RFK Jr.'s "MAHA" movement doesn't want to eliminate chronic illness. They want to eliminate the chronically ill.

Public health, modern medicine and disease mitigation will suffer under RFK Jr. because he sees sick people- not sickness- as the problem.

Last week, RFK Jr's HHS made headlines as deep cuts saw over 10,000 staff laid off across the department. The move contrasted with RFK’s claim that he would “end the chronic disease epidemic”- although not with his other campaign promise, to take “a break” from infectious disease research for “about eight years”.

To most logical people, RFK’s two stated ambitions appear to conflict with each other. How can we possibly tackle the chronic illness crisis, while slashing- even halting- funding for medical research into infectious disease? Since 2020, it’s only become more clear than ever that infectious diseases like EBV, HIV, HPV, herpes, syphilis, and now COVID-19 lead to chronic illness.

The answer lies in RFK and his MAHA movement’s broad and basic misconceptions about health, science, medicine, and disease, and their eugenicist fantasies about a world, not free of illness, but free of sick and disabled people.

MAHA, or “Make America Healthy Again”, is an acronym which, like MAGA, harkens back to some temporally ambiguous bygone era when Americans were “healthy” (and great). Never mind that the American lifespan has consistently increased since records began way back in 1860, with the notable exceptions of the Civil War, the Great Depression, and the COVID pandemic. Never mind the invention of vaccines- which RFK himself has been notoriously squirrely when not outright hostile about. Never mind across the board increases in standards of hygiene throughout the 20th century, the introduction of water filtration, pasteurization, and infection control practices.

MAHA wants to “go back”, to “RETVRN” in fascist parlance. Fascist and far-right movements are steeped in nostalgia for things that never happened, happy eras of freedom and glory that never existed; MAHA is no exception. What is it, exactly, that they miss about those bygone eras? What’s changed, what do they want to change back, and how do those things play into their ideas about illness and wellness?

One major difference between the modern approach to medicine and the pre-modern era- the one MAHA seems so obsessed with, with their hankering for “raw” milk, unvaccinated babies, unregulated food stuffs, and unproven folk remedies- is the modern emphasis on prevention and treatment of disease. As in, viruses and bacteria. Another difference is the suite of rights disabled people have won to participate in public life.

Many MAHA adherents do not seem to believe in avoiding infectious disease at all. Take raw milk. It’s milk “straight from the cow” that hasn’t yet undergone pasteurization. Pasteurization doesn’t involve the introduction of any scary-sounding chemicals with long, unpronounceable names; it’s simply the process of heating up milk to destroy bacteria and viruses within. But to hear “natural health” proponents tell it, the process of destroying pathogens isn’t worth the trade-off of destroying potential good bacteria; they claim the unadulterated milk, full of bacteria both good and bad, will boost their immune systems long-term.

These ideas about “building the immune system” echo their beliefs about avoiding vaccines, where again, they believe that disease prevention is a net negative for human health. No studies support these claim, and millennia of human history make a very strong case against it.

MAHA believes that dyes in food can hurt you, as can artificial ingredients, having a bad attitude, failing to get enough sun, eating the wrong foods, eating the wrong amount, sunscreen, lack of exercise, the wrong kind of exercise; all of these things can lead to chronic illness. Diseases on the other hand, the biggest killer of human beings throughout our entire existence on Earth, are good for you. They make the immune system stronger, leaving you better off.

This may seem, logically, odd. Prior to vaccines, antibiotics and modern hygiene, half of babies did not survive childhood, largely due to infectious disease. But their belief system has an internal logic.

To MAHA, sunscreen, pasteurization and food dyes are unnatural, and therefore harmful. COVID-19, measles, the flu, RSV, and any other contagious disease you can imagine are natural, therefore not harmful. Sunlight? Natural, can’t be harmful or cause cancer. Cow’s milk? Natural, can’t really be harmful. Measles? Natural, people should catch it so they can build their immune system. You get the picture. Natural, good. Unnatural, bad.

And when people die doing these “natural” things die anyway, does that suddenly upend their world view? Well, no. Instead, they fold their worldview around these deaths. Death, too is natural, and death too, is good. Take the Texas parents who recently lost their unvaccinated 6-year-old daughter to measles, yet refused to reverse their anti-vax stance, stating “it was her time”. A death caused by something inherently natural and therefore harmless like cow’s milk, sunlight or measles, must have been caused by the inherent weakness of the body, and that too, therefore, is natural. It is the elimination of the weak through natural selection.

In other words, the future MAHA wants is a eugenic one. They dislike that there are so many elderly, chronically ill, weak, overweight and disabled people in our society. Diseases might ensure that those people were, rather than sick, dead.

Liberals act confused about the future MAHA wants; one where people die of common ailments as in the 19th century? But they misunderstand MAHA’s goals. MAHA does not want to save every life. MAHA wants to end the lives of those who can’t survive a world without vaccines, food safety, and hygiene, because MAHA believes that people exist on a spectrum of “weak” to “strong” and that they are the chosen Übermenschen who will survive without those things.

Think of RFK Jr’s strange comments about assessing the “threat” presented by SSRIs, ADHD medications, and weight loss drugs. His concern here is not the medical problem, it’s the medications, which fall into the category of “unnatural”. After his ideas about forcing depressed people to work on farms to “detox” from SSRIs went viral, anti-depressant users were quick to point out that such a project would kill people. To MAHA, killing depressed people who can’t survive without SSRIs is, again, the point. Removing disabled people from society who can’t work productively without medication is the point. That’s not a problem for them, that’s a solution.

Similarly, when MAHA imagines a world without chronic illness, it’s not because they imagine billions of dollars invested in cures for MS, Rheumatoid arthritis or Type 2 Diabetes; clearly it’s not, because their champion, RFK Jr., just cut funding across HHS to no backlash from his base. Rather, they simply imagine that without things like Red Dye #3, sunscreen, fattening fast food and pasteurization, people will stop developing these conditions. As for those who are already sick? Without vaccines, pharmaceuticals, or medical research, the remaining chronically ill will die off. It is “their time”.

MAHA seems to believe that ill health can come only from “unnatural” contaminants (meaning man-made, like sunscreen, “chemtrails” and vaccines), consumption and poor habits. Because consumption and “bad habits” are personal choices, MAHA therefore views health as a personal choice. And in turn, those who develop chronic illnesses or who die of infectious diseases are simply reaping the consequences of their poor choices.

It’s true that well-balanced meals with proper nutrition, clean water and air, and time and space to exercise can contribute to better health outcomes. It’s also true that all of the above correlate with income and access to financial resources. This is where you’ll find that, unsurprisingly, the far-right eugenic thought of MAHA intersects with the racist, classist, jingoist and fatphobic rhetoric of MAGA. It’s not just anyone that will be eliminated by the eugenics of letting diseases rip and stripping funding for social programs. It’s poor people, disabled people, trans people, Black people, indigenous people, immigrants, marginalized people of all stripes.

Of course, while marginalized people will always be more harmed by eugenic policies, it’s not true that well-off ableists will be spared. People also die of infectious diseases randomly, not because they didn’t take their Vitamin D or because they didn’t eat enough kale or because they weren’t on the Paleo diet or the all-meat diet. Anybody can become ill with measles and die; anybody can drink raw milk, get an infection, and die. There’s no special type of person who is immune to pathogens, and if MAHA got everything it wanted, chronically ill and disabled people wouldn’t cease to exist. Instead, as infectious disease flourishes, chronic illness numbers will too.

MAHA seems to believe that by simply allowing “nature” to take over, sick people will die out; you only have to look at all of human history to understand that that, before vaccines and antibiotics, people didn’t “naturally” develop super-strong immune systems making them resistant to measles, mumps and smallpox. They didn’t evolve resistance to cow milk bacteria and skin cancer. They didn’t stop getting sick as the weak died and only the strong survived. Instead, life expectancy was 45 and everyone’s teeth fell out. Many people were “sickly” and home and bed bound.

Of course, disabled people in the past were also denied basic rights that have taken decades and indeed centuries to achieve. Ugly laws targeting the poor and disabled were on the books in the US until the 1970s. Mentally and physically disabled people were kept, often chained and abused in horrific conditions, in asylums from the time of the country’s founding. The deinstutionalization movement only took off since the 1950s. The Americans with Disabilities Act wasn’t passed until 1990.

When we ask ourselves what “healthier” time MAHA is harkening back to, we can be sure they aren’t referring to a time of higher life expectancy or lower child mortality rates. But it may be that they pine for a time when disabled people were segregated from society, and people they consider “weak” died of preventable illness.

It’s worth noting that, while MAHA has quietly been building steam in the background of American political life, chronic illness has been growing at an alarming rate since 2020. But the culprit isn’t SSRIs or sunscreen. It’s COVID-19, which leads to a serious illness called Long COVID and increases your risk of developing dozens of other health problems.

Unlike the wild theories circulated on social media by MAHA moms and meat-eating misogynists, there are plenty of scientific studies that demonstrate this connection. COVID infections are leading to higher rates of cognitive problems, increasing your risk of dementia and Parkinson’s disease. It leads to autoimmune conditions including rheumatoid arthritis, lupus, vasculitis, inflammatory bowel disease, and type 1 diabetes mellitus.

Of course, SARS-COV-2 is not the only virus with post-acute effects. Just this week, the Breakthrough Prize in Life Sciences was awarded to Alberto Ascherio, who demonstrated that an Epstein-Barr infection is the key risk factor for Multiple Sclerosis (MS). In the last half-decade alone, we have made major progress toward identifying a huge piece of the chronic illness puzzle. Viruses and bacterial infections are a major progenitor of chronic illness. Imagine what a game changer that information would be in the hands of a government that actually cared about preventing and ending chronic illness.

Unfortunately, that isn’t what MAHA cares about at all. MAHA cares about their worldview: that health is a personal choice, practiced by superior people. That “clean” food and working out are the only tools needed to accomplish health- not vaccines, masks, air purifiers, or any sort of disease prevention tools whatsoever. Because disease, to MAHA, is a purifying fire that cleanses the population of the weak. And a “healthy” society isn’t a society that prevents illness; it’s a society that embraces it.

Anti-vaxxer ideas are explicitly eugenicist in ways that liberal critiques often elide. For example, liberals will often exclaim disbelievingly that anti-vaxxers are choosing to “risk their child’s life”. But an anti-vaxxer sees it another way: if the child is fit and strong, the child will survive. If the child dies, that is because the child was weak. (And of course, in their mind, since their child is “healthy”, their child is therefore not at risk). This anti-human idea has lately been integrated more broadly into mainstream thought when the topic is COVID. When ongoing deaths and disability from the virus are brought up, this same logic is employed; well, those deaths and injuries are all right, because they happened to weak people. I’m “healthy”, so I won’t get Long COVID.

I wrote previously about how mainstream media’s decision to normalize repeated COVID infections- even as it became clear that long-term disability is a common outcome of a single infection- mainstreamed anti-vaxxer ideas about viruses, immune systems and eugenics. The shared social understanding that COVID is something that “only hurts the weak” and is therefore okay, undoubtedly softened the ground for this same logic to be applied to previously vaccine-controlled viruses like measles.

But this eugenicist logic extends, of course, far beyond COVID. If your loved one doesn’t survive cancer, is that a tragedy because the government cut funding for cancer research? Or, could the argument be made that the government shouldn’t be the business of spending large sums of money trying to help a small group of people who are likely to die soon anyway- isn’t cancer just “nature’s way”? Aren’t cancer patients just, in the words of Anthony Fauci, “falling by the wayside”? Once you start employing the logic of eugenics, isn’t it hard to know where to stop?

Maybe it makes more sense to focus that money on young, healthy people. Keeping them healthy- what RFK calls preventative medicine. But he doesn’t mean preventing infectious disease. He simply means eliminating random chemicals, banning certain types of food, all while cutting regulations and boosting alternative medicine, convinced that this alone will end the scourge of cancer and chronic illness. This, despite the fact that plenty of scientific evidence shows that viral and bacterial illnesses cause a great deal of chronic illness and also contribute significantly to the development of cancers later in life.

It’s critical for people to learn the internal logic of MAHA in order to effectively organize against it, because if you are critical of anti-vaxxers while adopting some of their talking points and central concepts, you ultimately boost their world view. You may be up to date on your vaccines, but do you sneer at the idea that you could end up with Long COVID? Do you refuse to mask because you assume every person harmed by COVID is inferior to you, with your superior eating habits and commitment to the gym? Do you ignore advocates who organize for institutional mitigations like better quality indoor air, because you believe that people who die from COVID don’t really matter the way you do?

All of the above beliefs are in line with RFK Jr. and MAHA’s philosophy about health, wellness, and disease. They are all beliefs grounded in eugenics, the idea that some people are more fit and thus more suited to life. These beliefs are both anti-human and anti-science. It’s not true that feeding your kid every healthy vegetable and every vitamin will protect them from measles. Just like it’s not true that going to the gym 5 days a week will protect you from Long COVID. Disease and disability do afflict the marginalized disproportionately, but they are also random.

Societies are healthy when they work together to protect the collective, not when they individualize health and purposely push the weakest toward harm and death. MAHA fantasizes about reanimating an America that never existed; one where, once disabled people are disappeared from view and the weak die of vaccine-preventable illnesses, everyone remaining will become strong, thin, fit and naturally sunburn-resistant.

Over the past five years, we’ve already seen what happens when “the vulnerable” are left at the mercy of unmitigated disease. It doesn’t make those around them stronger while purging the population of the disabled. It makes everyone sicker, while creating more disabled people than ever before. Eliminating vaccines, ignoring disease mitigation, cutting infectious disease research, banning pharmaceuticals, and institutionalizing people will bring more of the same.