The Food-Pharma Civil War at HHS

MAHA in the cabinet

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My aim with this newly independent Acute Condition is to leverage my unique experience in policy, healthcare, and tech. I think MAHA is a particularly interesting topic because it touches on all of those — it’s a movement that’s affecting health policy, and the coalition contains more than a few people from San Francisco tech world (Nicole Shanahan, ex-wife of Google cofounder Sergey Brin, being perhaps the most prominent). And if you take a broad view of what constitutes “MAHA,” there are quite a few companies currently building in this space.

Robert F. Kennedy, Jr. was sworn in as Secretary of Health and Human Services in February. Definitely unexpected, definitely a little weird, especially by the standard of previous secretaries of HHS. During Trump’s first term, Alex Azar served as HHS secretary to generally positive reviews. He had a background in pharma and biotech, and he didn’t really make news. 

Kennedy, on the other hand, has embraced making news. He was an unorthodox pick for the largest federal agency by budget (although the vast majority of that budget goes toward Medicare and Medicaid spending, not HHS administration). He negotiated his position in the administration in return for dropping out of the presidential race, where he was running as an independent candidate, and endorsing Donald Trump. He brought with him a coalition of the crunchy left and carnivore diet-curious right, which reflects Kennedy’s background as an environmentalist, vaccine skeptic, and purveyor of roadkill.

This coalition began referring to itself as MAHA (for Make America Healthy Again) and seemed ready to score some obvious and real victories: longitudinal nutrition research funded from neutral, government sources (nearly 1 in 7 nutrition studies published in major journals have industry ties, and those with industry ties are much more likely to have an industry-favorable result); research into chronic disease causes; working across agencies on campaigns to reduce the overweight and obesity that is afflicting nearly 70% percent of active duty service members. These are all goals in line with the Make America Healthy Again Commission, which the Trump administration formed in February. 

So far, though, the only victories seem to be stemming from the social media power of the loose MAHA coalition, rather than the power of HHS.