I’m thrilled. This administration is putting common sense back in to governance. In a sense these moves also restore basic ethics. By ignoring equipoise, the NIH has been funding a whole slate of garbage that has not resulted in the betterment of our patient’s lives. Parkinson’s and Alzheimer’s treatments have made virtually no progress. This misallocation of funding was done all under the guise of radical compassion. I used to think this travesty happened because of ignorance, but what was revealed over the pandemic was a truly evil face. Much of it was purposeful.
It is easy to see why our healthcare expenditure has nearly doubled in the last 14 years while life expectancy has decreased for the first time since the industrial revolution.
We owe a lot to our heroes, Battacharya, Prasad,Kheriaty, Makary, Atlas, Kuldorff, and others in the US and Jefferson and Henegan in the UK.
I did not expect the correction to happen all at once, but perhaps it will. What a blessing if so.
The process of funding research has become more and more political, and with that politics, the winners are those with influence, not those with good ideas.
In fact, good ideas would be completely unwelcome in the current structure. It’s Thomas Kuhn, the custodians of all the old paradigms.
Profitable sacred cows that are clearly wrong but profitable continue getting funding:
1. Mutation theory of cancer.
2. Cholesterol theory of cardiovascular disease.
3. Stents, the view of vascularity as mere plumbing.
4. Blood pressure, requires everyone be on drugs.
5. High stomach acid theory of GERD.
6. Amyloid plaque theory of dementia.
There are many many more. All the above theories get tons of funding because they sell drugs. The people selling drugs (and medical devices) are running EVERYTHING in the political realm of NIH. Everything.
Meanwhile anyone with truly innovative ideas would hardly survive a moment there.
So excited to see the changes that Dr. Bhattacharya will bring to refresh and improve the NIH! And as always, so thankful to be able to support your amazing Substack, Dr. Prasad - and so grateful to you for always speaking the truth, and for your willingness to share your wisdom, knowledge, and insight with such eloquence and integrity! You truly are the best!🙏🏼❤️💯
This reminds me of the SNL skit where they tell Rachel Maddow that she has to stop reacting to everything. Trump says because he's just trolling. And she says "breaking news Trump wants to trade Connecticut for Italy." I honestly think half the stuff he does when he riffs it's clearly flight of ideas but some of it is just to drive them crazy. Half the country seems to get that you can't listen to every word he says and take it literally. But they'd rather have a guy who thinks out loud, who's engaging and clearly for whatever it's worth he does not have dementia and age related loss of stamina. I am 68 and I am watching him and thinking how does he have the energy? I don't know that I could even if I had the job.
I watched the NIH give the smart cells crew 10 million of your tax dollars while they are bragging about selling their insulin/concanavalin mess to Merck for "half a billion dollars". BTW nothing ever came from said POS technology.
Then there was the solulink character ripping off thermo customers with their so called "anhydrous DMF"
The NIH throws your tax dollars away on absolute nonsense all the time
I beg to differ with VP and JI on this one. A lot of crappy papers get a lot of citations and many good papers do not because they do not align with the doxa. The field of atherosclerosis and statins is just one of several examples. It is not only the «prestigious» medical journals that have been spoiled by money, e.g. Nature and Science will sometimes (often?) publish poor quality papers for money and/or prestige (I have come to hate that word). Although I agree many and maybe most NIH are probably mediocre and/or politicized scientists, I don’t think using citation numbers as the sole criterion will fix the problem. There are just way too many papers published in way too numerous journals. This is a complex problem that will not be cured by simple solutions.
How about requiring publication of every taxpayer funded study before an organization or a person can get more funding? They selectively publish what will sell drugs rather than publishing anything that would suggest caution.
Vinay, please set up a live event for the Kennedy confirmation. Get your pals Z-dog and Marty Makary as fellow panelist. Better yet invite Dr Jay as well . Let’s have some real debate/analysis here of this confirmation.
Then when they question Marty or Jay, switch out for Kennedy. He would be a great guest for you. We all would love you to interview him.
I’m not a scientist, so I’m not qualified to comment on most of this, but I certainly agree with the last sentence! Academics, and others, would do better to not run around with their hair on fire over every utterance and policy of the new administration. Years ago, Steve Bannon spoke of “flooding the zone with shit,” as a political strategy. His goal was, and continues to be, distracting opponents so that they can’t focus on anything, including what’s most important. Did Elon intend a Nazi salute? It’s impossible to know, and it doesn’t really affect anyone, so why bother dying on that hill? It’s the job of the opposition party to oppose, and effective opposition has to be focused. Let’s keep the main thing, the main thing. Let’s not get all excited about every squirrel we see outdoors. Let’s also remember that the voters chose the current administration, and they need to learn the consequences of their choices.
You keep championing Bhattacharya and Ionnides yet they authored the deeply flawed Santa Clara seroprevalence study which the Great Barrington Declaration was based on, which, by the way, you didn’t sign. I have always been impressed with your appreciation of sound research and science yet I am perplexed by your love of these guys. What gives?
The study had limitations and some flaws, but deeply flawed? They ended up being closer to reality that the WHO/CDC. The GBD had flaws, but it was nothing compared with the disastrous COVID policies that were based on poor data being used by mediocre modellers
yes deeply flawed. Jet Blue funding, Facebook recruiting, faulty testing and more made for a deeply flawed study. This data, which made it seem like the infection mortality rate was extremely low led to the GBD. If the GBD had been implemented at that time, prior to vaccinations and during the great death spike of 2020/2021 it would have been even more of a disaster.
The same arguments (funding, recruiting and testing) could apply to just about any study that supported the COVID narrative (aka The Science); the overall conclusion that COVID cases were way higher than assumed by authorities was still closer to reality (and reporting the CFA as the IFA was misleading). People in the USA died in such high numbers mainly because of poor general health and poor management of long-term care facilities/nursing homes. Your last affirmation is pure speculation, especially when you look at some European countries, especially Sweden (which also failed to protect the old and frail).
speculation? what about your comments about that the GBD being nothing compared to covid policies. We will never know one way or another because GBD wasn’t implemented during the late 20 winter. But I think it would have added fuel to an already blazing fire. Vinay knows that but because he’s taken a political position he won’t say so. but just remember he never signed it.
Speculation in part, but with some arguments, the major one being Sweden (and other countries). As for the consequences of COVID policies, sharp increases in substance abuse, deaths of despair, and anxiety/depression in young people, domestic violence, long term impaired development (especially in poor people which may never recover), old people in care homes dying alone like dogs (we would not allow that!) behind plexiglass, massive inflation, and yes skyrocketing polarization... this may be small change to you and all Faucian apologists, but to me, as a (conservative, but left leaning) parent, I think humanity simply has gone mad.
please don’t label me . The GBD would have been a disaster if implemented just prior to the death spike of 20/21. After the spike and after the rollout of vaccinations principles of the GBD were reasonable.
Bingo on the intellectual diversity statement. NIH needs deep thinkers, risk takers (rarely found in the shlogging paper-pushing hallways of bureaucracies) and quirky curious scientists that are poking into the odd nooks and crannies of medicine and even seemingly unrelated disciplines. And they need people that are highly disciplined and can tightly design RCT’s to generate good data. Thomas Kuhn talks about the everyday routine experimental science that essentially confirms the current paradigms. However, it is clear that 1) these paradigms are not solving many of the current puzzles of medicine, and 2) based on what I read here, they aren’t even doing a good job of basic research. So it’s time for a scientific revolution. Let the party begin!
While pausing, perhaps an additional goal could be figuring out how to fund RCT’s for pharmaceuticals that have been shown to have efficacy for cancer or other major diseases, but will not be funded by big Pharma because they do not qualify for patenting. Study sections could assess the utility of RCT’s for each pharmaceutical in this category. Such a funding mechanism could potentially have major benefits for public health.
We should be trying *everything* including exercise, supplements, food, as well.
I'm honestly shocked that the pharmaceutical companies haven't pushed back against the finding that the best treatment for depression is exercise. How'd they let that one through?? Maybe they figure people are too lazy to do it.
I spent the first Trump presidency listening to MSNBC and waiting for him to be carted off to jail. How the tables have turned. I'm actually excited for his presidency this time and can't wait to see if he can restore governance and common sense to our government. I really hope he doesn't disappoint!
Looking forward to how the NIH priorities evolve under JB. The biggest challenge we face as a society is a rapidly aging demographic which will put increasing strain on our society. JB as an economist may bring a unique perspective.
I’m thrilled. This administration is putting common sense back in to governance. In a sense these moves also restore basic ethics. By ignoring equipoise, the NIH has been funding a whole slate of garbage that has not resulted in the betterment of our patient’s lives. Parkinson’s and Alzheimer’s treatments have made virtually no progress. This misallocation of funding was done all under the guise of radical compassion. I used to think this travesty happened because of ignorance, but what was revealed over the pandemic was a truly evil face. Much of it was purposeful.
It is easy to see why our healthcare expenditure has nearly doubled in the last 14 years while life expectancy has decreased for the first time since the industrial revolution.
We owe a lot to our heroes, Battacharya, Prasad,Kheriaty, Makary, Atlas, Kuldorff, and others in the US and Jefferson and Henegan in the UK.
I did not expect the correction to happen all at once, but perhaps it will. What a blessing if so.
The process of funding research has become more and more political, and with that politics, the winners are those with influence, not those with good ideas.
In fact, good ideas would be completely unwelcome in the current structure. It’s Thomas Kuhn, the custodians of all the old paradigms.
Profitable sacred cows that are clearly wrong but profitable continue getting funding:
1. Mutation theory of cancer.
2. Cholesterol theory of cardiovascular disease.
3. Stents, the view of vascularity as mere plumbing.
4. Blood pressure, requires everyone be on drugs.
5. High stomach acid theory of GERD.
6. Amyloid plaque theory of dementia.
There are many many more. All the above theories get tons of funding because they sell drugs. The people selling drugs (and medical devices) are running EVERYTHING in the political realm of NIH. Everything.
Meanwhile anyone with truly innovative ideas would hardly survive a moment there.
So excited to see the changes that Dr. Bhattacharya will bring to refresh and improve the NIH! And as always, so thankful to be able to support your amazing Substack, Dr. Prasad - and so grateful to you for always speaking the truth, and for your willingness to share your wisdom, knowledge, and insight with such eloquence and integrity! You truly are the best!🙏🏼❤️💯
This reminds me of the SNL skit where they tell Rachel Maddow that she has to stop reacting to everything. Trump says because he's just trolling. And she says "breaking news Trump wants to trade Connecticut for Italy." I honestly think half the stuff he does when he riffs it's clearly flight of ideas but some of it is just to drive them crazy. Half the country seems to get that you can't listen to every word he says and take it literally. But they'd rather have a guy who thinks out loud, who's engaging and clearly for whatever it's worth he does not have dementia and age related loss of stamina. I am 68 and I am watching him and thinking how does he have the energy? I don't know that I could even if I had the job.
Good!
I watched the NIH give the smart cells crew 10 million of your tax dollars while they are bragging about selling their insulin/concanavalin mess to Merck for "half a billion dollars". BTW nothing ever came from said POS technology.
Then there was the solulink character ripping off thermo customers with their so called "anhydrous DMF"
The NIH throws your tax dollars away on absolute nonsense all the time
I beg to differ with VP and JI on this one. A lot of crappy papers get a lot of citations and many good papers do not because they do not align with the doxa. The field of atherosclerosis and statins is just one of several examples. It is not only the «prestigious» medical journals that have been spoiled by money, e.g. Nature and Science will sometimes (often?) publish poor quality papers for money and/or prestige (I have come to hate that word). Although I agree many and maybe most NIH are probably mediocre and/or politicized scientists, I don’t think using citation numbers as the sole criterion will fix the problem. There are just way too many papers published in way too numerous journals. This is a complex problem that will not be cured by simple solutions.
How about requiring publication of every taxpayer funded study before an organization or a person can get more funding? They selectively publish what will sell drugs rather than publishing anything that would suggest caution.
And all data needs to be published too.
I'm all in for changes as proposed and Jay seems like a great choice.
This only makes sense because Trump may have wisely delegated this task to a non-sycophant. I'll take it.
Vinay, please set up a live event for the Kennedy confirmation. Get your pals Z-dog and Marty Makary as fellow panelist. Better yet invite Dr Jay as well . Let’s have some real debate/analysis here of this confirmation.
Then when they question Marty or Jay, switch out for Kennedy. He would be a great guest for you. We all would love you to interview him.
I’m not a scientist, so I’m not qualified to comment on most of this, but I certainly agree with the last sentence! Academics, and others, would do better to not run around with their hair on fire over every utterance and policy of the new administration. Years ago, Steve Bannon spoke of “flooding the zone with shit,” as a political strategy. His goal was, and continues to be, distracting opponents so that they can’t focus on anything, including what’s most important. Did Elon intend a Nazi salute? It’s impossible to know, and it doesn’t really affect anyone, so why bother dying on that hill? It’s the job of the opposition party to oppose, and effective opposition has to be focused. Let’s keep the main thing, the main thing. Let’s not get all excited about every squirrel we see outdoors. Let’s also remember that the voters chose the current administration, and they need to learn the consequences of their choices.
You keep championing Bhattacharya and Ionnides yet they authored the deeply flawed Santa Clara seroprevalence study which the Great Barrington Declaration was based on, which, by the way, you didn’t sign. I have always been impressed with your appreciation of sound research and science yet I am perplexed by your love of these guys. What gives?
The study had limitations and some flaws, but deeply flawed? They ended up being closer to reality that the WHO/CDC. The GBD had flaws, but it was nothing compared with the disastrous COVID policies that were based on poor data being used by mediocre modellers
yes deeply flawed. Jet Blue funding, Facebook recruiting, faulty testing and more made for a deeply flawed study. This data, which made it seem like the infection mortality rate was extremely low led to the GBD. If the GBD had been implemented at that time, prior to vaccinations and during the great death spike of 2020/2021 it would have been even more of a disaster.
The same arguments (funding, recruiting and testing) could apply to just about any study that supported the COVID narrative (aka The Science); the overall conclusion that COVID cases were way higher than assumed by authorities was still closer to reality (and reporting the CFA as the IFA was misleading). People in the USA died in such high numbers mainly because of poor general health and poor management of long-term care facilities/nursing homes. Your last affirmation is pure speculation, especially when you look at some European countries, especially Sweden (which also failed to protect the old and frail).
speculation? what about your comments about that the GBD being nothing compared to covid policies. We will never know one way or another because GBD wasn’t implemented during the late 20 winter. But I think it would have added fuel to an already blazing fire. Vinay knows that but because he’s taken a political position he won’t say so. but just remember he never signed it.
Speculation in part, but with some arguments, the major one being Sweden (and other countries). As for the consequences of COVID policies, sharp increases in substance abuse, deaths of despair, and anxiety/depression in young people, domestic violence, long term impaired development (especially in poor people which may never recover), old people in care homes dying alone like dogs (we would not allow that!) behind plexiglass, massive inflation, and yes skyrocketing polarization... this may be small change to you and all Faucian apologists, but to me, as a (conservative, but left leaning) parent, I think humanity simply has gone mad.
please don’t label me . The GBD would have been a disaster if implemented just prior to the death spike of 20/21. After the spike and after the rollout of vaccinations principles of the GBD were reasonable.
Bingo on the intellectual diversity statement. NIH needs deep thinkers, risk takers (rarely found in the shlogging paper-pushing hallways of bureaucracies) and quirky curious scientists that are poking into the odd nooks and crannies of medicine and even seemingly unrelated disciplines. And they need people that are highly disciplined and can tightly design RCT’s to generate good data. Thomas Kuhn talks about the everyday routine experimental science that essentially confirms the current paradigms. However, it is clear that 1) these paradigms are not solving many of the current puzzles of medicine, and 2) based on what I read here, they aren’t even doing a good job of basic research. So it’s time for a scientific revolution. Let the party begin!
While pausing, perhaps an additional goal could be figuring out how to fund RCT’s for pharmaceuticals that have been shown to have efficacy for cancer or other major diseases, but will not be funded by big Pharma because they do not qualify for patenting. Study sections could assess the utility of RCT’s for each pharmaceutical in this category. Such a funding mechanism could potentially have major benefits for public health.
10000%
We should be trying *everything* including exercise, supplements, food, as well.
I'm honestly shocked that the pharmaceutical companies haven't pushed back against the finding that the best treatment for depression is exercise. How'd they let that one through?? Maybe they figure people are too lazy to do it.
Says the dude whose entire career is funded by a sketchy Enron wash-out. LOL
I spent the first Trump presidency listening to MSNBC and waiting for him to be carted off to jail. How the tables have turned. I'm actually excited for his presidency this time and can't wait to see if he can restore governance and common sense to our government. I really hope he doesn't disappoint!
Looking forward to how the NIH priorities evolve under JB. The biggest challenge we face as a society is a rapidly aging demographic which will put increasing strain on our society. JB as an economist may bring a unique perspective.