Introduction
One year into Secretary Robert F. Kennedy Jr.’s tenure at the Department of Health and Human Services, infectious disease specialist Dr. Ben Young raises a critical alarm: the very institutions that have safeguarded American and global public health for decades are being weakened at an alarming pace. As Senior Medical Advisor at the Wellness Equity Alliance, Dr. Young draws on three decades of experience in HIV medicine, global health policy, and community-based care to make a sobering assessment — the damage being done today will take years, if not decades, to undo.
Decades of Progress at Stake
How Modern Public Health Was Built
Dr. Young spent his career working in infectious disease clinics across continents, collaborating with the CDC, ministries of health, and pharmaceutical executives to expand access to life-saving treatments. His generation helped secure universal access to antiretroviral therapy — making HIV medicines available worldwide while preserving intellectual property frameworks and sustaining industry investment in innovation.
The results were historic. Life expectancy rose across large parts of sub-Saharan Africa for the first time in generations. HIV and AIDS, once a guaranteed death sentence, became a chronic and manageable condition. In the United States and in countries with reliable treatment access, people living with HIV achieved near-normal life expectancy — a triumph of science, policy, and sustained institutional commitment.
That progress rested on the combined strength of the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the Food and Drug Administration (FDA), and the President’s Emergency Plan for AIDS Relief (PEPFAR). It was built on community trust, evidence-informed science, and the political will to protect public health above ideology.
Troubling Departures at the CDC
Expertise Exits as Politics Enters
The CDC’s authority has historically rested on decades of technical excellence and careful insulation from political ideology. Under the current administration, the agency has experienced a troubling and accelerating departure of senior epidemiologists and laboratory scientists. This is not routine turnover. It reflects an environment in which career expertise is challenged not through open scientific debate, but through public insinuation, political framing, and institutional pressure.
When agencies lose their most experienced professionals, the knowledge infrastructure that took decades to build begins to erode — quietly at first, then catastrophically.
Vaccine Policy Reshaped Under ACIP
Uncertainty Replacing Clarity
The Advisory Committee on Immunization Practices (ACIP), long considered the gold standard for evidence-based vaccine policy, has been restructured in ways that dilute its deep bench of immunologic and epidemiologic expertise. Changes framed as “broadening perspectives” have, in practice, introduced uncertainty into what was once a methodical, transparent, and science-driven review process.
Immunization policy depends on clarity. Pediatricians, internists, insurers, and state health departments cannot operate under ambiguity. When federal leadership repeatedly revisits settled vaccine science or elevates marginal hypotheses into mainstream public discourse, the message to communities is unmistakable: doubt the system, doubt expertise, doubt the vaccines.
The consequences are already visible — modest but meaningful declines in vaccine uptake across several regions, rising exemption rates, and outbreaks of diseases once firmly under control. In infectious disease, small percentage shifts translate directly into preventable deaths.
The Rise of Public Skepticism
Credibility Lost Is Rarely Recovered
Public health credibility, once eroded, is extraordinarily difficult to rebuild. After COVID-19, trust was already fragile. What was required was careful restoration: clearer communication, improved data transparency, and stronger safeguards against conflicts of interest. What has emerged instead is an increasingly adversarial posture toward the very scientific institutions tasked with protecting the public.
Skepticism has a legitimate role in science. Transparency is essential. But leadership carries responsibility for the signals it amplifies. When the head of HHS casts sustained doubt on foundational vaccine science — even without formally dismantling programs — the downstream effect on public behavior is measurable and real.
Global Consequences: Lives Lost
750,000 Excess Deaths in One Year
The global consequences of this policy environment are sobering. According to estimates from ImpactCounter.com, disruptions in funding and program continuity linked to the current administration’s policy shifts have contributed to approximately 750,000 excess deaths worldwide over the past year — 500,000 of them 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.
Dr. Young has witnessed firsthand what consistent treatment access accomplishes — and what interruption destroys. When antiretroviral supply chains falter, viral loads rebound. When adherence programs weaken, drug resistance emerges. When prevention campaigns stall, case rates rise quietly before exploding into public crises. The architecture of HIV success — global procurement systems, predictable regulatory frameworks, and durable public-private agreements — depends entirely on stability and trust.
HIV Treatment and Industry Partnerships
Collaboration, Not Confrontation
It is worth recalling that the global expansion of HIV treatment required genuine collaboration with the pharmaceutical industry, not its demonization. Negotiators worked to establish tiered pricing, voluntary licensing, and generic competition in lower-income markets while preserving patent protections in wealthier economies. That carefully struck balance allowed innovation to continue even as access expanded dramatically across the developing world.
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 treatment platforms require years of sustained investment under stable regulatory expectations. When agencies are perceived as politicized, capital retreats, and medical innovation slows — with patients ultimately paying the price.
Secretary Kennedy has directed legitimate attention toward chronic disease, environmental exposures, and food system reform. These are real concerns. But infectious diseases do not wait while leadership recalibrates. Pathogens exploit weakened infrastructure and distracted institutions.
Trust: The Most Endangered Asset
What We Stand to Lose
One year into this administration, the scaffolding is weaker. Expertise is thinner. Global partners are cautious. Industry is more hesitant. Communities are more uncertain. Diagnostic laboratories still function and treatments remain available — but the foundations beneath them are less stable than they were a year ago.
The question before policymakers and the public is not whether institutions should evolve — they must, and reform is necessary. The question is whether that reform will strengthen the scientific foundations that made modern infectious disease control possible, or continue to erode the credibility on which those foundations rest.
From HIV to measles to the next pandemic pathogen, success has always depended on trust — in science, in institutions, and in each other. That trust is now the most endangered public health asset of all.
