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KFF Health News Dec 17 2024

Many of President-elect Donald Trump's candidates for federal health agencies have promoted policies and goals that put them at odds with one another or with Trump's choice to run the Department of Health and Human Services, Robert F. Kennedy Jr., setting the stage for internal friction over public health initiatives.

The picks hold different views on matters such as limits on abortion, the safety of childhood vaccines, the covid-19 response, and the use of weight-loss medications. The divide pits Trump picks who adhere to more traditional and orthodox science, such as the long-held, scientifically supported findings that vaccines are safe, against often unsubstantiated views advanced by Kennedy and other selections who have claimed vaccines are linked with autism.

The Trump transition team and the designated nominees mentioned in this article did not respond to requests for comment.

It's a potential "team of opponents" at the government's health agencies, said Michael Cannon, director of health policy studies at the Cato Institute, a libertarian policy organization.

Kennedy, he said, is known for rejecting opposing views when confronted with science.

"The heads of the FDA and NIH will be spending all their time explaining to their boss what a confidence interval is," Cannon said, referring to a statistical term used in medical studies.

Those whose views prevail will have significant power in shaping policy, from who is appointed to sit on federal vaccine advisory committees to federal authorization for covid vaccines to restrictions on abortion medications. If confirmed as HHS secretary, Kennedy is expected to set much of the agenda.

"If President Trump's nomination of RFK Jr. to be secretary is confirmed, if you don't subscribe to his views, it will be very hard to rise in that department," said Amesh Adalja, an infectious disease specialist and senior scholar at the Johns Hopkins Center for Health Security. "They will need to suppress their views to fit with RFK Jr's. In this administration, and any administration, independent public disagreement isn't welcome."

Kennedy is chair of Children's Health Defense, an anti-vaccine nonprofit. He has vowed to curb the country's appetite for ultra-processed food and its incidence of chronic disease. He helped select Trump's choices to lead the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health. If confirmed, he would lead them from the helm of HHS, with its more than $1.7 trillion budget.

Clashes are likely. Kennedy has supported access to abortion until a fetus is viable. That puts him at odds with Dave Weldon, the former Florida congressman whom Trump has chosen to run the CDC. Weldon, a physician, is an abortion opponent who wrote one of the major laws allowing health professionals to opt out of participating in the procedure.

Weldon would head an agency that's been in the crosshairs of conservatives since the covid pandemic began. He has touted his "100% pro-life voting record" on his campaign website. (He unsuccessfully ran earlier this year for a seat in Florida's House of Representatives.)

Trump has said he would leave decisions about abortion to the states, but the CDC under Weldon could, for example, fund studies on abortion risks. The agency could require states to provide information about abortions performed within their borders to the federal government or risk the loss of federal funds.

Weldon, like Kennedy, has questioned the safety of vaccines and has said he believes they can cause autism. That's at odds with the views of Marty Makary, a Johns Hopkins surgeon whom Trump plans to nominate for FDA commissioner. The British American said on the "Brian Kilmeade Show" on Fox News Radio that vaccines "save lives," although he added that it's good to question the U.S. vaccine schedule for children.

The American Academy of Pediatricians encourages parents and their children's doctors to stick to the recommended schedule of childhood vaccines. "Nonstandard schedules that spread out vaccines or start when a child is older put entire communities at risk of serious illnesses, including infants and young children," the group says in guidance for its members.

Jay Bhattacharya, a doctor and economist who is Trump's selection to lead NIH, has also supported vaccines.

Kennedy has said on NPR that federal authorities under his leadership wouldn't "take vaccines away from anybody." But the FDA oversees approval of vaccines, and, under his leadership, the agency could put vaccine skeptics on advisory panels or could make changes to a program that largely protects vaccine makers from consumer injury lawsuits.

"I do believe that autism does come from vaccines," Kennedy said in 2023 on Fox News. Many scientific studies have discredited the claim that vaccines cause autism. Related StoriesAI-generated handoff notes: Study assesses safety and accuracy in emergency medicineStudy: Brain volume changes correlate with social behavior differences in psychiatric conditionsResearch uncovers dietary patterns influencing Mediterranean Diet adherence

Ashish Jha, a doctor who served as the White House covid response coordinator from 2022 to 2023, noted that Bhattacharya and Makary have had long and distinguished careers in medicine and research and would bring decades of experience to these top jobs. But, he said, it "is going to be a lot more difficult than they think" to stand up for their views in the new administration.

It's hard "to do things that displease your boss, and if [Kennedy] gets confirmed, he will be their boss," Jha said. "They have their work cut out for them if they're going to stand up for their opinions on science. If they don't, it will just demoralize the staff."

Most of Trump's picks share the view that federal health agencies bungled the pandemic response, a stance that resonated with many of the president-elect's voters and supporters — even though Trump led that response until Joe Biden took office in 2021.

Kennedy said in a 2021 Louisiana House oversight meeting that the covid vaccine was the "deadliest" ever made. He has cited no evidence to back the claim.

Federal health officials say the vaccines have saved millions of lives around the globe and offer important protection against covid. Protection lasts even though their effectiveness wanes over time.

The vaccines' effectiveness against infection stood at 52% after four weeks, according to a May study in The New England Journal of Medicine, and their effectiveness against hospitalization was about 67% after four weeks. The vaccines were produced through Operation Warp Speed, a public-private partnership Trump launched in his first term to fast-track the shots as well as other treatments.

Makary criticized covid vaccine guidance that called for giving young children the shots. He argued that, for many people, natural immunity from infections could substitute for the vaccine. Bhattacharya opposed measures used to curb the spread of covid in 2020 and advised that everyone except the most vulnerable go about their lives as usual. The World Health Organization warned that such an approach would overwhelm hospitals.

Mehmet Oz, Trump's choice to head the Centers for Medicare & Medicaid Services, an agency within HHS, has said the vaccines were oversold. He promoted the use of the anti-malaria drug hydroxychloroquine as a treatment. The FDA in 2020 revoked emergency authorization of hydroxychloroquine for covid, saying that it was unlikely to be effective against the virus and that the risk of dangerous side effects was too high.

Janette Nesheiwat, meanwhile, a former Fox News contributor and Trump's pick for surgeon general, has taken a different stance. The doctor described covid vaccines as a gift from God in a Fox News opinion piece.

Kennedy's qualms about vaccines are likely to be a central issue early in the administration. He has said he wants federal health agencies to shift their focus from preparing for and combating infectious disease to addressing chronic disease.

The shifting focus and questioning of vaccines concern some public health leaders amid the spread of the H5N1 bird flu virus among dairy cattle. There have been 60 human infections reported in the U.S. this year, all but two of them linked to exposure to cattle or poultry.

"Early on, they're going to have to have a discussion about vaccinating people and animals" against bird flu, said Georges C. Benjamin, executive director of the American Public Health Association. "We all bring opinions to the table. A department's cohesive policy is driven by the secretary."

This article was reprinted from khn.org, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF – the independent source for health policy research, polling, and journalism. Source:

KFF Health News

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Trump hints Ukraine election may be needed for peace – as he addresses Kyiv being left out of Russia talks

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Trump hints Ukraine election may be needed for peace - as he addresses Kyiv being left out of Russia talks

Donald Trump has suggested Russia’s war in Ukraine could have been “settled very easily” as he criticised Kyiv’s negotiation skills.

In comments after an extraordinary meeting between senior American and Russian officials on Tuesday morning in Saudi Arabia, the US president said of Ukraine: “They’ve had a seat [at the table] for three years and a long time before that.

“This could have been settled very easily. Just a half-baked negotiator could have settled this years ago without, I think, the loss of much land and without the loss of any lives and without the loss of cities that are just laying on their side.”

While touting his own negotiation skills, Mr Trump also said he was “more confident” about a peace deal after Tuesday’s talks, attended by US secretary of state Marco Rubio.

Follow live: Lavrov tells US that NATO troops in Ukraine is ‘unacceptable’

While speaking from Mar-a-Lago in Florida, Mr Trump also said he would not oppose seeing European peacekeeping troops stationed in Ukraine as part of a peace deal with Russia.

He also repeated a proposal that Ukrainian leader Volodymyr Zelenskyy hold elections in Ukraine as a condition of peace.

‘Not a Russian thing’

“We have a situation where we haven’t had elections in Ukraine, where we have martial law, essentially martial law in Ukraine, where the leader in Ukraine, I mean, I hate to say it, but he’s down to 4% approval rating.”

He added: “If Ukraine wants a seat at the table, wouldn’t the people have to say – it has been a long time since they had an election?

“That’s not a Russian thing, that’s something coming from me and coming from many other countries also.”

Mr Trump also told reporters he and Russian leader Vladimir Putin had discussed Ukraine before the full-scale invasion in 2022.

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“President Putin and I would talk about Ukraine, and it was the apple of his eye, I will tell you that,” he said.

“But he never, there was never a chance of him going in. And I told him: ‘You better not go in, don’t go in, don’t go in.’ And he understood that and he understood it fully.”

From Trump to Zelenskyy – it was goodbye

In another place, at another time, it would have been: “You’re fired.”

Donald Trump coined it differently when he was asked about Volodymyr Zelenskyy, but the sentiment was the same.

Asked about suggestions that Russia wanted elections in Ukraine as part of a peace deal, the US president replied: “I hate to say it, but he’s down to a 4% approval… when they want a seat at the table, wouldn’t the people of Ukraine say it’s been a long time since we had an election? That’s not a Russia thing, that’s coming from me and other countries.”

From one president to another, it was goodbye. A farewell to the notion that Trump respects Zelenskyy as an equal player in peace negotiations.

Read James Matthews’s full analysis here

US and Russia ‘need vibrant diplomatic missions’

Mr Trump added he will probably meet with Mr Putin before the end of the month.

At Tuesday morning’s talks, US and Russian officials agreed to restore embassy staffing and establish a high-level team to negotiate peace in Ukraine in another sign of the significant American change in diplomatic relations with Moscow.

Mr Rubio said the two countries “need to have vibrant diplomatic missions that are able to function normally”. The US and Russia also agreed to explore closer relations and economic cooperation at the meeting.

“Should this conflict come to an acceptable end, the incredible opportunities that exist to partner with the Russians geopolitically on issues of common interest and frankly, economically, on issues that hopefully will be good for the world and also improve our relations in the long term,” Mr Rubio said.

Read more from Sky News:
Trump’s ‘diplomacy’ does not look good for Ukraine – analysis
Starmer wants US ‘backstop’ to deter Russia
Who is attending Russia and US peace talks?

He added ending Russia’s war in Ukraine would require concessions from all sides.

The comments came as talks between Russian and US officials in Saudi Arabia ended – part of a remarkable US policy reversal after years of former president Joe Biden leading international efforts to isolate Moscow.

‘Very useful’ talks, Lavrov says

Speaking to reporters after the meeting, Russian foreign minister Sergei Lavrov said “the conversation was very useful”.

“We not only listened, but also heard each other,” Mr Lavrov said.

“And I have reason to believe that the American side has started to better understand our position, which we have once again outlined in detail, using specific examples, based on President Putin’s repeated speeches.”

US State Department spokesperson Tammy Bruce said even though Ukraine was not at the table on Tuesday, any actual peace negotiations will include the country.

Meanwhile, President Volodymyr Zelenskyy said his country will not accept any outcome from this week’s talks if Kyiv does not take part. No Ukrainian officials were present at the meeting.

U.S. Secretary of State Marco Rubio meets with Saudi Foreign Minister Prince Faisal bin Farhan Al Saud, Saudi National Security Advisor Mosaad bin Mohammad Al-Aiban, U.S. National Security Advisor Mike Waltz, U.S. Middle East envoy Steve Witkoff, Russian Foreign Minister Sergei Lavrov and Russian President Vladimir Putin's foreign policy advisor Yuri Ushakov, at Diriyah Palace, in Riyadh, Saudi Arabia.
Pic: Reuters
Image:
Inside Tuesday’s talks in Saudi Arabia. Pic: Reuters

Ukraine losing ground to Russia

The talks came as Ukraine is slowly but steadily losing ground against more numerous Russian troops in a grinding war that began nearly three years ago.

The Ukrainian air force said Russian troops launched a barrage of 176 drones at Ukraine on Monday night, most of which were destroyed or disabled by jamming.

One Russian drone struck a residential building in Dolynska in the Kirovohrad region, wounding a mother and her two children and prompting an evacuation of 38 apartments, the regional administration reported.

Four more residential buildings were damaged by drone debris in the Cherkasy region of Ukraine, according to local officials.

European allies left scrambling

Ties between Russia and the US had fallen to their lowest level in decades in recent years – a rift that had been widening since Russia annexed Crimea from Ukraine in 2014 and worsened after Moscow’s full-scale invasion in 2022.

At that point, the US, along with European nations, imposed a raft of sanctions on Russia and the allies have repeatedly expanded the measures to damage the Russian economy.

But the recent US diplomatic blitz on the war has sent Mr Zelenskyy and key European allies scrambling to ensure a seat at the table amid concerns that Washington and Moscow could press ahead with a deal that will not be favourable to Ukraine.

On Monday, France called an emergency meeting of European nations, including the UK, to discuss the war.

Saudi Arabia seeks to be diplomatic player

The meeting between the US and Russia on Tuesday at the Diriyah Palace in the Saudi capital of Riyadh also highlights de facto leader Crown Prince Mohammed bin Salman’s efforts to be a major diplomatic player, burnishing a reputation severely tarnished by the 2018 killing of Washington Post journalist Jamal Khashoggi.

Saudi state media described the talks as happening at the prince’s direction. Saudi Arabia has also helped in prisoner negotiations and hosted Mr Zelenskyy for an Arab League summit in 2023.

Mr Zelenskyy had been due to travel to Saudi Arabia this week but rescheduled it to 10 March, suggesting he wanted to avoid his visit being linked to the US-Russia talks since Ukrainian officials were not invited.

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Donald Trump’s direction of travel in diplomacy does not look good for Ukraine

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Donald Trump's direction of travel in diplomacy does not look good for Ukraine

That the United States chose to hold talks with Russia about Ukraine without Ukraine sums up the power imbalance that is upending security assumptions for the whole of Europe.

Volodymyr Zelenskyy, the Ukrainian president, has consistently warned that Kyiv must have a seat at the negotiating table for any discussions about ending Vladimir Putin‘s war to have a chance of success. His European allies also want to have a voice.

Yet these requests were ignored by Donald Trump and his strongman approach to diplomacy, with the president instead dispatching his top diplomat and two other senior envoys to meet Russian counterparts in Saudi Arabia on Tuesday.

Steve Witkoff, Marco Rubio and Mike Waltz.
Pic: Reuters
Image:
(L-R) The US delegation in Riyadh included Steve Witkoff, Marco Rubio and Mike Waltz. Pic: Reuters

Ukraine war latest: Trump says he’s ‘more confident’ of peace deal

Mr Zelenskyy, apparently by chance, had been due to embark on a pre-planned trip to the kingdom later that same day.

However, he decided to delay the visit to avoid the appearance of giving any kind of legitimacy to the bilateral encounter between Moscow and Washington.

Unfortunately for Kyiv, beyond noisy protest, it has very limited options when it comes to channelling the disruptive force of the Trump White House in its favour.

More on Donald Trump

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The Ukrainian military remains hugely reliant on US weapons to fight Russia’s invasion and Mr Zelenskyy has made clear he would want an American element in any international security force that might be agreed upon to monitor a ceasefire – even though this is a role the US appears reluctant to fill and the Kremlin has said would be “unacceptable”.

It means Mr Trump has significant leverage over his Ukrainian counterpart which he will surely use to try to force through negotiations even on terms less favourable to Kyiv.

Read more:
Analysis – Russia tries to appeal to Trump’s business background

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Ukrainians react to US-Russia talks

The US has already reportedly tried to make Ukraine sign away a large portion of its natural resources to pay for US support – an uncomfortable offer that Mr Zelenskyy has so far declined but an indication of the new transactional approach to US foreign policy.

Mr Trump has repeatedly vowed to end Russia’s war in Ukraine – even claiming during the US election campaign that he would do this within 24 hours.

But he never spelled out how.

The past week, however, has offered an indication of the direction of travel and it does not look good for Ukraine.

From unilaterally picking up the phone to Vladimir Putin to sanctioning such a high-level meeting with the Russians in Riyadh, the only currency that seems to matter to the White House is power and right now both Kyiv and its European partners are looking all too weak.

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Donald Trump’s direction of travel in diplomacy does not look good for Ukraine

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By

Donald Trump's direction of travel in diplomacy does not look good for Ukraine

That the United States chose to hold talks with Russia about Ukraine without Ukraine sums up the power imbalance that is upending security assumptions for the whole of Europe.

Volodymyr Zelenskyy, the Ukrainian president, has consistently warned that Kyiv must have a seat at the negotiating table for any discussions about ending Vladimir Putin‘s war to have a chance of success. His European allies also want to have a voice.

Yet these requests were ignored by Donald Trump and his strongman approach to diplomacy, with the president instead dispatching his top diplomat and two other senior envoys to meet Russian counterparts in Saudi Arabia on Tuesday.

Steve Witkoff, Marco Rubio and Mike Waltz.
Pic: Reuters
Image:
(L-R) The US delegation in Riyadh included Steve Witkoff, Marco Rubio and Mike Waltz. Pic: Reuters

Ukraine war latest: Trump says he’s ‘more confident’ of peace deal

Mr Zelenskyy, apparently by chance, had been due to embark on a pre-planned trip to the kingdom later that same day.

However, he decided to delay the visit to avoid the appearance of giving any kind of legitimacy to the bilateral encounter between Moscow and Washington.

Unfortunately for Kyiv, beyond noisy protest, it has very limited options when it comes to channelling the disruptive force of the Trump White House in its favour.

More on Donald Trump

👉 Listen to Sky News Daily on your podcast app 👈

The Ukrainian military remains hugely reliant on US weapons to fight Russia’s invasion and Mr Zelenskyy has made clear he would want an American element in any international security force that might be agreed upon to monitor a ceasefire – even though this is a role the US appears reluctant to fill and the Kremlin has said would be “unacceptable”.

It means Mr Trump has significant leverage over his Ukrainian counterpart which he will surely use to try to force through negotiations even on terms less favourable to Kyiv.

Read more:
Analysis – Russia tries to appeal to Trump’s business background

Please use Chrome browser for a more accessible video player

Ukrainians react to US-Russia talks

The US has already reportedly tried to make Ukraine sign away a large portion of its natural resources to pay for US support – an uncomfortable offer that Mr Zelenskyy has so far declined but an indication of the new transactional approach to US foreign policy.

Mr Trump has repeatedly vowed to end Russia’s war in Ukraine – even claiming during the US election campaign that he would do this within 24 hours.

But he never spelled out how.

The past week, however, has offered an indication of the direction of travel and it does not look good for Ukraine.

From unilaterally picking up the phone to Vladimir Putin to sanctioning such a high-level meeting with the Russians in Riyadh, the only currency that seems to matter to the White House is power and right now both Kyiv and its European partners are looking all too weak.

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