RFK Jr is a danger to public health – but local Maha laws could be a bigger threat | Katrina vanden Heuvel

Even within the freak show that is Donald Trump’s cabinet, the health and human services secretary Robert F Kennedy Jr has a singular knack for dominating the headlines with the most disturbing sort of carnivalesque spectacle.

In recent months, he’s amplified harmful misinformation linking Tylenol and autism and dismissed the entire CDC vaccine advisory committee, replacing them with skeptics and conspiracy theorists. And even as that agency debated and ultimately scrapped its hepatitis B vaccination recommendation for many newborns, Kennedy courted further controversy for his alleged involvement in a tabloid-fodder love triangle.

But focusing exclusively on RFK Jr’s transgressions risks overlooking the broader exploits of the Make America healthy again (Maha) movement. While his never-ending fount of personal and professional controversies draws national news coverage, a dangerous array of Maha initiatives fly under the radar – including hundreds of state-level legislative efforts to roll back public health advances.

According to a recent AP investigation, more than 420 anti-science bills have been introduced in states across the US this year, primarily targeting MAHA fixations such as immunization, fluoridation and raw milk. Dozens of measures have already become law. In October, Idaho passed its Medical Freedom Act, making vaccine requirements illegal within the state. Arkansas approved a law expanding raw milk sales in April, while Utah and Florida enacted water fluoridation bans.

Some of the most extreme legislation thankfully faces slim odds of passage, like the attempt by Minnesota Republicans to ban mRNA treatments as “weapons of mass destruction”. The bill, which was reportedly drafted not by legislators or public health experts but by a Florida-based hypnotist, would criminalize the distribution of the Moderna and Pfizer Covid vaccines.

Each of these initiatives runs counter to decades of science. US childhood vaccines have prevented more than a million deaths since 1994. Raw milk causes 840 times more illness than its pasteurized alternative, according to 2017 CDC research – and just last month Illinois saw 11 instances of food poisoning apparently linked to raw milk. Fluoride, meanwhile, decreases cavities by 25%.

Why, then, promote such bills at all? While Maha followers are quick to point out the financial incentives propelling major food and drug companies, their movement is also rife with moneyed interests, including several lobbying groups connected to Kennedy himself. The AP also reported on a California farmer, Mark McAfee, who claims to run the world’s largest raw milk operation. He testified in support of a Delaware law legalizing the sale of his product. Unmentioned during his statehouse visit, however, was the fact that his company’s milk has reportedly been recalled eight times and linked to a salmonella outbreak that left 165 people ill. McAfee is projected to take in $32m in sales this year alone. (McAfee says four of the recalls were not related to illness and disputes the number of people sickened in the salmonella outbreak.)

Though state-level anti-science policy may be profitable for its peddlers, it’s profoundly harmful to the American public, and in fact might even yield more long-term damage than RFK Jr’s federal-level wreckage. While future presidential administrations and Congresses can reverse his HHS guidance, repopulate the CDC, and re-fund lifesaving research, state legislation – particularly in states with effective one party rule – can more stubbornly persist.

And unlike many other local policies, regional public health regulations can have irreversible national effects. During the Covid-19 pandemic, lax local restrictions fueled spillover infections across state lines. The ongoing measles outbreak that began in Texas in January has since spread to states including Oklahoma, New Mexico, and Utah – largely through unvaccinated individuals. A virus knows no political boundaries.

Thwarting the circulation of measles, whooping cough, and the disinformation that often precedes their transmission requires urgent public health reform and in states across the country, officials and healthcare experts are attempting to meet this moment. This October, 15 Democratic state executives created the Governors Public Health Alliance to share data and coordinate preparedness efforts. And earlier this year, the liberal PAC 314 Action launched a $25m campaign to elect more science-supporting physicians, nurses and other healthcare workers – not only in Congress, but also in statehouses and governors’ mansions.

Health experts are also attempting to win back public trust in medical advice. In Boston, researchers launched a pilot program that found them partnering with TikTok influencers to share fact-based guidance on weight supplements. Though viral videos will not be enough to restore our endangered measles elimination status, they may help spread medical messaging that is backed by science, yet does not reek of the intellectual arrogance that often accelerates science skepticism.

For when it comes to the epidemic of Maha misinformation, RFK Jr is merely patient zero. To stifle the spread of the anti-vaccine, anti-science ideology that has already emerged in hotspots across the country, it’s going to take a combination of reclaiming traditional political power and winning over hearts and minds on new terrain. In other words: an alternative, holistic approach.

• Katrina vanden Heuvel is editor and publisher of the Nation, a member of the Council on Foreign Relations, and a contributor to the Washington Post, the New York Times and the Los Angeles Times