America is watching foodborne illnesses and vaccine-preventable diseases surge while the secretary of Health and Human Services tells us to “eat real food.” The irony is hard to miss.
Jalapeño-linked salmonella has sickened hundreds across multiple states. Cyclospora has produced waves of debilitating illness.
A massive egg recall tied to a multistate salmonella outbreak involved more than 1.5 million dozen eggs. Investigators from the Food and Drug Administration and the Centers for Disease Control and Prevention have linked recalled eggs to an outbreak that, as of late July, had sickened about 100 people in 17 states and hospitalized 26.
These are not abstract statistics. They are parents watching children suffer, businesses throwing away food,
people who don’t feel safe eating a salad or omelet, and a food supply that feels less reliable by the day.
I do not raise these concerns lightly. My public health training and much of my work as U.S. surgeon general focused on chronic diseases – notably, my call to action on hypertension control.
High blood pressure remains a leading driver of heart disease, stroke and premature death. I’ve never believed that chronic disease is a secondary concern. America’s chronic disease burden is crushing – and any serious health improvement strategy must confront it.
That’s why HHS Secretary Robert F. Kennedy Jr.'s past statement that we should “give infectious disease a break for eight years” reveals a fundamental misunderstanding of public health. You cannot effectively focus on chronic diseases while you're being repeatedly overwhelmed by acute infectious outbreaks.
Fighting foodborne illnesses and chronic disease isn't an either-or choice
Uncontrolled salmonella, cyclospora, measles and the next emerging threat won’t step aside so we can concentrate on diabetes or hypertension. Those illnesses disrupt lives, strain hospitals, erode trust and make longer-term prevention far harder.
The recent measles executive order makes that tension even harder to ignore. At a time when measles is resurging, the order calls for major changes to the childhood vaccine schedule, including separating the combined measles, mumps and rubella vaccine into individual shots.
Public health experts have warned that splitting the MMR vaccine and spacing out vaccinations could create additional barriers to timely protection. The immediate concern is measles itself, but there is a broader consequence: Every preventable outbreak consumes the same finite pool of epidemiologists, laboratory capacity, investigators and public health workers we need to detect and contain the next threats, including the foodborne ones.
Secretary Kennedy and I disagree sharply on vaccines, on his prioritizing of infectious versus chronic disease and on certain public health tools. He has been clear about shifting resources away from infectious disease surveillance and response, and his skepticism of what he views as public health overreach.
I respect that he is trying to address real problems. Eroded public trust and America’s chronic disease crisis are undeniable.
But disagreement does not erase data. Outbreaks are rising. Response capacity is reduced. And the secretary holds a unique authority – and responsibility – to act.
Scaling back CDC, FDA and health infrastructure has taken a toll
Some damage cannot be quickly undone. The U.S. Agency for International Development’s dismantling removed significant global surveillance capacity. CDC and FDA staffing is far leaner.
FoodNet, the active surveillance network that tracked foodborne pathogens across an area representing about 16% of the population, was narrowed to focus only on mandatory tracking for salmonella and STEC (Shiga toxin-producing E. coli).
These changes were justified as efficiency and prioritization. Fair enough. The question is whether we are prioritizing the right things as more Americans are getting sick from food and preventable infections skyrocket.
Here are five practical steps Secretary Kennedy can take immediately within existing constraints:
1) Restore full mandatory tracking under FoodNet for key foodborne pathogens, using remaining CDC capacity and state partnerships. FoodNet is the only active, multipathogen system that produces reliable national burden estimates and trends.
It costs little compared with the toll of the illnesses it monitors. Making the other pathogens mandatory again represents prioritization, not a massive new budget request.
2) Fill critical vacant leadership positions at CDC and key FDA food-safety roles with experienced infectious-disease and outbreak-response experts, and give them clear authority. Permanent, qualified leaders improve speed, coordination and messaging.
3) Direct remaining FDA and CDC inspectors and epidemiologists to prioritize high-risk foods and imports – including produce such as jalapeños and leafy greens – and accelerate traceback and recall protocols while expanding state and industry partnerships.
Smart allocation of remaining resources shortens the window between first illnesses and source identification. The recent egg outbreak is a reminder that foodborne threats can emerge from very ordinary foods and spread widely before consumers know there is a problem.
4) Use the bully pulpit for clear, consistent and evidence-based messaging that affirms the established safety and effectiveness of routine childhood vaccines. Measles is overwhelmingly occurring among unvaccinated and undervaccinated people.
The secretary does not need new research budgets to state what the data already shows. He should strongly – not just occasionally and under questioning – support catch-up vaccinations.
5) Even though USAID cuts removed substantial global surveillance, funding and expertise, prioritize remaining HHS and CDC international health-security resources toward targeted bilateral partnerships and rapid data sharing in high-risk regions.
Pathogens don’t respect borders – and detection overseas protects Americans at home.
Uncontrolled outbreaks undermine Kennedy's own goals
These steps don’t require abandoning a focus on chronic disease or government efficiency. They simply insist that infectious threats cannot be wished away.
Secretary Kennedy has said that he wants Americans to eat real food and live healthier lives. Uncontrolled outbreaks undermine both goals.
I have long urged for greater attention to chronic disease while insisting that government meet its basic protective duties to prevent and address infectious diseases. Those ideas are not in conflict.
The HHS secretary has the platform and the authority to act. The outbreaks are already here. The tools and resources that remain can still be used more effectively.
The only real question is whether he will choose to use them.
Dr. Jerome M. Adams is a distinguished professor at Purdue University and a former U.S. surgeon general.
This article originally appeared on USA TODAY: I'm a former surgeon general. Kennedy shouldn't give disease 'a break.'
