President-elect Donald Trump said on Thursday he has selected Robert F. Kennedy Jr., an environmental activist who has spread misinformation on vaccines, to lead the Department of Health and Human Services, the United States’ top health agency.

In a post on X, Kennedy vowed to work to end chronic disease, clean up corruption and provide Americans with the data they need to make informed decisions, vowing to Trump he would work to “Make America Healthy Again.”

Kennedy ran for president in this year’s election as an independent before dropping out in August and endorsing Trump in exchange for a role in the Republican’s administration.

Trump’s cabinet

MARCO RUBIO, secretary of state

On Wednesday, Trump tapped U.S. Senator Marco Rubio to be his secretary of state, putting the Florida-born politician on track to be the first Latino to serve as the United States’ top diplomat.

Rubio, 53, was arguably the most hawkish option on Trump’s shortlist for secretary of state. The senator has in past years advocated for a muscular foreign policy with respect to U.S. geopolitical foes, including China, Iran and Cuba.

Over the last several years he has softened some of his stances to align more closely with Trump’s views. The president-elect accuses past U.S. presidents of leading the U.S. into costly and futile wars and has pushed for a less interventionist foreign policy.

MATT GAETZ, attorney general

Trump said on Wednesday that he had selected Gaetz, a U.S. representative, to be his nominee for attorney general.

“Few issues in America are more important than ending the partisan Weaponization of our Justice System,” Trump said in a statement announcing the selection of the Florida lawmaker.

Trump’s inner circle has described the attorney general as the most important member of the administration after Trump himself, key to his plans to carry out mass deportations, pardon Jan. 6 rioters and seek retribution against those who prosecuted him over the past four years.

TULSI GABBARD, director of national intelligence

Trump on Wednesday named Gabbard, a former Democratic representative and critic of the Biden administration, as his director of national intelligence.

Gabbard left the Democratic Party in 2022 to become an independent and has little direct experience with intelligence work. If confirmed she would become the top official in the U.S. intelligence community after Trump starts his second term in January.

ROBERT F. KENNEDY, JR., health and human services secretary

Kennedy is an environmental activist who has spread misinformation about the dangers of vaccines. He has suggested he would gut the 18,000-employee Food and Drug Administration, which ensures the safety of food, drugs and medical devices, and replace hundreds of employees at the National Institutes of Health.

Kennedy ran for president in this year’s election, first as a Democrat and then as an independent, before dropping out in August in exchange for a role in Trump’s administration.

The Department of Health and Human Services oversees the Food and Drug Administration, the Centers for Disease Control and Prevention, the National Institutes of Health and the massive Medicare and Medicaid Services programs, which provide health coverage for the poor, those aged 65 and older, and the disabled.

PETE HEGSETH, defense secretary

Trump said on Tuesday he had picked Hegseth as his secretary of defense. Hegseth is a Fox News commentator and veteran who has expressed disdain for the so-called “woke” policies of Pentagon leaders, including its top military officer.

Hegseth, if confirmed by the Senate, could make good on Trump’s campaign promises to rid the U.S. military of generals who he accuses of pursuing progressive policies on diversity in the ranks that conservatives have rallied against.

It could also set up a collision course between Hegseth and the chair of the Joint Chiefs of Staff, Air Force General C.Q. Brown, who Hegseth accused of “pursuing the radical positions of left-wing politicians.”

LEE ZELDIN, EPA administrator

Trump announced on Monday he had appointed Zeldin, a former congressman from New York state, as administrator of the Environmental Protection Agency.

Zeldin, 44, a staunch Trump ally, served in Congress from 2015 to 2023. In 2022, he lost the New York governor’s race to Democratic incumbent Kathy Hochul. Trump has promised to overhaul U.S. energy policy, with the aim of maximizing the country’s already record-high oil and gas production by rolling back regulations and speeding up permitting.

MIKE WALTZ, national security adviser

Trump said on Tuesday he had picked Waltz, a Republican U.S. representative, to be national security adviser. Waltz is a retired Army Green Beret who has been a leading critic of China.

Waltz, a 50-year-old Trump loyalist who also served in the National Guard as a colonel, has criticized Chinese activity in the Asia-Pacific and has voiced the need for the U.S. to be ready for a potential conflict in the region.

The national security adviser is a powerful role, which does not require Senate confirmation. Waltz will be responsible for briefing Trump on key national security issues and coordinating with different agencies.

While slamming the Biden administration for a disastrous withdrawal from Afghanistan in 2021, Waltz has publicly praised Trump’s foreign policy views.

SUSIE WILES, chief of staff

Trump announced last week that Wiles, one of his two campaign managers, will be his White House chief of staff.

While the specifics of her political views are somewhat unclear, Wiles, 67, is credited with running a successful and efficient campaign. Supporters hope she will instill a sense of order and discipline that was often lacking during Trump’s first four-year term, when he cycled through a number of chiefs of staff.

TOM HOMAN, ‘border czar’

Trump announced on Sunday night that Homan, the acting director of Immigration and Customs Enforcement during Trump’s first administration, will be in charge of the country’s borders.

Trump made cracking down on people illegally in the country a central element of his campaign, promising mass deportations.

Homan, 62, said on Monday he would prioritize deporting immigrants illegally in the U.S. who posed safety and security threats as well as those working at job sites.

ELISE STEFANIK, UN ambassador

Trump announced on Monday that Stefanik, a Republican congresswoman and staunch Trump supporter, would be his ambassador to the United Nations.

Stefanik, 40, a U.S. representative from New York state and House Republican conference chair, took a leadership position in the House of Representatives in 2021 when she was elected to replace then-Representative Liz Cheney, who was ousted for criticizing Trump’s false claims of election fraud.

Stefanik will arrive at the U.N. after bold promises by Trump to end the Russia-Ukraine war and Israel’s war in Gaza.

ELON MUSK AND VIVEK RAMASWAMY, heads of Department of Government Efficiency

Trump on Tuesday named tech billionaire Musk and Ramaswamy, a former Republican presidential candidate, to lead a newly created Department of Government Efficiency, rewarding two of his well-known supporters from the private sector.

Trump said that Musk and Ramaswamy will reduce government bureaucracy, slash excess regulations, cut waste and restructure federal agencies. Trump said the new department would bring in external expertise and work with the White House and Office of Management and Budget.

KRISTI NOEM, homeland security secretary

Noem, the governor of South Dakota, has been picked to serve as the next homeland security secretary, Trump said on Tuesday.

Noem, 52, once seen as a possible running mate for Trump, is currently serving her second four-year term as South Dakota’s governor. She rose to national prominence after refusing to impose a statewide mask mandate during the COVID-19 pandemic.

The Department of Homeland Security is responsible for everything from border protection and immigration to disaster response and the U.S. Secret Service.

DOUG BURGUM, Interior secretary

Trump said on Thursday that he had chosen Burgum, the governor of North Dakota, to be interior secretary. Speaking at an event at his Mar-a-Lago retreat in Florida, Trump said he would make the formal announcement on Friday.

“He’s going to head the Department of Interior, and it’s going to be fantastic,” Trump said. Burgum, 68, a wealthy former software company executive, has portrayed himself as a traditional, business-minded conservative. He ran against Trump for the Republican presidential nomination before quitting and becoming a loyal Trump supporter.

The Interior Department manages public lands and minerals, national parks and wildlife refuges. The department also carries out the U.S. government’s trust responsibility to Native Americans.

JOHN RATCLIFFE, CIA director

Trump said on Tuesday he had picked Ratcliffe, the former director of national intelligence, to serve as director of the Central Intelligence Agency in his second administration.

A former congressman and prosecutor who served as director of national intelligence during Trump’s last year in office, Ratcliffe, 59, is seen as a hardcore Trump loyalist who could likely win Senate confirmation. Still, during his time as director of national intelligence, Ratcliffe often contradicted the assessments of career civil servants, drawing criticism from Democrats who said he politicized the role.

SCOTT BESSENT, potential treasury secretary

Bessent, a key economic adviser to Trump, is widely seen as a top candidate for treasury secretary. A longtime hedge fund investor who taught at Yale University for several years, Bessent has a warm relationship with the president-elect.

While Bessent has long favored the laissez-faire policies that were popular in the pre-Trump Republican Party, he has also spoken highly of Trump’s use of tariffs as a negotiating tool. He has praised the president-elect’s economic philosophy, which rests on a skepticism of both regulations and international trade.

ROBERT LIGHTHIZER, potential trade czar or treasury secretary

A loyalist who served as Trump’s U.S. trade representative for essentially the then-president’s entire term, Lighthizer will almost certainly be invited back.

Though Bessent likely has a better shot at becoming treasury secretary, Lighthizer has an outside chance, and he might be able to reprise his old role if he’s interested.

The Wall Street Journal has reported Trump wanted Lighthizer as his trade czar.

Like Trump, Lighthizer, 77, is a trade skeptic and a firm believer in tariffs. He was one of the leading figures in Trump’s trade war with China and the renegotiation of the North American Free Trade Agreement, or NAFTA, with Mexico and Canada during Trump’s first term.

HOWARD LUTNICK, potential treasury secretary

The co-chair of Trump’s transition effort and the longtime chief executive of financial services firm Cantor Fitzgerald, Lutnick is in the running for treasury secretary.

A bombastic New Yorker like Trump, Lutnick, 63, has uniformly praised the president-elect’s economic policies, including his use of tariffs.

He has at times given elaborate, unvarnished opinions about what policies will be enacted in Trump’s second term. Some Trump allies had privately complained that he too often presented himself as speaking on behalf of the campaign.

LINDA McMAHON, potential commerce secretary

McMahon, a professional wrestling magnate and former Small Business Administration director, is seen as the frontrunner to lead Trump’s Department of Commerce, three sources briefed on the plans said.

McMahon, 76, is a major donor and was an early supporter of the Republican president-elect when he first ran for the White House almost a decade ago. This time, Trump tapped her to co-lead a transition team formed to help vet personnel and draft policy ahead of the Nov. 5 election.

McMahon is the co-founder and former CEO of the professional wrestling franchise WWE. She later served as director of the Small Business Administration, resigning in 2019, and went on to lead a pro-Trump political action committee that supported his 2020 reelection bid.

KASH PATEL, potential candidate for national security posts

A former Republican House staffer who served in various high-ranking staff roles in the defense and intelligence communities during Trump’s first term, Patel frequently appeared on the campaign trail to rally support for the candidate.

Any position requiring Senate confirmation may be a challenge, however.

Patel, 44, has leaned into controversy throughout his career. In an interview with Trump ally Steve Bannon last year, he promised to “come after” politicians and journalists perceived to be enemies of Trump.

During Trump’s first term, Patel, seen as the ultimate Trump loyalist, drew animosity from some more experienced national security officials, who saw him as volatile and too eager to please the then-president.

Kennedy, the son and nephew of two titans of Democratic politics, has frequently talked about tackling what he calls the “chronic disease epidemic” of conditions including obesity, diabetes and autism, and reducing chemicals in food.

“The Safety and Health of all Americans is the most important role of any Administration, and HHS will play a big role in helping ensure that everybody will be protected from harmful chemicals, pollutants, pesticides, pharmaceutical products, and food additives that have contributed to the overwhelming Health Crisis in this Country,” Trump said in a post on social media.

Later on Thursday during a speech at his Mar-a-Lago home in Florida, Trump praised Kennedy, saying he would do “unbelievable” things in his new position. “We want you to come up with things and ideas and what you’ve been talking about for a long time,” Trump said, without elaborating.

The Department of Health and Human Services oversees drug regulation, public health agencies including the Centers for Disease Control and Prevention and health insurance for more than 140 million people including the poor, those aged 65 and older, and the disabled through Medicare and Medicaid.

HHS had a $3.09 trillion budget for fiscal year 2024, representing 22.8% of the U.S. federal budget.

Drew Altman, president of health research firm KFF, described the move as historic and said what Kennedy, if confirmed, would ultimately do in the role remains to be seen, given he has not often discussed programs like Medicaid and Medicare, which account for much of the U.S. health budget.

“Historically, secretaries have been people with real experience and standing in national healthcare and he certainly is not that, and has views from outside the mainstream, and is a renegade appointment,” Altman said.

The appointment, which had been seen as a possibility for weeks, raised concern among some public health advocates who said Kennedy could have a negative role in Americans’ health given his power over these agencies. The Democratic Party decried the decision.

Some politicians and business groups supported the nomination, such as the National Community Pharmacists Association, which said it was encouraged by his willingness to take on corporations.

HEALTH PRIORITIES

Kennedy has been a part of Trump’s transition team and has been reviewing candidate resumes for the top jobs at U.S. health agencies.

Kennedy has suggested he would gut the 18,000-employee Food and Drug Administration – which ensures the safety of food, drugs and medical devices – and replace hundreds of employees at the National Institutes of Health.

“FDA’s war on public health is about to end,” he wrote on X in late October, adding that includes its “aggressive suppression” of psychedelics, peptides, stem cells, raw milk, sunshine, and other items.

“If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack your bags,” he wrote.

In early November, he said he would recommend fluoride be removed from public water supplies, falsely claiming on X that the chemical is associated with bone fractures and cancer.

In a New York Times opinion article published in September, Kennedy criticized the popular Novo Nordisk NOVOb.CO weight loss drug Ozempic, saying, “Instead of fixing our food system and addressing the obesity crisis at its root, the author focuses on a drug that may palliate the symptom – and gladden the wallets of distant Big Pharma execs.”

Dr. Ashish Jha, former White House COVID-19 Response Coordinator and dean of the Brown University School of Public Health, said: “Most people don’t realize this is not about fluoride in water, or even vaccines, as important as they are. The HHS Secretary oversees Medicare. He and his appointees will decide what medicines are available to the American people.”

James Capretta, senior fellow at the American Enterprise Institute and a former White House staffer under George W. Bush, said it is not clear what impact Kennedy will have but that it will not be immediate.

“There’s lots of constraints on policy making on the agency level, even at the secretarial level,” he said.

VACCINES

Shares of vaccine makers including Pfizer Inc PFE.N and Moderna MRNA.O fell after news of Kennedy’s appointment and were down in after-hours trading by as much as 2%.

Kennedy has been criticized for making false medical claims, including that vaccines are linked to autism. He opposed state and federal restrictions imposed during the COVID-19 pandemic and was accused of spreading misinformation about the virus.

He disputes the anti-vaccine tag, saying he wants more rigorous testing of vaccines instead. However, he chaired the Children’s Health Defense, a nonprofit organization that focuses on anti-vaccine messaging.

In an interview in March, when he was still running for president, Kennedy said Americans who want a vaccine for themselves or their children would continue to have access to them if he were to be elected. But he said he doubted the efficacy of measles vaccines.

Measles is one of the most contagious human viruses and is almost entirely preventable through vaccination. It requires 95% vaccine coverage to prevent outbreaks among populations. U.S. coverage rates have fallen below that level among young children, the CDC said this month.

Vaccines have saved over 154 million lives in the 20th century – the equivalent of six lives every minute of every year for the past 50 years, said Michael Osterholm, an infectious disease expert from the University of Minnesota.

“Immunization has continued to be the single greatest contributor of any health intervention to ensuring that babies not only see their first birthdays, but they continue leading healthy lives into adulthood,” he said.