Meidas Health, Episode 13: Trump's First Surgeon General Speaks Out

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Speaker 2 Rules and restrictions apply. Hi, Mighty Smitey.
Welcome to episode 13 of Midas Health. This is a great episode that we have in store for you.
I have my first co-host, Anjali Kalmani of Yahoo News.

Speaker 2 She's a senior health reporter for Yahoo News, a dear friend. We also have one of our country's most distinguished healthcare leaders, Dr.

Speaker 2 Jerome Adams, the 20th Surgeon General here to talk about all matters, health and health policy. Without further ado, I'm going to bring in Dr.
Adams and Anjali. Thank you both for being here.

Speaker 2 Hey, glad to be with you today.

Speaker 6 Same.

Speaker 2 Awesome. So, you know, for our listeners here, Anjali is joining me as a co-host for this episode.
I think we're going to try this out.

Speaker 2 Just given that, you know, one person often isn't enough to really make sure that we're answering and are asking all the right questions. So, Anjali, I really appreciate you being here.

Speaker 2 I don't know what that means about me, guys, that you needed two people to

Speaker 2 ask me questions, but we'll see how this goes.

Speaker 6 I know, I know. You're going to feel all the pressure.
I can't wait for this. I'm so glad.
Thank you so much, much, Ben.

Speaker 2 Yeah, I'm delighted. You know,

Speaker 2 first of all, Jerome, I know it's been a pretty sobering week. You've been quite outspoken.
I just wanted to give you the floor to speak to our listeners about how you're doing.

Speaker 2 Well,

Speaker 2 I'm feeling okay. I'm hanging in there to give context because you never know who's going to be listening to this or when.

Speaker 2 Last Friday on August 9th, a gunman opened fire at the Centers for Disease Control

Speaker 2 and Prevention headquarters in Atlanta.

Speaker 2 And at least as far as preliminary reports, they suggest that the shooter may have been motivated by anti-vaccine sentiment. So I'm very concerned that this tragedy isn't an isolated event.

Speaker 2 I see it as a reflection of ever-escalating threats public health workers face in a climate that's being shaped by misinformation, politicization, and inflammatory rhetoric.

Speaker 2 And unfortunately, much of that is coming from our current health leadership. So I'm in a moment where I'm fearful as a public health worker and

Speaker 2 someone who

Speaker 2 every day is going into the hospital or going into the clinic or going into

Speaker 2 work at Purdue University trying to improve public health. I'm concerned for my friends and colleagues at the CDC, at the NIH, at the FDA.

Speaker 2 And I'm concerned for our country and our citizens because we're in a moment where instead of tamping down

Speaker 2 the rhetoric and really trying to bring people together, it seems that our current health leaders are intent on throwing gasoline on the fire. An example of that is this event happened on Friday.

Speaker 2 It took 18 hours for our health secretary to issue a statement. on Twitter

Speaker 2 condemning the violence.

Speaker 2 But as I said very publicly, it was a tepid statement

Speaker 2 that literally excused people if

Speaker 2 they felt like the CDC and the federal government was not serving them. It gave them an out in terms of the violence.
And in the meantime, the secretary posted a picture of him fishing,

Speaker 2 but didn't say no violence, didn't say I support

Speaker 2 the people I'm supposed to be leading at the CDC, didn't say this is unequivocally

Speaker 2 unacceptable. And then you had the NIH director, the current NIH director, Dr.
Bhattachara, on earlier this week,

Speaker 2 Monday or Tuesday of this week, put out an op-ed doubling down on, quite frankly, falsehoods regarding mRNA vaccines.

Speaker 2 And so I don't want to take up all of our time talking about this, but literally people are being shot at. And at least one person,

Speaker 2 the officer who responded to that attack, David Rose, was killed because of this current environment that we're in.

Speaker 6 Jerome, I wonder, I mean, considering that you have been part of a prior administration with, you know, Trump in the hot seat, you yourself have been part of the health leadership before.

Speaker 6 How does this term differ from what you experienced? Because there was a lot during COVID.

Speaker 6 There was a lot of anger and there was a lot of frustration from the public, but I don't think it manifested in the way that we're seeing now.

Speaker 2 Well, there's a saying in politics and in life, never waste a good crisis.

Speaker 2 And I don't want to oversimplify things, but I think a lot of people politically have tried to leverage our once-in-a-century pandemic, which would have been difficult by any measure to deal with,

Speaker 2 into a political advantage. And to be frank, both Democrats and Republicans have done this alternatively.
I was just doing an interview where I pointed out that in 2020, the two highest profile

Speaker 2 people to say they wouldn't trust the vaccines were Kamala Harris at the vice presidential debate and

Speaker 2 Governor Cuomo of New York City, who literally said, I'm going to not trust the FDA on this.

Speaker 2 I'm going to stand up my own review committee before I say COVID vaccines are safe for the people of New York. Now, that said,

Speaker 2 what you're seeing right now is a climate where politics is about pulling together coalitions to get to 51%.

Speaker 2 And the current administration has pulled together a coalition of folks who were in the MAGA camp,

Speaker 2 who are traditional

Speaker 2 conservative Republicans.

Speaker 2 And there's a big difference between those groups. But then also a coalition that includes what are now self-described as Maha,

Speaker 2 the Kennedy followers. And they're a very interesting constituency because

Speaker 2 Kennedy started off running as a Democrat and then he shifted to be a third-party candidate. And he found that the best way to advance his agenda was essentially to assimilate into and co-opt.

Speaker 2 the Republican Party.

Speaker 2 And in many ways, that's what's happened from a health standpoint. So you asked what was different.
What was different is in the first administration,

Speaker 2 there were debates about health and health policy, but there were never debates about whether or not we trusted vaccines.

Speaker 2 Donald Trump trusts vaccines. He's vaccinated.
His kids are vaccinated. I've had conversations with him about it.

Speaker 2 HHS Secretary Azar during the first administration, when we had a measles outbreak, said unequivocally, vaccines work, they are safe, and people should get vaccinated.

Speaker 2 These were things that we actually saw our leaders do and say and emulate in the first administration. And now you're seeing RFK

Speaker 2 being given permission to do

Speaker 2 to do whatever he wants.

Speaker 2 Trump said, I'm going to let RFK run wild on health. And he's holding true.
to his word right now.

Speaker 2 You saw the Advisory Committee on Immunization Practices get disbanded and replaced by people

Speaker 2 who have a history of profiting off of misinformation. Robert Malone,

Speaker 2 who was named to that committee after the CDC attacks, said very provocative things about

Speaker 2 public health workers and really doubling down on the dangerous rhetoric. And that's someone who's been named to replace the people

Speaker 2 on the ACIP committee. He unilaterally removed recommendations for pregnant women to get the COVID-19 vaccine.

Speaker 2 He pulled $500 million

Speaker 2 in funding for mRNA, which

Speaker 2 vaccines, which doesn't just affect vaccines. mRNA technology is being used to develop cures for cancer and rare diseases like cystic fibrosis.
And so again, you're really seeing RFK coming forward

Speaker 2 with a lot of what he's been doing and saying. for well over a decade as the head of an anti-vax group,

Speaker 2 but it's being put into the mainstream because he's now the most powerful person on the planet in terms of health. When you look at the influence and the financing that HHS has.

Speaker 6 Right. And I know we've talked about that broadly.
You know, in the past, there have been discussions. We've been talking, you know, as a society and as a country about the

Speaker 6 decrease of interest in vaccinations.

Speaker 6 I'm curious about, you know, the rest of the leaders you called out, Dr. Bhattacharya.
I know that there's also Marty Makari over at FDA. There are others who are surrounding him right now

Speaker 6 in reference to RFK.

Speaker 6 And I just wonder, having been in the position yourself where you may not fully agree with the leadership and those who are on the ladder above you, you've been more vocal now than in the past.

Speaker 6 What can you tell us about putting yourself back in that position about maybe what is the priority in terms of keeping your position and trying to do as much as you can in that seat versus disagreeing and going out on a limb and kind of defending your position?

Speaker 2 Well, it's a great question. And it's a question I get from audiences and people who are interested in leadership roles all the time.
And what I say is every job has guardrails.

Speaker 2 Every job, you have a boss. Every job.

Speaker 2 is going to have pros and cons. And when you think about these major health positions,

Speaker 2 you go in and they're political appointments. So number one,

Speaker 2 if you want to get the job and keep the job, that doesn't happen by you going out there and literally just setting fire to

Speaker 2 the platform of the party and the person who brought you in. That is just a fact.
I deal with that, you know, dealt with that when I was surgeon general.

Speaker 2 And I deal with that every day when I'm working as a anesthesiologist in the hospital. I can't go out and say my boss sucks and this institution is doing terrible things.

Speaker 2 Now that said, I can tell you personally that

Speaker 2 I have said to

Speaker 2 people above me in the past,

Speaker 2 I will never lie to you and I will never lie for you. And I'm proud to say that

Speaker 2 I held up to that standard throughout my time serving the Trump administration. And I've worked for three Indiana governors

Speaker 2 and I've said that. Meaning, I'm going to tell you the truth behind the scenes so that you understand where I'm coming from, because my job is to be your health advisor.

Speaker 2 I also understand that the final decision may not come down to what I say is best from a health perspective, because everything has

Speaker 2 multiple variables. So, COVID is a great example of this and a lot of the frustration around COVID.
People die if you don't take COVID precautions. That's a fact.

Speaker 2 People also die if you go overboard with COVID precautions and you shut down their opportunities to earn an income and

Speaker 2 they can't put food on the table. They can't pay their rent.

Speaker 2 Those are very real trade-offs. And so I say that because you're not always going to get your way.
But for me, it was always about: do I have the opportunity to give input?

Speaker 2 And if you decide something different than what I tell you, then don't expect me to go out there and defend it

Speaker 2 as your health. representative.
What concerns me about the folks who are part of this current administration, I know some of them,

Speaker 2 but

Speaker 2 it seems like in many cases, they are, whether they believe it or not, are willing to go out there and actually continue to spread myth information that RFK Jr.

Speaker 2 has

Speaker 2 also been spreading. And so that's what's terribly concerning to me.
The mRNA situation is a great one.

Speaker 2 If you don't agree with them on that, fine, but don't go out there and put out an op-ed

Speaker 2 saying things that just are blatantly untrue if you're the NIH director.

Speaker 2 And so that's what concerns me is that you have folks who either who are in these high-profile positions, who either just don't understand the science or who are willing to

Speaker 2 go along with the spread of misinformation for the sake of

Speaker 2 maintaining their position in the administration. One of the best pieces of

Speaker 2 advice I got was a long time ago when I was asked to be Indiana State Health Commissioner, and a former health commissioner told me, Make sure you have your resignation letter filled out on day one.

Speaker 2 And what he meant by that is, you have to understand where your guardrails are, and you've got to be prepared to walk away if you disagree.

Speaker 2 During my time as Surgeon General, I always felt that I was doing more harm than good. And as I mentioned, I also never went out there and lied or misled on behalf of the administration.

Speaker 2 And

Speaker 2 I can't speak for them personally, but I have to feel like some of the folks in some of these positions in NHHS are getting perilously close to crossing that line.

Speaker 2 Jerome,

Speaker 2 your candor is,

Speaker 2 as always,

Speaker 2 I think it's just

Speaker 2 so welcome and it's really appreciated.

Speaker 2 I know we've talked about this. You were in an impossible situation.
I think it's easy for everybody.

Speaker 2 And

Speaker 2 I remember saying this to you directly when I saw you for the first time in person a few years ago at an NBA event.

Speaker 2 It was easy for me and others in the peanut gallery to quarterback and opine, oh, you were in the hot seat. All eyes were on you.

Speaker 2 I am curious, a few years now removed from your role as Surgeon General, do you think knowing what you know now, would you have taken that position if knowing what you know now? Absolutely.

Speaker 2 Absolutely. I mean, I would have.
And so here's the thing.

Speaker 2 Number one, I was the second African-American male

Speaker 2 to serve as Surgeon General in history

Speaker 2 in over 200 years.

Speaker 2 And so when you get asked to do something historic like that, where you get to go and represent not just yourself,

Speaker 2 but an entire group of people who have been underrepresented throughout the history of of this nation.

Speaker 2 It's going to take a lot to say no to that.

Speaker 2 And I can't tell you how many times since then, since my time as Surgeon General, people have come up to me and told me how much it meant to them to see me on TV, to see me at the White House, to see me commanding the attention of the most powerful person on the planet and sharing my perspective.

Speaker 2 I got to talk about my asthma. I got to lift up substance misuse disorder and the the story of my brother who suffers from addiction.

Speaker 2 I got to promote a naloxone advisory that has saved countless lives. We know naloxone dispensing went up 400% after that advisory.

Speaker 2 During the pandemic, I was involved with Operation Warp Speed, helping increase diversity in those clinical trials.

Speaker 2 They ultimately ended up being the largest and most diverse clinical trials in history.

Speaker 2 So, as I mentioned earlier, there's always trade-offs, but I feel like I was able to do a lot of good and a lot of unique good. And alternatively, interestingly enough,

Speaker 2 you see right now in this moment, the cost of me not having been there. And that's a very

Speaker 2 interesting phenomenon that's occurring right now. When I was surgeon general, As you mentioned, it was easy for people to say, well, you should just leave.
You shouldn't be there.

Speaker 2 You're propping him up. They didn't see the harm that would have been done had I not been there.

Speaker 2 And that's the problem with public health, interestingly enough, is no one sees the harm that was averted. No one sees the measles case that was prevented.

Speaker 2 They only see the harm that's going on in the moment.

Speaker 2 But now you literally see the harm that's being done when good people, when people with the background and experience to actually give good and sound advice to our leaders aren't there.

Speaker 2 I want to give you your flowers here for a second.

Speaker 2 And just for all our listeners who may not know this about you, of course they know you as the former surgeon general but part of the reason you you were picked for that role is you did incredible work jerome in 2015 in addressing uh a a massive outbreak hid outbreak in scout county indiana i'm just looking at some of my notes here um which was linked to injection drug use um and you helped implement a needle exchange program to curb the spread of hiv

Speaker 2 um and that work i have to say i i remember reading about it in real time deeply admiring it i admire that about you there's real substance here. You're practicing anesthesiologist.

Speaker 2 You're the type of person that should be in that role.

Speaker 2 And I think, yeah, and I do think a lot of people sort of piled on because it was easy to pile on.

Speaker 2 I am curious, when you see what happened last week, you know, I see this as a pulmonologist, the way that Kennedy is talking about and Babucharia are talking about the mRNA vaccines.

Speaker 2 And just talking about it in a way that is fundamentally wrong.

Speaker 2 In the secretary's post on Twitter, he talked about how these vaccines are not good at preventing upper respiratory tract infections. And

Speaker 2 I remember convening with fellow clinicians of mine and saying, you know, he's either he's talking about it in those terms to deflect and confuse, or he doesn't know the difference between the upper and the lower respiratory tract.

Speaker 2 Yeah, I don't know what you're worth. Either you're being ignorant or you're either you're ignorant or you're being nefarious.
I mean, quite fair.

Speaker 2 Exactly. And I'm wondering how you, if you were still in the role,

Speaker 2 as say you you were the current Surgeon General, how you would approach that specific issue, either behind the scenes or at a podium?

Speaker 2 Well, number one, and I've talked about this in a stat news op-ed that I did after the shooting. I've talked about it on Face the Nation.

Speaker 2 Number one, as a leader, you've got to have those clear guardrails. And one of those clear guardrails is no violence.
Violence is wrong. I don't care how angry you are.

Speaker 2 Period, point blank, end of story.

Speaker 2 That's got to be a non-starter. And anyone who is not willing to come forward and say that in a high position at HHS doesn't deserve to be there.
I'm sorry.

Speaker 2 I just, I feel very strongly about that, especially with my colleagues being under attack and being shot at. That's number one.
Number two, I would get asked questions all the time.

Speaker 2 And the media does this. They will try to pitch you.
against your boss, against your leaders.

Speaker 2 But as I mentioned, I laid the ground rules with my leaders early on.

Speaker 2 I'm not going to lie to you. I'm not going to lie for you.

Speaker 2 If there's something that you want to do that's not consistent with what I've told you I think you should be doing, then don't expect me to go out and be the flag bearer for you on this issue.

Speaker 2 Again, I don't know what conversations were had behind the scenes between some of these individuals and RFK.

Speaker 2 But that said,

Speaker 2 that's something that I think is important, that behind the scenes conversation.

Speaker 2 And then whenever I got asked a difficult question that was putting me at odds, I would always go back to, here's what the science says.

Speaker 2 And so if Donald Trump wants to say or believe something, if someone else wants to believe or say something, that's their prerogative to believe and to say it.

Speaker 2 But me, I can only control what I say as Jerome Adams, the surgeon general or former surgeon general.

Speaker 2 And so you can look at countless media interviews where I've done where I would be asked, do you agree with Donald Trump?

Speaker 2 uh on this issue do you agree with the current policy on this issue and and i would always bring it back to, hey, here's what the science says.

Speaker 2 Here's what we know on this issue based on the science right now.

Speaker 2 Because I'm speaking not as a representative of the administration. It wasn't my job to defend Donald Trump or defend anyone else.
It was my job to speak on the science as I knew it. So that's how.

Speaker 2 I personally handle those situations. And I think that because I was honest behind the scenes, people, even when they disagreed with me internally, still respected me for it.

Speaker 2 There are plenty of times that I said things that Donald Trump

Speaker 2 didn't agree with, but he still respected me in terms of someone who was going to give him honest feedback and someone who wasn't going to take debate to be pitted against him publicly, but would still speak my truth when asked.

Speaker 6 Well, and I wonder about that, because to your point, Jerome, you know, there there has been more of a, I want to call it like a unified front, at least publicly, publicly, between the health leaders in a way that I don't remember seeing in the past.

Speaker 6 And maybe, maybe that's just me. I would love your take on that too.

Speaker 6 So and I think the framing of this is also that, you know, you and your predecessors and, you know, even Vivek Murthy, those who have been in this position have had their say, have had their platform, and it seems like a very specific role within the administration.

Speaker 6 And they've, and largely individuals who have been qualified in somewhere or you know fit sort of a quote-unquote traditional um

Speaker 6 you know background in terms of being being in this type of position and so not to like continue belaboring you know this whole idea but i think it's interesting to to get your perspective on what we're looking at right now so do you think that those kinds of background conversations are not happening or that the conversations are more hey we have to have this unified front everyone's on the same page and if you're not in you're out well one of of the things I would say is that I would say that we had a unified front

Speaker 2 when we were

Speaker 2 during the first Trump administration, but that unified front was around the science. Alex Azar, Brett Trewa,

Speaker 2 myself,

Speaker 2 the FDA commissioners who we worked with, Scott Gottley,

Speaker 2 initially Seema Verma, we would all powwow and get together. And we would hash it out.

Speaker 2 And sometimes, you know, even when you're talking about science and and data, there are different interpretations of it.

Speaker 2 And we would hash it out behind the scenes and we would say, okay, it's important for us to present a unified front to the American people. What is a message that we can agree on?

Speaker 2 And who's the best person to carry forth that message? So I say that because the unified front isn't what's different. It's what that unification is around.

Speaker 2 And during Trump 1.0, that unification was around science. I mean, Operation Warp Speed.

Speaker 2 No one wants to give President Trump his laurels on this, but it is the greatest scientific achievement of the last 75 years in this country, easily, estimated to have saved at least 2 million by the most conservative estimates, but by many estimates, over 20 million lives saved.

Speaker 2 Clearly, we supported science and innovation in the first administration. And what's different now is that that unity isn't around science and public health and building up the infrastructure.

Speaker 2 It seems to be a unity around demonizing public health, tearing down the infrastructure, and

Speaker 2 loyalty to RFK and the Maha movement. And so

Speaker 2 you didn't hear me out there saying Alex Azar is always right, you know, and consistency with anything that Alex Azar said.

Speaker 2 But that's where I see the difference between 1.0 and 1. and 2.0

Speaker 2 is around what they're unifying around that litmus test that it seems everyone had to take and is being judged by.

Speaker 6 Well, and I know that some have called out the irony of Trump being in power and having, you know, 1.0 support mRNA and then 2.0 essentially tear it down and all the work that was set up by Operation Warp Speed, using that as sort of

Speaker 6 a backdrop for this, for continuing this conversation.

Speaker 6 What are your thoughts about that, about having, you know,

Speaker 6 I actually, just as a side note here, when I talk about, you know, the mRNA thing to folks who may not understand as much, I say that maybe the missed communication

Speaker 6 in

Speaker 6 this whole story was everyone got excited about the effectiveness of mRNA and then forgot to explain, you know, yes, it wears off just like every other vaccine. And oh, yes, it wears off much faster.

Speaker 6 It has, you know, a different time frame than other vaccines. And here is why.

Speaker 6 And I think the scientific community community got behind it so aggressively that the communication, which continues to be the problem, is the reason why we're facing this backlash right now.

Speaker 6 And is that maybe the reason why we're seeing this kind of movement where those who have felt unheard and those who are in position of power right now feel like they're serving the public by giving a voice to those folks who were against it or who felt like, you know, trust was lost?

Speaker 2 No,

Speaker 2 I think you hit on a key point there. Two key points that I quickly want to cover.
Number one is the sentiment of the public.

Speaker 2 Our healthcare system is the most expensive in the world, yet we're ranked 67th in life expectancy. People can't afford health care.
You saw Brian Thompson, the United CEO,

Speaker 2 who literally was assassinated on camera in broad daylight, and many people defended.

Speaker 2 That shows you the level of discontent that the public has. And shame on us if we won't, if we refuse to acknowledge that the system is broken.

Speaker 2 However, you can't attack individuals or parts of the system and expect that that's going to solve the

Speaker 2 broader issue. And that's what I see is going on right now.
We're attacking and demonizing individuals and literally trying to tear down the entire system. Now,

Speaker 2 to give the benefit of the doubt to

Speaker 2 someone like RFK, I think he does recognize the system is broken. However, being in a leadership role means recognizing you can't just tear everything completely down to the ground.

Speaker 2 You can't burn it all to the ground without hurting someone, number one.

Speaker 2 Number two, it means understanding that the language you use, the rhetoric you use actually matters because it can stoke violence on the part. of the public.

Speaker 2 So I think that is a place where they've gone wrong.

Speaker 2 Number three, there are a lot of people involved in the current current administration who criticize pharma and traditional medicine, but have no problems promoting ivermectin and hydroxychloroquine and glucose monitors for everybody and supplements.

Speaker 2 And so it's a little bit disingenuous to say those people are grifters. You shouldn't trust them.

Speaker 2 But then to say you should trust us, even though we profited off of disinformation and unvalidated remedies that we're promoting on our websites right now.

Speaker 2 And so to me, that's a lot of what the difference is.

Speaker 2 You acknowledge the systemic issues, you acknowledge the pain and the frustration that Americans are feeling, and then you have to offer them a real way forward, which gets to your point about communication.

Speaker 2 I have a whole chapter in my book right here where I talk about the importance of better communications training for public health officials and medical officials.

Speaker 2 When I was Surgeon General of the United States, I was running a 6 000 person agency public health service commission court a 6 000 person company a billion dollar budget and guess what i was doing my own social media i was doing my own tweets there is no ceo of any company in america that size that is doing their own media Fortunately, I'd had some media training, TV, radio written during my time as Indiana State Health Commissioner,

Speaker 2 which Dr. Gupta mentioned earlier.

Speaker 2 But that said, we need more support, more training, and

Speaker 2 the media communications

Speaker 2 routes changed drastically during my tenure. I often say I was the first real Twitter surgeon general.

Speaker 2 So people forget in early 2020, the debates we were having pre-pandemic even over Nurshviv on TikTok dancing, you know, and talking about patients.

Speaker 2 We've shifted from a time when Spirit Coop would go on the news

Speaker 2 if he wanted to say smoking was bad, and he had to hit four channels, ABC, CBS, you know, the big four channels at the time, and he would hit 70, 80% of America back then.

Speaker 2 And people would believe it, believe what, listen to what he was saying. Now I have hundreds of cable news channels that people are listening to that all have their own different events.

Speaker 2 You've got TikTok, you've got Snapchat, you've got Twitter,

Speaker 2 all these different venues through which people are receiving their information. And our health officials have not been trained to actually communicate via those channels.

Speaker 6 Jerome, I think you've given me a good

Speaker 6 next career option. I should just be a communications coach for scientific community folks.

Speaker 6 What do we think about that idea? I think maybe I've.

Speaker 2 We need it.

Speaker 2 We absolutely need it.

Speaker 2 I was talking to someone earlier just today, and I said, if you ask a doctor a question, question, we are trained to give you a 45-slide PowerPoint presentation answering that question.

Speaker 2 We're not trained to take complex information and distill it down into a 30-second TikTok into a limited character tweet.

Speaker 2 But that's how most people are consuming their health and medical information. And so from that perspective,

Speaker 2 it's no surprise that people are going to Joe Rogan.

Speaker 2 Interestingly enough, the current administration, you've noticed that a lot of their communication has been in more in meme format um more in a format that is uh likely to resonate with the public and and so i have to give them props for that that they're recognizing that that in order to reach the people um they they need to change the way that they're speaking to the people now unfortunately i don't like the message they're delivering but but uh but we need to to to understand that more broadly as opposed to having this aversion to to engaging on social media and to

Speaker 2 using the platforms that people are trying to reach are actually on.

Speaker 2 Jerome,

Speaker 2 as we're rapidly coming to a close with the time that we have with you, which, again, we really appreciate this.

Speaker 2 I wanted to end on

Speaker 2 what Maha means to you, because I think to just as we're, you know, we're seven, eight months into this experiment in Maha, what does it mean? What is it actually going to do in substance?

Speaker 2 And it strikes me that, you know, and related to everything you already just talked about, it's an idea and it's a statement, but there isn't a lot of actual execution or substance behind it.

Speaker 2 Let's just look at what, you know, prior to all the churn of the last week, what the EPA announced towards the beginning of the last week.

Speaker 2 You know, I think for those that are not news watching public, probably they missed it, but basically the EPA is washing its hands of any obligation to adhere to the endangerment finding that greenhouse gases are bad for human health.

Speaker 2 And the implications of that feel like they go completely in contradiction with what Secretary Kennedy wants to focus on when it comes to environment and human health.

Speaker 2 And you can draw these sort of contradictions when it comes to NIH budget, when it comes to how they're thinking about cutting or how they've already cut human capital from the FDA to protect our food supply.

Speaker 2 It's just the contradictions run rampant. And I'm wondering how you would guide our listeners to think about Maha from your perspective.
And, you know, is this something we should be taking seriously?

Speaker 2 Is there something here that's more than just style? Because it's been hard to really parse out. Well, I mean, again, Maha is a slogan, which is fashioned after MAGA.

Speaker 2 And

Speaker 2 so to your point,

Speaker 2 the question is, what's under the hood? What's behind it? What does it really mean?

Speaker 2 And it's a slogan that's easy to buy into. America is unhealthy.
We do want to make it healthier, healthy.

Speaker 2 Well,

Speaker 2 that's one challenge is to make it healthy again. I think there's a fundamental understanding

Speaker 2 of

Speaker 2 what was happening in the past that made us healthier versus unhealthy. We were not a healthy nation back when we didn't have vaccinations.
period. So this idea that somehow going back to a time when

Speaker 2 most people didn't have a polio vaccine or measles vaccine

Speaker 2 is going to make us healthier is just, it's faulty logic. So I think the problem is the slogan is causing people to focus on things that are just plain wrong or on or on many of the or on

Speaker 2 things that

Speaker 2 I think benefit certain people in certain worldviews. Number two, the approach thus far seems seems to be very much on the individual.
It's on you to eat healthier.

Speaker 2 It's on you to exercise more and pulling away from the role that community, that society, and that government can play. I can't eat healthy if I can't afford my foods, but we're cutting SNAP benefits.

Speaker 2 I can't get screened for cancer if you cut my Medicaid. So understanding that we all exist within the context of a broader community.

Speaker 2 And then finally, one of the things that I focus on in my current role at Purdue University is helping people understand those social drivers of health.

Speaker 2 And not everyone who's listening may be familiar with it, but only about 20% of your health is determined by access to traditional health care, what happens in doctors' offices or clinics.

Speaker 2 The other 80%

Speaker 2 is determined by things like transportation, like affordable housing, like a living wage,

Speaker 2 like daycare.

Speaker 2 And so when we pull back from those social supports, it's going to be much harder to make America healthy again.

Speaker 2 And that's what I really think is at the core of this.

Speaker 2 Back when America was healthier in many ways, we cared about one another. We supported one another as communities.
And we're going more towards this individualistic

Speaker 2 way of existing. And that's leading to poor health.

Speaker 2 And to the extent that Maha is feeding into that and furthering that individual health mindset, I think we're going to continue to see ourselves going the wrong direction and not the right direction.

Speaker 2 You know, and Jerome, I just wanted to add on, I couldn't agree more with everything you just said.

Speaker 2 It strikes me that whenever I see Secretary Kennedy do a Twitter video to make some sort of announcement, like he did with the mRNA vaccines, he does it in a way where it sounds like what he's saying makes sense, where it's credible to those that might not be spending their entire day thinking about, say, an mRNA vaccine.

Speaker 2 But I think, you know, we talked earlier about the upper versus the lower respiratory tract distinction, probably lost on the majority of people that were watching it. Huge implications.

Speaker 2 He was wrong and

Speaker 2 creating a lot of confusion. You know, these vaccines don't prevent infection.
They prevent

Speaker 2 mild symptoms in the upper respiratory tract that prevents severe pneumonia, as we all know and talked about. He then also talked about whole cell vaccine technology, which I bring up because

Speaker 2 you had talked about the polio vaccine, Pertustis vaccine.

Speaker 2 It's not like this is some sort of novel technology, but when he's referencing it, and especially to his followers, they're like, oh, well, of course, why wouldn't we be thinking about this alternative technology?

Speaker 2 And yet the broader context matters, but he does it, and he does this with fluoride and

Speaker 2 seeming to be a champion of environmental health, talking about things, cherry-picking data, but then ignoring the broader context of what they, for example, they're doing with the EPA. It's really,

Speaker 2 to use your word, it's, he's either deflecting or it's just nefarious intent, but he continues to do this. And there's this pattern of it.

Speaker 2 And I thought it was very vivid last week with these announcements. Absolutely.
I think, you know, I talked about leadership earlier. And one of the important things

Speaker 2 in regards to being an effective leader is to know what you don't know.

Speaker 2 We see this happen all the time when people go out there and they overestimate

Speaker 2 their understanding of an issue. And that's particularly hard when you're running an agency like HHS.
And there is so much that's under you that you can't be an expert on everything.

Speaker 2 It's one of the things I actually loved about being surgeon general is I had a 6,000 person public health service commission course.

Speaker 2 So when I wanted to talk about fluoride, I called up my dentist and I had my dentist brief me and then stand beside me when we're talking about fluoride.

Speaker 2 I had nurses, I had doctors, I had pharmacists.

Speaker 2 If I had a drug issue, I would call up my pharmacists and say, you know, give me the inside scoop on this because you went to school for this and you know this better than what I ever will.

Speaker 2 We had engineers, we had environmental

Speaker 2 people

Speaker 2 who would come in and help me understand

Speaker 2 environmental issues like lead and lead exposure.

Speaker 2 And so one of the things that bothers me, And that I really feel that Secretary Kennedy needs to do a better job of is understanding that he isn't expected to be and never will be the expert on everything.

Speaker 2 And that's why we need to lean into and support science.

Speaker 2 And he's got the best scientist in the world working at HHS, but it seems he's determined that he's smarter than all of them and will only listen to the ones that confirm what he already wants to believe.

Speaker 2 or

Speaker 2 thinks is right.

Speaker 2 And so we're going to continue to see him falter as a leader if he's not willing to acknowledge he doesn't know everything and to lean on the people who he has available to him who actually are experts on these complex topics.

Speaker 6 Yeah, I think, Jerome, just to kind of put a fine point on it,

Speaker 6 you know, we're in a position where

Speaker 6 Kind of recapping what you said, in the past, it was easier for leaders to kind of go through news outlets or go through dedicated channels to reach the public.

Speaker 6 And now with the internet, with social media, those guardrails are no longer there.

Speaker 6 And so there's no one sort of questioning or no one filtering, if you will, if you want to use, you know, sort of the mainstream version of that to get that information out there. And that.

Speaker 6 comes with its problems, which is the institutional knowledge is gone. The experts are voiceless.
And so we're in a position of having the top leaders of the country say whatever they want.

Speaker 6 And then folks like myself have to do fact checking and feel like we're kind of screaming in a void where no one's listening.

Speaker 6 And so I just wondered, what do you think this does for the reputation of the country globally, but also for the future?

Speaker 2 Well,

Speaker 2 and I know we're short on time, but one of the things that you hit on is I think critically important. You said globally.
And America, what happens here doesn't just matter in our country.

Speaker 2 We have been the leaders. The CDC has been a leader worldwide.

Speaker 2 The fact that we pulled away from the Paris Climate Accords, the fact that we pulled away from the WHL, the fact that literally major health organizations and health professionals are saying, we can't trust the CDC anymore because they've put all these

Speaker 2 people on the ACA who shouldn't be there. We can't trust the FDA anymore.
because they're putting out unilateral advice that isn't consistent with what the science tells us.

Speaker 2 We can't trust NIH anymore because their employees literally wrote a letter chastising their current director for his stance on mRNA vaccines. And so

Speaker 2 it's going to hurt us immediately.

Speaker 2 It's going to hurt our reputation long term, which hurts science because now you don't have a trusted entity globally that people look to

Speaker 2 for advice in tough times. And from a national security standpoint, it's going to hurt us.

Speaker 2 China is very actively and willingly stepping into the void that we are creating in terms of health leadership.

Speaker 2 And I don't think people appreciate how much of a danger that presents for us now and in the future. When people go, we can't trust HHS anymore.
We're going to go to China

Speaker 2 and work with them on these complex health issues.

Speaker 2 That scares me.

Speaker 6 Yeah, we've definitely been seeing that in the biotech world.

Speaker 2 But yeah, again, go ahead.

Speaker 2 No, I just wanted to

Speaker 2 thank you to the 20th Surgeon General of the United States, Jerome Adams, Dr. Jerome Adams.
I know you're busy. I know these times are,

Speaker 2 we use the word lightly unprecedented, but truly they are. And you've given us a lot of clarity as you always do.
Thank you, Jerome. Well, thank you.

Speaker 2 And as I close, I would encourage you all to go to the CDC Foundation and give to the family of Officer David Rose. They're raising money money for his family.

Speaker 2 He is the person who was shot at the CDC and killed last week. And I'd say that's the least we can do in these difficult times to support our folks and commit to better discourse.

Speaker 2 You can be mad at someone. You can be angry.
You can be frustrated.

Speaker 2 But don't

Speaker 2 let's try to be the change that we want to see in this world

Speaker 2 and do our own individual small parts to create a climate where we can have some of these nuanced conversations, some of these difficult conversations

Speaker 2 without literally putting targets on each other's backs.

Speaker 2 I just want to make sure for our listeners, we have the right

Speaker 2 URL, CDC Foundation.org's room, is that right? Correct, correct. Great.

Speaker 2 Well, Anjali, any final remarks here?

Speaker 6 No, I just want to say thank you. Thank you for having me here, Ben.
It was great to co-host with you. And thank you so much, Dr.
Adams, for joining us. It's been a pleasure to reconnect.

Speaker 2 Thanks. It's been,

Speaker 2 I don't want to say it's been fun because we've been talking about some tough issues, but I think very serious topics, yes.

Speaker 2 But

Speaker 2 it's been productive, and I want to thank you all for raving it up.

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