Stopping bird flu in its tracks may be RFK Jr.’s first real test. Let’s hope he meets the moment.
Now that he has been confirmed as secretary of health and human services, Kennedy must recognize his performance is a matter of life-and-death on a population scale.
Robert F. Kennedy Jr. just became our nation’s next secretary of the U.S. Department of Health and Human Services, which makes him one of the most influential health leaders in the world. In this role, Kennedy will be responsible for our nation’s pandemic preparation and response. His performance is a matter of life-and-death on a population scale, and we want him to be successful in his new position.
A novel influenza virus, H5N1, which is commonly called bird flu, is currently a major threat to our nation’s poultry, cows, and wild birds. Over 150 million poultry birds have been culled (killed) since 2022 to control outbreaks of this highly pathogenic virus occurring within flocks. This is a grave economic risk.
For example, a fourth-generation duck farmer on Long Island may have to close his business because of the recent culling of all 100,000 of his ducks. H5N1 also poses an infection risk to people who have close contact with animals, including farm and food processing workers, as well as to people exposed to raw milk. Kennedy has historically been a raw milk advocate, which counters guidance from the Centers for Disease Control and Prevention.
Scientists are concerned H5N1 may mutate in ways that enable easier transmission from animals to humans, and from person to person, thus increasing the risk of a flu pandemic.
Because H5N1 is unlike flu strains our human population has encountered before, we have limited immunity. If H5N1 were to circulate among people, mortality could be high. The first documented human H5N1 death was reported on Jan. 6 in Louisiana, to a person exposed to a combination of “a backyard flock and wild birds.”
Before leaving office, the Biden administration appropriated $306 million to fund H5N1 research, vaccine development, and response. It is unclear how this research is affected by the new administration’s stalling of grant-funded research and slashing of National Institutes of Health budgets at universities across the country. Kennedy must advocate for sustained research investments in this arena.
Concerningly, Kennedy signaled contrary intentions in the lead-up to his Senate confirmation, when he asserted, “We’re going to give drug development and infectious disease a break … for about eight years.”
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Kennedy’s aversion to infectious disease research is alarming; there is never a good time to stop investing in infectious disease control. We should strengthen, not weaken, our epidemic surveillance systems, vaccine research, and development of novel therapies, especially considering the H5N1 threat.
One of the sturdiest pillars of public health is vaccination, including routine childhood vaccines as well as vaccines to prevent novel infections. For two decades, Kennedy has — vociferously and consistently — made outrageously inaccurate statements regarding vaccines, including the claim that “there is no vaccine that is, you know, safe and effective.”
Instead, it is estimated that vaccines have prevented over one million deaths among children born in the U.S. between 1994 and 2023 — thereby also saving “$540 billion in direct costs and $2.7 trillion in societal costs.”
One of the sturdiest pillars of public health is vaccination, yet for two decades, Kennedy has made inaccurate statements regarding vaccines.
In addition, Kennedy called the COVID-19 vaccines “the deadliest vaccine ever made,” with zero sound evidence to support his claim. Through 2023, it is estimated COVID vaccines saved three million American lives — an incredible achievement of science and public health.
When questioned by the Senate Finance Committee, Kennedy said, “If you show me the data, I will be the first person to assure the American people that they need to take those vaccines,” but historically, he has not been an evenhanded, neutral skeptic. He has denied or disregarded volumes of science that would undermine his claims.
In the event of an H5N1 flu pandemic, our best defense would be a new vaccine targeting this flu strain. As secretary of HHS, Kennedy would have to support its development, testing, and approval, lead its distribution and implementation, and build public confidence by unequivocally communicating that vaccines save lives. This is a tall order for a person who has built a reputation, career, and wealth through sustained anti-vaccine legal work.
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During a pandemic and every day, Americans need access to clear, timely public health communication so they can make sound decisions for their families, schools, workplaces, and communities. That pillar of public health was weakened two days into the new administration, when the president silenced federal health agencies. He ordered the CDC, the Food and Drug Administration, and the NIH — which Kennedy now oversees — to stop communicating with the American public.
This was a highly atypical and concerning move. As a result, timely updates about H5N1 and other public health issues were not shared by the government. For example, a CDC report was posted online last week that documented transmission of H5N1 flu between domestic cats and their owners. That report rapidly disappeared from the internet without satisfactory explanation and has not been reposted.
Kennedy must protect the public’s right to know about health threats — allowing our federal health agencies to communicate fully and transparently with the people whose tax dollars fund those systems.
Kennedy must protect the public’s right to know about health threats — allowing our federal health agencies to communicate fully and transparently.
In the face of evolving public health threats, there will be uncertainty and difficult decisions to be made to save lives and address the needs of families, schools, workplaces, and communities.
Kennedy must surround himself with people who can support his leadership with sound science, ethical policymaking, and expert implementation.
He will need to invest in the foundations of pandemic preparedness and response. He is the secretary of HHS we have. Now, he must meet the moment.
Carolyn Cannuscio is an associate professor of family medicine and community health at the University of Pennsylvania Perelman School of Medicine. Rachel Feuerstein-Simon is a public health researcher in the department of family medicine and community health at the Perelman School of Medicine and a doctoral student in epidemiology at the CUNY Graduate School of Public Health and Health Policy.
The opinions expressed in this article do not necessarily represent those of the University of Pennsylvania Health System, the Perelman School of Medicine, or the CUNY Graduate School of Public Health and Health Policy.