Make Our Children Healthy Again: MAHA Commission releases strategic plan

_{© The White House}

Federal health and agricultural leaders will use a new 128-point strategy report whose title is its goal: “Make Our Children Healthy Again.”

On Sept. 9, the Make American Healthy Again (MAHA) Commission published its second report, following up on the first document published in May. It continues with an outline of actions to address four opportunities for progress: poor diet, chemical exposure, lack of physical activity and chronic stress, and overmedicalization.

The 20-page report has recommendations supporting four key pillars to Make America Healthy Again:

• Driving innovation through research
• Policies to realign incentives and systems.
• Increase public awareness and knowledge.
• Private sector collaboration.

“These four pillars are designed to address root causes and deliver transformative health outcomes for American children,” said Vince Haley, director of the president’s Domestic Policy Council. He served as master of ceremonies for the press conference to announce the plan.

At the top of the list: a new National Institutes of Health (NIH) MAHA Chronic Disease Initiative that leverages and aligns existing research projects. It will improve NIH coordination on chronic disease research, and generate actionable results for diseases arising in childhood and adulthood.

NIH will have a new whole-person-health approach to chronic disease prevention research, supporting the science and interventions that promote wellness, resilience and optimal health at all stages of life.

Health and Human Services Secretary Robert F. Kennedy, Jr., and Agriculture Secretary Brooke L. Rollins, were flanked by top aides working with policies involving medicine, food and the environment. They credited the leadership of President Donald J. Trump for his willingness to promote a national agenda dedicated to health.

Robert F. Kennedy, Jr.
_{© U.S. Department of Health and Human Services}

In his opening remarks, Kennedy recounted varying statistics that tally how the United States spends more money on health care than any nation, yet has the lowest life expectancy and poorer health outcomes than other developed nations. Diabetes and autism rates are climbing. Girls hit puberty at earlier ages. Young men have lower-than-normal testosterone levels and sperm counts, and many cannot qualify for military service, creating a national security crisis.

“This is an existential crisis for our country, and I'm so grateful I work for a president that is willing to run through walls to stop this and to heal our kids,” Kennedy said. “We have the most business-friendly president, probably in history. But there's never been a president in my lifetime that is more willing to challenge businesses when they overreach.”

Effects on agriculture

While the MAHA initiative involves many different elements, the top federal leaders are aligned on the goal, Kennedy said.

Brooke L. Rollins, JD
_{© U.S. Department of Agriculture}

They also have support of MAHA moms and dads across the country, Rollins said. Kennedy touched on agriculture, where food begins, and Rollins discussed the health effects on people.

So far, 12 states have received approval to restrict the sale of junk food as part of the Supplemental Nutrition Assistance Program, and more have an interest. State governors of all political stripes are pursuing innovation in that program. And food processors including Tyson Foods, PepsiCo, Smucker, Kraft, Heinz, General Mills, ConAgra, Nestle and Hershey all have committed to removing petroleum food dyes from their products, Rollins said. The federal government is leveraging its buying power, with the U.S. Department of Agriculture spending nearly $1 billion on healthier foods for food banks and nutrition programs, she added.

Kennedy said some results and changes will take place by the end of the year, and Rollins mentioned a big one: the USDA dietary guidelines that will be published soon.

“Nutrition advice must be sound, simple and clear,” Rollins said. “These guidelines will prioritize whole, healthy and nutritious foods such as whole fat dairy, fruits, vegetables and meats, and suggest limiting highly processed foods and those high in sugar.”

What’s in the plan?

NIH will link multiple datasets through a new “Real World Data Platform,” (RWDP), that aims to create a single integrated dataset for researchers examining chronic disease. It will cut administrative overhead while maintaining rigorous privacy and consent protections for patients.

The federal agencies will expand use of new approach methodologies (NAMs),

Autism and vaccine injury, two pet issues of Kennedy are on the list.

HHS, through NIH and the U.S. Centers for Medicare & Medicaid Services (CMS), will study root causes of autism. HHS and NIH also “will investigate vaccine injuries with improved data collection and analysis, including through a new vaccine injury research program at the NIH Clinical Center that may expand to centers around the country.”

Environmental perspective

The Environmental Protection Agency is supporting a mandate that the American public demands, said Administrator Lee Zeldin.

EPA is “accelerating innovative and vetted crop protection products to enhance an American system of agriculture that is already the best in the world,” while also confronting dangerous imported, banned pesticides, Zeldin said. EPA this year rejected six herbicide products because the requesting company had incorrect information on their applications, and were not responsive to inquiries, he said.

EPA also is committed to gold standard science, and will work to advance precision agriculture with things like computer-assisted spray technologies and robotic monitoring, he said.

A ‘nightmare scenario’ for health

Jay Bhattacharya, MD, PhD
_{© National Institutes of Health}

The United States is in a time when the children of the nation are going to be less healthy and have shorter lives than the generation before, said National Institutes of Health (NIH) Director Jay Bhattacharya, MD, PhD. It is a “nightmare scenario,” he said, but the MAHA Commission action plan has 128 concrete steps out of that.

There is common-sense advice to improve children’s health, such as less sugar in the diet and more exercise. But there also are real scientific issues that need to be addressed, Bhattacharya said. Some examples: rising autism rates, increases of Type 1 diabetes, long-term use of antidepressants in children. Just in nutrition alone, scientific research posited eggs were bad for people due to cholesterol, “but now they’re a super-food,” he said.

How do physicians react?

Martin Makary, MD, MPH
_{© U.S. Food and Drug Administration}

Doctors are thirsty for a fresh, new agenda, said Food and Drug Administration (FDA) Commissioner Marty Makary, MD, MPH.

“We can tell that something's not right,” he said. “We've done a terrible thing to doctors in this country. The health care system has put them on a hamster wheel where we are treating, we're prescribing, we're operating — I was on this wheel — and then we code and we bill, and we're measured by our throughput. And we do get inspired by the might of modern medicine and the drugs that we can prescribe, but sometimes we leave demoralized.”

Despite more prescriptions and surgeries, there are more ailments in patients, Makary said.

“I'm not suggesting it's causal, but the medical community is thirsty to talk about the root causes that we don't talk about because historically, that's just not been a part of the NIH agenda until now,” he said.

NIH sets the research agenda for every university hospital in the country, and researchers are talking about new, big issues, such as the microbiome, food as medicine, micronutrients in soil, microplastics, screen time, “and all sorts of topics that we know are central to the health of kids,” Makary said. He also recounted actions that have taken place in the president’s term to improve health.

Refocusing CDC

HHS Deputy Secretary Jim O’Neill, current acting director of the U.S. Centers for Disease Control and Prevention, said CDCwill refocus on its 1946 million to protect Americans from infectious disease, and will earn the trust of the public through integrity and radical transparency.

COVID-19 was especially deadly due to the interaction between infectious disease and chronic disease, he said.

“Tools that are meant to fight disease, such as vaccines, antibiotics and therapeutics can save lives, can also trigger adverse events in some patients, and that truth must no longer be denied or distorted,” O’Neill said. “We are bringing transparency and research this critical connection.”

Mental health at the forefront

Pierre Yared, vice chair of the White House Council of Economic Advisors, cited the importance of renewed focus on mental health, especially for adolescents.

“We are in a very serious situation when it comes to mental health,” he said. “Based on various metrics, depression, anxiety, suicidal thoughts, we have seen a deterioration of these measures over the past decade, and this is an unacceptable situation. Mental health issues are the number one cause of death for our teenagers, and this is a very significant problem that our nation must address.”

AI in oncology

Technology, and specifically artificial intelligence computer programs, will play a role in medicine, and especially cancer in children and adults, said Michael Kratsios, director of the White House Office of Science and Technology Policy.

“I truly believe that trained on the appropriate data sets, the statistical recognition that constitutes our cutting edge AI models will revolutionize early diagnosis, personalized treatment planning, real time, health monitoring and preventive care in ways that will really transform patient outcomes for Americans of all ages, but especially for America's kids,” he said.