| Robert F. Kennedy Jr.’s ascent to head of US health policy promised to bring about radical change by cleaning up foods, policing medicines and reining in the influence of corporate profiteers, all in the name of making America healthy again. In practice, he’s delivered mostly rhetoric. The latest example is Thursday’s report from Kennedy’s MAHA Commission, billed as a “call to action” on the rising rates of chronic disease in the US. Over the course of 69 pages, the report name-checks processed foods, drugs and pesticides as contributors to declining childhood health. But its actual prescriptions, relegated to a single page at the end, was just a list of recommendations for further study, some of which are already underway. It was a stark contrast from the sweeping crackdown many in the food, agriculture and pharmaceutical industries had feared. But it was in keeping with Kennedy’s track record since taking office in February. In March, Kennedy gave food makers an ultimatum to remove synthetic dyes. But his action in April wasn’t a ban. Instead, the FDA announced that it would work with companies to phase out dyes as Kennedy said there was an “understanding” with manufacturers. (There wasn’t any such agreement, industry lobbyists said.) A longtime vaccine critic, Kennedy has repeatedly threatened to upend how the US approves and recommends shots. But the health department’s actual policy changes have, thus far, had little impact on the pharmaceutical industry. Kennedy had promised that on President Donald Trump’s first day in office, the White House would call for the removal of fluoride from public water systems. That didn’t happen. Instead, the FDA announced this month that it’s launched a safety review of ingestible prescription fluoride products for children. Even Kennedy’s anti-corporate streak appears to be getting watered down. While the MAHA report includes some sharp words for big business and the role of products like pesticides in US health, administration officials took pains to praise industry and insist the report not be interpreted as a broadside to corporate America. All this could still change. Kennedy said the report is meant to serve as a blueprint for the administration’s plans for health and that more specific policy recommendations will come in August. But if the past few months are any clue, the follow-through may not live up to the rhetoric. — Damian Garde | 
