Something seems to be shifting in how public institutions understand chronic illness.
It is slow and quiet—not yet visible to the public—but noticeable if you watch the signals closely. I want to share a perspective that brings a number of developments together. It may help us understand where things are heading.
1. A system that is overloaded
Both in the United States and in Europe, public health systems are overwhelmed by chronic illness. There are thousands of studies, committees, working groups, and guidelines. Everyone is very busy, yet no one seems to have a clear overview. And when no one has the overview, it becomes almost impossible to ask the most basic question:
What is the underlying mechanism of chronic disease?
For decades, the dominant assumption has been that chronic illness is mainly:
autoimmune,
degenerative, or
genetic.
This has produced an enormous and expensive system focused largely on managing symptoms rather than understanding root causes.
2. A different way of thinking is emerging
In my book
Clearing the Ground (see my posting of 26 July 2025), I describe chronic disease as arising from a disturbance in the relationship between the cell and the viruses that live within us—particularly herpesviruses.
When cellular immunity is strong and metabolism is stable, these viruses remain latent. When immunity weakens or metabolism becomes unstable, viral activity increases. The cell responds with interferon signalling and inflammation. Over time, this response can become systemic.
This offers a more integrated and, in many ways, simpler explanation of chronic illness: not an immune system “attacking itself,” but an immune system attempting to control viral and metabolic stress inside the cell.
3. Why systems resist change
Public health systems do not change easily. They are built on layers of trust, accountability, professional identity, and economic incentives. Pharmaceuticals, reimbursement structures, clinical guidelines, and academic careers are all deeply anchored in the existing model.
As a result, even when new ideas are valid, systems tend to change only when the cost of not changing becomes too high.
4. Europe waits; the United States is moving
European institutions are aware that change is needed. I know this from correspondence with the European Commission and the European Council. The issue is “in the system.” The language in official replies is beginning to shift, with references to “global health transitions” and “joint actions with Member States.”
Still, Europe remains cautious. Historically, Europe rarely “clears the ground” itself. It tends to move once scientific consensus has already shifted elsewhere.
5. The American system appears to be preparing for a reset
In contrast, the United States seems to be preparing for a major re-evaluation of chronic disease—and to take the lead. This is visible in several developments:
- The March 2024 report of the U.S. Office of the Director of National Intelligence, which highlighted fragilities in public health and their global impact.
- President Trump’s inaugural statement in January 2025: “We will not be deterred. Together, we will end the chronic disease epidemic.”
- The appointment of Secretary Robert F. Kennedy Jr., known for questioning established paradigms and challenging medical orthodoxy.
- The very creation of MAHA, explicitly designed to address chronic illness at a systemic level.
During the September MAHA meeting, it was said that next year “big things will come that will blow people away.” That phrase only makes sense if those driving the change understand that there could be a potential blowback that could derail reform. Accordingly, MAHA and HHS appear to be preparing not only new policies, but also preparing themselves—institutionally, psychologically, and operationally—for resistance.
Post script: Recent steps from December 25 reinforce this impression:
Reorganization of state capacity, with appointments to key HHS positions aligned with rethinking immunity, metabolism, regulatory barriers, and public trust.
https://www.hhs.gov/press-room/hhs-five ... -maha.html
The launch of PHS Mission Fit, aimed at strengthening readiness, resilience, and unity across the U.S. Public Health Service (USPHS) Commissioned Corps. As one of the eight U.S. uniformed services, the USPHS is capable of executing non-consensus policy shifts when ordered. Strengthening it as a disciplined, resilient force is a classic move when a government anticipates turbulence but wants continuity of execution.
https://www.linkedin.com/posts/commissi ... 37856-pONq
The appointment of Harvey Risch as Chair of the President’s Cancer Panel. Risch is not a conventional “incremental oncology” figure. His work focuses on etiology, prevention, immune factors, and infectious and metabolic drivers. This signals a move away from cancer as a purely stochastic genetic accident—and toward cancer as a systemic, potentially preventable disease process linked to immunity, metabolism, infection, and environment. In other words, cancer is being repositioned within the broader chronic-disease framework, which closely aligns with the core thesis of my book.
https://www.hhs.gov/press-room/dr-harve ... panel.html
None of this proves that a paradigm shift is inevitable. But these are precisely the kinds of structural moves governments make when preparing for one.
6. What this could mean for people with chronic illness
For those of us living with diseases like MS, these developments matter.
If chronic disease increasingly comes to be understood as virally and metabolically driven, it opens the door to therapies aimed at:
- reducing viral burden,
- stabilising cellular metabolism,
- strengthening natural immunity, and
- calming systemic inflammation.
This represents a fundamentally different philosophy from long-term immune suppression. It is about helping the body regain control of its own biology.
7. A quiet transition may be starting
With the latest MAHA appointments, it appears that the U.S. is building the administrative structure needed for a new approach. This will take time. Nothing is official yet.
But groundwork is being laid.
MAHA and HHS are not only preparing policy—they are preparing themselves for transition. If that transition unfolds, my book
Clearing the Ground would offer a conceptual framework for understanding it.
For now, I will continue to follow these developments carefully.
Warm regards,
Leo