Canada must be ready for anything with the rise of RFK Jr.

You would think that the return of a Kennedy scion to the White House would be a moment to celebrate, at least for many of a particular political stripe. But the nomination of Robert F. Kennedy, Jr to be Secretary of Health and Human Services (HHS) in the new Trump administration has left many aghast, especially doctors, scientists, and educators.

Despite President John F Kennedy having famously championed the polio vaccine, his nephew RFK Jr is an avowed anti-vaccination zealot, blaming a host of repeatedly unproven ills on such inoculations.

He has additionally claimed that wifi radiation causes autism, allergies, asthma, eczema. (There is no compelling scientific evidence for any of this.) He has suggested that the 1918 Spanish Flu was the result of vaccine research. (The flu vaccine was developed in the 1930s.) He has stated that AIDS is not caused by a virus, but by “the gay lifestyle.” (Globally, the lion’s share of AIDS deaths have occurred amongst heterosexual people, and the causal link with the HIV virus has been repeatedly proven.)

The regularity and intensity of his medical misinformation has led prominent surgical oncologist Dr David Gorski to call RFK Jr, “an extinction-level threat to science-based federal health policy." Similarly, toxicologist Dr Ryan Marino tweeted, “RFK Jr.’s only previous experience in government public health is that he went to Samoa in 2019 and caused a measles outbreak that killed 83 people, including dozens of children.”

HHS includes a host of agencies, including the Centers for Disease Control (CDC), National Institutes of Health (NIH), and the Food and Drug Administration (FDA). They are tasked with regulating the food and medicine that Americans consume, deciding whether Medicare will pay for drugs and treatments, overseeing the licensing of drugs, directing billions of dollars in medical research, and managing sweeping data collection services that the whole world relies upon.

Based on his public statements, a radical RFK, Jr HHS leadership would seek to halt all new vaccine and drug development, promote evidence-free therapies like ivermectin for COVID, and solemnize the consumption of raw milk, a practice that now results in dozens of US hospitalizations annually, despite it presently being a  rare thing to do.

He would likely seek to discontinue the Vaccines for Children program, which provides free vaccines for children in low-income US families, likely leading to increased outbreaks of vaccine-preventable childhood illnesses.

But HHS is a large bureaucratic ship that does not turn on a dime. Surely, the yet-to-be-appointed heads of HHS agencies (like FDA, CDC, and NIH) would also hold sway. It is therefore unclear what policy changes a single man at the top could actually enact in short order. It would not be surprising, though, to see dramatic changes in funded research priorities, and slowdowns in vaccine licensing.

This is where the impact on Canadians might be most obviously felt. The Canadian government has historically mirrored the US’s actions on vaccine authorization. And it does often seem like our federal research priorities, as embodied in the Canadian Institute for Health Research (CIHR), reflect the mandates set forth by the NIH.

But RFK Jr’s biggest impact will be cultural. His appointment normalizes and celebrates the anti-evidence pseudoscience ethic that has come to define the modern information environment. It’s a signal to many that rejecting the most successful and transformative tools of public health is now mainstream and acceptable, often in preference for fringe and unproven approaches (like urine therapy, homeopathy, energy healing, and “detox” diets).

And RFK’s version is seductive. He sandwiches the meat of his dangerous ideas between slices of much welcome common sense: a focus on better nutrition, more exercise, and a long overdue divestment of corporate interest from our health and wellbeing.

With the rise of this alluring brand of thaumaturgy, we can expect an explosive growth of vocal opposition to safe and proven public health measures, right here in Canada. Regressive battles against water fluoridation, childhood vaccination, and milk pasteurization might just be the beginning.

Should a genuine public health crisis emerge during the second Trump reign, such as a human H5N1 pandemic, the presence of an anti-vaccine dogmatist in such a powerful health leadership role might prove catastrophic. At the very least, he might resist the manufacture and wide release of that disease’s existing vaccine. At most, he could promote nonsensical and ineffective therapies and prophylaxes.

But the appointment of RFK Jr could also be seen as an opportunity for Canadians. As we should have done during the first warning signs of COVID, here is our chance to free our health decision making patterns from American leadership, and to build vaccine and therapeutic manufacturing capacity at large scale domestically.

And perhaps we might even attract some of the world’s top medical minds as they flee the churn of misinformation south of the border.

We should be ready for anything.

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Raywat Deonandan is an Epidemiologist and Associate Professor with the Faculty of Health Sciences at the University of Ottawa.