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It is not hard to construct a scenario in which Donald Trump's plans to "Make America Healthy Again" (or MAHA) do the opposite of that.
不難想象，唐納德·特朗普的“讓美國再次健康”（MAHA）計劃恰恰相反。
His proposed secretary of health, Robert F. Kennedy junior, is one of the country's more prominent vaccine sceptics.
他提名的衛(wèi)生部長小羅伯特·肯尼迪是美國最著名的疫苗懷疑論者之一。
The man who would be in charge of the Centres for Medicare and Medicaid Services, which provides health coverage for two in five Americans,
醫(yī)生兼電視名人穆罕默德·奧茲擔(dān)任醫(yī)療保險和醫(yī)療補(bǔ)助服務(wù)中心主任，該中心為五分之二的美國人提供醫(yī)療保險，
is Mehmet Oz, a TV doctor who has talked about the medical benefits of communicating with the dead and invited a Reiki healer to assist him during surgery.
他曾談到與死者交流的醫(yī)療益處，并邀請靈氣治療師在手術(shù)期間協(xié)助他。
Dave Weldon, a former congressman and doctor, who has also cast doubt on the safety of vaccines, would lead the Centres for Disease Control and Prevention (CDC), which oversees the country's vaccine schedules.
前國會議員兼醫(yī)生戴夫·韋爾登也對疫苗的安全性表示懷疑，他將領(lǐng)導(dǎo)疾病控制和預(yù)防中心（CDC），該中心負(fù)責(zé)監(jiān)督美國的疫苗接種計劃。
Unless the Nixon-to-China theory applies to public health, these are not the people America would want in charge in a pandemic—or even just a regular epidemic.
除非“只有尼克松能去中國”的理論適用于公共衛(wèi)生，否則這些人不是美國希望在大流行病中掌權(quán)的人——甚至不是普通疫情中掌權(quán)的人。
At the same time, a central part of the MAHA agenda is something most experts agree on: America's main health problem is chronic diseases, and far too little is being done to prevent them.
與此同時，大多數(shù)專家都同意MAHA議程的核心部分：美國的主要健康問題是慢性病，而為預(yù)防這些疾病所做的努力卻太少。
Mr Kennedy has some sensible ideas about how to tackle that. So it is worth exploring what positive changes his tenure could bring about.
肯尼迪對如何解決這個問題有一些明智的想法。值得探討一下他的任期可能帶來哪些積極變化。
About 60% of American adults have a chronic illness, such as diabetes, heart disease or cancer; 40% have more than one.
大約60%的美國成年人患有慢性病，如糖尿病、心臟病或癌癥；40%的人患有不止一種疾病。
In 2016 these conditions cost America $3.7 trillion (or 20% of GDP) in medical spending and lost productivity.
2016年，這些疾病給美國帶來了3.7萬億美元的醫(yī)療支出（占GDP的20%）和生產(chǎn)力損失。
Yet the health-care system is focused on treating rather than preventing these conditions. Mr Kennedy wants to cut unhealthy foods from the American diet.
然而，醫(yī)療保健系統(tǒng)的重點(diǎn)是治療而不是預(yù)防這些疾病。肯尼迪希望從美國人的飲食中減少不健康的食物。
He thinks the cdc should be doing more about chronic diseases. And he wants a bigger share of government-funded research to focus on them.
他認(rèn)為疾病預(yù)防控制中心應(yīng)該更多地關(guān)注慢性病。他希望政府資助的研究中有更多的部分集中在慢性病上。
To achieve this ambitious agenda, Mr Kennedy, who does not have much experience running anything, would need to be clever about navigating the federal bureaucracy.
為了實現(xiàn)這一雄心勃勃的議程，沒有太多管理經(jīng)驗的肯尼迪需要巧妙地駕馭聯(lián)邦官僚機(jī)構(gòu)。
He has talked about firing hundreds of staff, such as the entire nutrition department of the Food and Drug Administration (FDA),
他談到要解雇數(shù)百名員工，例如食品藥品管理局(FDA)的整個營養(yǎng)部門，
and about pausing research on infectious diseases at the National Institutes of Health (NIH) to focus fully on chronic disease.
并暫停美國國立衛(wèi)生研究院(NIH)的傳染病研究，將精力全部集中在慢性病上。
In reality, though, lots of government employees have civil-service job protection.
但實際上，許多政府雇員都享有公務(wù)員的工作保障。
And the existence of many departments is mandated by law. Congress also has a say on the distribution of funds within some of them.
許多部門的存在都是法律規(guī)定的。國會對其中一些部門的資金分配也有發(fā)言權(quán)。
The things that prevent chronic diseases are no secret, says Georges Benjamin from the American Public Health Association:
美國公共衛(wèi)生協(xié)會的喬治·本杰明(Georges Benjamin)表示，預(yù)防慢性病的方法并不是什么秘密：
healthy diets, less tobacco and alcohol, more sport at schools and better screening for precursors, such as high blood pressure, blood sugar or early signs of cancer.
健康飲食、少抽煙少喝酒、在學(xué)校多運(yùn)動、更好地篩查高血壓、血糖或癌癥早期跡象等前兆。
Of those, reforming America's food system is closest to Mr Kennedy's heart.
其中，改革美國的食品體系是肯尼迪最關(guān)心的問題。
He wants to purge the American diet of processed foods packed with additives such as artificial colours and other chemicals.
他希望從美國飲食中清除含有人工色素和其他化學(xué)物質(zhì)等添加劑的加工食品。
But the federal food programmes with the biggest footprint are under the purview of the Agriculture Department.
但影響最大的聯(lián)邦食品計劃屬于農(nóng)業(yè)部的管轄范圍。
They include school meals (which 29 million children benefit from) and the Supplemental Nutrition Assistance Programme (formerly known as food stamps), which covers 42m people.
其中包括學(xué)校餐食（2900萬兒童從中受益）和補(bǔ)充營養(yǎng)援助計劃（以前稱為食品券），覆蓋4200萬人。
The national dietary guidelines, coming up for review in 2025, are a joint production by the Health and Agriculture Departments.
國家飲食指南將于2025年接受審查，由衛(wèi)生部和農(nóng)業(yè)部聯(lián)合制定。
