Ariel Cohen | (TNS) CQ-Roll Call

President-elect Donald Trump has pledged to involve anti-vaccine activist and conspiracy theorist Robert F. Kennedy Jr. in his next administration in some capacity, but whoever else he picks to run the major health agencies will have a major impact on the GOP health agenda of the next four years.

Top posts require Senate confirmation, meaning Trump will need Senate buy-in too. Positions include Health and Human Services secretary, which requires Senate confirmation; Centers for Disease Control and Prevention director, which will require Senate confirmation beginning in January 2025; Food and Drug Administration commissioner and National Institutes of Health director, which also require Senate confirmation.

Republican health priorities will likely include increased health care transparency and lowering drug costs, as well as limiting health care access for LGBTQ individuals and, potentially, further limiting access to abortion. This might look like rolling back Title X regulations, which are federal dollars for family planning, or the Mexico City policy, which blocks federal funding for nongovernmental organizations that provide abortion counseling or services.

It could also look like rollbacks of rules regarding nondiscrimination in health care, drug price negotiation interference or nursing home staffing mandates.

Here are some of the names being mentioned for future Trump health policy roles:

Robert F. Kennedy Jr.

Trump reiterated his pledge to involve RFK Jr. in his administration during his victory speech on Tuesday, but it’s unlikely he’ll be nominated to lead a major agency.

“He’s going to help make America healthy again. He’s a great guy and he really means it. He wants to do some things, and we’re going to let him go to it,” Trump told supporters at the West Palm Beach Convention Center during his victory speech Tuesday night.

In an MSNBC interview on Wednesday morning, Kennedy said he would clear out entire departments of the FDA, including the nutrition department, which was recently revamped as part of the agency’s effort to create a Human Foods Program.

Many experts say they imagine Kennedy will serve more as an informal adviser to Trump, because it could be difficult to get a majority of senators, even in a GOP-led chamber, to confirm him.

“I see someone like that a little more in kind of the Elon Musk type of role … somebody who is whispering in the ear of the administration,” said K&L Gates government affairs adviser and former RNC delegate Amy Carnevale.

Joseph A. Ladapo

Florida Surgeon General Joseph Ladapo is under consideration to lead HHS, ABC News first reported.

Like Kennedy, Ladapo is a vaccine skeptic.

Under his leadership, Florida skirted CDC pandemic guidelines regarding masks and social distancing, as well as vaccine requirements for children. In October 2022, he recommended that men between ages 18 and 39 avoid the COVID-19 mRNA vaccines because of a slightly increased risk for cardiac-related deaths. The study he referenced was widely criticized, and the FDA and CDC sent him a letter asking him to stop spreading disinformation.

Lapado was first appointed by Republican Gov. Ron DeSantis in 2021.

After Trump’s win, Ladapo tweeted on Wednesday that the “future of health freedom in America looked brighter.”

“Just as in Florida, it’s time to say ‘No’ to trampling on people’s rights, to gaslighting citizens about experimental vaccines that harm instead of help & to muzzling doctors who dissent with orthodoxy. Light triumphs over darkness,” he said.

Roger Severino

Roger Severino, the former director of the HHS Office of Civil Rights under Trump and current vice president of domestic policy at the Heritage Foundation, wrote the HHS portion of Project 2025.

Severino is one of the most vocal abortion opponents in the GOP. He has repeatedly said that the government should not treat abortion as health care and calls for reversing approval of medication abortion, codifying the Hyde amendment and removing the morning-after pill from the contraceptive mandate.

In Project 2025 he also encourages the NIH to stop promoting “junk gender science” and redefine the definition of sex so it does not include gender identity, among other things.

Brian Blase

Brian Blase, a former Trump special assistant to the president for economic policy at the White House’s National Economic Council and currently the president of Paragon Health Institute, could come back around for a second administration.

In his most recent email blast, Blase called Trump’s victory “an opportunity to build on the health care successes of his first term” — pointing mainly to policies that expanded the availability of short-term health plans, association health plans and price transparency.

During the Biden administration, Blase has been analyzing and promoting the expansion of health savings account plans. He has proposed providing lower-income exchange enrollees the option to receive a portion of their subsidy as a HSA deposit rather than a subsidy to the insurer.

He also argued against the Biden administration’s expansion of Medicaid during the COVID-19 public health emergency, and called for limiting the program’s scope to just the lowest-income and most vulnerable individuals.

Paul Mango

Mango, another former Trump administration official and an adviser at the Paragon Institute, served as HHS deputy chief of staff from 2019 through 2021 and served as HHS Secretary Alex Azar’s formal liaison to Operation Warp Speed. From 2018 to 2019, Mango served as chief of staff for the Centers for Medicare and Medicaid Services. His institutional knowledge of the department could be seen as an asset to an incoming Trump administration.

Eric Hargan

Another Trump administration alumni, Eric Hargan served as deputy HHS secretary under Trump and also as acting secretary. He also served on the board of Operation Warp Speed. Hargan oversaw the setup and launch of the pandemic-era Provider Relief Fund.

Hargan was also acting HHS deputy secretary under then-President George W. Bush.

These days he’s the founder and CEO of the Hargan Group, where he focuses on health care, government relations and public affairs.

Joe Grogan

Joe Grogan served as an assistant to Trump and director of his Domestic Policy Council. He also was a member of the White House Coronavirus Task Force in the early days of the pandemic. But Grogan didn’t stay in the administration the entirety of the first term and resigned in May 2020 to join Verde Technologies.

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During his time in the White House, Grogan worked closely on efforts to lower drug costs, ban surprise medical bills and expand COVID-19 testing. He’s been a vocal opponent of the Biden administration’s policies to have Medicare negotiate drug costs, saying it would lead to less pharmaceutical innovation, and has repeatedly called for FDA reform to speed up the drug review and approval process.

These days Grogan is also at Paragon Health Institute where he serves as chairman of the board.

Bobby Jindal

The former Louisiana governor is now chair of the Center for a Healthy America, a wing of the America First Policy Institute, a conservative think tank advising Trump. Jindal’s focus on health policy isn’t new: he served as HHS assistant secretary under George W. Bush. Over the last few years he’s called for changes to the health care exchanges, increased price transparency measures and advocated against single-payer health care.

©2024 CQ-Roll Call, Inc., All Rights Reserved. Visit cqrollcall.com. Distributed by Tribune Content Agency, LLC.

By SETH BORENSTEIN, MELINA WALLING and SIBI ARASU

BAKU, Azerbaijan (AP) — Soaring rhetoric, urgent pleas and pledges of cooperation contrasted with a backdrop of seismic political changes, global wars and economic hardships as United Nations annual climate talks began Monday and got right to the hard part: money.

In Baku, Azerbaijan, where the world’s first oil well was drilled and the smell of the fuel was noticeable outdoors, the two-week session, called COP29, got right to the major focus of striking a new deal on how many hundreds of billions — or even trillions — of dollars a year will flow from rich nations to poor to try to curb and adapt to climate change.

The money is to help the developing world transition their energy systems away from planet-warming fossil fuels and toward clean energy, compensate for climate disasters mostly triggered by carbon pollution from rich nations and adapt to future extreme weather.

“These numbers may sound big but they are nothing compared to the cost of inaction,” the new COP29 president, Mukhtar Babayev, said as he took over. “COP29 is a moment of truth for the Paris Agreement ” which in 2015 set a goal of limiting warming to 1.5 degrees Celsius (2.7 degrees Fahrenheit) since pre-industrial times.

This year, the world is on pace for 1.5 degrees of warming and is heading to become the hottest year in human civilization, the European climate service Copernicus announced earlier this month. But the Paris 1.5 goal is about two or three decades, not one year of that amount of warming and “it is not possible, simply not possible,” to abandon the 1.5 goal yet, said World Meteorological Organization Secretary-General Celeste Saulo.

Signs of climate disasters abound

FILE – Homes destroyed by Hurricane Beryl sit in Clifton, Union Island, St. Vincent and the Grenadines, July 4, 2024. (AP Photo/Lucanus Ollivierre, File)

The effects of climate change in disasters such as hurricanes, droughts and floods are already here and hurting, Babayev said.

“We are on the road to ruin,” he said. “Whether you see them or not, people are suffering in the shadows. They are dying in the dark. And they need more than compassion. More than prayers and paperwork. They are crying out for leadership and action.”

United Nations Climate Secretary Simon Stiell, whose home island of Carriacou was devasted earlier this year by Hurricane Beryl, used the story of his neighbor, an 85-year-old named Florence, to help find “a way out of this mess.”

Her home was demolished and Florence focused one thing: “Being strong for her family and for her community. There are people like Florence in every country on Earth. Knocked down, and getting back up again.″

That’s what the world must do with climate change, especially with providing money, Stiell said.

“Let’s dispense with any idea that climate finance is charity,” Stiell said. “An ambitious new climate finance goal is entirely in the self-interest of every nation, including the largest and wealthiest” because it will keep future warming from hitting 5 degrees Celsius, where he said the world was going before it started fighting climate change.

A backdrop of war and upheaval hangs over talks

In the past year, nation after nation has seen political upheaval, with the latest being in the United States — the largest historic carbon emitter — and Germany, a climate leading nation.

The election of Donald Trump, who disputes climate change and its impact, and the collapse of the German governing coalition are altering climate negotiation dynamics here, experts said.

“The global north needs to be cutting emissions even faster and should be decreasing by 20, 30, 40% now. But instead we’ve got Trump, we’ve got a German government that just fell apart because part of it wanted to be even slightly ambitious,” said Imperial College London climate scientist Friederike Otto. “So, we are very far off.”

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Initially, Azerbaijan organizers who were hoping to have nations across the globe stop fighting during the two weeks of negotiations. That didn’t happen as wars in Ukraine, Gaza and elsewhere continued.

Dozens of climate activists at the conference — many of them wearing Palestinian keffiyehs — held up banners calling for climate justice and for nations to “stop fueling genocide.”

“It’s the same systems of oppression and discrimination that are putting people on the frontlines of climate change and putting people on the front lines of conflict in Palestine,” said Lise Masson, a protester from Friends of the Earth International. She slammed the United States, the U.K. and the EU for not spending more on climate finance while also supplying arms to Israel.

Mohammed Ursof, a climate activist from Gaza, called for demonstrators at the talks to “get power back to the Indigenous, power back to the people.”

Jacob Johns, a Hopi and Akimel O’odham community organizer, came to the conference with hope for a better world.

“Within sight of the destruction lies the seed of creation,” he said at a panel about Indigenous people’s hopes for climate action. “We have to realize that we are not citizens of one nation, we are the Earth.”

Hopes for a strong outcome

The financial package being hashed out at this year’s talks is important because every nation has until early next year to submit new — and presumably stronger — targets for curbing emissions of heat-trapping gases from the burning of coal, oil and natural gas. That’s part of the 2015 Paris agreement for nations to ratchet up efforts every five years.

Some Pacific climate researchers said that the amount of money on offer was not the biggest problem for small island nations, which are some of the world’s most imperiled by rising seas.

“There might be funding out there, but to get access to this funding for us here in the Pacific is quite an impediment,” said Hilda Sakiti-Waqa, from the University of the South Pacific in Fiji. “The Pacific really needs a lot of technical help in order to put together these applications.”

First, delegates must agree an agenda for the two-week meeting, and it’s already proved a sticking point.

“We’ve seen this (delay) in the past,” said Jennifer Morgan, State Secretary for Germany’s federal foreign office. “My experience right now is that countries are really here to negotiate.”

The long-term global average temperature is now 1.3 degrees Celsius (2.3 degrees Fahrenheit) above pre-industrial times, only two-tenths of a degree from the agreed-upon threshold.

For the world to prevent more than 1.5 degrees of warming, global carbon emissions must be slashed by 42% by 2030, a new United Nations report said.

“We cannot leave Baku without a substantial outcome,” Stiell said. “Now is the time to show that global cooperation is not down for the count. It is rising to the moment.”

Associated Press reporter Charlotte Graham-McLay in Wellington, New Zealand contributed.

Read more of AP’s climate coverage at http://www.apnews.com/climate-and-environment

Follow Seth Borenstein on X at @borenbears and Melina Walling at @MelinaWalling

The Associated Press’ climate and environmental coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

By MICHELLE L. PRICE

NEW YORK (AP) — Donald Trump is naming longtime adviser Stephen Miller, an immigration hard-liner, to be the deputy chief of policy in his new administration.

Vice President-elect JD Vance posted a message of congratulations on Monday to Miller on X and said, “This is another fantastic pick by the president.” The announcement was first reported by CNN.

Miller was a senior adviser in Trump’s first term and has been a central figure in many of his policy decisions, notably his move to separate thousands of immigrant families as a deterrence program in 2018. Miller helped craft many of Trump’s hard-line speeches and plans on immigration.

Since Trump left office, Miller has served as the president of America First Legal, an organization of former Trump advisers fashioned as a conservative version of the American Civil Liberties Union, challenging the Biden administration, media companies, universities and others over issues such as freedom of speech and religion and national security.

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By JILL COLVIN and FARNOUSH AMIRI

NEW YORK (AP) — President-elect Donald Trump has chosen Rep. Elise Stefanik to serve as his ambassador to the United Nations, picking a loyal ally with little foreign policy experience to represent the U.S. at the international organization.

“Elise is an incredibly strong, tough, and smart America First fighter,” Trump said in a statement Monday announcing his pick for the role — his first selection that will require Senate confirmation.

Stefanik, 40, who serves as House Republican Conference Chair, has long been one of Trump’s most loyal allies in the House, and was among those discussed as a potential vice presidential choice.

Born and raised in upstate New York, Stefanik graduated from Harvard and worked in former President George W. Bush’s White House on the domestic policy council and in the chief of staff’s office.

In 2014, at 30, she became the youngest woman ever elected to Congress, representing upstate New York. She later became the youngest woman to serve in House leadership.

Stefanik was known early in her tenure as a more moderate conservative voice. But she soon attached herself to the former president, quietly remaking her image into that of a staunch MAGA ally — and seeing her power ascend.

She became the House Republican Conference Chair in 2021.

Stefanik spent years positioning herself as one of Trump’s most trusted allies and confidants on the Hill. She endorsed him in the 2024 race before he had even launched his bid, and aggressively campaigned on his behalf during the GOP primary.

She saw her profile rise after her aggressive questioning of a trio of university presidents over antisemitism on their campuses led to two of their resignations — a performance Trump repeatedly praised.

She also defended him vigorously in both of his impeachment trials and railed against his four criminal indictments, including filing an ethics complaint in New York against the judge who heard his civil fraud case.

Nikki Haley, who challenged Trump for the GOP nomination, was among those who previously held the U.N. ambassador role in his first term.

Stefanik’s appointment to the job comes despite her minimal experience in foreign policy and national security.

While she is a member of the House Armed Services Committee and serves on the coveted House committee that oversees national intelligence, her pick further solidifies Trump’s preference for unconditional loyalty in his second administration over career experience.

One area of foreign policy that Stefanik has been vocal about is Israel.

Since the start of the Israel-Hamas war, Stefanik has focused much of her attention on the United Nations, accusing the world body and international organizations of antisemitism for their criticism of Israel’s bombardment of Gaza, which has resulted in the death of more than 43,000 Palestinians, according to the group’s Health Ministry.

She has gone as far as calling last month for a “complete reassessment” of U.S. funding for the United Nations. while helping push for the blocking of American support for the U.N. agency that provides humanitarian aid to Palestinians in the region.

Her departure for the United Nations will also mean that Republicans, who are on track to have a razor-thin majority in the House, will be down one crucial vote. But Stefanik’s district is located in a deeply red part of upstate New York, where Republicans are likely guaranteed to win the special election that will take place after she leaves office.

“Republicans will hold this safe Republican seat as part of a Republican majority in the House that will help deliver on President Trump’s historic mandate,” Ed Cox, the chair of the New York Republican party, said in a statement Monday.

Trump did not say much about the U.N. during his campaign, but has generally advocated for a less interventionist foreign policy. He has also repeatedly questioned the utility of international alliances, including NATO, and he has threatened allies with higher tariffs and said he will not protect them unless they contribute more to their own defense.

Trump has also talked about how he initially wanted to select his eldest daughter, Ivanka Trump, for the role after he was elected the first time.

“’You would be a great ambassador to the United Nations, United Nations secretary.’ There’d be nobody to compete with her, I tell you,” he said at a Moms for Liberty Summit in August. “She may be my daughter, but nobody could have competed with her.”

Amiri reported from Washington.