Why do people get sick? Ask Robert F. Kennedy Jr., America’s highest-ranking public-health official, and he may chalk it up to their terrain.
For centuries, doctors and scientists have agreed that germs are the underlying cause of infectious diseases. Someone coughs on you, you get a cold. Drink
raw milk
, and you might end up with E. coli or listeria. This widely accepted truth is the basis of pasteurization, vaccines and antibiotics.
But Kennedy has long embraced ideas rooted in theories that run counter to germ theory and help explain his deep mistrust of vaccines and his efforts to remake the U.S. public-health system. Those efforts came to a head last week as the Trump administration
fired the head of the Centers for Disease Control and Prevention
and other top officials quit their jobs in the midst of disagreements with Kennedy vaccine policy. On Thursday, Kennedy testified
before a heated Senate panel
about the administration’s health agenda and the recent staffing shake-ups.
“Secretary Kennedy is committed to building the healthiest generation in American history,” said Andrew G. Nixon, director of communications at the Department of Health and Human Services in a statement. “He is working to end the chronic disease epidemic and restoring trust in public health through transparency, gold-standard science, and evidence-based medicine.”
As chemist Louis Pasteur’s germ theory of disease was gaining traction in the 1800s, his rival Antoine Béchamp raised an alternative explanation: Disease, he said, was caused by the state of the body, which he referred to as the “terrain.” In his view, a strong inner environment, bolstered by nutritional food and a healthy lifestyle, could fend off illness.
Most doctors and scientists rejected Béchamp’s view, and the science of germ theory, bolstered by a German doctor named Robert Koch who identified bacteria that caused specific diseases like anthrax and tuberculosis, became a foundational piece of modern public health. Today scientists recognize that even healthy people can get sick when a virus infects them. But Béchamp retained a fringe following, one that has spread in the internet era. Kennedy’s critiques of germ theory reflect the persistent support of that sentiment.
Germ theory, Kennedy wrote in his 2021 book “The Real Anthony Fauci: Bill Gates, Big Pharma, and the Global War on Democracy and Public Health,” is at the heart of his critique of American healthcare.
“The ubiquity of pasteurization and vaccinations are only two of the many indicators of the domineering ascendancy of germ theory as the cornerstone of contemporary public health policy,” he wrote in the book. “A $1 trillion pharmaceutical industry pushing patented pills, powders, pricks, potions and poisons and the powerful professions of virology and vaccinology … fortifies the century-old predominance of germ theory.”
In his book, Kennedy refers to Béchamp approvingly as a “miasmist”—a believer in miasma theory, which predates both germ and terrain theory. It is the belief that disease is caused by bad air, or something poisonous in the environment. There is firm consensus in the public-health community that environmental factors like air quality, as well as good nutrition, are important for good health, but these factors do not reliably protect people from getting infected by viruses.
As his political profile grew, Kennedy made his war on germ theory part of his public platform. As a presidential candidate in 2023, he promised to tell the National Institutes of Health to “give infectious disease a break for about eight years,”
NBC reported
. On a 2023 episode of Joe Rogan’s popular podcast, Kennedy said “it’s hard for an infectious disease to kill a healthy person with a rugged immune system”—an assertion that runs counter to modern medical consensus. When Rogan said that wasn’t true of the 1918 Spanish flu, which killed more than
50 million people globally,
Kennedy replied: “Well, the Spanish flu was not a virus.” He said that people became sick and died after receiving a new vaccine that was being tested at a military base in Kansas—a conspiracy theory that has been disproved. In his book, Kennedy writes that “government virologists” have invoked the Spanish flu to “terrorize generations of Americans with vaccine compliance.”
Kennedy’s
Make America Healthy Again movement
has advanced fringe proposals such as removing
fluoride
from public water and defying vaccine schedules. Meanwhile, wellness influencers are promoting myriad “detoxifying” supplements and treatments to their millions of followers. All of this has brought long-debunked ideas about health back into the zeitgeist.
Actor Woody Harrelson, a vocal Kennedy supporter, asserted his belief in terrain theory while appearing on Rogan’s podcast in February. “People’s immune system gets messed up from what they’re consuming,” he said. “And in a nutshell, that’s why I believe in Béchamp’s theory as opposed to the germ theory. And, at least, it’s got to be both.” Harrelson, who declined an interview request, also discussed the theory on Bill Maher’s
podcast in 2022
, where Maher showed support for the theory too.
In their remarks, Harrelson and Maher acknowledge that germs do exist—but that healthy people tend not to be affected by them. “No serious person would contend that terrain isn’t a factor in our health,” Maher said in a statement. “A pathogen invading healthy terrain will have a harder time surviving. Terrain is a key factor among many.”
Others, like Dr. Jessica Peatross, entertain more extreme views. A physician, health coach and guest on MAHA-favorite podcasts such as Alex Clark’s “Culture Apothecary,” Peatross promotes terrain theory and said she finds conspiracies that viruses do not exist to be “intriguing.” “I don’t want to dwell on what is actually making people sick,” she said, adding that she is instead focused on the remedy to help people feel better. On a 2024 episode of jujitsu practitioner and conspiracy theorist Eddie Bravo’s podcast featuring NFL quarterback Aaron Rodgers, Bravo, who believes the earth is flat, backed terrain theory. Larry Cook, a prominent vaccine critic whose X handle is @stopvaccinating, has tweeted about germ theory and terrain theory.
Paul Offit, a doctor, professor and
virology expert
, said Sec. Kennedy’s views were evident in his response to the 8-year-old girl in West Texas who died of
measles
, Offit said; Kennedy suggested that malnourishment and living in food deserts played a role in what appeared to be a clear-cut case of infectious disease.
“And what does he do? He pushes vitamin A,” said Offit, noting that the supplement is not an effective treatment for measles.
Write to Sara Ashley O’Brien at
sara.obrien@wsj.com