Dr. Georges Benjamin has seen many infectious disease outbreaks and bioterrorism threats in the near-25 years he's led the American Public Health Association, or APHA, a professional group representing thousands of public health workers and researchers across the country.
But the current crisis hitting the field is different: "I think public health is under attack by our own federal government more than anything else," he says.
The Trump Administration is making deep cuts to staffing and funding for the existing health system, and at the same time, the Make America Healthy Again movement is on the rise. Under the leadership of health secretary Robert F. Kennedy Jr., the movement aims to upend long-held norms in the health system, which Kennedy decries as "corrupt."
MAHA emphasizes tackling chronic diseases with a focus on individual medical choice and comes with headline grabbing, Instagram-famous leaders — and a set of solutions not based on the best available evidence, public health leaders say. Traditional public health, in contrast, has focused on systemic solutions to preventing both infectious and chronic disease.
More than 11,000 public health leaders and researchers convene this week to grapple with these changes, and defend their vision for America's health. The APHA's annual meeting, held in Washington, D.C. for the first time in over a decade, is taking a defiant stance.
In an opening session titled "Mission Possible" focused on rebuilding the U.S. health system.
"This year's mission is clear," said the announcer in a movie-trailer style video introducing the event, "Defend the integrity of public health. Protect vaccinations and immunization systems. Expose and resist political interference. And above all, never let fear win."
Participants flocked between call-to-action sessions such as "Defending Science as a Higher National Value: A National Imperative" and "Attacks on Science and the Public's Health: How We Are Fighting Back," and others on more typical public health topics such as epidemiology, climate change and modernizing data collection. The meeting is scheduled to end with a "Rally for the Public's Health" on the National Mall Wednesday.
Tearing down the system
The Trump administration's policies are "burning the health system to ash," said Benjamin, in his opening statements at the conference.
In an interview, Benjamin elaborated. In addition to cutting staff and funding for public health, "they are also taking apart health care financing and health insurance."
"They're undermining the core systems that we have for people to get good, solid medical care in our country," he adds. White House policies are also interrupting the pipeline for doctors and nurses, and changing tariff policies are making it harder to import drugs and new technologies, he says.
"The question is, three-and-a-half years from now, when the next administration comes in, how do we fix it?" The good news, then, is that it provides a relatively blank slate on which to build a better health system, Benjamin says.
But MAHA, supported by new institutions like the MAHA Institute, a think tank founded earlier this year to influence federal policies, has its own vision for transforming public health.
Their aims include "cleaning up corruption in the health system and restoring the integrity of the public health and medical systems," according to MAHA Institute co-founder and co-president Mark Gorton. "It's not that I'm saying we should utterly destroy public health, but we need to recenter it around truth," he says.
Gorton is not a medical doctor. He founded the tech company LimeWire. He also started Tower Research Capital, an investment firm, and he's been a big supporter of Secretary Kennedy — or Bobby, as he calls him — for years.
But Gorton says individuals can take responsibility for their own health.
"The fact that you have a government which thinks that it knows better than people themselves how best to take care of themselves, and that government bureaucrats are in a position to tell people what to do about their health is quite simply, I think, perverse," he says.
In Gorton's opinion, the U.S. health system is "a fear machine to market pharmaceutical products," the public health system "has a long history of overhyping fake pandemics," and Americans would be healthier if they stopped drinking fluoridated water and getting vaccinated.
Public health leaders say Gorton's assessment of public health measures is misinformed.
"The reason that most of us are alive long enough to be able to complain about public health is because of public health," says Benjamin with APHA.
He notes that public health has saved millions of people from early deaths through improving sanitation, vaccination, and discouraging unhealthy behaviors like smoking.
Understanding MAHA
But public health leaders are listening to MAHA's critiques — and trying to find what common ground they can.
"MAHA doesn't come out of nowhere," says Dr. Carmen Nevarez, a longtime public health leader, and conference speaker. "It comes out of people's lived realities, and circumstances where they felt that something was not addressed correctly."
Health care costs are undeniably high in this country. The COVID pandemic years were hard and isolating for many people. And MAHA influencers are more interesting and fun to watch than traditional public health messaging, says Sarah Story, executive director of the Jefferson County, Colorado Health Department, who spoke on a panel titled "Breaking the Mold: Bold Leaders Shaping the Future of Public Health" at the conference.
"MAHA Moms are great at making life look effortless — they're attractive and fit and their houses are always clean," Story says. "And they're successful at getting their message across because they've tapped into something that is true and valid, that parents are afraid of big corporations poisoning their children."
The approach contrasts with traditional public health, which has been "paternalistic for a couple of generations," Story says. "We've been talking as if we're teaching people," which has been a turnoff to many.
Public health's goals, of achieving optimal health for all, may seem to overlap with those of MAHA, but there are key differences, says Benjamin, of APHA: "Our approach is more evidence-based than theirs." For example, Kennedy has raised alarm about an unproven link between Tylenol and autism and he promoted vitamin A as a broad-based treatment for measles.
And while MAHA focuses on individual freedom, public health does occasionally limit it, says Nevarez. "There's times when you have to say: sorry, you're not just a danger to yourself, you're a danger to others. And that's why we're going to limit your freedom."
When she served as the health officer for the city of Berkeley, Calif., that work included measures like requiring someone with tuberculosis to get treated so they didn't infect others, or shutting down a restaurant with a rat infestation.
"If you live alone on an island, this is not your problem. If you live with neighbors and people in a city with you, it's your problem," Nevarez says.
At this week's meeting, public health leaders are rallying for their own vision for protecting Americans' health.
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