President-elect Trump’s decision to nominate Robert F. Kennedy Jr., a divisive vaccine skeptic and purveyor of disinformation, to lead the sprawling Department of Health and Human Services has raised concerns among academics.

If the U.S. Senate confirms Kennedy, he will oversee many federal agencies, including the Centers for Medicare and Medicaid Services, the Food and Drug Administration and the National Institutes of Health — the largest source of federal research funding for universities, which received more than $30 billion from HHS 2022.

“Over the edge. Down the rabbit hole. Totally crazy,” wrote Jeffrey Flier, professor and former dean of Harvard Medical School, on X in response to Kennedy’s nomination. – I would not have thought this possible until now. Completely independent of politics this must be seen as unacceptable in 2024.”

Ashish Jha, dean of the Brown University School of Public Health, wrote on X that because the HHS secretary “shapes health policy in profound ways,” Kennedy is “an extraordinarily poor choice for the health of the American people.

“Our healthcare system is far from perfect,” wrote Jha, who also served as President Biden’s White House Covid-19 response coordinator. “But it has spurred so much progress that has benefited the American people. This appointment, if confirmed, puts all of that at risk.”

Among the many agencies Kennedy will oversee, he may first turn his attention to the NIH, given his public comments about his plans to downsize the agency on his first day in office.

At an event in Arizona just days before Trump chose him to lead the department, Kennedy said that on Jan. 21, “600 people will walk into offices at NIH and 600 people will leave.” That was reported by NPR. (Nearly 20,000 people work at the NIH.)

In addition to the layoffs, Kennedy has said he wants to shift the NIH’s focus away from infectious diseases, such as COVID-19, and toward chronic diseases such as obesity. Last November, according to NBC NewsKennedy told an anti-vaccine group, “I’m going to say to the NIH scientists, ‘God bless you all. Thank you for public service. We’re going to give infectious diseases a break for about eight years.'”

NBC News also reported that Kennedy, who has spread the discredited claim that vaccines cause autism, said he wanted to force medical journals to publish retracted studies.

“It’s just a jumble of complaints, some of which could have broad ideological support from a more populist agenda,” including things that aren’t “well-grounded in research like his opposition to vaccines,” said David Guston, professor and founding director for the School for the Future of Innovation in Society at Arizona State University. “It provides an opportunity for potentially strange coalitions to emerge around a variety of reforms, some that may be research-based (and) others that could not be.”

Even if the Senate confirms Kennedy, he and other department heads “only have so much room to make changes,” Guston said, noting that what really matters is how they communicate with the public.

“A more potentially damaging situation is the rhetoric and focal point that RFK could provide for a more robust anti-vaccine movement to emerge even among more accepted childhood vaccines,” he said. “It’s going to be problematic vis-à-vis the public because the public doesn’t follow things through the peer-reviewed literature, but through how they’re represented on X or other social media.”

Inside Higher Ed Kennedy could not be reached for comment Friday.

After Trump announced him as his pick to lead HHS, Kennedy said on X: “We have a generational opportunity to bring together the best minds in science, medicine, industry and government to end the chronic disease epidemic. I look forward to to work with the more than 80,000 employees at HHS to free the agencies from the suffocating cloud of corporate capture so they can pursue their mission to once again make Americans the healthiest people on earth.”

Kennedy also wrote that he would work to “return our health authorities to their rich tradition of gold-standard, evidence-based science,” and promised to give Americans “transparency and access to all data so they can make informed choices for themselves and their families.” ”

Trump echoed Kennedy’s sentiments on Truth Social, his own social media network, saying “Mr. Kennedy will restore these agencies to the traditions of gold standard scientific research and beacons of transparency, to end the chronic disease epidemic, and to make America great and healthy again!”

The president-elect has previously said he would let Kennedy go “wild in health.”

Jim Olds, a professor of neuroscience and public policy at George Mason University who led the Biological Sciences Directorate at the US National Science Foundation from 2014 to 2018 and previously worked in the NIH Intramural Research Program, said Inside Higher Ed that Kennedy’s public skepticism towards water fluoridation and vaccines worry him.

“I’m hopeful that if RFK Jr. is confirmed,” Olds said, “his unusual views on vaccines will not be the primary driver of what (HHS) primarily does.”

Although Kennedy’s public criticism of the department has been directed at the NIH, Medicare and Medicaid Services make up the majority of the HHS budget. He is also unlikely to be able to influence NIH funding because final decisions must go through congressional appropriations committees, which during Trump’s first term largely ignored the president’s calls to drastically cut research funding.

And just as the academic community’s deepest fears about the first Trump administration’s calls to cut science funding didn’t pan out, Olds said he “feels very confident” in NIH’s leadership. Between that and the powerful patient interest lobbying groups that support the NIH, he predicted that the agency is unlikely to experience the level of disaster that some are predicting in Kennedy’s appointment.

However, he did not rule out the possibility of Republicans reforming the agency. Earlier this year Republican lawmakers called for a restructuring of the NIH in response to allegedly allowing dangerous experiments during the pandemic.

With Republicans in control of Congress and the White House, Olds said such proposals could “have legs.”

“I wouldn’t be surprised if we see some changes,” he said. “But change has never hurt the NIH. It’s been around a long time and has undergone continuous evolution.”