After voting to confirm Robert F. Kennedy Jr. as health secretary, Senator Bill Cassidy, a doctor and Republican of Louisiana, is embracing “the gestalt” of Kennedy’s measles response.Perhaps no vote was as agonizing for Senator Bill Cassidy, the Louisiana Republican and medical doctor, than his vote to confirm Robert F. Kennedy Jr. as President Trump’s health secretary. Mr. Cassidy wondered aloud for days how Mr. Kennedy, the nation’s most vocal and powerful critic of vaccinations, might handle an infectious disease crisis.Now, as a measles outbreak rages in West Texas, Mr. Cassidy has found out. It all comes down, he said, to “the gestalt.”On Monday, days after the Texas outbreak killed an unvaccinated child, Mr. Cassidy, who chairs the Senate Health Committee, was clipping down a Capitol corridor when he was asked about Mr. Kennedy. He pointed to a Fox News Digital opinion piece in which Mr. Kennedy advised parents to consult their doctors about vaccination, while calling it a “personal” decision.“That Fox editorial was very much encouraging people to get vaccinated,” he said.Reminded that Mr. Kennedy had described it as a personal choice, Mr. Cassidy thought for a moment. “If you want to like, parse it down to the line, you can say, ‘Discuss with your doctor,’” Mr. Cassidy said. “He also said, ‘We’re making vaccinations available. We’re doing this for vaccination. We’re doing that for vaccination.’ So if you take the gestalt of it, the gestalt was, ‘Let’s get vaccinated!’”Mr. Cassidy’s assessment — that the whole of Mr. Kennedy’s message was more than the sum of its parts — reflects how the measles outbreak has put a spotlight on how Mr. Trump’s unorthodox choice to run the country’s top health agency has brought a once-fringe perspective into the political mainstream, creating discomfort for some Republicans.As the founder and chairman of his nonprofit, Children’s Health Defense, and later as a presidential candidate, Mr. Kennedy has repeatedly downplayed the benefits of vaccination. He has also repeatedly suggested that the measles, mumps and rubella vaccine causes autism, despite extensive research that has found no link.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Health Secretary Robert F. Kennedy Jr. announced Wednesday that his department had issued new “guidance on sex-based definitions” aimed, in part, at keeping transgender women and girls out of female sports and fulfilling President Trump’s pledge that the federal government will recognize only two sexes: male and female.“This administration is bringing back common sense and restoring biological truth to the federal government,” Mr. Kennedy said in a statement. “The prior administration’s policy of trying to engineer gender ideology into every aspect of public life is over.”As part of the initiative, the Health and Human Services Department has launched a new web page for the federal Office on Women’s Health. The page, entitled “Protecting Women and Children,” features a video with Riley Gaines, the former University of Kentucky all-American swimmer who says she was put at a competitive disadvantage when competing against a transgender woman.The guidance offers detailed definitions for the words “male” — “a person of the sex characterized by a reproductive system with the biological function of producing sperm” — and “female” — “a person of the sex characterized by a reproductive system with the biological function of producing eggs (ova).”The announcement came in response to an executive order Mr. Trump issued on Jan. 20 that gave the health department 30 days to issue “clear guidance” to the public on how to interpret sex-based definitions. “These sexes are not changeable and are grounded in fundamental and incontrovertible reality,” the order declared.On Tuesday, Mr. Kennedy delivered a welcome address to department employees in which he said his agency would work toward helping Americans “to discover our own paths to living our fullest lives, unleashing the potential in every one of us to make good personal choices that allow us to nourish, to heal and to develop ourselves.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

A core group of so-called disease detectives, who track outbreaks, was apparently spared. But other young researchers are out of jobs.The notices came all weekend, landing in the inboxes of federal scientists, doctors and public health professionals: Your work is no longer needed.At the National Institutes of Health, the nation’s premier biomedical research agency, an estimated 1,200 employees — including promising young investigators slated for larger roles — have been dismissed.At the Centers for Disease Control and Prevention, two prestigious training programs were gutted: one that embeds recent public health graduates in local health departments and another to cultivate the next generation of Ph.D. laboratory scientists. But the agency’s Epidemic Intelligence Service — the “disease detectives” who track outbreaks around the world — has apparently been spared, perhaps because of an uproar among alumni after a majority of its members were told on Friday that they would be let go.President Trump’s plan to shrink the size of the federal work force dealt blows to thousands of civil servants in the past few days. But the cuts to the Department of Health and Human Services — coming on the heels of the coronavirus pandemic, the worst public health crisis in a century — have been especially jarring. Experts say the firings threaten to leave the country exposed to further shortages of health workers, putting Americans at risk if another crisis erupts.Public health officials, for instance, have been tracking a lethal strain of bird flu that they say remains a low risk to Americans. In recent weeks, however, it claimed its first victim in the United States — a patient in Louisiana who had been exposed to a backyard flock.“It’s not canceled,” Elon Musk, the billionaire in charge of the downsizing, wrote on social media in response to the blowback about the purported dismantling of the Epidemic Intelligence Service.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

The No. 2 official at the National Institutes of Health abruptly resigned and retired from government service on Tuesday, in another sign that the Trump administration is reshaping the nation’s public health and biomedical research institutions.The official, Dr. Lawrence A. Tabak, a dentist and researcher, was long considered a steadying force and had weathered past presidential transitions. In a letter that Dr. Tabak sent to colleagues on Tuesday, he did not give a reason for his decision. One person familiar with the decision said Dr. Tabak had been confronted with a reassignment that he viewed as unacceptable.“It has been an enormous privilege to work with each of you (and your predecessors) to support and further the critical NIH mission,” Dr. Tabak wrote.Dr. Tabak resigned at a turbulent time for the institutes, the nation’s premier biomedical research industry, composed of 27 separate institutes and centers that study and develop treatments for diseases like cancer and heart conditions as well as infectious diseases like AIDS and Covid. The N.I.H. spends roughly $48 billion a year on medical research, much of it in grants to medical centers, universities and hospitals across the country.President Trump’s decision to slash billions of dollars in N.I.H. grant funding has sparked a bitter court battle. And the Senate on Wednesday voted to advance the nomination of Robert F. Kennedy Jr., a vaccine skeptic and the president’s pick for secretary of the Department of Health and Human Services, which oversees the N.I.H.Mr. Kennedy has said he would cut 600 N.I.H. jobs.The N.I.H. said it would soon have a statement about Dr. Tabak’s decision.Dr. Tabak was not well-known to the public. But his decision to leave is surprising, and destabilizing for an agency that is on the political hot seat. He was viewed as someone who could work across party lines; he had survived the presidential turnovers of both parties and had indicated he expected to stay on after Mr. Trump was elected in November.Ordinarily, Dr. Tabak would have ascended to the job of acting N.I.H. director during the transition from one administration to the next. But the Trump administration installed another researcher, Matthew Memoli of the National Institute of Allergy and Infectious Diseases as acting director. Dr. Memoli criticized Covid vaccine mandates, as did Mr. Kennedy.As acting director of the N.I.H. last year, Dr. Tabak pushed back against Republicans’ assertions that a lab leak stemming from U.S. taxpayer-funded research might have caused the coronavirus pandemic. He told lawmakers that viruses being studied at a laboratory in Wuhan, China, bore no resemblance to the one that set off the world’s worst public health crisis in a century.Ellen Barry

President Trump on Friday reinstated a longstanding Republican anti-abortion policy known as the “Mexico City Rule,” which bars federal funding from going to any overseas nongovernmental organization that performs or promotes abortions.The move came after he addressed thousands of abortion opponents in Washington on Friday to mark the 52nd anniversary of the Supreme Court’s 1973 decision in Roe v. Wade, which created a national right to abortion and which the court overturned in 2022.Federal law already bans the use of taxpayer dollars to support abortion services abroad. But in 1984 President Ronald Reagan went one step further, blocking foreign aid to nongovernmental organizations that discuss abortion as part of family planning services, or advocate abortion rights, even if those groups are not using American tax dollars to do so.In the four decades since, the policy has had a seesaw history. Democratic presidents, including Joseph R. Biden Jr., have revoked it and Republicans have reinstated it. It has been in effect for 21 of the past 40 years.That Mr. Trump reinstated the ban is not a surprise. When he ran for president in 2016, he took a strong anti-abortion stance, winning the support of Christian conservatives by promising to appoint justices to the Supreme Court who would overturn Roe. In the two and a half years since Roe was overturned, abortion has become a more complicated issue for Republicans, and Mr. Trump did not make it a centerpiece of his 2024 campaign.But Mr. Trump still needs to tend to his party’s right wing, particularly because his pick for health secretary, Robert F. Kennedy Jr., has a muddled record on abortion. While visiting with senators on Capitol Hill last month, Mr. Kennedy promised Senator Josh Hawley, Republican of Missouri, that he would support reinstatement of the policy as part of a broad anti-abortion agenda.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

President Trump moved quickly on Monday to withdraw the United States from the World Health Organization, a move that public health experts say will undermine the nation’s standing as a global health leader and make it harder to fight the next pandemic.In an executive order issued about eight hours after he took the oath of office, Mr. Trump cited a string of reasons for the withdrawal, including the W.H.O.’s “mishandling of the COVID-19 pandemic,” and the “failure to adopt urgently needed reforms.” He said the agency demands “unfairly onerous payments” from the United States, and complained that China pays less.The move was not unexpected. Mr. Trump has been railing against the W.H.O. since 2020, when he attacked the agency over its approach to the coronavirus pandemic and threatened to withhold United States funding from it. In July 2020, Mr. Trump took formal steps to withdraw from the agency. But after he lost the 2020 election, the threat did not materialize. On his first day in office, Jan. 20, 2021, former President Joseph R. Biden Jr. blocked it from going into effect.Leaving the W.H.O. would mean, among other things, that the Centers for Disease Control and Prevention would have no access to the global data that the agency provides. When China characterized the genetic sequence of the novel coronavirus in 2020, it released the information to W.H.O., which shared it with other nations.More recently, the W.H.O. has become a target of conservatives over its work on a “pandemic treaty” to strengthen pandemic preparedness and set legally binding policies for member countries on surveillance of pathogens, rapid sharing of outbreak data, and building up local manufacturing and supply chains for vaccines and treatments, among others.Talks on the treaty broke down last year. In the United States, some Republican lawmakers viewed the agreement as a threat to American sovereignty.Lawrence O. Gostin, a public health law expert at Georgetown University who helped negotiate the treaty, said that a United States withdrawal from W.H.O. would be “a grievous wound” to public health but an “even deeper wound to American national interests and national security.”Founded in 1948 with help from the United States, the World Health Organization is an agency of the United Nations. Its mission, according to its website, is to “confront the biggest health challenges of our time and measurably advance the well-being of the world’s people.”That includes bringing aid to war-torn areas like Gaza and tracking emerging epidemics like Zika, Ebola and Covid-19. The annual budget of W.H.O. is about $6.8 billion; the United States has typically contributed an outsize share.According to Mr. Gostin, it will take some time for the United States to withdraw. A joint resolution adopted by Congress at the agency’s founding addressed a potential withdrawal, and requires the United States to give a year’s notice and pay its financial obligations to the organization for the current fiscal year.

The administration is committing an additional $306 million toward battling the virus, and will distribute the money before President-elect Donald J. Trump takes office.The Biden administration, in a final push to shore up the nation’s pandemic preparedness infrastructure before President-elect Donald J. Trump takes office, announced on Thursday that it is committing an additional $306 million toward efforts to ward off a potential outbreak of bird flu in humans.Federal health officials have been keeping a close eye on H5N1, a strain of avian influenza that is highly contagious and lethal to chickens, and has spread to cattle. The virus has not yet demonstrated that it can spread efficiently among people.The Centers for Disease Control and Prevention says that the current risk to humans remains low, and that pasteurized milk products remain safe to consume. But should human-to-human transmission become commonplace, experts fear a pandemic that could be far more deadly than Covid-19.The Biden administration has already spent about $1.8 billion battling bird flu since the spring of last year; $1.5 billion of that was spent by the federal Agriculture Department on fighting the virus among animals. The remainder has been spent by the Health and Human Services Department on efforts to protect people, according to federal officials.The additional $306 million will go toward improving hospital preparedness, early stage research on therapeutics, diagnostics and vaccines. About $103 million will help maintain state and local efforts to track and test people exposed to infected animals, and for outreach to livestock workers and others at high risk.The funds will be distributed in the next two weeks, Dr. Paul Friedrichs, the director of the White House Office of Pandemic Preparedness and Response Policy, said in an interview Thursday.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Senator Mitch McConnell, the Republican leader and a survivor of polio, issued a pointed statement in support of the polio vaccine on Friday, hours after The New York Times reported that the lawyer for Robert F. Kennedy Jr. has petitioned federal regulators to withdraw the vaccine from the market.Without naming Mr. Kennedy, Mr. McConnell suggested that the petition could jeopardize his confirmation to be health secretary in the incoming Trump administration.“Efforts to undermine public confidence in proven cures are not just uninformed — they’re dangerous,” said Mr. McConnell, who is stepping down as his party’s Senate leader next month but could remain a pivotal vote in Mr. Kennedy’s confirmation. “Anyone seeking the Senate’s consent to serve in the incoming administration would do well to steer clear of even the appearance of association with such efforts.”Mr. Kennedy has said he does not want to take away anyone’s vaccines. His lawyer, Aaron Siri, filed the petition in 2022 on behalf of the Informed Consent Action Network, a nonprofit run by Mr. Kennedy’s former communications director. Mr. Siri is advising Mr. Kennedy as he vets candidates for the Department of Health and Human Services.Mr. McConnell, 82, of Kentucky, contracted polio as a child, more than a decade before the vaccine became widely available. When his left leg was paralyzed, his mother took him for treatment in Warm Springs, Ga., at the same treatment center frequented by another famous polio survivor, President Franklin D. Roosevelt.Although Mr. McConnell eventually recovered, the lingering effects of the disease followed him into adulthood, leaving him with a wobbly, uneven gait. He has spoken often of the experience.“From the age of 2, normal life without paralysis was only possible for me because of the miraculous combination of modern medicine and a mother’s love. But for millions who came after me, the real miracle was the saving power of the polio vaccine,” Mr. McConnell said.

A lawyer working with Robert F. Kennedy Jr. has asked the F.D.A. to withdraw approval of the current shot because it hasn’t been tested against a placebo. Scientists say such a test would be unethical.On the day in 1955 that Jonas Salk’s polio vaccine was pronounced “80 to 90 percent effective” against the form of the disease that caused paralysis, 500 medical scientists and 150 reporters jammed into an auditorium at the University of Michigan for the announcement. Pots clanged, horns honked and factory whistles blew around the country.In the seven decades since, polio — a disease that once killed or paralyzed more than half a million people around the world each year — has been vanquished in the United States.A lawyer advising Robert F. Kennedy Jr. has asked the Food and Drug Administration to revoke its approval of the current polio vaccine, a successor to the Salk vaccine, because it has not been tested against a placebo.Experts say the move would be disastrous, because the polio virus is still around.“We would have big outbreaks of polio,” warned Dr. Walter Orenstein, who ran immunization programs for the Centers for Disease Control and Prevention in the late 1980s and 1990s. Because some people infected with polio are asymptomatic, Dr. Orenstein said, the virus could spread through the population unnoticed — until people started getting paralyzed.The Salk vaccine was tested against a placebo in 1.8 million American first- and second-grade schoolchildren in a so-called double-blind placebo-controlled trial — the gold standard in American medicine, in which half the study subjects get an inert vaccine and doctors, parents and patients did not know who got which.Salk himself objected to the use of a placebo during the clinical trial; he couldn’t imagine depriving a child of a lifesaving vaccine. As the petition before the F.D.A. notes, the current vaccine, manufactured by Sanofi, was not tested against a placebo; scientists and doctors almost universally agree that withholding a lifesaving vaccine would be unethical.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

President-elect Donald J. Trump’s selections to run the nation’s health agencies are alarming infectious disease experts.President-elect Donald J. Trump had already succeeded in rattling the nation’s public health and biomedical establishment by the time he announced on Tuesday that he had picked Dr. Jay Bhattacharya to run the National Institutes of Health. But amid growing fears of a deadly bird flu pandemic, perhaps no one was more rattled than experts in infectious disease.Dr. Bhattacharya, a Stanford University medical economist and outspoken opponent of lockdowns, masking, school closures and other Covid-19 mitigation measures, and Mr. Trump’s other health picks have one thing in common. They are all considered Covid contrarians whose views raise questions about how they would handle an infectious disease crisis.Robert F. Kennedy Jr., Mr. Trump’s choice for health secretary, has said he wants the N.I.H. to focus on chronic disease and “give infectious disease a break for about eight years.” Dr. Martin Makary, the president-elect’s choice to run the Food and Drug Administration, incorrectly predicted in 2021 that the nation was “racing toward an extremely low level of infection.”Dr. David Weldon, a Republican former congressman who is Mr. Trump’s choice to lead the Centers for Disease Control and Prevention, has espoused the debunked theory that thimerosal, a mercury compound in certain vaccines, causes autism. As a congressman, he introduced legislation that would strip the C.D.C. of its role in ensuring vaccine safety, saying the agency had a “conflict of interest” because it also promotes vaccination.And Dr. Mehmet Oz, the talk show host who has been picked by Mr. Trump to run Medicare and Medicaid, prodded officials in the first Trump administration to give emergency authorization for the malaria drug hydroxychloroquine to treat Covid-19. The F.D.A. later revoked the authorization when studies showed the drug carried risks, including serious heart issues, to coronavirus patients.Robert F. Kennedy Jr. has said he wants to focus on chronic diseases rather than infectious diseases as head of the Department of Health and Human Services. Haiyun Jiang for The New York TimesWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.