I think we have a huge problem with trust in this country and that predates RFK Jr.

When you have somebody who has made those comments very openly about the CDC not being trustworthy or the FDA not being trustworthy and that's who's leading the health department, I think we're in real danger.

Hello and welcome to GZERO World.

I'm Ian Bremmer and today we are taking a deep dive into medicine and health care and President Trump's second term and what it could mean not just for the United States but for the rest of the world.

In his first few weeks in office, President Trump has issued dozens of executive orders to push for deep spending cuts.

Some of his biggest targets are America's public health institutions like the CDC, the NIH and FDA.

Just as new pandemic threats like bird flu are making headlines.

Trump has already started changing US health policy.

He nominated RFK Jr., a noted vaccine skeptic, to lead the Department of Health and Human Services.

He also withdrew the United States from the World Health Organization, which will impact global efforts to fight infectious disease.

What will the future of health care and medical policy in America look like?

Are Trump's efforts to reshape public health a much needed correction to an overly bureaucratic system?

Or are they the prescription for the next pandemic?

I'm joined by New York Times science and global health reporter, Apoorva Mandavilli.

Don't worry, I've also got your puppet regime.

This just in, former President Joe Biden has signed with a prestigious Hollywood talent agency, and we were in the room for those negotiations.

But first, a word from the folks who help us keep the lights on.

Funding for GZERO World is provided by our lead sponsor, Prologis.

Every day, all over the world, Prologis helps businesses of all sizes lower their carbon footprint and scale their supply chains.

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Cox is working to create an impact in areas like sustainable agriculture, clean tech, health care, and more.

Cox, a family of businesses.

Additional funding provided by Jerry and Mary Joy Stead, Carnegie Corporation of New York.

And...

It's a MAGA world with Donald Trump back in the White House.

But you've heard of MAHA, right?

Make America Healthy Again.

I don't really know how to pronounce that.

A movement popularized by Robert F. Kennedy Jr. after ending his 2024 presidential campaign that was going nowhere.

But after attacking Trump, it went from a fringe slogan to a national rallying cry.

Don't you want a president that's going to make America healthy again?

With RFK Jr. likely to lead the Department of Health and Human Services, the MAHA movement is set to shake up health policy, both for public health officials and for big pharma.

So what is MAHA?

It's a worldview that blends concerns about corporate influence on health care with skepticism towards mainstream medicine, combines wellness culture and vaccine hesitancy, alternative medicine and deep state conspiracy.

The MAHAverse is sprawling.

Its supporters want to take on big medicine, eliminate processed foods, remove environmental toxins and curb vaccine mandates.

It's an ethos that defies ideological boundaries.

Just look at Kennedy's confirmation hearing.

I very much like the slogan that you coined, Make America Healthy Again.

Hear the guy break who says, I just want to follow the science where it leads without presupposition.

I look forward to seeing you help make us healthy again.

Thank you, Senator.

MAHA brings together progressives and libertarians and conservatives.

It unites farmers and fitness influencers, new age environmentalists and entrepreneurs, mommy bloggers, podcast pros.

At its core, MAHA supporters believe that pharmaceuticals, pesticides and processed foods make an American sick, driven by profit hungry corporations.

The cure, exercise and healthy eating, but also unpasteurized milk, unfluoridated water and other ideas at odds with established medical science.

That's what makes MAHA tricky because it blends common sense health advice with pseudoscience and misinformation.

It is fueled by a real crisis, but 40 percent of Americans suffer from chronic disease.

The U.S. spends more on health care than any other country, but has a lower life expectancy than all of its peers among advanced industrial nations.

There's plenty of reasonable stuff in the MAHA agenda, tackling obesity and cutting junk food, addressing root causes of disease, all things that we should welcome, but also traffics and conspiracy, reinforcing the idea that public health agencies are in bed with big pharma to keep people sick for profit.

And this is where the Alex Jones plandemic crowd intersects with the crunchy vaccine safety community.

In many ways, COVID coalesced them from fringe skeptics into a broad movement deeply suspicious of government health mandates.

Why does this matter?

Because Donald Trump has embraced it.

Yes, he loves McDonald's and Diet Coke, but he has also railed against vaccine mandates and pushed his own dubious medical cures.

See hydroxychloroquine and ivermectin.

MAHA is poised to wield a lot of influence over government agencies from the HHS and the CDC to the EPA and the USDA.

And like MAGA and so many broader themes in politics right now, it is a product of collapsing American trust in institutions.

MAGA remade the Republican Party, and MAHA could do the same for health care.

Here to help us unpack how the Trump administration could transform the health industry and what it will mean for the future of U.S. medical institutions and the fight against infectious disease, we have New York Times science and global health reporter, Apoorva Mandavilli Apoorva Mandavilli, welcome to GZERO World.

My pleasure.

So we've now seen you've been reporting quite closely on the RFK Jr. Senate confirmations.

Tell me what you've made of that.

Any surprises as you've seen it?

Well, I expected them to be heated because, you know, he has made a lot of controversial statements and I expected that at least some of the senators would really hold him to those and ask him.

But it really went way beyond my expectations.

It was just so dramatic at times.

You know, we had Senator Maggie Hassan breaking down in tears, talking about her adult son with cerebral palsy and saying, how dare you say things like Democratic senators don't care about what causes autism.

You had Bernie Sanders and RFK Jr. yelling at each other.

You had - - Over pharma funding.

- Exactly.

And, you know, you also saw, I think, some really meaty conversations about the science, about whether vaccines cause autism, which RFK Jr. has maintained that there is a link.

And you saw very clearly, you know, Dr. Cassidy, Senator Cassidy saying, no, the short studies have shown that that is not the case.

Convince me that you now believe that there's not anything there.

And then you saw Rand Paul, another GOP doctor, directly arguing with Senator Cassidy.

So that was very unusual.

So you just had a lot of very dramatic moments.

Lots of lots of surprises.

Lots of places where the Trump administration, where President Trump is focusing on things that are indeed problems, but a lot of disagreements on how one would go about fixing them.

Where do you think RFK is getting it right that something is truly out of whack with the U.S. health system today?

I think it's very, very clear that we do have a problem with chronic diseases in this country.

That's something he talks about a lot.

He doesn't always get his numbers right.

You know, he said things like 48 percent of America's teenagers are diabetic when the real number is point three five percent.

Those numbers are not exactly close.

No, they're astronomically different.

But what he does get right is that those numbers have been going up.

They've been going up for decades and they have been especially going up in kids who are obese.

And even that has been a huge problem.

Now, there are more and more kids who are obese.

And to be fair, those numbers are mostly going down in other wealthy economies around the world.

We are much worse off.

We're not the only ones, but we are much worse off than a lot of other countries.

And we also have just a lot of cancers and they are rising in young people and in women.

So there's it's there's clearly something in our food and our environment, whatever it is that is driving these very unhealthy trends.

And I think he is right about that.

And also that we don't think enough, spend enough money on prevention as we do on treating it after there already is a problem.

Is it fair to say that he has a fundamental mistrust about corporate interests in this area?

I think he does.

And obviously he takes it too far in some arenas, like with vaccines, for example, where he is convinced that all the pharma companies are out to poison all the kids and they don't care how many have died.

He has said things like that.

He has said that about CDC scientists as well.

So he does seem to have this very innate mistrust in large organizations, whether they're corporate or even government.

Interesting that he's going to go be a very big government person.

But he's not wrong about that.

He does say the thing about RFK statements is if you really look at them, there is always a grain of truth in there somewhere.

But I think where he starts to go wrong is when he takes those things and really runs with them.

And I think with the comparing 0.35 to 48 percent, he takes the very real statement he has on his hands and he exaggerates it to a point where it is no longer true.

So let's get into the vaccine point, because, I mean, I certainly have heard a lot of vaccine skepticism from RFK.

In fact, that's how he first got on my screen well before he was running for president.

Has he moderated that now that he's in a position where he has to say nice things to senators to get his job?

Do you buy any of that moderation?

Because, you know, one could make the argument, oh, he just wants to get in.

One could also make the argument, oh, he was saying a lot of this before because it's the way that he gets himself known.

Where do you fall on that spectrum?

He has said a lot of things, and I don't actually think he has walked them back enough.

You know, he in the hearings, for example, he kept making the point that there are all these studies that he knows of showing that vaccines cause autism, for example, even though there were people on the committee, Bernie Sanders, Dr. Cassidy, saying, look, the studies are out there and that is not what they're showing.

He could not budge from his status on that, from his stance on that.

But he did take back some other things.

You know, he has said things like no vaccine is safe and effective, for example.

He did go back on that.

Like the polio vaccine, for example.

Things that we need children to take because otherwise we're going to have big problems.

Yes, exactly.

And he's now OK with that.

You're saying that this is something that as head of Health and Human Services, you would expect that he's not going to be a problem on those baseline continued vaccine programs for kids.

I wouldn't go that far.

You wouldn't go that far.

No.

And I don't think we can be certain that if, you know, as the head of HHS, that he's not going to do things that actually undermine vaccines.

I don't think we can assume that vaccines are sacred and will not be touched.

Now, I remember during the pandemic in Brazil, when Bolsonaro, Jair Bolsonaro was in charge, he was quite skeptical on vaccines.

Yet the country has had very strong health care programs.

And as a consequence, you had enormous amounts of basic trust in doctors and science.

Where's the United States compared to that?

I think we have a huge problem with trust in this country, and that predates RFK Jr.

I mean, I don't think that he's going to create that problem, but we already are going into it.

You know, if you talk about Bolsonaro, COVID was a very big part of when he was really making a lot of misstatements about COVID and about the vaccines.

Right.

We did not come out of that entire era with a great deal of trust in the public health establishment.

And so now when you have somebody who has made those comments very openly about the CDC not being trustworthy or the FDA not being trustworthy, and that's who's leading the health department, I think we are in real danger of having people say even more.

I don't trust anything that's that was said previously about any of these things.

I'm just going to go with what that guy is saying.

What does vaccine skepticism look like in the United States right now?

How much of a present day problem is it?

It's a growing problem.

So during the pandemic, the vaccination rates started to slip for other reasons, logistical reasons, but they haven't come back up.

You know, from what to what?

Give us a sense of what it looks like.

So we say for heart immunity, which is the rate at which, you know, the population, a community is protected, you need 95 percent of kids to be vaccinated for polio or for measles.

And we fell to 93 percent, which doesn't seem like a lot across the country.

And that doesn't seem like a lot to percentage points, but that's hundreds of thousands of children.

And if you look state by state, because it's the states that set the vaccination policies, there are states where the rates of exemptions have really gone up quite a lot.

And now you've got states like Louisiana saying we're not going to promote vaccines if you want to go get them.

That's fine.

We're not going to provide the information.

And I think we're going to see a lot more of that.

Let me ask you about another issue that's come up recently, which is the World Health Organization.

Trump in his first term briefly pulled the US out of the WHO.

Now that seems to be made permanent.

One of the first steps he's taken.

World Health Organization originally established by the United States and allies, part of the U.N. system.

The U.S. has been principal donor to the WHO.

What are the implications of withdrawal?

Huge.

How so?

The WHO does a lot of things that I think we don't really think about a lot in this country.

I mean, let's talk about the rest of the world for a second, but it does also matter to Americans and I'll explain why.

But in many parts of the world, they don't have their own CDC, they don't have their own FDA.

And the WHO essentially plays that role.

It provides health guidelines just like the CDC does for us.

It approves drugs just like the FDA does for us.

And so when the WHO loses its money, its funding, and the U.S. is its biggest donor, so when they pull out, the WHO is a lot poorer.

Those things are really going to hurt.

And we Americans, we also benefit from the WHO.

So the WHO comes up with a diagnostic code system that we use here.

The ICD, it's called.

Every doctor, every insurer uses this.

It also comes up with chemical names for drugs, you know, antibiotics, like you might know it as amoxicillin, might be sold as something else in another country, but as long as you know that's what it is, you can get it anywhere.

And one of the big things that it does is every fall, we get a flu vaccine.

And that is based entirely on information that's collected by the WHO.

Globally, through its massive surveillance network.

Now we might still be able to find out what that information is, but we would essentially be freeloading and not actually contributing to the conversation.

So we would have no say in it, and we would be bystanders in this process.

And then suspension of support, USAID, you know, I see PEPFAR, for example, South Africa right now, a big part of the HIV prevention and fighting budget around the world.

What do you think the implications are of all this?

Where do you think the rubber hits the road?

USAID is basically dead.

That's what it's looking like.

It's subsumed into the State Department.

The office has been shut down.

Well, it's assumed that the State Department isn't dead, right?

I mean, the money still gets potentially spent, right, since Congress.

Potentially.

I mean, a lot of it.

But I'm just saying, we don't know that yet.

The USAID is dead in its current form.

Let's put it that way.

It's going to look very different, whatever it is.

What does that mean, though?

What does different mean?

I think they're seen as giving money away to all kinds of things that are unimportant.

And you know, Elon Musk, for example, has said they're criminals.

And they, a lot of the top leaders in the organization have been let go, have been fired.

There are people who can't even access their own email accounts.

There's a lot going on there that I think really has been quite disruptive.

And they're not allowed to talk to any of their partners in various countries.

Again, there's this perception that everything that USAID does is for the benefit of other people and not Americans.

But some of what USAID does is very important to us.

So, you know, there have been at least about a dozen Ebola outbreaks in Africa in the last few years.

There have been something like...

Including one right now.

Including one right now in Uganda.

And there's been about 20 swine flu outbreaks.

And USAID helped contain those.

And those, if they come here, could decimate our agricultural industry.

Ebola, if it comes here, would be a huge public health disaster.

There's Marburg, another infectious disease that's very similar to Ebola, another hemorrhagic fever going on in Tanzania.

And USAID is often on the ground in those situations, helping to contain those outbreaks.

And that's something that could very directly affect us.

I'm seeing more concern about bird flu these days, including here in the United States.

You've said that we need to take it more seriously.

Why is that?

Because we should.

But specifically?

I mean, give us a sense.

So a lot has changed in the last few months with bird flu.

You know, as you may know, there's been this virus, H5N1, one of the bird flu viruses, circulating in the U.S. since early 2024.

It's been in dairy cattle.

It's been in wild birds, but spilled into dairy cattle at some point.

And now it's in herds all over the country.

So that was already a big problem.

There have been a couple of human cases that we know about, right?

67.

Yeah.

And so what has changed is that in June, we had three cases.

Now we've had 67.

So there's been a big increase in that.

And now there are two versions of this virus that are circulating, and one of them is pretty new and it's already in wild birds all over the country.

And so that... And is this a potentially likely fatal disease in humans?

We don't actually know.

I mean, that's one of the problems.

It has been fatal, you know, elsewhere in the world, it's been fatal.

And here we've had one case so far.

But we don't know exactly what the death rate would be, for example, because A, there haven't been enough cases for us to know that, and B, surveillance has been just really, really poor.

So we don't actually know what this virus is doing, how it's evolving, how widely it has spread.

We have a vague sense.

But that first death was quite a wake-up call.

It was in a person in Louisiana who was over 65 and had some underlying conditions.

But then there was also a teenager in Canada who was 13.

She was very obese.

But beyond that, no risk factors.

And she was ill and hospitalized with organ failure for weeks.

So this virus could actually be quite bad for a lot of people, but we don't have a very good lens on what it's doing.

So that's one of the reasons I think that scientists are quite worried.

But now you have this virus that's clearly changing, and having two versions run around is never a good thing because flu viruses are very good at what we call reassortment, mixing and matching, and picking up new mutations.

And also we have seasonal flu going on.

So if you had a person who became infected with bird flu and became infected with the seasonal flu, bird flu could pick up the ease with which seasonal flu spreads.

And then off we go, spreading among people.

So the idea that it's now in cows and it's been in cows and it's not going anywhere, that means we are probably looking at a permanent scenario of farm workers being exposed to this virus and for that virus to then have a lot of opportunities to mutate and become adapted to people.

Now, we've just gone through an unprecedented pandemic.

It's been the most disruptive episode for our lives for pretty much almost everyone around the world.

Surely the United States is in a better position coming out of that to respond to another pandemic were it to occur.

Tell me that's true.

It's not true.

It's not true.

Well, how is that not true?

Coming after like three years of pandemic in this country?

Well, you saw it play out.

You saw exactly what people were willing to do and what they were not.

And it's not that scientifically we're not able to do it, but from a policy perspective, whether states and even the federal government is willing to do the things it needs to do and whether citizens are willing to do the things they need to do.

I think that's where the response is really going to fall down.

So given that there has been a lot of political opposition to the way COVID was handled by many of the officials that are coming in, what do you think that might mean for a bird flu epidemic were we to see one?

I think it actually could be quite tricky.

RFK Jr. really is a proponent of raw milk, which is full of virus actually at this point, bird flu virus.

And health officials say that raw milk is dangerous to drink, but he has continued to support it, for example.

We have bird flu vaccines that are in the federal stockpile, and he has said those are dangerous.

Asked about it in the hearing, he did say that he would support whatever vaccine, but again, he's been so anti-vaccine so many times over the years, it's really fully hard to believe that.

He's definitely opposed to mRNA, which would be our fastest, most efficient way to get to a vaccine.

And even the other nominees, Jay Bhattacharya, who's supposed to head the NIH, Marty Makary, who's supposed to head the FDA, they have been at times huge critics of how COVID was handled, not always without basis, but certainly they're not big fans of the big public health measures that were taken.

So it's really quite an open question what would happen if we had to have a big bird flu epidemic or pandemic, how they would actually deal with it and whether they would support the things needed to contain something like that.

I mean, I understand why lots of people would have problems trusting the media, trusting the political leaders, trusting corporate leaders.

Trusting doctors seems to be kind of fundamental.

It does feel like in the United States right now, when we talk about the CDC, we talk about Dr. Fauci, we talk about the politicization has gone into an area that heretofore really was off limits for that, or at least it felt that way.

Am I right about that?

You're partly right.

And here I actually get to say something positive.

I don't think that trust in doctors is as bad as you might think.

I think surveys have actually shown that even now, even with all of the partisanship and all of the negativity, people do trust their own doctors.

That has not really gone away.

They may have feelings about Dr. Fauci, but their own doctor, generally people do trust them.

And it might surprise you to hear that in a recent survey, Americans actually said that they don't think we're doing enough to prepare for pandemics.

So who knows, they might still surprise us all.

Apoorva Mandavilli Thanks for joining us today.

It's my pleasure.

And now we head to a land where the biggest medical mystery is how its population moves around without legs.

I've got your Puppet Regime.

Just in, former President Joe Biden has signed with a prestigious Hollywood talent agency and we were in the room for those negotiations.

Mr. President, we couldn't be more excited about this opportunity.

What did you have in mind?

Not much these days, but let's see, Barack Obama got those nature documentaries.

That could be fun.

The majestic northern moose surveys the...

I once knew a fella named Moose, Mookey Monticello back in Scranton, Pennsylvania.

He used to sell whistles down by the train station.

I love it.

It's giving brain rot, but in a good way.

What else?

How about an action movie?

An action movie.

I love it.

And you could do your own stunt.

Yeah, you already know I know how to ride a bicycle.

Anything else you'd like to try?

How about a comedy special?

How's your comedic timing?

Well, I did wait until July to drop out of the presidential race.

Someday that'll seem funny.

- Puppet Regime That's our show this week.

Come back next week and if you like what you've seen, or even if you don't, but you want raw milk, a lot of raw milk, we can get that for you.

Why don't you check us out at gzeromedia.com.

Funding for GZERO World is provided by our lead sponsor, Prologis.

Every day, all over the world, Prologis helps businesses of all sizes lower their carbon footprint and scale their supply chains with a portfolio of logistics and real estate and an end-to-end solutions platform addressing the critical initiatives of global logistics today.

Learn more at prologis.com.

And by Cox Enterprises is proud to support GZERO.

Cox is working to create an impact in areas like sustainable agriculture, clean tech, health care and more.

Cox, a family of businesses.

Additional funding provided by Jerry and Mary Joyce Stead, Carnegie Corporation of New York and (upbeat music)