Authoritarian governments are based on the idea that some people are better than others. This translates into the idea that some people have special insight based only upon their superiority. They don’t have to listen to experts, who just muddle the clear picture the leader can see. When reality intrudes on that vision, the problem is not the ideology of the leader, it is obstruction by political opponents.
The results of this disdain for expertise shows these days most immediately in the policies of Secretary of the Department of Health and Human Services Robert F. Kennedy Jr. As measles continues to spread across the U.S., a spokesperson for Health and Human Services said Friday that Kennedy will turn the country’s health agencies away from promoting vaccination, which is 97% effective in preventing the disease, and toward exploring new treatments for it, including vitamins.
“It’s not that there’s been a lack of studies,” Dr. Michael Osterholm, an epidemiologist at the University of Minnesota, told Teddy Rosenbluth of the New York Times. Decades of research have not discovered dramatic treatments, while vaccinations have proven safe and effective at preventing the life-threatening disease.
Rosenbluth noted that “[p]ublic health experts are baffled by Mr. Kennedy’s decision to hunt for new treatments, rather than endorse shots that have decades of safety and efficacy data.” This stance seems to contradict Kennedy’s longstanding focus on preventing disease.
Kennedy has also falsely claimed that the measles, mumps, and rubella vaccine (MMR) contains “aborted fetus debris,” that parents should “do their own research,” and that he will institute testing for new vaccines with placebo-controlled trials, a practice medical experts warn could be unethical as subjects believe they are protected from disease when they are not.
Infectious disease expert Paul Offit told Jessica Glenza of The Guardian: “It’s his goal to even further lessen trust in vaccines and make it onerous enough for manufacturers that they will abandon it.”
At the end of March, Kennedy also vowed to study possible links between vaccines and autism, although repeated scholarly studies have shown no link. Kennedy has tapped David Geier, who does not have a medical degree and was disciplined in Maryland for practicing medicine without a license, to perform the study.
On Thursday, former New York Times global health reporter Donald G. McNeil Jr. noted that both Geier and Kennedy have made significant money thanks to their anti-vax stands as they monetize alleged treatments and sue pharmaceutical companies.
In Ars Technica on April 30, microbiologist and senior health reporter Beth Mole explored another angle to understand Kennedy’s policies. She noted that Kennedy, who is neither a doctor nor a public health expert, does not believe in the foundational principle of modern medicine: germ theory.
In a 2021 book, Kennedy argued the idea that microscopic viruses, bacteria, parasites, and fungi cause disease serves the pharmaceutical industry and the healthcare industry that grew around it by “emphasiz[ing] targeting particular germs with specific drugs rather than fortifying the immune system through healthy living, clean water, and good nutrition.” He accused those supporting this system, including Anthony Fauci, the former director of the National Institute of Allergy and Infectious Diseases who was a proponent of the Covid vaccine, of misleading the American public.
While Kennedy appears to believe germs exist, he also claims to believe in the older theory of disease called “miasma theory,” although as Mole points out, he misunderstands that theory—the idea that diseases are caused by poisonous vapors—and really appears to believe in another old idea: “terrain theory.” Terrain theory maintains that diseases are signs that the internal “terrain” of the body is out of whack.
This would explain Kennedy’s assertion—refuted by doctors—that the children who died of measles were malnourished. As medical blogger Kristen Panthagani, MD/PhD, explains: Kennedy’s way of thinking is “the belief that infections don't pose a risk to healthy people who have optimized their immune system.”
While underlying medical conditions certainly affect people’s health, Mole notes that “the evidence against terrain theory is obvious and all around us.” But if you think germs are less important than overall health, things like the pasteurization of milk to kill E. coli, salmonella, and Listeria bacteria—which Kennedy opposes—are unnecessary.
In 1876, German microbiologist Robert Koch discovered that the cause of anthrax was a bacterium. Germ theory challenged established practices In the U.S., where doctors in the 1860s during the Civil War believed the best demonstration of their skill was their bloody aprons and instruments, instruments they kept in a velvet-lined case.
In 1881 the doctor overseeing President James Garfield’s recovery from a gunshot wound repeatedly probed the president’s wound with dirty instruments and his fingers, prompting assassin Charles Guiteau to plead not guilty of the murder by claiming, “The doctors killed Garfield, I just shot him.”
But just four years later, germ theory was so widely accepted that the U.S. Army required medical officers to inspect their posts every month and report the results to the administration, and by 1886, disease rates were dropping. By 1889, the U.S. Army had written manuals for sanitary field hospitals, and the need to combat germs was so commonplace medical officers rarely mentioned it.
And now, in 2025, the top health official in the United States, a man without degrees in either medicine or public health, appears to be rejecting germ theory and reshaping the nation’s medical system around his own dedication to a theory that was outdated well over a century ago.