Closed-door debut of the MAHA Commission is a shaky start, scholars say

The Make America Healthy Again Commission, established by an executive order from President Donald Trump, is off to an inauspicious start with its closed-door inaugural meeting on March 11, according to the authors of a Viewpoint published today in JAMA Health Forum.

The invitation-only mix of officials and non-officials at the commission’s debut is completely contrary to the emphasis on transparency described in the executive order creating the commission, chaired by Secretary of Health and Human Services Robert F. Kennedy, Jr. But, more broadly, the authors say that thus far the MAHA Commission seems focused on casting doubt on accepted scientific knowledge, promoting tangential issues or unscientific policies—all of which threaten to distract from the well-studied root causes of chronic disease.

The viewpoint is by Lawrence O. Gostin and Sarah A. Wetter, both of the O’Neill Institute for National and Global Health Law at Georgetown University, and Dr. Peter G. Lurie, president of the Center for Science in the Public Interest and a former Associate Commissioner of the Food and Drug Administration during the Obama administration.

Chronic diseases are the leading causes of death and disability in the US, and the need for a national strategy is urgent, according to the authors. Yet they say the idea of “making Americans healthy again” assumes HHS has neglected evidence-based policies—and that the commission can identify the neglected solutions in six months.

Moreover, the commission’s stated priorities depart from the known causes of chronic disease, with no mention of primary drivers such as added sugars, sodium, alcohol, and tobacco. Instead, the order devotes space to various classes of drugs, chemicals, and additives whose relationship to chronic disease is uncertain. Gostin, Wetter, and Lurie go on to suggest eight key policies, including reducing sodium and added sugars in the food supply, mandatory front-of-package nutrition labeling, and nicotine reduction in tobacco products. They also endorse protecting access to important federal feeding programs and advancing proposals for Medicare and Medicaid to cover GLP-1 agonist drugs such as Ozempic and Wegovy.

“America’s outsized burden of chronic diseases demands a comprehensive strategy,” Gostin said. “But if the Trump administration were truly sincere in its goal of chronic disease prevention, it would lead with science. The Commission would be comprised of the leading public health experts on nutrition and physical activity. And it would not focus on Kennedy’s pet peeves that have only marginal impacts on overweight and obesity in the United States.

The Center for Science in the Public Interest, for its part, was encouraged to see Secretary Kennedy recently directed the FDA to “explore” eliminating the loophole that enables food companies to self-certify that food additives are “generally recognized as safe,” or GRAS. Lurie and his co-authors also recommend overhauling the agency’s post-market review of already-approved food chemicals.

But the MAHA Commission is operating in the context of arbitrary and drastic cuts to all of the nation’s health agencies, including the FDA and its newly revamped Human Foods Program. And just today, in a video posted on the social network X, Secretary Kennedy announced a new round of 10,000 layoffs at HHS. According to the Wall Street Journal, 3,500 positions at the FDA, or 19 percent of its workforce, will be eliminated.

“It beggars belief to suggest that this commission will discover long-ignored solutions that have been hiding in plain sight, and that it will do so on a vast array of social problems in a scant 180 days,” Lurie said. “In fact, the scientific evidence on diet and disease has been accumulating for decades, including important research conducted by government scientists. You can either wage war on chronic disease or wage war on the federal workforce, but you can’t do both at the same time.”

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