In testimony before the Senate this week, Robert F. Kennedy Jr. made it apparent that he would prioritize chronic illnesses over infectious ones if he were confirmed as secretary of health and human services.
Kennedy told the Senate Committee on Health, Education, Labor, and Pensions on Thursday that we have spent a lot of money on drug development and infectious disease research, but not much on chronic illness.
Kennedy attributed the excessive expense of health care to the prevalence of chronic diseases in the US and said he was in a unique position to stop it. In his introductory remarks, he noted that the prevalence of chronic diseases in children should be given priority, along with the rising incidence of diabetes, cancer, obesity, and asthma. (The National Survey of Children’s Health indicates that about 40% of children have a chronic disease, despite Kennedy’s claim that 66% of children have.)
Kennedy was questioned about his history of promoting conspiracy theories, speaking out against vaccines, and changing his opinions on abortion during his appearance before two Senate committees this week. Some Democratic senators fiercely opposed him, and Sen. Bill Cassidy, R-La., the health committee’s chair and a physician, expressed doubts.
Kennedy, if confirmed, would be in charge of 13 agencies, including the Centers for Disease Control and Prevention and the National Institutes of Health, with a $1.7 trillion yearly budget. Kennedy had recommended an eight-year hiatus from studying infectious diseases like measles and COVID before the hearings.
Kennedy told senators that the federal government spends a lot more money on infectious diseases than chronic ones. However, official records indicate the opposite: With $8.1 billion, infectious illnesses came in ninth on the list of research topics supported by the NIH last year.
In contrast, cancer, a single chronic illness, was given almost the same amount of money in 2024. $8.9 billion was given to brain illnesses.
Numerous other illnesses Kennedy mentioned, such as Alzheimer’s ($3.9 billion), diabetes ($1.2 billion), and cardiovascular disorders ($2.9 billion), also receive billions of dollars in federal funding.
According to Statista, a statistical information firm, federal spending for autism, a chronic illness that Kennedy has incorrectly connected to vaccines and did not deny during the hearings, has increased for more than ten years. The group discovered that NIH funding for autism research increased from $169 million in 2011 to $305 million in 2024.
A large portion of the rise in autism incidence has been ascribed by researchers to increased awareness and improvements in diagnostic tools. Although environmental variables like air pollution and parents having children later in life may also contribute, genetics accounts for a large portion of the risk of autism.
Kennedy is right when he says that the prevalence of other chronic diseases is also rising. Prostate and pancreatic cancer diagnoses are on the rise, as is colorectal cancer in women and men under 65. Between 2012 and 2022, the prevalence of Type 2 diabetes also increased by 19%.
Increases in some chronic diseases may be related to advancements in infectious disease prevention and treatment, which have helped people live longer and survive potentially fatal illnesses, according to Joel Kaufman, a physician-epidemiologist at the University of Washington.
According to him, chronic diseases have replaced infectious diseases as the leading cause of illness and disability in affluent nations worldwide. The success we’ve had in controlling infectious diseases is a contributing factor.
Kennedy’s claims were not addressed by the NIH or the CDC, two significant federal supporters of research on infectious and chronic diseases. The top research organizations for two of the most prevalent chronic illnesses in the United States, the American Heart Association and the American Diabetes Association, also chose not to comment.
Kennedy stated in a number of his letters to senators that he thinks there is a dearth of study on the etiology—the underlying causes and origins of chronic diseases. Kennedy has long been interested in potential links between human health and environmental pollutants.
The National Institutes of Health (NIH) spends a pitiful fraction of its $42 billion budget—nearly nothing—on tackling the obesity pandemic. Kennedy added, “We know it’s an environmental toxin. Why aren’t we committing science to identifying those toxins and then getting rid of them?”
Last year, the NIH allocated about $1.2 billion for obesity research. Although heredity, ultraprocessed food intake, and inactivity are known risk factors for obesity, scientists are beginning to believe that exposure to chemicals like BPA and PFAS may also be a cause.
According to two epidemiologists, investigations on prospective cures frequently receive more money than research into the underlying causes of chronic diseases. According to Dr. Beate Ritz, a professor of epidemiology at the University of California, Los Angeles Fielding School of Public Health, research on environmental risk factors isn’t as common as research on genetics or lifestyle modifications, especially in the field of prevention research.
More research on the effects of microplastics, flame retardants, pesticides, and PFAS, in particular, would be beneficial, she added, for the study of chronic diseases.
We definitely need to conduct more research on chemicals that are present in food, the air, and the water because we don’t know enough about their long-term, low-dose impacts, Ritz said.
Kennedy’s claim that funding for research on infectious diseases comes at the expense of chronic disease, however, is a false dichotomy, according to specialists. Restricting research on bacterial or viral illnesses could hinder efforts to better understand the former, as many chronic diseases are caused by these infections.
Garth Ehrlich, a professor of microbiology and immunology at Drexel University College of Medicine in Philadelphia, stated that there is growing evidence that many chronic illnesses have an infectious genesis. Infectious disease and chronic illness seem to go hand in hand.
According to recent studies, the Epstein-Barr virus may be the cause of multiple sclerosis, a chronic neurologic disorder.Conversely, Parkinson’s disease has been connected to hepatitis C, which is caused by the bacteria H. pylori. Additionally, viruses or bacteria are responsible for up to 30% of malignancies, including cervical cancer.
According to Ritz, we are increasingly seeing that many bugs that do not kill us have long-term consequences.
Despite a wealth of evidence supporting the safety of human papillomavirus (HPV) vaccines, which lower the risk of cervical cancer, Kennedy has repeatedly questioned their efficacy. Merck, a pharmaceutical company, is being sued by his former law firm for allegedly failing to alert customers to the potential negative effects of the HPV vaccine. Kennedy stated in ethics records that he intended to keep collecting fees from those litigation, but he announced on Friday that he would give his son the cash.
On Thursday, Kennedy also expressed support for the study of Lyme disease, another potentially chronic condition that starts with an infection—in this case, from bacteria transmitted by ticks. Given Kennedy’s earlier allegation on a podcast that Lyme disease was a military bioweapon, the topic came up several times throughout the hearings. Kennedy made an effort to disassociate himself from that declaration by stating on Thursday that he would back vaccination research to Sen. Susan Collins, R-Maine.
Kennedy added, “I have had Lyme disease, and no one will fight harder than me to find a vaccine or a treatment for Lyme disease.”