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The announcements came Friday night, as President-elect Donald Trump's picks for the nation's top health leadership roles: New York's family physician and Fox News' surgeon general. Florida physician and former congressman to head the US Centers for Disease Control and Prevention; Surgeon and researcher at Johns Hopkins for the US Food and Drug Administration.
Public health experts, former government officials and researchers — including 10 people who spoke to — began to address praise, criticism and questions about Trump's choices: Dr. Janet Neshiwat for the US surgeon general, Dr. David Weldon for the CDC director, and Dr. Marty McCurry faces Senate confirmation hearings each for FDA commissioner.
Several health experts say McCarry and Neshiwat are reasonable choices to test against Robert F. Kennedy Jr., a prominent anti-vaccine conspiracy theorist who heads the U.S. Department of Health and Human Services at the federal health department. Many have raised concerns about Weldon, who Trump previously promoted to lead the CDC. Law This shifted vaccine safety oversight away from the CDC and repeatedly raised questions about the safety of previously studied vaccines.
A key challenge for the Trump administration's new public health leaders is keeping politics out of science, experts say.
reached out to Neshiwat and Makarin for comment, but did not receive a response. could not reach Weldon.
In response to questions from , Trump transition spokeswoman Katie Miller said, “Mr. Kennedy is the right choice to lead HHS and put Americans back into health care, not corporations.
Dr. Ashish Jha, dean of Brown University's School of Public Health and former White House covid-19 response coordinator, said one important question senators will have to push each candidate is how they will handle the situation inside. The recommendations of scientists at the CDC or the FDA conflict with what the health secretary wants.
“It's reasonable to disagree with people” on health policy, Jha said. “There are people out there who are smart, who are well-educated, who believe in modern medicine, who read data differently than I do, and come out differently than I do. It's a very common part of scientific discourse.”
Several experts who spoke to generally described Makari and Neshiwat as open-minded doctors who respect the scientific process — even if they disagree with some of their policies. Some said this could put Trump at odds with Kennedy, who he chose to be the nation's top health care secretary.
“It's hard to resist your boss,” said Jaha. “There's going to be a lot of pressure on all of these people, the director of the CDC, the commissioner of the FDA. It will be very difficult for them to make only the decisions that are right for the health of the American people and not be swayed by someone who doesn't understand evidence and data but holds opinions.
Weldon has his own biases. Prior to vaccination, and his appointment to the CDC director caused more hesitation among experts.
Although Dr. Makari and Neshiwat seem to have no experience in managing large organizations such as the FDA [the US Public Health Service]In an email to , Dr. Jerome Adams, who served as surgeon general in the first Trump administration, said: “I believe they are competent doctors who make science-based decisions.
“However, aside from his lack of experience with large organizations (and the CDC's support for it), I am concerned about Dr. Weldon's previous statements about vaccines and believe he should be closely scrutinized during his confirmation hearing,” Adams wrote. . “The CDC plays a critical role in global health, and it would be disastrous if its leader promoted baseless theories and exacerbated vaccine hesitancy.”
Vaccination is far from the only issue on which federal health leaders are guiding policy, but experts say it's one of the most important right now — and each leader's approach could be a bellwether.
The Covid-19 pandemic has brought vaccines into the public health spotlight and created opportunities for further investigation, but also dangerous suspicions and conspiracies. Dr. Peter Hotez, director of vaccine development at Texas Children's Hospital, said they had fatal results.
Hundreds of thousands of Americans have lost their lives due to lack of access to a vaccine against Covid-19, and spikes in preventable diseases like whooping cough and measles “pose a major threat to the health of the American public,” he said.
“It's very dangerous for the country, and now it's deadly,” Hotez said. This will continue to be one of our greatest challenges in depoliticizing anti-science.
How a public health leader evaluates scientific data on vaccines is “an important litmus test,” said Dr. Jennifer Nuzzo, professor of epidemiology and director of the Epidemic Center at Brown University's School of Public Health.
“It shows how one makes decisions about complex and high-profile issues and what kind of evidence and rigor one requires when making those decisions,” she said. “When you see someone who says there is no safe and effective vaccine, and that statement contradicts all the evidence we have, that really makes you question the judgment and character of the person making that statement. In my view, that negates any serious government responsibility.”
Dr. Amesh Adalja Weldon, a senior fellow at the Johns Hopkins Center for Health Security, is concerned about Congress's efforts.
“I think it's very serious [the] The next head of the CCC can be the vaccine misinformation, especially in relation to prevention [thimerosal],” Adelja wrote in an email, referring to the mistaken belief that immunity is linked to autism. “It takes a great deal of reluctance, especially from a physician, to accept false ideas that would undermine the acceptance of one of mankind's greatest technological advances.”
Weldon's partial past and hazy present
“World Health Organization?” It's the most common response Dr. Brian Castrucci said he heard following Weldon's selection to lead the CDC.
“As far as anyone knows [Weldon has] He didn't have a lot of connections or experience working in the health department. He doesn't seem to have experience working in the public health field,” said Castrocchi, president and CEO of the De Beaumont Foundation, a nonprofit focused on strengthening the U.S. public health system.
“I think, unfortunately, considering who the candidate might be, there's almost a sense of relief, and in some ways, an acceptance by some people of not knowing who this person is. That's not enough for me,” Castrucci said.
Weldon served in Congress for 14 years from 1995 to 2009, representing the Florida district near Tampa.
In 2007 Weldon Introduced The Vaccine Safety and Public Confidence Assurance Act aims to create a “vaccine safety review agency” within HHS that is independent of the CDC. “The Centers for Disease Control and Prevention is responsible for promoting both high vaccination rates and vaccine safety, which some consider a conflict of interest.”
Dr. Paul Offitt, director of the Center for Immunization Education at Children's Hospital of Philadelphia, recalled running into Weldon when he was on the CDC's Advisory Committee on Immunization Practices, a board of independent experts who advise the agency on how to use vaccines. To control diseases.
“He was a firm believer in that,” Weldon said. [the measles, mumps and rubella vaccine] It was the cause of autism. And he believed… that if you separate that vaccine into three parts, you can eliminate autism, which is, of course, nonsense, because previous studies have shown that you're no more susceptible to autism. You haven't been vaccinated.”
But Weldon's position on the House Appropriations Committee, where the CDC is funded by the government, at the time “forced a major vote” to give the vaccine to three instead of one, Offit recalled. Studies had previously shown that this had nothing to do with autism, so “it was embarrassing,” he said.
“And Weldon got what he wanted,” Offit said. “Because the way that story was carried was something to think about when we didn't have to discuss it like that.”
“These are science-based agencies. They depend on good science to move forward. And that's dangerous when you have a person who has a series of fixed beliefs held by the strength of religious beliefs.”
If Kennedy and Weldon are confirmed, Offit said, “I think there's every reason to believe that the way we administer and administer vaccines in this country will collapse and cause the vaccination rate to drop.” And the first disease that comes back is measles. And I think we're going to end up with measles again, and thousands of cases, some children dying from a preventable disease.
Hotez said Weldon's name hasn't been on his radar for more than a decade and a half, and it will be important to hear if his position has changed at his confirmation hearing.
CDC directors are already appointed by the president, but the position will be subject to Senate confirmation starting in January.
There is much to learn about Makari and Nesheiwat too. Neither responded to 's comment.
The US Surgeon General serves as the voice of the administration's public health policy as they promote their own agendas that they feel are important to the health of the American public.
Hotez was speaking regularly with Nesheywat in the early days of the Covid-19 pandemic, leading public health voices in the media as they worked together on how to handle the data onslaught and communicate effectively with the public. She said she was “open-minded and really interested in understanding and learning and learning,” and that's a good sign of how she handles the overall role of the surgeon.
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