Kennedy's criticism largely stems from his belief that modern medicine and mainstream science are part of a global conspiracy to generate pharmaceutical profits. Kennedy is a germ-theory denier who believes people can maintain their health not by relying on evidence-based medicine, such as vaccines, but by clean living and eating—a loose concept called "terrain theory."

Access to top scientific and medical journals is essential for federal scientists to keep up to date with their fields and publicize high-impact results. One NIH employee added to Nature news that it "suppresses our scientific freedom, to pursue information where it is present."