What another Trump presidency could mean for public health

Public health leaders have worked with a Trump administration before, and now they’re going to have to do it again.

Dr. Georges C. Benjamin of the American Public Health Association said he hopes President-elect Trump will invest in public health and appoint qualified people to key health posts.

With Donald Trump winning a second term in the White House, public health experts are hoping they can get the administration to tackle key public health priorities, such as preparing for pandemics, the opioid crisis and a host of others.

Dr. Georges C. Benjamin, executive director of the American Public Health Association, tells Chief Healthcare Executive® that he wants to solve problems affecting public health.

“We worked with the Trump administration from the last term,” Benjamin said. “So, we know how to work with them if they want to work with us.”

“Obviously our biggest concern is that, you know, policy is people,” he continued. "And we want to make sure that they propose people who are well qualified, well credentialed, for the various health leadership positions.”

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Many health organizations will be sending names to the Trump administration for consideration for key health agency posts, he notes. But Trump has said several times in the past few weeks that Robert F. Kennedy Jr. is going to play a key role on public health in his second term.

And that’s a prospect that has alarmed some health officials, given Kennedy’s anti-vaccine views, even as he has downplayed his opposition to vaccines. He also repeatedly has cited debunked research tying vaccines to autism.

Benjamin said he has “significant concerns” about Kennedy’s role in health policy.

“Vaccines is a really big issue,” Benjamin said. “As you know, there’s a lot of vaccine skepticism out there that's resulted in low vaccine uptake, and we've had a substantial number of disease outbreaks because of the protesters … measles, people inadequately vaccinated from COVID, inadequate vaccinations from influenza. So big concerns about that confusion.”

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Kennedy told NBC News Wednesday that it’s possible he could lead the U.S. Department of Health & Human Services or possibly be “a "White House health czar." He also said that he’s not aiming to get rid of vaccines.

"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.

In an interview on NPR Wednesday morning, Kennedy also said the Trump administration would push to remove fluoride from drinking water.

Benjamin said he doubted fluoride is going to be removed from water, but he said that he’s concerned that people will be confused about the safety of fluoride.

“There are many communities that don't have fluoride in the water, and we're trying to expand water fluoridation at a time when we need it, and their course will make it difficult,” Benjamin said.

Benjamin expressed skepticism that Kennedy would win confirmation for posts that would require the approval of the Senate. Even if he’s not moved to a cabinet-level position, Kennedy could have influence on health policies and decisions.

Still, Sen. Marco Rubio, a Florida Republican, suggested that Kennedy could in fact gain Senate confirmation for a key health post in a CNN interview.

“I think the Senate is gonna give great deference to a president that just won a stunning, what I think is an electoral college landslide when all is said and done, and a mandate,” Rubio said. “And he’s being given a mandate to govern.”

Looking at Trump’s first term, Benjamin said that his administration had capable people in key White House posts. He noted the success of Operation Warp Speed, which created the first COVID-19 vaccine.

“They certainly had really well-trained, some good people in the last administration,” Benjamin said. “I think the challenge was that sometimes they didn't use them. And then sometimes, they had people that had more sway who really weren't as competent or qualified to lead issues.”

“That came out with great concern during COVID, where you had this absolutely amazing response with Operation Warp Speed,” Benjamin said. “At the same time, you had this scattered engagement on the COVID side, on the public health side, despite having some really well-trained, well-credentialed, smart people there.”

And Benjamin is hoping Trump will place qualified people in key public health posts.

“We can disagree on policy or we can agree on policy, but it has to be coherent,” he said. “You know, it has to have a rationale, it has to be evidence-based.”

Benjamin also points to many public health problems that need attention from the federal government. “We still have an opioid epidemic, an obesity epidemic, a rising STD epidemic, an epidemic of premature maternal mortality,” Benjamin said. “We've got two or three food-borne outbreaks out there right now.”

“So the number of health crises that are occurring as we speak require someone … that understands health, understands the science,” he said.

Benjamin said he’s worried about funding prospects for key agencies tasked with protecting public health, including the Centers for Disease Control and Prevention.

“We’ve got significant concerns about funding,” Benjamin said. “We haven't really had a good champion on the public health side in a while.”

Benjamin has been in Washington a long time, and he said he’s aiming to solve problems. He’s hoping the Trump White House and next Congress will invest in programs to protect public health.

“I want to reiterate the fact that the public health system has been totally devastated, and we need to really rebuild the next generation public health system,” Benjamin said. “I would hope that they would take that on this quest.”