Trump embraces conspiratorial language to attack Big Pharma

Driving the news: Trump's comments about drugmakers, posted in policy proposals and videos on his campaign website, have largely flown under the radar as his campaign speeches have doubled down on extreme rhetoric, like his use of anti-immigrant language and praise of foreign authoritarians over the weekend.

Details: One of the "Agenda47" proposals on Trump's campaign website — "Addressing Rise of Chronic Childhood Illnesses" — cites an "unexplained and alarming growth in the prevalence of chronic illnesses and health problems, especially in children."

• Trump in a June video that was also posted to Truth Social questions whether the food we eat, environmental toxins, or the "over-prescription of certain medications" is contributing to this increase.
• "Too often, our public health establishment is too close to Big Pharma —they make a lot of money, Big Pharma — big corporations, and other special interests, and does not want to ask the tough questions about what is happening to our children's health," Trump said in the video.
• "If Big Pharma defrauds American patients and taxpayers or puts profits above people, they must be investigated and held accountable," he said.

• Trump goes on to call for a "a special Presidential Commission of independent minds who are not bought and paid for by Big Pharma" to investigate the rise in chronic illness.

The intrigue: Trump's language around childhood illness is reminiscent of Robert F. Kennedy Jr., a prominent vaccine skeptic who's running for president as an independent and has been praised by Trump as a "common sense guy."

• In a video on his campaign website, Kennedy promises to "end the chronic disease epidemic in this country."
• Kennedy has promoted the discredited theory that vaccines cause autism, though he doesn't directly make this claim in the video. But he previously tied "the children's health crisis" to "environmental toxins" and vaccines in an e-book published by the Children's Health Defense, which he founded.
• Kennedy is "pleased" that Trump is highlighting the rise in childhood disease, said Kennedy campaign spokesperson Stefanie Spear. Trump's attention to the issue "testifies to the success of Children's Health Defense and many other activist organizations in putting the chronic disease epidemic on the political radar," she said.

Reality check: The rate of conditions including disabilities, mental health diagnoses, ADHD diagnoses and obesity have gone up among children in recent years, according to the American Academy of Pediatrics.

• There are numerous and complex health, societal and environmental factors that underlie these numbers. Increased awareness and better ability to diagnose some conditions are believed to be contributing factors.
• Trump's "conspiratorial language" is "unhelpful," said vaccine scientist and pediatrician Peter Hotez, who said the anti-vaccine movement in recent years has sought to tie vaccines to a range of chronic diseases.
• "Now that the far right has adopted the anti-vaccine movement, it's very conspiracy-laden," Hotez said.
• The anti-vaccine movement's rhetoric on chronic illnesses, now being voiced by Trump, is "so vague and so badly crafted, how do you even address it? " he said.
• "It gives them a license to bring up any condition they want, whether it's asthma or whether its peanut allergies or whether it's lupus. They just use it as a catchall for whatever they feel like alleging at the time."

What they're saying: The Trump campaign did not respond to a request for further explanation.

• A spokesperson for PhRMA, the main drugmaker lobby, did not address Trump's proposals directly when asked about them.
• "Political rhetoric surrounding health care will only continue to rise as we enter an election year. Candidates should focus on voter's top priorities; lowering out-of-pocket costs and holding insurers and their [pharmacy benefit managers] accountable," Alex Schriver, PhRMA's senior vice president of public affairs, told Axios in an emailed statement.
• Two leading physician organizations, the American Medical Association and the American Academy of Pediatrics, declined interview requests to discuss Trump's agenda.

The big picture: Trust in public health institutions plummeted among Republicans during the pandemic, with prominent members of the party questioning the safety of COVID vaccines and the actions of vaccine makers and government agencies.

• Despite Trump's own history of vaccine-skeptical comments, his administration's Operation Warp Speed produced safe and effective COVID vaccines at an unprecedented pace — an achievement that his base doesn't give him much credit for.
• Vaccine skepticism has grown among GOP voters in recent years, and recent KFF polling found that Republicans are significantly more likely than Democrats to believe that misinformation about COVID-19 and vaccines is true — although independents aren't very far behind them or, in some cases, are more likely to believe misinformation.
• For example, 29% of Republicans said it's probably or definitely true that the combined measles, mumps and rubella vaccine has been proven to cause autism in children, compared with 14% of Democrats and 34% of independents. Scientific research has repeatedly found no association between the MMR vaccine and autism.

Trump's calls for investigations into "Big Pharma" also tap into GOP voters' anxieties over education, gender-affirming care for adolescents and the youth mental health crisis.

• A schools-related proposal on Trump's campaign website calls for the Food and Drug Administration to convene an "outside panel to investigate whether transgender hormone treatments and ideology increase the risk of extreme depression, aggression, and violence." He made a similar pledge during a speech at the National Rifle Association's annual meeting this spring.
• The campaign says the Trump administration will explore whether "common psychiatric drugs, as well as genetically engineered cannabis and other narcotics, are causing psychotic breaks."
• It also calls for a Department of Justice investigation into whether "Big Pharma and the big hospital networks" have covered up the "horrific long-term side effects of 'sex transitions' in order to get rich at the expense of vulnerable patients."
• And a proposal to "dismantle the Deep State" specifically calls out "Big Pharma" as part of the plan to "ban federal bureaucrats from taking jobs at the companies they deal with and regulate."

The bottom line: The idea that you can trust the prescription drugs that a health provider offers you is a basic societal norm.

• While mainstream politicians on the left and right for years have criticized the pharmaceutical industry over pricing, there's been a common understanding that the U.S system can be trusted to place safe and effective drugs on the market and to remove them if new evidence showing otherwise arises.
• But Trump is suggesting negligence or cover-ups of safety issues.
• "Elements of the GOP, especially the far-right, has been targeting science and scientists as enemies of the state," Hotez said. "I was hoping Trump would not go there."