Robert F Kennedy Jr, the US health secretary, is a chaotic person, but his Make America Healthy Again (Maha) agenda tends to follow a predictable logic. Large-scale, mandatory public health interventions – such as childhood vaccine requirements – are generally treated with suspicion and undermined. Personal choice – to drink unpasteurised milk, for example – is to be unleashed, and unburdened by regulation. In theory, Maha promises freedom and autonomy; in practice it tends to replace the precautionary principle with exhortations for individuals to “do your own research”, and sidelines scientific expertise in favour of “wellness” hucksters and profiteers.
This is particularly obvious in Mr Kennedy’s recent claims that he will open up the sale of “about 14” injectable peptide drugs to the public. Peptides are molecules often used by our bodies for sending signals – so there are many kinds of peptides, and the safety and efficacy of each is a separate question. The widely used “weight-loss jab” drugs are peptides but so are the toxic compounds in snake venom that dissolve living cells. Mr Kennedy is likely to be referring to a subset of 17 peptides restricted by the US Food and Drug Administration (FDA) in 2023 due to “potential significant safety risks”. None have been proved to be safe or effective for human use, so there is no clear argument for reversing the decision.
But peptides fit very nicely into the wider Maha logic. Some show promise in treating disease, but most are promoted for biological enhancement: there are suggestions that certain peptides may increase muscle mass or have cognitive benefits. The evidence for these effects in humans is thin, but reports of people self-administering peptide therapies – usually bought from China “for research use only” – are widespread. This is especially true in Silicon Valley, which is pioneering a kind of self-directed medical speculation, betting that risky and minimally evidenced treatments might pay off and give individuals a social or intellectual edge. Given the contemporary obsession with wellness and optimisation, it’s likely that this will enter the wider culture soon enough. The number of retailers selling “for research use” peptides in the UK and Europe suggests grey market use is common.
The Maha project wants to make the grey market the only market. Mr Kennedy doesn’t need full FDA endorsement of his favoured dodgy products so much as a lack of proscription. Peptides are clearly drugs and shouldn’t be allowed for widespread use without rigorous clinical trials. Opening loopholes for sale would in effect sanction mass public use, as some US-based pharmacies and even the group behind the controversial Enhanced Games sports contest is lobbying to sell them.
It can be frustrating that promising therapies often don’t receive the attention and funding needed to shepherd them through to approval, but the precautionary principle has successfully led public health policy for generations, and it should not be abandoned or circumvented so easily. It is also worth noting that we simply don’t know peptides work without doing the scientific research. Anecdote is not evidence. Other governments are unlikely to be cavalier as Mr Kennedy about peptides. But people everywhere will continue to call for more personal choice and more bodily autonomy, and those conversations are important. They are also all the more reason for the case for safety, proof and regulation to be made.
