The banks celebrated in silence. Oil and gas giants are preparing new investment plans. Tech giants breathed a collective sigh of relief. And cryptocurrency companies have gone even crazier than usual. Their leaders may not like the president-elect’s personality or his rhetorical style, but most American businesses welcomed Donald Trump’s election victory.

There is only one exception: big pharmaceutical companies. The eccentric opinions of his Secretary of Health Robert F. Kennedy Jr. pose a real threat to the pharmaceutical industry – and the UK’s life sciences giants will be at the front of the line.

Even amid some appointments that can be gently described as “controversial,” the choice of Kennedy as the new head of the US Department of Health and Human Services in Trump’s cabinet is explosive.

During his election campaign, while running for president himself, Kennedy held a range of opinions that seemed to come straight from the grumpiest corners of the Internet.

He has described the Covid-19 vaccine as “the deadliest vaccine ever”, and argued last year that the virus itself was “ethnically targeted” to spare Ashkenazi Jews and Chinese . (Despite video footage of his remarks, Mr. Kennedy insisted he was simply pointing out that Covid-19 “appears to disproportionately affect certain races.”)

He criticized the new generation of weight-loss drugs, arguing that they only “fatten the wallets of pharmaceutical executives.” He argued that government spending and research budgets should be redirected toward preventative medicine, and even floated the idea of ​​removing fluoride from the water system and removing additives from foods.

The president-elect appears to have embraced Kennedy’s beliefs.

“For too long, Americans have been crushed by the industrial food complex and pharmaceutical companies that engaged in deception…and misinformation,” Trump said in announcing his nomination. If he lives up to this speech, American health policy will change dramatically – and not for the better.

It was hardly surprising that while Wall Street was booming, pharmaceutical companies were down sharply on the news of the appointment. Vaccine makers Moderna, Pfizer and BioNTech all suffered sharp declines, as did European rivals such as GSK and Sanofi.

These falls appear likely to continue over the coming months as Kennedy assembles his team, and prepares to take charge of his department. It is true that there may be legitimate questions to be asked about Covid vaccines, whether they were rushed into adoption, and even the origins of the virus itself. It is possible that the pharmaceutical industry is overmedicating diseases, ignoring alternative treatments. But one thing is surely clear: RFK Jr is a weirdo who peddles wild conspiracy theories.

This is a real challenge for the pharmaceutical industry, and the UK will be at the forefront. Pharmaceutical giants have always had their critics, mainly on the left, but they have generally focused on excessive profits, or safety standards, or access to medicines for poorer countries. RFK Jr is something completely different. It attacks the entire scientific foundations of the industry.

The UK will unfortunately be one of the countries most exposed to his strange world view. Some of our largest companies could well be hit very hard. For AstraZeneca, 44% of its sales are in the United States. For GSK, it’s just as important, with US sales more than double its UK revenue.

Certainly, Denmark, headquarters of the manufacturer Ozempic Novo Nordisk, and Switzerland, where Novartis and Roche are located, are also exposed. But for the British economy and for the London Stock Exchange, the life sciences sector is of unique importance. It is the only truly world-class technology industry the UK has. It now risks being driven out of its largest and most profitable market, or at least suffering significant damage.

The pharmaceutical industry must figure out how to respond to the threat that RFK Jr. poses, and the government must be prepared to help. The industry needs to step up its lobbying efforts, explaining to officials, and just as importantly to voters, what work it does and why it matters.

RFK Jr himself might not be listening. He is clearly not open to rational argument. But voters will, and they won’t like the idea of ​​restrictions on the medications they often rely on, nor will they want to take risks with the safety of the water system. If ordinary Americans can be persuaded to support the industry, it will make a big difference.

Then the UK must be prepared to do whatever it can to help. We have not yet concluded a free trade agreement with the United States, but negotiations could well resume with Trump in the White House. He is far more sympathetic to the UK than President Biden ever was. As these negotiations begin, the UK must ensure that a deal preserves full and open access to the US market for UK life sciences companies. Even without a full-scale trade deal, ministers and diplomats can at least try to persuade the Trump administration to give the industry a fair hearing.

It is true that RFK Jr may well prove more docile in power than his grumpy speeches during the election campaign suggest. During Trump’s first term, many of his wildest ideas never came to fruition.

Health Ministry officials may well convince their boss that many drugs are actually very useful and save hundreds of thousands of lives, while significantly reducing the cost of treatment.

That said, RFK Jr looks like a fanatic. His main support as a candidate was among conspiracy theorists, and he spent much of his career campaigning against the pharmaceutical and food industries. One point is certain. It poses a major threat to one of Britain’s largest and most important industries – and the next few years look set to be very difficult.

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