With his confirmation hearings in the rearview mirror, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. now faces a major test of leadership: extinguishing a long-simmering outbreak of avian influenza. Like many doctors, I disagree with Kennedy on a number of scientific issues—we could not be further apart on vaccines, raw milk, and the relationship between HIV and AIDS. But I also believe that Kennedy—an environmental activist with widespread public support—has an opportunity to transform global approaches to pandemic prevention.
After completing my medical residency, I traded my scrubs for a hazmat suit. For nearly a decade, I investigated outbreaks around the world with the U.S. Centers for Disease Control and Prevention, and in 2020, during the darkest days of the COVID-19 pandemic, former Mayor Bill de Blasio appointed me to lead New York City's contact tracing program.
Those experiences left no doubt in my mind that disease prevention is wildly underfunded. This is as true of chronic conditions—as Kennedy has championed—as it is of infectious diseases. Rather than addressing their root causes, the U.S. government instead plays whack-a-mole as new viruses emerge.
The disconnect is ideological. Many people around the world have come to view humans as separate and distinct from the rest of nature, rather than one part of a vast and interconnected web of life—including microbes such as the virus that causes avian flu.
It's an act of hubris, responsible for millions of deaths.
Spillovers in Big Ag
Here's the reality: All five viral pandemics from 1918 to 2009 resulted from viruses that jumped from animals to people, and with COVID-19, some evidence points to the same. This phenomenon is called spillover, and it's becoming more common, accelerated by the perpetual expansion of unsafe practices when raising farmed animals. If Secretary Kennedy wants to Make America Healthy Again and prevent a repeat of the last pandemic, then his department's work should start outside—in cow pastures, pigsties, and chicken coops.
It's an act of hubris, responsible for millions of deaths
Kennedy takes office in a moment of crisis. Avian flu is spreading among animals throughout the United States, and at least 70 people have already contracted the virus. Its emergence is in part the consequence of the global pursuit of cheap animal protein with little regard for unintended health consequences.
Chickens, cows, and pigs aren't so different from humans. When they're stressed and malnourished, they're more likely to get sick—especially when they're forced to live in a pool of fecal matter.
Agricultural mega-facilities, which can hold hundreds of thousands of animals, are industrial-scale petri dishes. These animals are highly inbred, and this genetic similarity means that if one is susceptible to an infection, they all probably are. In such settings, disease spreads like wildfire.
As pathogens spread, they mutate, growing deadlier and more transmissible. To mitigate this threat, many farm animals are pumped full of antibiotics, which facilitates the creation of drug-resistant super bacteria. Acquiring big bags of these drugs is easy—I have even had one mailed to my home.
Three Steps for Stopping Bird Flu Through One Health
Now is the moment for Kennedy to build on the narrow avian flu plan recently announced by the U.S. Department of Agriculture.
First, he should support agricultural workers on the frontlines. They face the highest risk of becoming patient-zero, yet they often lack paid sick leave, primary care, and basic protective equipment, such as masks and gloves. A champion for public health must also be a champion for workers by expanding rural health-care access and delivering workplace protections.
Second, Kennedy should stand up for science and medicine. The indiscriminate firing of U.S. health staff means that fewer people are working to protect the health of populations. Slashing government research-related funds means that fewer lifesaving treatments will be available in the future—and will leave the U.S. economy worse off. Additionally, pausing communication from U.S. health agencies means that the public loses access to critical data to address health threats.
Now is the moment for Kennedy to build on the narrow avian flu plan recently announced by the U.S. Department of Agriculture
Finally, he should demolish long-standing barriers between the agricultural and health sectors. In medicine, One Health is the idea that animal, human, and ecosystem health are inextricably linked. Kennedy seems to understand this notion—as does Gerald Parker, the new head of the White House pandemic office and former dean for Global One Health at Texas A&M. These two could present an alternative vision for the future of farming—one that is more hygienic, humane, and sustainable. They could pioneer a market-based approach that puts holistic regenerative agriculture on a level-playing field with industrial farming, which has benefited from government subsidies for years.
My time as a disease detective was a whirlwind. I crawled through a bat cave in Nigeria. I vaccinated raccoons from an airplane over Ohio. I deployed to Liberia to work on the frontlines of the largest Ebola outbreak ever. Those experiences helped me rediscover something within myself—a core belief that was buried during years of medical training.
Growing up, my family practiced Jainism, an Indian religion that dates back millennia. The faith's core tenet is that souls should serve one another, and those souls can be found everywhere—plants, animals, even air and water.
No matter our faith, we've all felt a similar connection to other beings before. As kids, we've brought home injured birds in a shoebox and fed stray cats. We've kept pet spiders and smooched snails on the playground. We are born with an instinct that all life on this planet is somehow intertwined. Kennedy, with his reverence for nature and unexpectedly broad appeal, could help people reclaim that feeling—and turn it into lifesaving policy.
