X last month.  

 

While deaths from measles outbreaks since the start of the Trump administration have been few, the U.S. has seen a 35-year high in cases—more than 5,300 since January 2025—and nearly 500 hospitalizations, including 280 teenagers and young children. But Means’ suggestion that the pre-vaccine measles toll was insignificant isn’t supported by estimates from the Centers for Disease Control and Prevention (CDC): In that era, the country experienced between 3 million and 4 million cases each year, 400 to 500 deaths, and 48,000 hospitalizations.

 

Means had made similar arguments about recent foodborne illness outbreaks. Responding to Fox News host Jessica Tarlov’s criticism of the administration’s response to measles and cyclospora outbreaks, Means wrote, “These imbeciles like  @JessicaTarlov are gleeful that there are a couple cases of diarrhea that they can blame on RFK.” The U.S. has struggled with foodborne illness for years, and outbreaks have been common across administrations, though the Trump administration also cut a range of programs and funding aimed at improving food safety. Regardless, there have not just been “a couple cases of diarrhea.” The country has experienced the largest cyclospora outbreak in history, with more than 19,500 confirmed cases and more than 9,000 additional cases that have yet to be confirmed in a lab. More than 1,000 people have been hospitalized, and two have died.

 

Means has falsely claimed food recalls are at a multiyear low, after apparently confusing data on total product recalls (which include everything from medical devices to drugs and tobacco products to food). The number of food recalls in fiscal year 2025 was the highest since 2018, and this year’s recalls are on pace to exceed last year’s.

 

Oversimplifying chronic disease.

 

Kennedy and Means say they want to shift attention to chronic disease, specifically conditions like obesity and diabetes that are linked to food and lifestyle choices, because those conditions are responsible for more death and suffering than infectious disease. As a matter of raw numbers, they are right: Chronic disease is the greatest healthcare burden on the country, in terms of both deaths and cost. A large portion of this burden can be attributed to poor diet and lack of exercise, but shifting Americans’ lifestyles in a better direction at scale is a complex public policy and cultural challenge involving deeper and broader issues than media attention and narratives.

 

HHS officials have spent a great deal of time talking up efforts to remove food dyes and provide inspiration in the form of cooking shows and workout videos, but the administration has so far fallen short on broader reforms to food and agriculture policy. For example, officials are still struggling to come up with a regulatory definition for ultraprocessed food, months after Kennedy had promised results; food industry executives reportedly nixed the public release of the definition last month. Pushing states to remove sodas and sugary drinks from SNAP benefits is a step in the right direction, according to some nutrition policy analysts, but it’s unclear whether the administration’s overall SNAP policies will be a net win for healthier eating after taking into account the significant cuts to the program Congress passed last year.

 

The administration has also been comparatively quiet on chronic disease factors that are unrelated to food, such as smoking and alcohol consumption. The CDC’s Office on Smoking and Health, which ran a longstanding and effective antismoking ad campaign and funded state smoking cessation programs, has been shuttered since April 2025. The administration’s new dietary guidelines, released this January, included a mix of improvements upon the previous guidance and revised suggestions with little data to back them up. They substituted recommended daily limits on alcohol consumption with a vague admonition to “consume less alcohol for better health.” Smoking and drinking were not addressed in last year’s MAHA Commission report on causes and solutions to the childhood chronic disease crisis.

 

The complexity of chronic disease and the administration’s mixed record haven’t stopped Kennedy and Means from trying to claim credit for any positive shifts. “The Trump administration will see the largest declines in diabetes and obesity in modern American history - as a direct result of its policies,” Means claimed earlier this summer. “Yet all the media can talk about is measles.” Obesity rates have been falling, but that decrease tracks closely with increased use of GLP-1 weight-loss drugs. The Trump administration’s attempts to lower the cost of drugs like GLP-1s have been a mixed bag. What’s more, both Means and Kennedy voiced opposition to the use of GLP-1s because they see it as a pharmaceutical solution to a problem that should be addressed through diet and wellness changes, though they’ve softened their tone since joining the administration.

 

Promoting distrust.

 

The administration has claimed it is restoring trust in the public health system, but Kennedy and Means spend a good deal of time encouraging distrust. “Americans distrust of the media and medical system is rational. Why should you trust institutions that relentlessly lied (and never apologized) on so many other topics like COVID,” Means posted last week. Trust in the CDC’s public health recommendations declined from 77 percent last spring to 50 percent a year later, according to a poll by Harvard University and the de Beaumont Foundation. Other polls have documented similar declines across federal health agencies.

 

As a direct result of this administration’s promotion of vaccine hesitancy, primary care doctors and pediatricians are having to spend more and more of their time fielding questions about vaccines. That’s a direct trade-off with time spent discussing other health priorities. “There will never be a day where mothers ask less questions about the pharmaceutical products they put in their children’s bodies,” Means said last month. “And that’s a good thing.” In Means’ estimation, skepticism isn’t just a salutary means to improve the healthcare system; it’s an inherent good. Doctors are facing the knock-on effects of this broadening skepticism in trends like increasing refusals of vitamin K shots for newborns. For his part, President Donald Trump described the measles, mumps, and rubella vaccine last month as possibly “quite lethal.”

 

Much of the media attention paid to infectious disease has come in reaction to Kennedy’s unilateral overhaul of longstanding vaccine recommendations and his promotion of false claims about vaccination in the midst of the outbreaks. If the secretary had done what he pledged to do during his confirmation hearing and checked his anti-vaccine priors at the door, Means’ media criticism might hold more weight. “As HHS secretary, he has selectively cherry-picked many of his longstanding interests and their purported causes (often contrary to scientific evidence) and framed his narrative under the header of chronic disease,” Dr. Anand Parekh, a former HHS official in the Bush and Obama administrations who worked on chronic disease issues, including nutrition and infectious disease response, argued in an essay last month. “This tunnel vision carries a very high opportunity cost. We have spent the first year of Kennedy’s tenure having to talk about vaccines, raw milk, acetaminophen, peptides, and fluoride instead of sodium, tobacco, added sugars, alcohol, adverse childhood experiences, and other established chronic disease risk factors.”

 

Only since the 2024 presidential campaign has Kennedy focused his advocacy intently on diet and nutrition. For years before, he argued that vaccines are one of the biggest drivers of chronic disease. “He believes falsely that vaccines are causing chronic diseases, and he sees these outbreaks as a very, very small price to pay for his war against vaccines, which he believes are a major cause of chronic diseases,” Dr. Paul Offit, who directs the Vaccine Education Center at the Children’s Hospital of Philadelphia and has followed Kennedy’s anti-vaccine advocacy for years, told The Dispatch. “The problem is vaccines don’t cause what he’s claiming them to cause. The only outcome of this is these massive outbreaks, [and] not just measles. We had almost 300 children die of influenza last year. We had close to 200 die this year.” Kennedy has canceled public campaigns promoting flu vaccination, removed the universal recommendation for childhood flu vaccination, and suggested publicly in January that it would be better if fewer children got the vaccine.

 

While Kennedy presents the media and Democrats as using infectious disease to distract from chronic disease, his beliefs about vaccines have long promoted a false dichotomy between the two health issues. Though some public health leaders agree that the work of preventing and fighting infectious disease outbreaks strains limited health resources, that’s a reason to work toward getting outbreaks under control, not to downplay them. “You cannot effectively focus on chronic diseases while you’re being repeatedly overwhelmed by acute infectious outbreaks,” Dr. Jerome Adams, surgeon general during the first Trump administration, argued last month. “Uncontrolled salmonella, cyclospora, measles and the next emerging threat won’t step aside so we can concentrate on diabetes or hypertension. Those illnesses disrupt lives, strain hospitals, erode trust and make longer-term prevention far harder.”

 

At this point, it’s certainly plausible to argue that Kennedy’s HHS tenure will be characterized not by a significant reversion of chronic disease rates, but by atrophying public health programs and systems and a worsening trust crisis that has fueled the resurgence of vaccine-preventable diseases. Contrary to Means’ and Kennedy’s claims, Adams believes the damage to outbreak surveillance and response and plummeting public trust will be the enduring legacy. “What makes me sad isn’t the argument,” he wrote Monday. “It’s the ledger we’re handing our kids: lower trust, fewer people who can count cases, and diseases we had already beaten coming back.”