Now Comes the Hard Part for MAHA

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Good politicians are rarely modest. The job requires an uncanny ability to sell each bit of incremental progress as a success in and of itself. That’s especially true for someone like Robert F. Kennedy Jr., who dares to take on America’s health problems and faces considerable skepticism from a large number of Americans—including many of those who work beneath him at The Department of Health and Human Services. Kennedy’s overarching goal of addressing chronic disease could take many lifetimes to achieve. But in just under seven months, Kennedy said at an event on Tuesday, he has “accomplished more already than any health secretary in history.”He’s right that the clip at which he’s shaken the government’s health agencies is remarkable by any measure—dizzying for his supporters and critics alike. He has successfully pressured many food companies to promise to remove certain synthetic dyes from their products. He has persuaded states to adopt their own MAHA-friendly policies. He’s tapped into a vocal post-COVID culture that’s cheering him on. And, especially in recent weeks, he has pushed to remake America’s vaccine guidelines.What happens next, however, is where things will get even more interesting. RFK Jr. has spent a lot of time attempting to diagnose and explain America’s health woes. Kennedy’s team dedicated much of his first few months in office writing a report that lays out why American kids are so unhealthy. Earlier this week, Kennedy released the MAHA strategy for how it will go about tackling the problems of chronic disease in kids.The 20-page document is essentially a to-do list of 128 recommendations, including calling for the FDA to “promote innovation in the sunscreen market”and promising to further investigate the purported causes of vaccine injuries. By Kennedy’s telling, its release was a triumph. “There never had been an effort like this across all the government agencies,” Kennedy said at Tuesday’s event, where he unveiled the strategy alongside several members of Trump’s Cabinet.But the new report underscores how much easier it is to describe the problem of America’s health woes than to solve them. The document highlights how exposure to a number of chemicals in our environment and our food might affect health. It calls for the development of a “research and evaluation framework” to explore this issue. But the report doesn’t articulate any strategy for what will be done about it once the research is complete. The report falls into a similar trap on issues with decades of research already focused on them, such as autism.Some steps in the report can presumably be accomplished quickly, and may indeed improve America’s health, even if modestly. On Tuesday, Kennedy laid out several goals he expects to achieve before the end of the year. They include defining ultraprocessed foods, requiring nutrition courses in medical schools, and closing a loophole that allows food companies to introduce new chemicals into the country’s food supply without oversight if they self-declare that the ingredients are “generally recognized as safe,” or GRAS.Kennedy and his team can be slippery when discussing goals, however. During Tuesday’s press conference, FDA Commissioner Marty Makary ran through a list of what the agency has achieved under his watch—and mentioned the same loophole that Kennedy had cited a few minutes earlier. As Makary’s put it, the FDA already “took action” on that issue. And he’s right: In March, Kennedy directed the agency to “explore rulemaking” to remove the loophole, but Makary seems to be claiming credit for considering taking action. During a Senate hearing last week, Kennedy similarly said that he had tackled the GRAS loophole. If the administration can claim victory after merely considering an action, it could presumably declare that America is on its way to becoming healthy again because the new report’s recommendations were written down on paper. (“We look forward to taking action to close the GRAS loophole,” an HHS spokesperson said in an email.)All this exposes a hole in the MAHA movement. Many of its overarching goals are laudable. As Jim O’Neill, the acting CDC director and Kennedy’s top deputy at HHS, said at the press conference: “All Americans deserve to be healthy, and we are going to get there.” But exactly how RFK Jr. will even measure America’s collective health remains to be seen. He seems to hope that rates of chronic disease will shrink to the levels seen during his childhood: “76.4 percent of Americans are suffering a chronic disease,” he said on Tuesday. “When my uncle was president, it was 11 percent.” Perhaps America won’t be healthy again until we achieve similar statistics, or until each of the MAHA strategy’s recommendations are achieved. Perhaps America won’t be healthy again until Kennedy simply decides to declare victory, regardless of what the next three years bring.