What Is This Thing Called AHA?
Looking for method in the madness
As I wrote last week, Kennedy’s HHS reorganization is mainly about destruction, political payback, and control. But RFK Jr., while delusional, does seem to genuinely care about health.
His brainchild, and the only part of his reorganization that doesn’t involve destruction, is the new Administration for a Healthy America, or AHA. The closest he has come to explaining AHA’s purpose is “ending the chronic disease epidemic with clean water, safe food, effective medicine, good science, radical transparency, and a healthy environment.”
What is this strange animal?
Kennedy’s views on health
Trying to fathom what Kennedy has in mind for AHA requires peering inside that mind.
Kennedy has long been fascinated by nature – particularly animals – and the environment. As a college student, he kept a pet owl. He’s a falconer and in recent times has kept a pet emu. As lawyer, he helped get a multi-million-dollar judgment against a factory that exposed neighbors to heavy metals.
Much of his life, though, Kennedy’s passion for nature has been surpassed by his passion for drugs. According to a profile in the New Yorker, Kennedy spent all of his teenage and young adult years “chasing a high and coming down into a deep despair.” He used many drugs, including chewing tobacco, marijuana, LSD, cocaine and heroin. In 1983 he overdosed, was arrested for heroin possession, and spent five months in a rehab facility. He claims to be sober since, but in 2023 he admitted to using testosterone, and during his confirmation hearing he appeared to be sucking on nicotine pouches.
Kennedy has a particular interest in children’s health. He has a son with severe allergies, and he draws connections between chemical exposures and various diseases of children. “Pesticides, food additives, pharmaceutical drugs, and toxic waste permeate every cell in our bodies,” he said at a congressional hearing last September. “This assault on our children’s cells and hormones is unrelenting. They are swimming around in a toxic soup.”
There’s a strong paranoic strain to Kennedy’s health views. He believes the federal health agencies are hiding health risks of toxins and drugs because they are beholden to drug companies. He spouts off conspiracies involving not just Anthony Fauci and Pharma, but also Bill Gates, 5 G networks, and the design of the COVID-19 virus to “attack Caucasians and Black people” while sparing Jews and Asians.
Kennedy is heavily influenced by his long-term friendship with Mark Hyman, a physician who makes tens of millions of dollars selling laboratory tests and nutritional supplements. Among those nutritional supplements: boron, chromium, and mushrooms for “immune support”.
To most of us in public health, the term “chronic diseases” covers diabetes, cardiovascular disease, cancer, and dementia. But Kennedy throws many other health problems into that bucket, including autism, ADHD, mental illnesses, autoimmune diseases, and allergies. Our approach to those chronic diseases, he seems to believe, should be based on prevention and “natural” remedies, which to him includes vitamins, “nutraceuticals”, saunas, probiotics, raw milk, “clean foods”, sunshine, and exercise.
Much of that thinking is harmless, and some is even beneficial. Most of us could benefit from more sunshine and exercise. But Kennedy is also drawn to quack treatments that are far from natural. He has promoted the use of chelation (injections of drugs that bind to heavy metals), hyperbaric treatment, psychedelics, ivermectin, hydroxychloroquine, and – as treatment for measles – the steroid budesonide and the antibiotic clarithromycin.
How does Kennedy square his commitment to “natural” remedies with promotion of drugs and other treatments that dangerous and anything but natural? I guess if they “can’t be patented by Pharma” they must be good? Has it never occurred to him that big pharmaceutical companies are not the only ones who’ve discovered that selling remedies – even harmful ones - is lucrative?
What would AHA include?
According to an HHS press release, the Administration for a Healthy America would be assembled from these organizational units of HHS:
Health Resources and Services Administration (HRSA)
Substance Abuse and Mental Health Services Administration (SAMHSA)
Agency for Toxic Substances and Disease Registry (ATSDR)
Office of the Assistant Secretary for Health (OASH)
National Institute of Occupational Safety and Health (NIOSH)
AHA will be organized into six Divisions, which make it look mostly like a mashup of HRSA and SAMHSA, with a dash of ATSDR thrown in:
From HRSA
Primary Care
Maternal and Child Health
HIV/AIDS
Workforce
From SAMHSA
Mental Health
From ATSDR
Environmental Health
Where is the synergy?
The theoretical benefit of reshuffling federal agencies is to better coordinate or integrate their actions on the ground. For example, I believe HHS would be more effective in preventing chronic diseases if the FDA’s food and tobacco regulation were combined with the CDC into a larger prevention agency. I’m struggling mightily, though, to figure out how AHA might help coordinate anything.
OASH is a small unit that mainly publishes plans and recommendations, including the Healthy People Objectives and the Physical Activity Guidelines for Americans. I assume that as part of AHA, OASH will become Kennedy’s main megaphone.
HRSA is already a grab-bag of an agency that plugs miscellaneous holes left by our medical care system. Its Primary Care bureau funds community health centers for the poor and uninsured. Its Maternal and Child Health bureau supports home visiting services for new mothers and their babies, its HIV/AIDS bureau pays for treatment and wraparound services for people with HIV infection, and its Workforce bureau funds training of medical professionals. It’s a very strange choice as a platform for a national health promotion campaign.
I’m not surprised that Kennedy is interested SAMHSA (drugs) and ATSDR (toxins). SAMHSA mainly pays for community clinics that treat people for mental illness and drug addiction. Maybe SAMHSA could work with HRSA’s Bureau of Primary Care to better integrate this treatment with primary medical care. That would be a step forward. But it would affect only about 10% of the primary care delivered in the U.S.
Beyond that, I’m stumped. ATSDR mainly does health assessments around specific Superfund toxic waste sites. What does that have to do with a network of primary care clinics or treatment for mental illness or addiction? Or treating HIV infection or training doctors?
What has been lost?
Meanwhile, Kennedy’s HHS reorganization plan slashes his own priorities. This environmentalist who’s determined to prevent chronic diseases has made big cuts in CDC’s National Center for Environmental Health and National Center of Chronic Disease Prevention, firing many of the nation’s best experts on toxins and chronic diseases.
More to the point, if Kennedy truly wanted to reduce Americans’ exposure to toxins, he would demand that the EPA prevent polluters from putting those toxins into our environment. Instead, Kennedy’s fellow Trump appointee over the EPA is unleashing the polluters.
And I have to say a brief eulogy for the National Institute for Occupational Safety and Health (NIOSH). The HHS cuts eliminated more than 2/3 of NIOSH staff, and its functions appear nowhere on the AHA org chart. I can only guess that what little that is left of NIOSH has been folded into AHA to hide evidence of the crime. Certainly, none of Kennedy’s pals has ever breathed in coal dust in a mine, inhaled toxins in a petrochemical plant, or lifted boxes in an Amazon fulfillment center, but don’t workers forced to take those risks deserve an agency protecting their health?
So trying to make sense of AHA is like trying to find the logic in Kennedy’s conspiracy theories. The dots just don’t connect. I don’t see a method. Just madness.