Who’s Who: President-Elect Trump’s Nominees and Possible Impacts for Global Health
Since clinching the presidency, President-elect Trump has moved quickly to announce his picks for critical Cabinet posts and top administration jobs, including key roles that will shape domestic and global health priorities. While many of these policy leaders’ stances remain unclear, below is a snapshot of what is currently known about each nominee. Public information on the nominees has primarily focused on their discourse around vaccines, with limited details available on other topics relevant to global health and development. ASTMH will continue to monitor these leaders’ policy positions closely as new information becomes available throughout the confirmation process.
Remember: these positions require Senate confirmation – if a nomination fails, the president can still appoint the individual to another influential role, such as a senior advisor, which could impact both domestic and global health policy.
Meet the Nominees
DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)
Robert F. Kennedy Jr. –
Nominee for HHS Secretary
Robert F. Kennedy (RFK) JR. was tapped by the President-elect for the nation’s top health care job: leading the Department of Health and Human Services. A vocal vaccine skeptic and environmental lawyer, his nomination to a major public health post surprised many and even caused vaccine-maker stocks to tumble. Democrat-turned-independent-to-Trump-ally has faced longstanding criticism for his controversial views on vaccines and the COVID-19 pandemic. However, Kennedy has clarified that he does not intend to remove vaccine access for those who want them, rather he intends to focus on improving the science of vaccine safety which he has previously stated has “huge deficits in it.” Under the banner of the “Make America Healthy Again” initiative, Kennedy has vowed to end the chronic disease epidemic, with a focus on big food and big pharma. He has proposed a significant redefinition of the government's role in health and medicine, advocating for anti-pesticide policies, the elimination of food additives, alternative medicine, and pollution control, among other areas of reform.
If confirmed, it is unclear how Kennedy would reconcile his focus on chronic disease with Project 2025's infectious-diseases-only approach for the CDC. His lack of experience in pandemic preparedness raises concerns, given the agency's ongoing responsibility to manage multiple infectious disease outbreaks. Kennedy has also signaled an interest in significant overhaul at the National Institutes of Health (NIH), including replacing 600 staff members on day one of the new administration. He contends that the NIH is too closely aligned with pharmaceutical companies and insufficiently focused on chronic diseases and alternative treatments.
Jay Bhattacharya MD, PhD –
Nominee for National Institutes of Health (NIH) Director
Jay Bhattacharya, a Stanford professor of health policy, holds four degrees from the university, including a medical degree and a PhD in economics. In April 2020, his research gained attention after authoring a study on COVID-19 seroprevalence, which concluded that many infected individuals were asymptomatic and suggested that the death rates from COVID were much lower than estimated. The study and its conclusions were widely criticized by the scientific community for being flawed. Bhattacharya was also a co-author of the Great Barrington Declaration, a controversial open letter calling for the end to broad lockdowns and other COVID-era policies, such as vaccine mandates, while advocating for herd immunity before a vaccine was even available. At the time, NIH Director Francis Collins referred to the declaration’s proposals as “fringe.” As both a physician and economist, Bhattacharya has been a vocal critic of the pandemic response, including leaders like Dr. Anthony Fauci. He has called for substantial reforms to American scientific institutions “so that they are worthy of trust again.”
Dave Weldon MD, PhD –
Nominee for Centers for Disease Control and Prevention (CDC) Director
Dr. Dave Weldon, a former Congressman from Florida (1995-2009) and physician, has publicly questioned vaccine safety and been a vocal critic of the agency he is poised to lead. During his tenure in Congress, he emboldened the theory that the preservative thimerosal caused autism in children and sponsored legislation to ban thimerosal from childhood flu vaccines. Weldon also pushed for the Measles, Mumps, and Rubella (MMR) vaccine to be split into separate components, prompting the CDC's Advisory Committee on Immunization Practices (ACIP) to vote on the matter. He introduced the Vaccine Safety and Public Confidence Assurance Act, which sought to move vaccine safety research out of the CDC and into an independent agency within HHS. Weldon is also known for authoring the "Weldon Amendment," an appropriations policy rider that prohibits HHS from discriminating in funding decisions against entities that do not provide abortions. In the wake of the Terri Schiavo case, a lawsuit centered around a severely brain-damaged woman who was in a persistent vegetative state, Weldon made a floor speech calling attempts to remove Schiavo’s feeding tubes a “grave injustice” and introduced legislation that would have required Schiavo’s case and others like it to be reviewed by a federal court. If confirmed, Weldon could potentially influence vaccine policy by appointing vaccine skeptics to ACIP and shaping the vaccine recommendation process. This is the first time that the CDC director will require Senate confirmation.
Martin “Marty” Makary MD, MPH –
Nominee for Food and Drug Administration (FDA) Director
Dr. Marty Makary, a pancreatic surgeon at Johns Hopkins, is a widely published health researcher, writing on subjects such as hospital safety and quality and health-care prices. He gained early recognition in the early 2000s for developing “The Surgery Checklist,” a pre-operative routine designed to reduce surgical errors, which was later popularized by public health expert and current Assistant Administrator for Global Health at USAID Atul Gawande in his 2009 book The Checklist Manifesto. In addition to his role at Johns Hopkins, Makary serves as the chief medical officer for the telehealth company Sesame and is a board member of the ophthalmology company Harrow Health. He became more widely known during the COVID-19 pandemic for questioning public health authorities and the medical establishment on policies such as booster shots and mask mandates. A vocal critic of the FDA, Makary previously stated, “We’ve gone from ‘Operation Warp Speed’ to develop a vaccine to ‘Operation Turtle Speed’ to review It.” Despite his stated criticisms, Makary has underscored that he is pro-vaccine.
Janette Nesheiwat –
Nominee for U.S. Surgeon General
Dr. Janette Nesheiwat is a family and emergency medicine physician, Fox News Medical Contributor, and the medical director of a chain of urgent care clinics in New York City. She has publicly supported vaccines, describing the COVID-19 vaccine as a “gift from God” and acknowledging the efficacy of the MMR vaccine. However, she criticized the CDC’s 2022 decision to add the COVID-19 vaccine to the childhood immunization schedule, suggesting the move was potentially profit-driven and clinically unnecessary. She has also been critical of the CDC’s handling of the pandemic and the use of government mandates. Nesheiwat is the author of Beyond the Stethoscope: Miracles in Medicine, a book that highlights global medical missions among other topics. She has also contributed to international relief efforts, including helping deliver medical supplies to Haiti after the 2010 earthquake. As U.S. Surgeon General, Nesheiwat would oversee the Public Health Service Commissioned Corps and serve as one of the government’s chief spokespersons on public health matters. While the position is often seen as symbolic, the Surgeon General still wields significant agenda-setting power and can help advance priorities on critical health issues both at home and abroad.
Jim O’Neill –
Nominee for HHS Deputy Secretary
Jim O’Neill, a biotech investor, has been nominated as deputy secretary of HHS, the number two spot at the department. In this role, O’Neill, would oversee the day-to-day operations of all sub-agencies, which are responsible for managing programs such as Medicare and Medicaid, leading public health emergency preparedness and response, shaping federal research priorities, and more. He would also have purview over the development and approval of HHS regulations while serving under Trump’s pick for HHS secretary, Robert F. Kennedy Jr. O’Neill, who is closely associated with billionaire Peter Thiel, has previously proposed that the FDA initially approve drugs based solely on their safety – not their efficacy.
DEPARTMENT OF STATE AND THE UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID)
Marco Rubio –
Nominee for Secretary of State
Florida Senator Marco Rubio is the top Republican on the Senate Select Committee on Intelligence, a longtime member of the Foreign Relations Committee, and a member of the Appropriations Subcommittee on State, Foreign Operations, and Related Programs Subcommittee, which oversees funding for global health programs at the State Department and USAID. The Department of State oversees key global health and global health security programs, including the United States President’s Emergency Plan for AIDS Relief (PEPFAR). Rubio has in the past underscored the lifesaving impacts of the program. He has been a steadfast supporter of Trump’s foreign policy, including positions on immigration and conflicts in the Middle East and Ukraine. However, he also has a notable record of advocating for the soft power of development assistance and global health initiatives.
Elise Stefanik –
Nominee for U.S. Ambassador to the United Nations (UN)
The nomination of New York Congresswoman Elise Stefanik as UN Ambassador signals a more assertive approach by the Trump administration toward the UN, particularly in response to its criticism of Israel and the war in Ukraine. Stefanik has been a steadfast ally of the president-elect, notably during the impeachment hearings, and has established herself as a prominent GOP fundraiser. While she has chaired the House Republican Conference, Stefanik has limited experience in foreign policy and national security. She has served on the House Armed Services Committee and the House Permanent Select Committee on Intelligence. As a Member of Congress Stefanik was critical of the UN and WHO.
USAID Administrator and Other Global Health Roles
As of this writing, no nominations have been made for the USAID Administrator or other health-related positions at USAID and the State Department.
Office of Management and Budget (OMB)
Russell “Russ” Vought - Nominee for Director
Russell (Russ) Vought was tapped by President-elect Trump to return to the Office of Management and Budget as director, a role he held during the first administration. A staunch social and fiscal conservative, Vought is considered as one of the architects of Project 2025, a Heritage Foundation-led report outlining the conservative agenda. He is a strong advocate for reducing non-defense spending and leveraging presidential powers to influence government expenditures. Vought has also voiced support for restoring impoundment authority that would enable the President to spend less than what Congress appropriates. Before his tenure at OMB, Vought served as vice president at Heritage Action. Earlier in his career, he was policy director for the House Republican Conference under then-Representative Mike Pence (R-IN), executive director of the conservative Republican Study Committee, and an aide to former Senator Phil Gramm (R-TX).
As OMB director, Vought will oversee the development of the FY2026 budget, which will outline President-elect Trump’s policy and funding priorities for his second term, including those related to global health. He will also play a critical role in negotiating final FY2025 funding if delays push those discussions into 2026.
THE “DEPARTMENT OF GOVERNMENT EFFICIENCY” (DOGE)
Elon Musk and Vivek Ramaswamy - Lead Advisors of the DOGE
Although not an official government department, the DOGE is expected to serve as a key advisory body to the Trump administration, with potential implications for health policy, including global health and global health security initiatives. While its exact policy blueprint remains unclear, DOGE leader Vivek Ramaswamy has already criticized the prevalence of federal staff and stand-alone offices focused on “diversity, equity, and inclusion” (DEI), calling for reductions in what he describes as “DEI bloat.” The DOGE is anticipated to advocate for reinstating Trump’s Schedule F executive order from his first administration. This order would allow federal agencies to reclassify certain employees, removing civil service protections and making them at-will workers, thereby making it easier to fire federal employees. Specifically, Schedule F would categorize certain positions as policymaking or policy-evaluating, and therefore would be more responsive to the political party. Against this backdrop, the duo is also expected to recommend and help implement sweeping measures, including large-scale federal workforce layoffs, agency relocations, and reductions in telework to reduce the federal workforce through attrition. Still, the DOGE leaders have conceded they will require congressional assistance to eventually fulfill some of their plans, such as eliminating agencies. However, DOGE leaders have acknowledged that achieving some of their more ambitious goals, such as eliminating agencies, will require congressional approval. Additionally, the DOGE is likely to be subject to the Federal Advisory Committee Act, which mandates public meetings and transparency in its activities. This will be important to ensuring accountability and transparency in its operations and recommendations.