President-elect Donald Trump has announced he wants to appoint vaccine sceptic Robert F Kennedy Jr as the head of the US Department of Health and Human Services.
The position has a broad remit across the US health industry, including food safety, pharmaceuticals, public health and vaccinations.
If his post is confirmed by the US Senate, he would be in charge of key health agencies with about 80,000 employees and a trillion-dollar budget.
RFK Jr has long expressed views that conflict with scientific evidence, especially on vaccines, and his nomination has provoked opposition from public health experts.
But he has also adopted positions with popular support, scrutinising the use of food additives and urging that the power of big pharma be curbed.
The nephew of President JFK, he ran for the White House himself as an independent but dropped out and backed Trump.
As secretary, Kennedy would be in charge of huge agencies such as the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the National Institutes of Health (NIH) and the Centers for Medicare and Medicaid Services.
This is where he stands on vaccines, food, fluoride and health agencies.
Vaccines
The vast majority of health experts champion inoculations for their long history of success – guarding against dangerous diseases and even eradicating deadly smallpox.
But as founder of the anti-vaccine group Children’s Health Defense, Kennedy has for nearly two decades been airing debunked claims about jabs.
In recent years, he has gained prominence in the US for making the discredited claim that childhood immunisations are linked to autism.
But he has denied on several occasions that he is anti-vaccination and says he had his own children immunised.
Kennedy has said that if he were to join the Trump administration, he would want to examine government vaccine safety data and share his findings with the public.
He recently denied that he would block or ban vaccinations, however.
“If vaccines are working for somebody, I’m not going to take them away. People ought to have choice, and that choice ought to be informed by the best information,” he told NBC News last week.
The stock prices of vaccine makers like Moderna, Pfizer and Merck fell after Trump announced his pick.
Food and pharmaceuticals
Announcing Kennedy’s nomination, Trump said Americans had for too long been “crushed” by food and drug companies engaging in “deception, misinformation, and disinformation”.
Kennedy has long blamed the food and drug industries – as well as the regulators who oversee them – for Americans’ poor health. He has said that he wants to overhaul the systems that oversee pesticides, herbicides, food additives and pharmaceuticals.
He has called for a ban on food dyes and additives, regularly citing Europe’s regulatory standards.
“We have 1,000 ingredients in our food that are illegal in Europe that are illegal in other countries and they’re making our kids sick,” he alleged in an NBC News interview. “They’re there because of corruption in our agencies.”
An FDA spokesperson told the BBC that it is necessary “to dig deeper and understand the context behind the numbers” when comparing estimates of authorised chemicals between the US and Europe.
Both “generally apply the same fundamental scientific approach to safety assessment when evaluating the safety of chemicals in food”, according to the FDA spokesperson.
“Different regulatory definitions and different methodologies can influence the results. Without clarity, comparisons can be misleading,” the official added.
Last month Kennedy accused the FDA on X of suppressing the use of “psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented”.
He said that those who were “part of this corrupt system” should be prepared to “pack your bags”.
Both ivermectin and hydroxychloroquine were held up as miracle cures for Covid but such claims have not been supported by science.
Fluoride in the water
Kennedy recently vowed to remove fluoride – a cavity-fighting mineral – from the US drinking water, which about two-thirds of Americans have in their water supply.
Though it is a decision made by state and local health authorities, Kennedy said on X earlier this month that “the Trump White House will advise all US water systems to remove fluoride from public water”.
He alleged the chemical found in toothpaste and regularly used by dentists “is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease”.
The US Public Health Service reduced the amount of fluoride it recommended adding to water in 2015, but the federal government has encouraged states since the 1960s to add small amounts of the chemical to water to help prevent cavities and aid oral health.
Recent court rulings have led to the reduction of fluoride in US water, and some experts have questioned the continued need for it in water systems given its wide availability in toothpaste and other dental products.
Most of western Europe does not add fluoride to its water. In England, about one in 10 people has fluoridated drinking water.
Removing it altogether could still pose a challenge, however, as the federal government does not have the final authority over that decision.
Firing hundreds of health officials
Kennedy has long claimed that chronic health issues have worsened due to the inaction of federal health agencies.
He said at a rally in Arizona earlier this month that he plans to fire and replace 600 employees at the NIH – which oversees vaccine research – as soon as Trump takes the White House.
The longtime lawyer also said last month that he intends “to have every nutritional scientist” in the health and agriculture departments fired on day one of a Trump presidency because he alleges they are co-opted by corporate interests.
He reportedly intends to take a serious look at those who work at other health agencies as well, including the Food and Drug Administration and the Centers for Disease Control and Prevention.