Prasad’s speech at the FDA was calm, even charming. However, he wasn’t appointed because of his past rigor. He was elevated because of his more recent firebrand attacks on public health institutions.
I’m grateful to Dr. Faust for sharing and thoughtfully commenting on Prasad’s remarks. But let’s be clear: his appointment is not a sign of balance. It is a warning shot. It reminds us what Trump has already done to public health and why any praise for Prasad should be tempered with deep caution, especially as the Prasad admiration tour starts to roll.
A calm speech doesn’t erase the reasons he was chosen.
It's an unfortunate reality that in order to get attention on the Right, a flashy and even toxic tone is what seems to work these days. For me, it makes me question otherwise reasonable ideas, and makes them less appealing. So, it backfires on people like you and me. But I guess it works on plenty of other people, so here we are.
Thank you. I think you put it exactly right. The fact that toxic rhetoric has become a gateway to influence is part of the damage. It makes us question ideas we might otherwise consider fairly, and it erodes trust in the institutions these voices now lead. I really appreciated your insight and hope we keep calling attention to how these dynamics shape public health leadership.
I agree with everything Dr. Faust said about Vinay Prasad from a historical perspective. I’ve learned a lot from him over the years, but got tired of the vitriol (like a dog with a bone - it just turned me off). My thoughts in recent months have been - hey, that guy is auditioning for a role in the Trump administration (ooh - pick me! Pick me!!). But when all is said and done, I’m really excited and hopeful over his appointment and especially glad to hear that the old Prasad showed up for work.
Thanks for this. It's unfortunate (but I think accurate) that many people see that kind of vitriol as a prerequisite for getting noticed. The ideas should stand on their own without name-calling, etc. I hope that civility can become the norm.
If he can carry forward as he did yesterday, he has a chance to do well. There's clearly a learning curve for a role like this, but he has the intellect to achieve some goals that many people (myself included) would support.
As an oncology drug developer & patient advocate who has spent chapters working in rare disease.. I welcome this sentiment
And for the rare disease fans, randomized controlled trials are not always necessary, and when they are done they are not always informative. So, we have some challenges ahead of us.”
“Evidence must also contextualize the condition—how rare and dire it is, and we should be flexible for the many people who do want to try things.”
I agree that his remarks yesterday were encouraging in this way. But, as others have stated, he has to show that the ranting and raving were a kind of performance art (or at least, poorly considered) if he is to be effective for long.
This is terribly worrisome for myeloma patients (I'm one): “I worry that the FDA is entirely beholden to the pharmaceutical industry. It was already approving myeloma drugs based on progression free survival — a surrogate that does not correlate with overall survival, as I explain in the video, but will lower the bar further. The FDA keeps patting itself on the back, but we have no idea what the optimal sequence of drugs is in myeloma, and the FDA’s low standards are primarily to blame.” Progression free survival for drug approval is absolutely essential for myeloma. Myeloma patients are surviving longer and longer, and we can't wait 10 to 15 years to see if if a drug improves overall survival before getting it approved. If Prasad had cancer, I doubt he'd want to wait that long to get a drug that shows promise. Myeloma treatment has been a huge success in the past ten or so years, giving hope to its patients. Ask the doctors and patients what they want. It's not because the FDA is beholden to the pharmaceutical industry.
Also, if a myeloma patient relapses (no longer in progression free survival), they're not going to stay on the same drug to see how long it takes to die -- they move to another drug that gives them a good response. And then another drug -- and it can be different for each patient, depending on their myeloma and what they respond to.
To go from 4th grade name calling to measured tones speaks to me of an unserious person looking out for himself> others. A domestic abuser with a stethoscope. No forgiveness.
Prasad’s speech at the FDA was calm, even charming. However, he wasn’t appointed because of his past rigor. He was elevated because of his more recent firebrand attacks on public health institutions.
I’m grateful to Dr. Faust for sharing and thoughtfully commenting on Prasad’s remarks. But let’s be clear: his appointment is not a sign of balance. It is a warning shot. It reminds us what Trump has already done to public health and why any praise for Prasad should be tempered with deep caution, especially as the Prasad admiration tour starts to roll.
A calm speech doesn’t erase the reasons he was chosen.
It's an unfortunate reality that in order to get attention on the Right, a flashy and even toxic tone is what seems to work these days. For me, it makes me question otherwise reasonable ideas, and makes them less appealing. So, it backfires on people like you and me. But I guess it works on plenty of other people, so here we are.
Thank you. I think you put it exactly right. The fact that toxic rhetoric has become a gateway to influence is part of the damage. It makes us question ideas we might otherwise consider fairly, and it erodes trust in the institutions these voices now lead. I really appreciated your insight and hope we keep calling attention to how these dynamics shape public health leadership.
I agree with everything Dr. Faust said about Vinay Prasad from a historical perspective. I’ve learned a lot from him over the years, but got tired of the vitriol (like a dog with a bone - it just turned me off). My thoughts in recent months have been - hey, that guy is auditioning for a role in the Trump administration (ooh - pick me! Pick me!!). But when all is said and done, I’m really excited and hopeful over his appointment and especially glad to hear that the old Prasad showed up for work.
Thanks for this. It's unfortunate (but I think accurate) that many people see that kind of vitriol as a prerequisite for getting noticed. The ideas should stand on their own without name-calling, etc. I hope that civility can become the norm.
Brilliant piece Jeremy
Thank you, sir!
Excellent piece. I am waiting to see how Dr. Prasad’s tenure at the FDA goes.
If he can carry forward as he did yesterday, he has a chance to do well. There's clearly a learning curve for a role like this, but he has the intellect to achieve some goals that many people (myself included) would support.
This is fascinating.
As an oncology drug developer & patient advocate who has spent chapters working in rare disease.. I welcome this sentiment
And for the rare disease fans, randomized controlled trials are not always necessary, and when they are done they are not always informative. So, we have some challenges ahead of us.”
“Evidence must also contextualize the condition—how rare and dire it is, and we should be flexible for the many people who do want to try things.”
I agree that his remarks yesterday were encouraging in this way. But, as others have stated, he has to show that the ranting and raving were a kind of performance art (or at least, poorly considered) if he is to be effective for long.
True. YEARS of big bluster to overcome!
This is terribly worrisome for myeloma patients (I'm one): “I worry that the FDA is entirely beholden to the pharmaceutical industry. It was already approving myeloma drugs based on progression free survival — a surrogate that does not correlate with overall survival, as I explain in the video, but will lower the bar further. The FDA keeps patting itself on the back, but we have no idea what the optimal sequence of drugs is in myeloma, and the FDA’s low standards are primarily to blame.” Progression free survival for drug approval is absolutely essential for myeloma. Myeloma patients are surviving longer and longer, and we can't wait 10 to 15 years to see if if a drug improves overall survival before getting it approved. If Prasad had cancer, I doubt he'd want to wait that long to get a drug that shows promise. Myeloma treatment has been a huge success in the past ten or so years, giving hope to its patients. Ask the doctors and patients what they want. It's not because the FDA is beholden to the pharmaceutical industry.
Also, if a myeloma patient relapses (no longer in progression free survival), they're not going to stay on the same drug to see how long it takes to die -- they move to another drug that gives them a good response. And then another drug -- and it can be different for each patient, depending on their myeloma and what they respond to.
To go from 4th grade name calling to measured tones speaks to me of an unserious person looking out for himself> others. A domestic abuser with a stethoscope. No forgiveness.