Sunday, December 7, 2025

The Attack on Biomedical Research - Part 6, Leadership (or Lack Thereof)

This will be the last segment in my series.  While there are additional important topics I can be discussing, I feel like I have hit the major ones.  Besides, it will be interesting to see what develops over the next several months as the current administration continues its remodeling of the executive branch of the government.

What is Leadership?

If you look up the term on the Mirriam Webster Dictionary website, you will see:

  1. the office or position of a leader
  2. capacity to lead
  3. the act or an instance of leading 
Sometimes I hated the dictionary as a kid, because it would take a word and rather than explicitly define it for you, would essentially use the word you were looking up to define it...like "leader" and "leading" as it does above.  Parsing the answer I get using ChatGPT

Leadership is the process of influencing, guiding, and motivating a group of people toward achieving a common goal. It involves setting a vision or direction, inspiring commitment, and coordinating efforts to bring that vision to life.....Leadership can take many forms—such as transformational leadership (inspiring change and innovation), servant leadership (prioritizing the needs of others), transactional leadership (focused on rules and performance), and situational leadership (adapting style to context)

Traditionally, the Secretary of Health and Human Services (HHS) has the leadership role that spans policy formulation, inter-agency coordination, regulatory oversight, and emergency management.  HHS has 13 agencies that include the Centers for Disease Control and Prevention (#CDC), the Food and Drug Administration (#FDA), the National Institutes of Health (#NIH), Indian Health Service (#IHS), and others.  The primary overall leadership goal is to protect the health of the nation and support vulnerable populations.
 
When I first heard that Robert F. Kennedy Jr. was being considered for the position of HHS Secretary, I knew the nation was in for troubled times.  As most of you know, RFK Jr. had a reputation of being a vaccine denier and built a significant proportion of his career around challenging the efficacy and safety of #vaccines.  It was ludicrous to even put him on a list of individuals to consider for HHS Secretary given this background, but also the fact the he has ZERO, NONE, ZILCH experience in #health, #biomedicine, or #PublicHealth was a larger deficiency.  Despite the zero experience, he was asked to lead an agency with the responsibility of providing the best possible health information for Americans and others across the globe.  This included directing the world's leading and best research enterprise, the NIH.  
 
RFK Jr. was appointed HHS Secretary in February 2025 and has immediate led the nation down the path of chaos, misinformation, and degraded health.  The real danger of RFK Jr. is that many of the things he says have a kernel of truth in them.  Some examples...yes, we should review the #VaccineSchedule given the number and types of recommended vaccinations have increased over the years.  Yes, the quality of our #FoodSupply has gotten worse and we should work towards limiting the amount and types of additives in our foods.  Yes, we should probably review if it makes sense to continue fluoridating the water supply given improvements in oral health, but also the broader access to fluoride through other sources.  Yes, it makes sense to do "gold standard" science to address the multitude of health questions affecting humans.
 
However, RFK Jr. jumps from the kernel of truth to outright nonsense and conspiracy theory-based thinking.  Taking each of the examples I noted above:
  • First and foremost, vaccines prevent disease....full stop.  RFK Jr. seems to have a problem saying this and jumps to the crazy notion of vaccines causing autism or causing unnecessary deaths.  Let me just be clear at this point.  The overwhelming evidence from studies in multiple populations across the globe support two important conclusions;  1) approved vaccines are safe and effective in preventing disease, 2)  there is no evidence vaccines cause #autism.   Instead of supporting the science that shows the efficacy of vaccines, he pushes alternative approaches that have little to no research supporting them.  The whole #Tylenol thing had me rolling my eyes.  Another example is our current #measles crisis.  RFK Jr. has not made a full-throated statement advising parents to vaccinate their children and instead has pushed alternatives that have exacerbated the crisis.  An example is his suggestion parents give their children vitamin A to treat their kids' measles.  Vitamin A has been shown to have some positive effects in children who are vitamin A deficient due to poor #nutrition.  However, there is no evidence vitamin A is helpful in children with sufficient vitamin A levels and, in fact, excessive vitamin A can have toxic effects.  Cases of what appear to be vitamin A toxicity have been reported in Texas, the epicenter of our current measles crisis.  Sorry...I went off on a tangent to the original statement I made.  In terms of the vaccine schedule, rather than cite science or recommend funding for studies to examine the vaccine schedule, RFK Jr. has made statements that may put children as risk for those diseases where vaccinations would provide protection.  He has essentially put children at risk whose parents listen to what he says.  We need research to assess what the "best" schedule might be to help maximize health, but protect and minimize any side effects.
  • The quality of our food supply has gotten worse in many different ways over the years.  Industrialized food production, mass food distribution, and other modern aspects of feeding our huge nation has put profits over health.  As an example, I read an interesting description regarding the revival of #HostessFoods, the makers of the famed #Twinkie.  One reason for the demise of the original company was the fact that they operated their own shipping/delivery of product directly to stores.  Given the relatively short shelf life of their baked goods (25 days for the Twinkie) the timing of baking, shipping, and selling the product was limited by the short shelf life.  This essentially became a challenge that Hostess could not overcome as their business expanded and they went bankrupt.  The person who revived Hostess purchased the majority of the company sans the shipping group.  He then figured out the main issue related to shelf life of the product and reformulated products to have a longer shelf life and relied on a third party shipper to distribute the product.  The Twinkie went from a shelf life of 25 days to 45 days (sorry folks, they don't last forever).  This, of course, was accomplished by adding different preservatives.  We really do need to think of how we process and distribute our food in terms of not just profit, but also in term of relative health.  However, simply jumping to everything needs to be "organic" (I hate this word, since everything we eat is organic....it's not like we're eating rocks) or unprocessed is not a solution.  Also, jumping to the way we did things in the "old days" is also not a solution, since it's not just the food additives that are affecting health.  The interactions amongst diet, physical activity, genetics, and other factors all play into our health and simply saying that removing additives will solve our problems is a gross misunderstanding of how all this works.  Sadly, there is no #MagicBullet when it comes the many health challenges we face as humans.  
  • The addition of #fluoride in our water supply has been credited with significant improvements in #OralHealth.  However, with the addition of fluoride to a multitude of oral products, one can question whether it makes sense to continue to fluoridate water.  We need research into whether this policy should be continued.  Unfortunately, RFK Jr. claims fluoride is #toxic and cites a single study that examined fluoride at concentrations 5-10 times higher than that used to fluoridate water.  Too much of anything can be bad and selectively choosing one study that supports your position is not putting the science into the right context.  As far as i am aware, the vast majority of research shows that fluoride at low concentrations can have benefits for oral health, while having no toxic side effects.  However, in this modern age where there are multiple sources of fluoride, it does make sense to do the science to see if maybe, just maybe, we don't need to fluoridate the water supply.
  • As you can see from the above examples, RFK Jr. cherry picks bits of "evidence" to support his own misguided positions, without considering the spectrum of studies that have been performed on a given topic.  As I always teach my students, no single scientific study proves anything.  It's only after we repeat studies over and over and get the same result, then we can come to some conclusion.  RFK Jr. clearly does not understand how science works.  He also does not understand that the US has been the home to the most innovative and creative minds that have been doing high-quality research for decades.  His current statements of the need to do "gold standard" research or the idea that we seen do start implementing "gold standard" research clearly shows what little he knows about #BiomedicalResearch and its history.  The US has been doing "gold standard" research for decades and it's because of that research human health has significantly improved over the years.  In fact, you can even say we've been doing "gold standard" research despite the limitations place on science due to outdated funding policies (a different topic).  Just because the research doesn't generate the result that YOU want, doesn't mean it was not performed to the highest standard.  Furthermore, the research community replicating and validating findings has the secondary effect that bad science tends to be weeded out and good science tends to be perpetuated.   
So it's one thing to be biased and attempting to push #HealthPolicy in a direction that aligns with your misguided thinking, but RFK Jr. can't do it all by himself.  So, he's been very busy pushing out career professionals in the various agencies under his purview and installing like-minded individuals.  The alarming thing about this is that he's bringing in individuals with equally little to no experience in health or individuals who have their own agendas that loosely align with RFJ Jr.'s who sadly have titles that make them sound like experts.  He has also invited non-health professionals to meetings as if they were experts in health.  The most recent example was the "Make America Healthy Again" (#MAHA) Summit where leaders in the #SelfHelp, #AlternativeHealth, #NutritionalSupplement, and other unregulated industries were invited to sit and discuss along with other fringe scientists.  I had to laugh at some of the reporting from that summit, since these individuals all railed against the #PharmaceuticalIndustry while touting the benefits of what their individual industries provide.  The reason I laugh is that while it's easy to target the pharmaceutical industry as the root of all evil, it is regulated.  They have to follow rules, go through a regulatory process, and meet certain standards for their products to make it out to the market.  I'm not saying they're angels, but at least they're regulated.  In contrast, the industries invited by RFK Jr. are not regulated.  They can essentially create a product, fire up a website, tout its benefits, and start selling you a product.  They are, for the most part, the modern equivalent of hustlers of snake oil.  They are, to me, the worst of the worst as they claim to be helping those with health issues when, in fact, what they hustle does nothing to help people seeking solutions and only lines their pockets.
 
Finally, I continue to be appalled by the injection of individuals with #MD, #PhD, or other titles who are either not experts in the areas they are commenting on, have been identified as having past histories of #ScientificFraud, or have put their egos ahead of everything else and inflated their stated expertise.  This is probably the most dangerous group of individuals, as they give an air of authority to the bad decisions being made in the name of improving health.  The most recent example of this is the realignment of the CDC's Advisory Committee on Immunization Practices (ACIP). Membership of this committee has been realigned to include individuals with clear anti-vaccine positions.  At their most recent meeting where they made the recommendation to discontinue universal #HepatitisB vaccination of infants, they invited speakers to discuss the evidence for or against universal vaccination.  Among the individuals who provided "scientific evidence" to support the discontinuation included a scientist who has no expertise in vaccination research (well, let's say they do very poor vaccination research), a scientist who previously had publications retracted due to scientific misconduct and has zero expertise in this particular arena, and an individual who has overstated their expertise in the field of vaccines.  It drives me bonkers when people of science place their own egos and agendas ahead of doing good science and letting the data tell you what the answer might be.  This again is tantamount to cherry-picking the "science" to generate a specific outcome.  
 
Look, I'm not saying science is perfect.  It isn't.  In fact, science is inefficient and subject to change.  When I was a student I learned that adipose tissue was simply a form of energy storage and that excess energy was diverted to adipose tissue as long-term storage to provide energy as needed.  Aside from a few other minor contributions, adipose tissue seemed pretty boring and straightforward.  However, in the middle of my career it was discovered that adipose tissue was actual an endocrine organ that secreted a whole host of different hormones, primarily involved in feeding regulation, although some performed other critical functions.  This new discovery totally changed the way I had to think about adipose tissue.  I can cite all kinds of examples like this and if you think about what we "knew" as "facts" as humans hundreds or thousands of years ago, but now know differently, this shouldn't be a surprise.  That doesn't mean you shouldn't believe science and it doesn't mean that we as scientists don't keep open minds about what may or may not be.  However, we do maintain the standard that scientific evidence should support any new knowledge.  It can't be just because you want to believe something to be true, which is what RFK Jr. and his friends seem to want and seem to push for in their efforts to change health policies.
 
This particular post was difficult to write, because I had to fight the temptation to rave on about other aspects of RFK Jr.'s "leadership" and where it's taking us.  I'm already very disturbed by many of the changes implemented at the NIH, including the review of grants by an administrative official to determine its suitability....this reeks of a "#PoliticalOfficer" reviewing grants to ensure they align with "#PartyIdeology."  We are definitely moving down a dark path...  
 
#DrWattAtUSC  #LetsMakeAmericaBuenoAgain   

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