I had been anticipating Robert F. Kennedy Jr.’s confirmation hearings for weeks. If confirmed as secretary of the Department of Health & Human Services, Kennedy will have 80,000 employees in his charge and be responsible for critical health departments, including the Centers for Disease Control (CDC) and the Food and Drug Administration (FDA).

Kennedy has no training in health care, public health, world health issues, or drug and vaccine safety. He does have lots of opinions, however, and these opinions could shape our nation’s wellness over the next several years. I will not rehash his statements about vaccine efficacy, his conspiracy theories about Lyme disease or about pesticides having an impact on children’s gender identity. I do, however, think we must take a moment to review the critical roles of science and public health and the danger of politicizing these issues.

Public health, as a field, came to be hundreds of years ago. Its focus — to prevent illness — was established by doctors, nurses and scientists who didn’t have the treatments available to stall the spread of illness. Instead, they came to understand that certain commonsense approaches could help to slow the number of people getting sick in a community, and, absent a host, end outbreaks. They encouraged sanitation, hand washing, isolation of those with a communicable diseases and immunization when and if available. These strategies remain the cornerstone of reducing contagion and preventing illness.

Public health is important in a country like the United States, where health care costs are high, and health insurance often comes with unaffordable co-pays or rejections of coverage for reasons only insurance companies understand.

Over the years, public health measures have controlled polio, whooping cough, measles, mumps, smallpox and more. These diseases have caused large numbers of deaths and disability throughout human history. Polio alone was once responsible for killing or paralyzing more than half a million people a year around the world. Researchers estimate that 300 million people died of smallpox in the 20th century. Today, as rates of vaccination have decreased in some communities, we are seeing outbreaks of measles, mumps, pertussis and other serious diseases.

Kennedy has previously said that there is “no such thing as a vaccine that is safe or effective” — although he is denying that now. Having him in such critical leadership position have catastrophic consequences. We’ve already seen what happens when people in positions of power disregard science.

Take the recent pandemic, for example. Worldwide, COVID-19 killed 7 million people, including more than 1 million in the U.S. Our country had the highest death rate among affluent countries. Scientists attributed this in large part to our lower rates of vaccination. I’m sure we all can recall the fevered political battles over whether masks were necessary, whether vaccines were safe, whether the CDC’s recommendations were to be believed. The data suggests the politicization of the virus lead to more death and disease.

We can only speculate about why Reagan was so unresponsive [to AIDS], but it appears that his silence was, in part, to keep his political base happy.

What a government leader says — and does not say — has a big effect. Former President Ronald Reagan, who was elected during the early stages of the AIDS pandemic, did not utter the word AIDS for the first four years of his presidency; he didn’t give a public speech on the topic until his second term was almost over. Reagan failed to use the power of his position to discuss the seriousness of this deadly virus, the potential means of transmission and how people could protect themselves.

At the onset of HIV/AIDS, the majority of those afflicted were gay men, IV drug users and people with hemophilia. We can only speculate about why Reagan was so unresponsive, but it appears that his silence was, in part, to keep his political base happy. In his case, that included the religious right who referred to AIDS as “God’s punishment.” As a result, politics trumped prevention, health care research and treatment, and people died. Reagan’s vice president, George H.W. Bush, however, was interested in stopping the spread of HIV. Real progress was made during the four years of his administration.

We could also look to public health efforts to reduce smoking-related diseases. For many years, we approached lung and heart diseases resulting from smoking as if they were inevitable. We know that prevention measures are less costly than treatment — and more effective at saving lives — but for years, politicians resisted criticizing tobacco companies. Progress was only made once public health professionals worked to enact a comprehensive strategy to reduce smoking. Warning labels, taxes, purchasing age increases, advertising campaigns, and the banning of indoor smoking in public buildings together reduced the risk of smoking-related cancers and death caused by cardiac disease. In the U.S., long term cigarette smoking rates have fallen dramatically, from 42.6% in 1965 to 11.6% today.

Robert F. Kennedy, Jr. says he wants to make our country healthier, citing that high amounts of sugar and artificial dyes contribute to obesity and poor health. He also suggests that beef tallow is healthier than many oils. We have heard him talk about the specific beliefs he has related to nutrition and vaccines, but he has not talked as much about health policy, or his beliefs about where the U.S. stands on access to health care, or how he sees as our role in global health concerns. Given that Trump has withdrawn the U.S. from the World Health Organization, how will Kennedy ensure that the CDC and National Institutes of Health (NIH) have the data they need? Kennedy is not taking this appointment with the seriousness it deserves.

The Universal Declaration of Human Rights hangs on the wall of my office. For years, it was presented to every graduate of the Harvard School of Public Health on commencement day. The Declaration is signed by Eleanor Roosevelt, who worked with other world figures to create the document. Human rights are defined as “rights inherent to all human beings, regardless of race, sex, nationality, ethnicity, language, religion, or any other status.” They are meant as universal and unwavering, absent the desires of those in power or political affiliation. Health care should never be politicized, not should our critical health systems be run by any agenda other than ensuring the wellbeing of every person.

We do not want to live in a constant state of anticipating potential health crises, worried about the credentials of those making decisions about how, where and when to act. We can and must do better.

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