MAHA, Medicine, Big Pharma and Science

The Trump appointment of RFK, Jr. to the cabinet position responsible for health and human services unleashed a mob of medical and pharmaceutical skeptics, contrarians, charlatans and outright anti-science crazies.  It is difficult to predict the long-term harm it will have on the medical and scientific community in the USA.  The anti-vaccine movement that propelled RFK, Jr into the political realm is on the ascendancy and there is little doubt that it will cause countless unnecessary sickness and deaths in the future.

 Make America Healthy Again (MAHA), like its forebearer MAGA, is a simplistic and specious concept that appeals to an uneducated and conspiracy-minded public. However, there are elements of this movement that bear closer and more sympathetic evaluation. The focus on nutrition and food additives is laudable.  The concern for environmental toxins is also praiseworthy, though certainly not revolutionary.  What is new and troubling in MAHA is the disdain it has for medical science, for pharmaceuticals and especially for vaccines.  

 

There is no doubt that chronic diseases and conditions like obesity and diabetes are epidemic in the USA.  The role of sweetened drinks and ultra-processed foods in these problems is well known and every administration has attempted to make the public more aware of this crisis.  

 

There has also been growing concern among scientists and physicians for many years about the potential role of environmental toxins due to pesticides, chemical waste, plastic pollution and population concentration in the rising cancer rates among younger people and various diseases, such as Parkinson’s.  Ironically, the Trump administration’s evisceration of the EPA makes it more likely that these toxins will proliferate.

 

But how poor is America’s health really?  When was America healthier?  Life expectancy at birth has risen from around 40-45 years in 1870 to 79 years today.  In the 1950’s, a period that seems to warm MAGA hearts, it was 68 years, 11 years lower than today.  The major factors in this amazing trajectory of life expectancy are multiple, but vaccines, antibiotics, sanitation, medical advancements in cardiology and oncology and healthier lifestyles (less smoking, more exercise, etc.) have all been critical.  

 

The improvement in longevity and in fighting disease is a testament to both medical science and the pharmaceutical industry.  The major problem with MAHA is that it is promoting a healthier America while fomenting distrust in the very institutions that will play an important role in achieving that goal.

 

There is no doubt that so-called Big Pharma is very energetic, like every profit-oriented industry, in its efforts to encourage use of pharmaceutical products.  Do Americans use too many drugs?  Very possibly.  But it is the responsibility of every individual to educate his or herself and work with the medical profession to determine what drugs should be taken.  America would be much less healthy without antibiotics, vaccines, blood pressure and cholesterol medications, diabetes medications, chemotherapy and many other amazing creations of the pharmaceutical industry.

 

There is an implicit assumption in the MAHA movement that nutritious foods can somehow eliminate the plague of chronic disease in our society and make the use of pharmaceutical products unnecessary.  This is simplistic.  Chronic disease is a complex phenomenon and nutrition is a notoriously difficult thing to study given the number of variables and the challenges of isolating them in studies.  If MAHA can influence lifestyle changes in children and adults to reduce obesity and diabetes (exercise, eating less and healthy, etc.) then that would be a noble achievement.  But every recent administration has pushed hard on that agenda with relatively small success, so one is doubtful.

 

Perhaps the most pernicious aspect of the MAHA movement is its vaccine skepticism and often outright anti-vaccine stance.  Vaccines are not perfect.  There are minute numbers of people who are injured by vaccines.  But these numbers are miniscule in comparison to the number of people who would sicken and die without vaccines and without a high percentage of public vaccination.  The autism link to vaccines has been debunked and discredited repeatedly, but the MAHA movement has used it to create hesitancy and doubt in the minds of millions of people.

 

What I fear about MAHA is that the good parts of its agenda will flail helplessly against societal habits - overeating, sitting in front screens all day long, etc. – and that its only legacy will be a lingering distrust of science, vaccines and medicine among a small but sufficient number of people to bring back the scourges of previously vanquished disease and open the door wide to future pandemics.  Let’s hope that RFK, Jr. will be unceremoniously kicked out before that becomes our reality.