Last month, the Senate pushed past concerns by public health experts to confirm Robert F. Kennedy Jr. as secretary of the Department of Health and Human Services (HHS). One of RFK Jr.’s signature proposals is to “take a break” from funding infectious disease research to focus on chronic disease. On the surface, this may sound like a reasonable reallocation of resources – but it fundamentally misunderstands the connection between infectious and chronic disease. Rather than being at odds, these two research streams are deeply intertwined, and prioritizing one at the expense of the other presents a dangerous false choice.

RFK Jr.’s proposal suggests that attention to infectious disease has come at the expense of chronic disease – even though chronic disease research already receives billions of dollars more in funding from the National Institutes of Health. He has also criticized the neglect of “root causes” in health research; in reality, infectious diseases often play a key role in the development and exacerbation of chronic conditions. Many chronic conditions have infectious origins. Research suggests that infection with the Epstein-Barr virus (which causes mononucleosis) can lead to multiple sclerosis later in life. One in five of those infected with SARS-CoV-2, the virus that causes COVID-19, experience lasting symptoms in the form of Long COVID. Approximately one in ten people who contract Lyme Disease experience persistent symptoms even after completing a course of antibiotics. And Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) — a chronic, long-term illness with profound impacts on quality of life — is usually preceded by a viral illness.

If RFK Jr. is truly concerned with addressing the “root causes” of chronic disease, then preventing and treating infectious diseases should be central to that effort. By controlling infections, we reduce the number of people who go on to develop chronic complications. His proposed reallocation of funds risks allowing new chronic conditions to emerge unchecked.

Infection can also exacerbate chronic conditions that already exist. In one survey, nearly 80 percent of those with Long COVID reported that their condition worsened following reinfection. Reinfection also triggered a relapse in 60 percent of those reinfected after their Long COVID symptoms had improved or disappeared. Viral and bacterial infections can strain the body, worsening cardiovascular disease, triggering autoimmune flares, and increasing the severity of metabolic disorders. Patients with compromised immune systems or conditions like diabetes are at higher risk of complications from infections. This makes reducing the prevalence of infectious diseases a critical accessibility measure for many of those with chronic conditions.

Addressing the root causes of chronic disease requires a preventative approach to infectious disease. Vaccines, for instance, have significantly reduced the burden of chronic conditions. Those who receive vaccinations against human papillomavirus (HPV) are far less likely to develop cervical cancer. The measles vaccine protects against an infection that can lead to long-term immunological and neurological complications. If research into infectious diseases is cut, future breakthroughs that could prevent chronic illnesses will be lost.

Recent progress in developing a next-generation COVID-19 vaccine — one that meaningfully curbs transmission and, consequently, reduces the incidence of Long COVID — highlights how investing in infectious disease prevention can play a crucial role in combating chronic illness. Several promising candidates have now progressed to human trials, funded by the Department of Health and Human Services’ Project NextGen. Investing in such preventative measures not only curtails the spread of infections but also reduces the likelihood of long-term health complications, illustrating why funding infectious disease research in general — and vaccines in particular — is critical to tackling chronic disease.

RFK Jr. has rightfully noted that using drugs to treat chronic conditions is far more profitable for pharmaceutical companies than ridding people of those conditions. It is also far more lucrative than preventing those conditions in the first place. The profit-driven nature of drug development means that corporate research dollars favor lucrative chronic disease treatments over preventive measures or actual cures (the saga of successful antivirals for Hepatitis C is illustrative). RFK Jr.’s proposal to deprioritize infectious disease potentially steers more patients toward a cycle of long-term treatment. This ultimately aligns with Big Pharma’s interests more than with those of public health.

To be sure, chronic disease research deserves funding and attention. There are still significant gaps in our understanding of chronic illnesses, and many patients suffer from a lack of effective treatments. Said research must also account for socioeconomic and environmental contributors, as health outcomes are inextricably linked to economic injustice and inequality. But a holistic, root-cause-oriented approach to chronic disease also requires a robust program of infectious disease research.

RFK Jr. is also right to insist that health research go beyond the development of new pharmaceuticals. Here too, though, there are opportunities to address both infectious and chronic disease simultaneously. Investments in indoor air quality, for example, could improve outcomes for asthma and allergy patients while reducing transmission of airborne infectious diseases like measles and COVID-19.

Truly helping those with chronic conditions requires a multi-pronged approach. We must find ways to prevent and effectively treat the causes of chronic conditions, which crucially includes addressing the infections that produce and exacerbate many of them. We must fund research into treatments and cures for those who currently suffer from chronic conditions. We must increase accessibility for those with these conditions, as part of a disability justice-minded approach to health. And for each prong, patients must be treated as partners rather than subjects. A standout example of this integrated research approach is the Patient-Led Research Collaborative, which has empowered Long COVID patients to shape and contribute to research on their condition and has prioritized both prevention and treatment. Such collaborations, in which patients play a central role in setting priorities and advancing research, offer a promising framework to tackle chronic conditions.

By contrast, RFK Jr.’s proposal represents a dangerous oversimplification of a complex issue. Infectious and chronic disease research should not be seen as competitors for funding but as vital allies in the fight to improve public health. Rather than abandoning promising prevention efforts and casting doubt on life-saving vaccines, the new HHS Secretary should work to ensure that our research priorities reflect the intertwined nature of infectious and chronic disease. Lasting progress in public health depends on collaboration, not false choices.