The Man With $1 Trillion Who Believes Death Is Optional

The $1 Trillion Budget Holder Who Thinks Death Is Wrong

Jim O'Neill controls America's health apparatus with an unusual philosophy: he's a self-described "Vitalist" who believes "death is humanity's core problem" and aging damage can be reversed. As deputy health secretary overseeing a $1 trillion budget and serving as acting CDC director, he's now in position to act on these beliefs.

In an exclusive interview with MIT Technology Review, O'Neill didn't just defend his controversial vaccine cuts—he outlined an ambitious plan to redirect federal health priorities toward longevity research. The implications stretch far beyond typical policy debates.

Fewer Shots, More Questions

Last month's decision to remove flu, rotavirus, hepatitis A, and meningococcal vaccines from universal childhood recommendations sparked fierce criticism from medical groups. Most states rejected the changes. O'Neill's defense? Parents find "more than 70 vaccine doses given to young children sounds like a really high number."

He claims the new schedule mirrors "consensus vaccines of other developed nations," but public health experts argue countries like Denmark and Japan aren't comparable to the US. Different population densities, healthcare access, and socioeconomic disparities make direct comparisons misleading.

What's more concerning: Kirk Milhoan, who leads the CDC's vaccine advisory committee, recently suggested measles and polio vaccines—currently required for school entry—should become optional. O'Neill stopped short of endorsing this but said current guidelines remain "subject to new data coming in."

The Longevity Lobby Gets a Friend

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While cutting established public health measures, O'Neill is dramatically expanding longevity research funding. His interest began around 2008 when billionaire Peter Thiel convinced him "aging damage could be reversible." Now he's channeling that enthusiasm into federal policy.

ARPA-H, the biomedical breakthrough agency, is receiving $170 million over five years just for organ replacement research. O'Neill personally recruited the new director, Alicia Jackson, partly for her longevity focus. He regularly meets with longevity advocates and has expressed interest in trying experimental brain tissue replacement himself "if progress goes in a broadly good direction."

Meanwhile, over $2 billion in NIH grants for cancer biology, health disparities, and neuroscience research were frozen or terminated last year.

Regulatory Disruption by Design

O'Neill's vision extends beyond research funding to regulatory reform. He supports creating "freedom cities" on federal land and served on the Seasteading Institute board until March 2024—a group that wants to build new countries at sea with their own medical regulations.

He regularly talks with the Alliance for Longevity Initiatives, a lobbying group pushing for experimental therapy access laws. He also knows Niklas Anzinger, a German entrepreneur now based in Próspera—a private city in Honduras where residents can suggest their own medical regulations.

In 2009, O'Neill predicted "the healthiest societies in 2030 will most likely be on the sea." Today, he modifies that to: "the healthiest societies are likely to be the ones that encourage innovation the most."

The Saturated Fat Gambit

Even nutrition policy reflects O'Neill's contrarian approach. He personally follows a diet "that has plenty of protein and saturated fat," echoing new federal dietary guidance that contradicts decades of cardiovascular research. Nutrition scientists have criticized the guidance for ignoring established evidence about saturated fat's health risks.

"Nutrition is still not a scientifically solved problem," O'Neill insists, promising more randomized controlled trials on "the healthiest fats." Translation: expect more dietary recommendations that challenge conventional wisdom.