The subversion of scientific expertise to replace it with podcasters and political sycophants is one of the biggest disasters of the current years.
The very concept of merit has been destroyed and replaced with judgement calls on celebrity (necessary for leadership role) and subservience to the political whims of the last 15 minutes (and you had better switch in the next 15 minutes or you're out).
One thing that's particularly frustrating about all this is that any conversation with the growing contingency of distrustful people has been made very difficult by what I would call poor, avoidable, and illiberal decisions made by the federal government during COVID. (TBF, decisions during a crisis are always hard.)
Lab leak theory was dismissed and actively suppressed. Inflated claims were made a priori about absolute vaccine efficacy that any responsible researcher who have not made.
Moreover, the trouble with trying to shut down real disinformation, eg claims that vaccines were more dangerous than the virus, is that many people will view any sort of paternalistic behavior by the government, especially around speech, with suspicion. ("Why do they care so much about what I say? They must be hiding something")
In the age of social media, I think the study of public health needs to consider more seriously the viral psychology. The irrationality and stubbornness of people needs to be expected when planning public policy.
When you argue with some anti vaxxers and get down to the core of their beliefs, their motivation is religon not science.
They believe its god that decides who lives and does and getting in the way of that with vaccines is subverting god's will.
But instead of leading with that upfront, which they know will not work, they turn to pseudoscience to scare everyone away from vaccines, regardless of their beliefs.
That might be true for some of them, but unfortunately I know a few anti vaxxers who also happen to be atheists. They just believe all the various conspiracy theories about vaccines.
> The subversion of scientific expertise to replace it with podcasters and political sycophants
> The very concept of merit has been destroyed ...
It's the subversion of truth. I think that way of saying it is more accurate, addresses the consequences, and is less occluded by jargon: People care about truth; 'scientific expertise' may seem esoteric to most people.
I think HN is frequently part of that process: Merit - expertise, actual trials and evidence - is replaced both by sensational too-clever hot takes / takedowns, and by political/social advocacy.
Most threads begin with a takedown, a 2 minute drive-by from an amatuer, often of years of research by someone spending their life studying the matter. For some issues, we all know what side many will take before you know any facts or evidence.
These comments are normalized and given greater credibility than the OP and than valuable comments. How is that any different than the things we criticize (other than the FDA's subversion of truth [EDIT:] is far more consequential [sorry, I didn't finish that sentence!])
There are valuable comments to be found; maybe that's one difference, but I'm wonder how the signal-to-noise compares with other forums.
How is discussion on HN different from the leadership levels at FDA?
Very different. Decisions with enormous health implications, enormous financial implications, are made at FDA.
At HN, most people are here to learn, here to understand more.
Vinay Prasad is a fraud, completely unfit for the leadership role he was placed into, making baffling and arbitrary decisions on his own, overturning those with far more experience, knowledge and expertise.
If a HN comment gets things wrong, a few people might be misinformed, if they are credulous enough to not double check things.
When the FDA makes decisions like they have been making, thousands to millions of peoples' lives are worse off, and billions in capital is wasted.
Discussion forums of all sorts are incredibly valuable, even when they get things wrong. I have lots of complaints about the overhyping of, say, CRISPR, especially on HN, but whatever, it's a far far higher signal-to-noise than a random person I meet around town. Mention you work on drug development for big pharma to the random person and they think you're evil, at least HN is less likely to have that basic misconception.
> Mention you work on drug development for big pharma to the random person and they think you're evil
this is how Martin Shkreli described his work of identifying drug patents to buy that he could jack up the prices on. If that's the extent of the description you gave, I think random people would be right to first think you are doing something evil
That is a good question, and I'm sure many of the people at UCSF are asking similar questions. However, his sort of misconduct is not the type that would usually violate tenure protections. Beyond the minor CV fibbing, without some evidence that he actually, say, solicited a bribe from Moderna, it's unlikely that he can face any sort of official sanction.
The fraud is in his supposed thrust towards better scientific rigor when he is so sloppy with major decisions of life and death.
Just as the comment up there says that HN comments that are critical and misinformed get a lot of attention and upvotes, Prasad has been highly critical and misinformed about scientific research, and his stint at the FDA has exposed that his critiques are much like that top-level HN comment that doesn't get things quite right.
For normal research universities, like UCSF, the titles of Professor and Associate Professors have tenure. Assistant Professors are tenure-track, meaning that they have the chance to get tenure. Prasad has the title of Professor.
One way they should balance in a functioning society is that while tenure would protect you from negative repercussions within the walls of an academic institution, a Congress with any semblance of seriousness and care toward the American people would ensure you never set foot inside a policy-making institution.
> he is so sloppy with major decisions of life and death
To be clear, the FDA regulates marketing claims. “Is the label accurate?”
Major decisions about life and death are between the doctor and the patient, not the FDA.
It sounds like you’re taking an expansive view of this government agency’s mandate. People will push back on this at the ballot box, even if they can’t put it to words themselves.
The FDA regulates which drugs make it to market which is itself an extremely powerful force (excessively so) on conversations between you and your doctor.
In the case of vaccines, FDA's decisions can quite obviously make a difference in whether we have a rampant lethal pathogen roaring through our schools and killing our children and elderly... or not.
It's pedantic to the point of being outright false to say the FDA is not involved in major decisions of life and death. Silly take.
Prasad, to the extent he had a reputation before, was for critiquing the scientific practice as inadequate, which would hope that he'd bring the idea of rigor to his stint at the FDA. Instead, we see quite the opposite:
- This baffling Moderna decision, which is so bad that many in the industry assumed it was from a failed bribe solicitation
- Prasad holding a defamatory PR event about the company producing the HD candidate treatment, and only talking "on background" to hide his identity, which is sleazy and unethical "The criticism apparently struck a nerve with Prasad. The FDA held a press briefing later Thursday in which an unnamed “senior FDA official”—who identified himself as a hematology-oncologist—launched into a diatribe against UniQure, saying its “failed therapy” was supported by “distorted and manipulated” data. As for Woodcock’s comments, the official said he “expect[s] better” from her." https://arstechnica.com/health/2026/03/trumps-divisive-fda-v...
- His first ouster and reinstatement last year, over a unilateral Duchenne muscular dystrophy decision, severely lacking in scientific rigor and analysis
- Lied on his CV about being on a highly prestigious council he was not on (The Cancer Letter is not a random YouTube channel, it's high quality cancer research journalism) https://www.youtube.com/watch?v=pCASAb7J-LE&t=41
As is often the case with such contrarians and critics, their own critiques apply most aptly to themselves.
Imagine being able to shut down discussion at the FDA because a few anonymous randos pushed a "flag" button when they saw something they disagreed with.
> Decisions with enormous health implications, enormous financial implications, are made at FDA.
Yes, I started writing that and didn't finish the sentence (see my edit near the end of the GP).
But I don't let HN off the hook: The attitude I described in the GP represents and perpetrates the same outlook that politically supports or tolerates this behavior from the FDA. HN users generally legitimize that approach rather than discrediting it.
> Mention you work on drug development for big pharma to the random person and they think you're evil
I think that's paranoid: The random person won't know what that means. Few who know will also know or care about the social implications. Of those who do, only some will be knee-jerk critical of big pharma, and fewer still of research rather than the business side. It's also a victim perspective: Big Pharma has enormous power; punching up at power by questioning, criticizing, and being skeptical (or even cynical) is not at all the same thing as punching down at the vulnerable. If someone wants the power and resources and salary of Big Pharma, benefitting from its enormous power, the pushback and reputation impact comes with it (though the latter is usually positive - great resume material and credibility).
So you don’t agree with their point and saw fit to draw out a response that fingerpoints at the the side that’s over the intolerance of the non-scientifically bound members of society? Great high horse fam.
Both VRBPAC and CDC's ACIP did remarkably good work during the pandemic under enormous pressure - what specific complaints do you have? They got safe and effective vaccines out there fast, did a really reasonable job of balancing the cost benefit w.r.t. side effects of both j&j's and the somewhat elevated myo/pericarditis risk from moderna's vaccine in young men, etc.
> Prasad was also behind the rejection of a closely watched gene therapy for Huntington’s disease made by UniQure
This guy is a disaster. But really it's not just him. It's the entire organizational structure that puts him, or any other one person, in the position that they have the power to do this. There is simply no one qualified.
We need to have expert scientists to set up trials and review the design of the trials and conduct the analysis of the data. This is something that is generally objective and not able to be done without skills and experience. But then you have to make a decision based on those results. And the decision is some sort of risk reward trade off. While science can quantify what that tradeoff is, which path to take is fundamentally outside of the scope of science.
Trade offs are not objective determinations at all because they are based on subjective preferences. And therefore it makes no sense to force it into a one size fits all approval or denial by some centralized body. The only rational approach to such a trade off is to allow each individual to choose for themselves. The only person's opinion on whether the risk justifies the reward for the experimental Huntington's disease treatment is the patient's. The best we can do with science is to use it for its intended purpose to produce good data for him to make his choice.
Is this the one that's a flu/Covid combo? I live in Europe and have been looking forward to it - especially since the flu part covers way more variants than traditionally - no longer a need to depend on flawed predictions as to what variants will be predominant. Also no longer a need for two sore arms.
Is this good because flu vaccines are an educated guess as to what will be circulating because it takes so long to culture them all and this will shorten the manufacturing time so the educated guess can take place later in the process (and be more accurate)?
The very concept of merit has been destroyed and replaced with judgement calls on celebrity (necessary for leadership role) and subservience to the political whims of the last 15 minutes (and you had better switch in the next 15 minutes or you're out).
Lab leak theory was dismissed and actively suppressed. Inflated claims were made a priori about absolute vaccine efficacy that any responsible researcher who have not made.
Moreover, the trouble with trying to shut down real disinformation, eg claims that vaccines were more dangerous than the virus, is that many people will view any sort of paternalistic behavior by the government, especially around speech, with suspicion. ("Why do they care so much about what I say? They must be hiding something")
In the age of social media, I think the study of public health needs to consider more seriously the viral psychology. The irrationality and stubbornness of people needs to be expected when planning public policy.
They believe its god that decides who lives and does and getting in the way of that with vaccines is subverting god's will.
But instead of leading with that upfront, which they know will not work, they turn to pseudoscience to scare everyone away from vaccines, regardless of their beliefs.
> The very concept of merit has been destroyed ...
It's the subversion of truth. I think that way of saying it is more accurate, addresses the consequences, and is less occluded by jargon: People care about truth; 'scientific expertise' may seem esoteric to most people.
I think HN is frequently part of that process: Merit - expertise, actual trials and evidence - is replaced both by sensational too-clever hot takes / takedowns, and by political/social advocacy.
Most threads begin with a takedown, a 2 minute drive-by from an amatuer, often of years of research by someone spending their life studying the matter. For some issues, we all know what side many will take before you know any facts or evidence.
These comments are normalized and given greater credibility than the OP and than valuable comments. How is that any different than the things we criticize (other than the FDA's subversion of truth [EDIT:] is far more consequential [sorry, I didn't finish that sentence!])
There are valuable comments to be found; maybe that's one difference, but I'm wonder how the signal-to-noise compares with other forums.
Very different. Decisions with enormous health implications, enormous financial implications, are made at FDA.
At HN, most people are here to learn, here to understand more.
Vinay Prasad is a fraud, completely unfit for the leadership role he was placed into, making baffling and arbitrary decisions on his own, overturning those with far more experience, knowledge and expertise.
If a HN comment gets things wrong, a few people might be misinformed, if they are credulous enough to not double check things.
When the FDA makes decisions like they have been making, thousands to millions of peoples' lives are worse off, and billions in capital is wasted.
Discussion forums of all sorts are incredibly valuable, even when they get things wrong. I have lots of complaints about the overhyping of, say, CRISPR, especially on HN, but whatever, it's a far far higher signal-to-noise than a random person I meet around town. Mention you work on drug development for big pharma to the random person and they think you're evil, at least HN is less likely to have that basic misconception.
this is how Martin Shkreli described his work of identifying drug patents to buy that he could jack up the prices on. If that's the extent of the description you gave, I think random people would be right to first think you are doing something evil
What’s with him being allowed to continue to practice at the University of California [1]?
[1] https://vinayakkprasad.com/
The fraud is in his supposed thrust towards better scientific rigor when he is so sloppy with major decisions of life and death.
Just as the comment up there says that HN comments that are critical and misinformed get a lot of attention and upvotes, Prasad has been highly critical and misinformed about scientific research, and his stint at the FDA has exposed that his critiques are much like that top-level HN comment that doesn't get things quite right.
How can one tell whether he has tenure?
I can dislike someone’s stance while at the same time recognizing that others benefit from the same protections.
If protections are reduced, the process will be weaponized.
This is a valid concern. So is moral hazard from a lack of accountability. I’m trying to figure out how those balance.
To be clear, the FDA regulates marketing claims. “Is the label accurate?”
Major decisions about life and death are between the doctor and the patient, not the FDA.
It sounds like you’re taking an expansive view of this government agency’s mandate. People will push back on this at the ballot box, even if they can’t put it to words themselves.
In the case of vaccines, FDA's decisions can quite obviously make a difference in whether we have a rampant lethal pathogen roaring through our schools and killing our children and elderly... or not.
It's pedantic to the point of being outright false to say the FDA is not involved in major decisions of life and death. Silly take.
- This baffling Moderna decision, which is so bad that many in the industry assumed it was from a failed bribe solicitation
- Linked in this article is the "truly evil" decision requiring sham brain surgery in the placebo arm for a Huntington Disease trial https://arstechnica.com/health/2026/06/truly-evil-fda-reject...
- Prasad holding a defamatory PR event about the company producing the HD candidate treatment, and only talking "on background" to hide his identity, which is sleazy and unethical "The criticism apparently struck a nerve with Prasad. The FDA held a press briefing later Thursday in which an unnamed “senior FDA official”—who identified himself as a hematology-oncologist—launched into a diatribe against UniQure, saying its “failed therapy” was supported by “distorted and manipulated” data. As for Woodcock’s comments, the official said he “expect[s] better” from her." https://arstechnica.com/health/2026/03/trumps-divisive-fda-v...
- His first ouster and reinstatement last year, over a unilateral Duchenne muscular dystrophy decision, severely lacking in scientific rigor and analysis
- Lied on his CV about being on a highly prestigious council he was not on (The Cancer Letter is not a random YouTube channel, it's high quality cancer research journalism) https://www.youtube.com/watch?v=pCASAb7J-LE&t=41
As is often the case with such contrarians and critics, their own critiques apply most aptly to themselves.
You called this “minor CV fibbing” above. If he was lying about this when he applied for tenure, wouldn’t that be Cause?
That should be their primary objective.
Yes, I started writing that and didn't finish the sentence (see my edit near the end of the GP).
But I don't let HN off the hook: The attitude I described in the GP represents and perpetrates the same outlook that politically supports or tolerates this behavior from the FDA. HN users generally legitimize that approach rather than discrediting it.
> Mention you work on drug development for big pharma to the random person and they think you're evil
I think that's paranoid: The random person won't know what that means. Few who know will also know or care about the social implications. Of those who do, only some will be knee-jerk critical of big pharma, and fewer still of research rather than the business side. It's also a victim perspective: Big Pharma has enormous power; punching up at power by questioning, criticizing, and being skeptical (or even cynical) is not at all the same thing as punching down at the vulnerable. If someone wants the power and resources and salary of Big Pharma, benefitting from its enormous power, the pushback and reputation impact comes with it (though the latter is usually positive - great resume material and credibility).
Be specific?
This guy is a disaster. But really it's not just him. It's the entire organizational structure that puts him, or any other one person, in the position that they have the power to do this. There is simply no one qualified.
We need to have expert scientists to set up trials and review the design of the trials and conduct the analysis of the data. This is something that is generally objective and not able to be done without skills and experience. But then you have to make a decision based on those results. And the decision is some sort of risk reward trade off. While science can quantify what that tradeoff is, which path to take is fundamentally outside of the scope of science.
Trade offs are not objective determinations at all because they are based on subjective preferences. And therefore it makes no sense to force it into a one size fits all approval or denial by some centralized body. The only rational approach to such a trade off is to allow each individual to choose for themselves. The only person's opinion on whether the risk justifies the reward for the experimental Huntington's disease treatment is the patient's. The best we can do with science is to use it for its intended purpose to produce good data for him to make his choice.