A million kids won’t live to kindergarten because of this disastrous decision

The deadliest country in the world for young children is South Sudan — the United Nations estimates that about 1 in 10 children born there won’t make it to their fifth birthday. 

But just a hundred years ago, that was true right here in the United States: Every community buried about a tenth of their children before they entered kindergarten. That was itself a huge improvement over 1900, when fully 25 percent of children in America didn’t make it to age 5. Today, even in the poorest parts of the world, every child has a better chance than a child born in the richest parts of the world had a century ago.

How did we do it? Primarily through vaccines, which account for about 40 percent of the global drop in infant mortality over the last 50 years, representing 150 million lives saved. Once babies get extremely sick, it’s incredibly hard to get adequate care for them anywhere in the world, but we’ve largely prevented them from getting sick in the first place. Vaccines eradicated smallpox and dramatically reduced infant deaths from measles, tuberculosis, whooping cough, and tetanus. And vaccines not only make babies likelier to survive infancy but also make them healthier for the rest of their lives. 

Robert F. Kennedy Jr., unfortunately, disagrees. President Donald Trump’s secretary of health and human services (HHS), a noted vaccine skeptic who reportedly does not really believe the scientific consensus that disease is caused by germs, recently announced the US will pull out of Gavi, an international alliance of governments and private funders (mainly the Gates Foundation) that works to ensure lifesaving vaccinations reach every child worldwide. His grounds? He thinks Gavi doesn’t worry enough about vaccine safety (he does not seem to acknowledge any safety concerns associated with the alternative — dying horribly from measles or tuberculosis).

The Trump administration had already slashed its contribution to Gavi as part of its gutting of lifesaving international aid programs earlier this year, leaving any US contributions in significant doubt. But if Kennedy’s latest decision holds, it now appears that the US will contribute nothing to this crucial program.

The US is one of many funders of Gavi, historically contributing about 13 percent of its overall budget. In 2022, we pledged $2.53 billion for work through 2030, a contribution that Gavi estimates was expected to save about 1.2 million lives by enabling wider reach with vaccine campaigns.

That’s an incredibly cost-effective way to save lives and ensure more children grow into healthy adults, and it’s a cost-effective way to reduce the spread of diseases that will also affect us here in the US. Diseases don’t stay safely overseas when we allow them to spread overseas. Measles is highly contagious, and worldwide vaccination helps keep American children safe, too. Tuberculosis is becoming increasingly resistant to antibiotics, which makes it harder and more expensive to treat, and widespread vaccination (so that people don’t catch it in the first place) is the best tool to ensure dangerous new strains don’t develop. 

It is genuinely hard to describe how angry I am about the casual endangerment of more than a million people because Kennedy apparently thinks measles vaccines are more dangerous than measles is. The American people should be furious about it, too. If other funders aren’t able to cover the difference, an enormous number of children will pointlessly die because the US secretary of health and human services happens to be wildly wrong about how diseases work. 

But the blame won’t end with him. It will also fall on everyone else in the Trump administration, and on the senators who approved his appointment in the first place even when his wildly wrong views were widely known, for not caring enough about children dying to have objected. 

We’re destroying the greatest achievements of our civilization for no reason

Kennedy, it’s worth noting, is not even a long-standing Trump loyalist. He’s a kook who hitched his wagon to the Trump train a few months before the election. He doesn’t have a huge constituency; it wouldn’t have taken all that much political courage for senators to ask for someone else to lead HHS. A lot of his decisions are likely to kill people — from his decision to ban safe, tested food dyes and instead encourage the use of food dyes some people are severely allergic to because they’re “natural” to his courtship of American anti-vaxxers and his steps to undermine accurate guidance on American child vaccination.

Trump could still easily override Kennedy on Gavi, if Trump cared about mass death. But if it holds, pulling out of Gavi is likely to be Kennedy’s deadliest decision — at least so far. He reportedly may not believe that AIDS is caused by HIV, either, and he can surpass the death toll of this week’s decision if he decides to act on that conviction by gutting our AIDS programs in the US and globally. 

But whether or not the Gavi withdrawal is the deadliest, it certainly stands out for its sheer idiocy. (The Gates Foundation is going to heroic lengths to close the funding gap, and individual donors matter, too: You can donate to Gavi here.)

None of this should have been allowed to happen. Since Kennedy’s confirmation vote in the Senate passed by a narrow margin with Mitch McConnell as the sole Republican opposing the nomination, every single other Republican senator had the opportunity to prevent it from happening — if they were willing to get yelled at momentarily for demanding that our health secretary understand how diseases work. 

I am glad the United States does not have the child mortality rates of South Sudan. I’m glad that even South Sudan does not have the child mortality rates of our world in 1900. I’m glad the United States participated in the worldwide eradication of smallpox, and I was glad that we paid our share toward Gavi until the Trump administration slashed funding earlier this year. I’m even glad that mass death is so far in our past that it’s possible for someone to be as deluded about disease as Kennedy is. 

But I am very, very sick of seeing the greatest achievements of our civilization, and the futures of a million children, be ripped to shreds by some of the worst people in politics — not because they have any alternative vision but because they do not understand what they are doing.