The ‘MAHA Report’ calls for fighting chronic disease

The Trump administration has declared that it will aggressively combat chronic disease in America. Yet in its feverish purge of federal health programs, it has proposed eliminating the National Center for Chronic Disease Prevention and Health Promotion and its annual funding of $1.4 billion. That’s one of many disconnects between what the administration says about health — notably, in the “MAHA Report” that President Donald Trump recently presented at the White House — and what it’s actually doing, scientists and public health advocates say. Among other contradictions:

• The report says more research is needed on health-related topics such as chronic diseases and the cumulative effects of chemicals in the environment. But the Trump administration’s mass cancellation of federal research grants to scientists at universities, including Harvard, has derailed studies on those subjects.

• The report denounces industry-funded research on chemicals and health as widespread and unreliable. But the administration is seeking to cut government funding that could serve as a counterweight.

• The report calls for “fearless gold-standard science.” But the administration has sowed widespread fear in the scientific world that it is out to stifle or skew research that challenges its desired conclusions.

“There are many inconsistencies between rhetoric and action,” said Alonzo Plough, chief science officer at the Robert Wood Johnson Foundation, a philanthropy focused on health.

The report, a cornerstone of President Donald Trump’s “Make America Healthy Again” agenda, was issued by a commission that includes Secretary of Health and Human Services Robert F. Kennedy Jr. and other top administration officials. News organisations found that it footnoted nonexistent sources and contained signs that it was produced with help from artificial intelligence. White House Press Secretary Karoline Leavitt described the problems as “formatting issues,” and the administration revised the report. Trump ordered the report to assess causes of a “childhood chronic disease crisis.” His commission is now working on a plan of action.

Spokespeople for the White House and Department of Health and Human Services did not respond to questions for this article.

The MAHA report says environmental chemicals may pose risks to children’s health. Citing the National Institutes of Health, it said there’s a “need for continued studies from the public and private sectors, especially the NIH, to better understand the cumulative load of multiple exposures and how it may impact children’s health.” Meanwhile, the administration has cut funding for related studies. For example, in 2020 the Environmental Protection Agency asked scientists to propose ways of researching children’s exposure to chemicals from soil and dust. It said that, for kids ages 6 months to 6 years, ingesting particulates — by putting their hands on the ground or floor then in their mouths — could be a significant means of exposure to contaminants such as herbicides, pesticides, and a group of chemicals known as PFAS.

One of the grants — for almost $1.4 million over several years — went to a team of scientists at Johns Hopkins University and the University of California-San Francisco. Researchers gained permission to collect samples from people’s homes, including dust and diapers. But, beyond a small test run, they didn’t get to analyse the urine and stool samples because the grant was terminated this spring, said study leader Keeve Nachman, a professor of environmental health and engineering at Hopkins.

“The objectives of the award are no longer consistent with EPA funding priorities,” the agency said in a May 10 termination notice. Another EPA solicitation from 2020 addressed many of the issues the MAHA report highlighted: cumulative exposures to chemicals and developmental problems such as attention-deficit/hyperactivity disorder, obesity, anxiety, and depression. One of the resulting grants funded the Center for Early Life Exposures and Neurotoxicity at the University of North Carolina-Chapel Hill. That grant was ended weeks early in May, said the center’s director, Stephanie Engel, a UNC professor of epidemiology.

In a statement, EPA press secretary Brigit Hirsch said the agency “is continuing to invest in research and labs to advance the mission of protecting human health and the environment.” Due to an agency reorganisation, “the way these grants are administered will be different going forward,” said Hirsch, who did not otherwise answer questions about specific grants. In its battle with Harvard, the Trump administration has stopped paying for research the NIH had commissioned on topics such as how autism might be related to paternal exposure to air pollution. The loss of millions of dollars of NIH funding has also undermined data-gathering for long-term research on chronic diseases, Harvard researchers said. A series of projects with names like Nurses’ Health Study II and Nurses’ Health Study 3 have been tracking thousands of people for decades and aimed to keep tracking them as long as possible as well as enrolling new participants, even across generations.

The work has included periodically surveying participants — mainly nurses and other health professionals who enrolled to support science — and collecting biological samples such as blood, urine, stool, or toenail clippings. Researchers studying health problems such as autism, ADHD, or cancer could tap the data and samples to trace potential contributing factors, said Francine Laden, an environmental epidemiologist at Harvard’s TH Chan School of Public Health. The information could retrospectively reveal exposures before people were born — when they were still in utero — and exposures their parents experienced before they were conceived. Harvard expected that some of the grants wouldn’t be renewed, but the Trump administration brought ongoing funding to an abrupt end, said Walter Willett, a professor of epidemiology and nutrition at the Chan school.