What We Have Lost in HHS Secretary Kennedy’s First Year

By Ben Young

“One year into this administration, we are at a precipice in the US.” — Dr. Ben Young, Senior Medical Advisor at the Wellness Equity Alliance.

Health and Human Services Secretary Robert F. Kennedy Jr. (Gage Skidmore photo via Flickr/Creative Commons license)

One year into Secretary Robert F. Kennedy Jr.’s tenure at the Department of Health and Human Services, I am deeply concerned that those institutions are being weakened in ways that threaten not only infectious disease control at home, but decades of global health gains.

I have spent my career in infectious diseases, much of it devoted to HIV medicine and policy. I worked in clinics across continents, with the CDC and ministries of health, and at negotiating tables with pharmaceutical executives.

Dr. Ben Young, Senior Medical Advisor at the Wellness Equity Alliance. (Photo courtesy of WEA)

Our generation helped secure universal access to antiretroviral therapy expanding HIV medicines around the world while preserving intellectual property frameworks and sustaining industry profit. It was not easy. It required trust, technical rigor, and political courage.

The results were unprecedented. Life expectancy rose across large swaths of Africa for the first time in decades. HIV and AIDS, once a death sentence, became a chronic and manageable condition. In the United States and in countries with reliable access to treatment, people living with HIV achieved near-normal life expectancy.

That progress was not accidental. It was built on institutions, including: the Centers for Disease Control and Prevention, the National Institutes of Health, the Food and Drug Administration, and the President’s Emergency Plan for AIDS Relief — PEPFAR. Progress was built on community trust with a shared commitment to evidence-informed medical science and public health.

Troubling Departures

The critical damage to the Centers for Disease Control and Prevention and to the Advisory Committee on Immunization Practices — ACIP — cannot be minimized.

CDC’s authority rests on decades of technical excellence and insulation from political ideology. Over the past year, the agency has experienced a troubling departure of senior epidemiologists and laboratory scientists. This is far from routine turnover. It reflects an environment in which career expertise is questioned not through scientific debate, but through public insinuation and political framing.

Vaccine Policy Reshaped

ACIP, long the gold standard for vaccine policy, has been reshaped in ways that dilute its deep bench of immunologic and epidemiologic expertise. Changes framed as “broadening perspectives” have, in practice, injected uncertainty into what was once a methodical and transparent review process. Immunization policy depends on clarity. Pediatricians, internists, insurers, and state health departments cannot operate on ambiguity.

When federal leadership repeatedly revisits settled vaccine science or elevates marginal hypotheses into public discourse, the signal to communities is unmistakable: doubt the system, doubt expertise. We are already seeing modest but meaningful declines in vaccine uptake in several regions, rising exemption rates, and outbreaks of diseases once firmly controlled.

In infectious disease, small percentage shifts translate into lives.

Global Consequences

Globally, the consequences are even more sobering. According to estimates from ImpactCounter.com, disruptions in funding and program continuity associated with policy shifts during the new administration have contributed to approximately 750,000 excess deaths worldwide in the past year – 500,000 of them among children. These figures reflect interrupted immunization campaigns, delayed HIV and tuberculosis treatment initiation, weakened malaria control programs, and disruptions to maternal and child health services.

I have witnessed what consistent treatment access can accomplish in the lives of my patients. I have also seen what interruption does.

When antiretroviral supply chains falter, viral loads rebound. When adherence programs weaken, resistance emerges. As prevention campaigns stall, case rates rise quietly before exploding into view. The architecture of HIV success, global procurement systems, predictable regulatory frameworks, and durable public-private agreements depends on stability and trust. Those are not abstract virtues; they are operational necessities.

HIV Treatment

It is worth recalling that the expansion of HIV treatment worldwide required collaboration with the pharmaceutical industry, not its demonization. We negotiated tiered pricing, voluntary licensing, and generic competition in lower-income markets while preserving patent protections in wealthier ones. That balance allowed innovation to continue even as access expanded dramatically.

Today, regulatory unpredictability and rhetorical hostility toward scientific institutions risk the very partnerships that enabled those breakthroughs. Vaccine development, antiviral research, and long-acting injectable platforms require years of investment under stable regulatory expectations. When agencies are perceived as politicized, capital retreats and innovation slows.

Secretary Kennedy has focused attention on chronic disease, environmental exposures, and food systems. These are legitimate concerns. The American healthcare system is too expensive and too reactive. But infectious diseases do not wait while we recalibrate. Pathogens exploit weakened infrastructure and distracted leadership.

The Rise of Skepticism

Public health credibility, once eroded, is extraordinarily difficult to rebuild. After COVID-19, trust was already fragile. What we required was careful restoration: clearer communication, improved data transparency, and stronger guardrails against conflicts of interest. What we have instead is an increasingly adversarial posture toward the very scientific institutions tasked with protecting the public.

Transparency is vital. Skepticism has its place. But leadership carries responsibility for signal amplification. When the head of HHS casts sustained doubt on foundational vaccine science even without formally dismantling programs the downstream effect is measurable in behavior.

One year into this administration, we are at a precipice in the US. Diagnostic laboratories still function. Treatments remain available. But the scaffolding is weaker. Expertise is thinner. Global partners are understandably cautious. Industry is more hesitant. Communities are more uncertain.

Trust Endangered

Public health is built slowly and lost quickly. The question before us is not whether institutions should evolve, they must. The question is whether reform will strengthen the scientific foundations that made modern infectious disease control possible, or whether it will continue to erode the credibility on which those foundations rest.

From HIV to measles to the next pandemic pathogen, our success has always depended on trust in science, in institutions, and in each other.

That trust is now the most endangered asset of all.

Dr. Ben Young is an infectious disease specialist with three decades of experience in global public health and HIV medicine. His work examines access to care, patient-reported outcomes, and the structural forces shaping health in underserved communities in the U.S. and abroad. Dr. Young has collaborated with public health institutions including the CDC, WHO, and United Nations and has worked extensively in rural and resource-limited settings, where distance, workforce shortages, and collapsing infrastructure routinely determine outcomes. He currently serves as a Senior Medical Advisor at Wellness Equity Alliance