Meanwhile DOGE has cancelled more than $2 billion in federal research grants. The US is shooting itself in the foot when it should be competing at its best.

https://www.cbsnews.com/amp/news/nih-layoffs-budget-cuts-med...

The administration is also pressing for a 55% budget cut to the National Science Foundation. The NSF is the primary funding agency for engineering, physics, mathematics, chemistry and computer science, among many other fields. If there's any doubt about the seriousness of that situation, the director has resigned over it. When some worried that US world leadership in physical and life sciences may be surpassed in a generation, I doubt anyone realized it could happen in one year.

https://www.science.org/content/article/nsf-director-resign-...

Indeed, now is the moment to step on the gas in biotech. The past 15 years have been nothing short of extraordinary in the field. We finally have the tools needed to effectively measure biology, manipulate biology, and increasingly predict biology. More recently, we have been able to turn more and more problems into computational problems.

With all of this coming together, we should be accelerating both public and private investment in biotechnology because we're getting closer and closer to transformative therapies. But...we're failing to rise to the occasion and meet the moment.

Could you give some examples/directions for interesting things that have popped up in the period you're mentioning? Sounds like a fun time.

The entire class of "biologics" drugs only came about in the past 15 years thanks to advances in sequencing and biotech. They are the mainstays of treatment for dozens of serious dermatologic, rheumatologic, and GI diseases, not to mention they directly cured multiple cancers.

Not op, but I’m in the field and can give you some things to read about:

- CAR-T

- CRISPR

- PRIME editing

- Base editing

- Modified mRNA

- PD-1 inhibitors

- On the cusp of personalized cancer vaccines

- ADCs

- Structure correctors

- Targeted protein degraders

- siRNAs

These have all really hit their stride in the past 15 years. Guess where all of them initially came from? Random ass government-funded academic research. Sure, you can split hairs with me on the 15 years and NIH/NSF etc funding, but it’s basically true. We are killing the golden goose…

Delivery vectors for nucleic acid have really progressed too. Peptide design and screening (also high throughput tools in general) have developed and led to great advances in peptide conjugates, such as peptide radioligands.

Tools wise cheap sequencing is a big one.

Fascinating, then, how the head of DOGE has deep financial interests in China. It’s really not out of bounds to suggest that his benefactors could’ve pulled some strings to kneecap the US.

No. No. That no longer applies, and I would argue never applies to a publicly funded entity like the federal government. When you're spending public dollars there is zero difference between incompetence and malice.

This administration has shown that it absolutely isn't incompetent. It's getting stuff done. Which means it's malice. Guaranteed. We're watching a self made disaster where few will profit, but will profit ENORMOUSLY.

What do you think the research goals of the NIH are? Why do you think the debt is decreasing now?

Give me a freaking break. One side is carrying on the Enlightenment ideals of rationality and secular humanism, while the other is trying to drag us back to the dark ages of superstition and fear. It has nothing to do with political “left” and “right” anymore. It’s just sane vs. insane.

I agree HN hides comments/posts too quickly, but the main issue here is that you can easily google federal outlays by month. This is an extremely easy thing to do. Unless you don't believe the data collected, there's nothing to debate. Why don't we have a debate about what color the sky is, or what 1+1 is?

What are people supposed to argue with the sort of person that claims destroying 2B of federal science funding is justified solely by alleviating 0.001% of the 1.83T deficit - aka accomplishing nothing?

There's nothing to be aware of, nothing to prepare for, it's an "argument" that destroys itself with simple division. (Taking their grossly exaggerated "3T per semester" deficit number - combining the 2020 peak in annual deficit and casually doubling it - at face value only makes the 2B from the NSF an even more insignificant 0.00033%)

I find nothing revelatory about it. Just another person that wants to vandalize anything associated with their vague meme-complex of woke-lib-fed-science-international stuff.

Go to your profile settings and change showdead from "no" to "yes".

You can adjust the HN settings to show flagged and dead comments.

It was a rubbish comment.

Flagging isn’t a super downvote for bad comments, it’s for posts that break the site guidelines, which the grandparent comment did not.

TIL. Thanks for this.

FWIW, I agree with you. It was an absurd comment, but it shouldn't have been flagged (and I wasn't the one who flagged it).

I'd honestly love to have a real discussion with people about this topic. HN comment sections, as imperfect as they may be, are afaik about the only place left on the internet where somewhat fact-based discussions of contentious topics happen.

The flagged comment is pretty inscrutable but I think I can explain the overall sentiment a bit better: half the country is under the impression that much of the science spending in this country is wasteful or even pernicious. They hear stories about studies of "racist highways" and "periods in transgender men," or the CDC claiming racism and gun control are diseases it should control, and think "why am I paying for this?". Combine this with the perception that the science establishment really shat the bed in their response to covid--lying about its origins, lying about the efficacy of masks, lying about the efficacy of the vaccine, lying about two more weeks, pushing ineffective and harmful lockdowns, etc--and half the country is ready to burn the whole thing down.

I, personally, know that science in general is a great good and should be funded. But the craziness, corruption, and dishonesty have to be excised or people are not going to support it.

To your comment in particular, the people supportive of these cuts don't think they're dragging us back to the dark ages. They think they're excising a tumor.

I’m not telling people stories about “racist highways” or “periods in transgender men.” I’m sure you’re not either. Maybe the problem here is whoever is telling those stories.

But in all seriousness, the time to have discussions about this was last year. The time for discussion has passed at this point. The damage is locked in now, as is the blowback that will result when people realize what was done.

> I'd honestly love to have a real discussion with people about this topic

https://www.themotte.org/

I'm happy to have this discussion, but I think you're making a false equivalence between the two sides. The examples you provided of liberal scientific overreach are either false or exaggerated. On the other side, you have an anti-vaxxer running the Department of Health and a president who suggested ingesting bleach to treat covid.

To respond to your examples specifically:

* Racist highways: I don't know what this is about.

* Periods in transgender men: This is a small, nuanced issue, not something worth destroying civilization over.

* Racism is a disease: Again, not familiar with this.

* Gun violence is a disease: It is the leading cause of death among children in this country, so treating it as an epidemic makes some sense. Should the CDC just pretend it's not happening?

* Lying about the origins of covid: Not sure who lied about this. The actual origin may never be known, but it most likely evolved from a disease that affected animals in Asia. There is no evidence that it was developed deliberately by China as a bioweapon.

* Lying about the efficacy of masks: Again, not sure what lie you're referring to. Masking was a rational response to an unknown virus. Since covid is a highly contagious respiratory disease, too much masking is certainly better than not enough masking.

* Lying about the efficacy of the vaccine: Again, not sure what lie you're referring to. The covid vaccines saved many thousands of lives.

* Pushing ineffective and harmful lockdowns: This was another rational response to an unknown virus. Lockdowns saved lives, even though they caused huge disruptions.

Your claim that the scientific community overreacted to covid is particularly unjustified and concerning to me. People like Anthony Fauci should be celebrated as heroes, not vilified.

> * Lying about the efficacy of masks: Again, not sure what lie you're referring to. Masking was a rational response to an unknown virus. Since covid is a highly contagious respiratory disease, too much masking is certainly better than not enough masking.

During the first few months of the pandemic the CDC, as well as various media commentators, stated that masks were not an effective measure. The advice was based on decades-old studies that established the "air-borne" vs "not air-borne" dichotomy, according to which COVID was not air-borne and thus masks were unnecessary. But the advice was also motivated by a desire to prevent a run on masks, which were in short supply and already being rationed in healthcare settings. Saying they lied is a stretch, but they were quite intransigent about it even as evidence piled up supporting masking efficacy. This history eventually became one kernel truth justifying a lot of anti-CDC, anti-institutional medicine rhetoric. Though that rhetoric existed before the incorporation of this history into their narrative, and of course the broader movement was always against masking, anyhow, so it's kind of inconsistent logically, but consistency isn't that important when it comes to politics.

>Lockdowns saved lives, even though they caused huge disruptions.

The problem with this argument and op's is that they're starting from different baselines. This next sentence is not meant to be as judgy as it sounds I'm afraid.

But your context is that lives are worth more than economic problems. The counterpoint that exists is that other people's lives aren't a valuable as my livelihood and income.

This is why rational debate breaks down so very quickly. We don't even have the same starting point anymore, let alone view of the facts at hand.

I think one can make a rational argument that the cost of the lockdowns was not worth the lives saved. I probably wouldn't agree with that argument, but I'd certainly hear it out, especially with regard to the impact on children's education.

The problem is that the current administration isn't interested in (or perhaps capable of) making rational arguments at all.

Was the last one? In quebec we were under curfew for two years.

I don't think most here would disagree about the perceptions that each side has. The problem is that is imperfect a lens to reality they are, it sure seems like the one side has embraced much of the fundamentals of QAnon even if most haven't realized it.

China's population is almost twice that of the US and EU combined. If what you're lacking for is patients, there's no better place to go to.

Not only that, but we're also a lot more obsessed with patient privacy. If somebody dies of cancer, there's no headline news about them dying of a cancelled trial, even if that's actually what happened. If patient data leaks, there's both a PR nightmare and legal consequences for the institution. That drives priorities.

I wouldn't be surprised if (some) Chinese researches are allowed to SELECT * from citizens where disease = 'bone_cancer', whereas researchers in the US have to send people to waiting rooms in hopes of catching an eligible patient[1]. Unless this gets changed, things won't get better.

We really need to start optimizing for min(deaths) instead of min(bad_pr) or min(outrage). That's a genuinely hard problem in a democratic society that respects the right to free speech (which, to be clear, is a very good society to live in IMO). In a way, it's a good problem to have.

[1] is a really good and accessible overview of why drug trials are so hard and what could be done to make them easier, it's worth checking out for anybody who wants to dive deeper into the subject.

[1] https://www.complexsystemspodcast.com/episodes/drug-developm...

I strongly disagree. There is no need for humans to be immortal, and there is nothing wrong with tacking healthcare research to public opinion at a bare minimum. If nothing else, it helps ensure our medical care doesn’t veer too far off track.

So much of policy success comes down to doing obvious and reasonable things, and most of the problem is how to incentivize making those choices. For all China's flaws, they've figured this out.

The best news here is that we might finally have a prosaic means to escape our modern-era applied biotech stagnation, the same way solar has appeared as a means to kick the feet out of traditional energy sources. China is pretty new to being an R&D powerhouse, but there are few more worthy causes.

The best outcome for the current China/U.S conflict is lots of peaceful competition that forces each society to innovate.

Well during the Cold War with U.S./USSR conflict there was a lot of competition that heralded many new technologies, especially the dual use technologies that are good for both civilian and military uses. I can imagine something happening again if the U.S. had good leadership.

The problem is that the U.S. has bad media focused on being "right" over actual truth. (See Fox News and the many far-right "alt news" organizationns.) This lack of care for the truth is the foundation the U.S. political system rests on top of. Without fixing that foundation, U.S. leadership will continue to either be terrible, or terribly constrained. Add in unlimited political funding from anonymous people/organizations, and the situation is only more impossible to fix. Good U.S. leadership is a pipedream, unfortunately.

One of the parties involved already decided they don't event wanna try to compete.

How on earth can you possibly claim that when China was a peasant society that was dicked over for a hundred years by western powers addicting them to opium? Obviously their careful planning and industrialization strategy is working.

There is no careful planning. Just take a look at the waste, the debts and the rapid policy changes. It is more like industrial Darwinism at scale. The main fuel was mainly WTO , export and slavery labor. The industrialization in my opinion is a by product of that process.

This is a highly propagandized view of China. Their industrial strategy was to get western capitalists to support industrializing the country by offering cheaper labor, but without surrendering control of the country to them, but now wages have risen quite substantially and their country is industrialized.

The western capitalists are now pissed that china didn't "liberalize" and let them take control of the country and are attempting to retaliate. This is why you have imbibed this propaganda that they created.

Interesting piece, but I think it is helpful to highlight some points not addressed that provide meaningful context. Though the US system is not perfect, I think we need to acknowledge the US does have a robust, enviable biomedical / regulatory ecosystem, and lots of thought and effort have gone into curating the system that we all enjoy today. To engage with a select few of the points made:

1) Author cites that China introduced priority review mechanisms, conditional approvals, and accelerated timelines to streamline approval pathways. They fail to mention that the US helped pioneer these same mechanisms and that they are currently, actively, in use. We DO have priority review vouchers to incentivize investment in orphan disease, conditional approval pathways, and breakthrough designations for drugs addressing unmet needs to name a few. The US has been, and continues to be an innovator on these topics and credit should be given here - this stuff isn't new to us and there is a rich history of attempts to incentivize innovation ranging from offering prizes for cures to disease, to purchasing experimental therapeutics in advance of approval to ensure sponsors have the cashflow to continue development.

2) Regarding acceptance of foreign data, whose data do you think the rest of the world wants to use by designing their policies the way they have? Many countries are willing to accept foreign data because that includes data generated in the US, where historically and presently, standards are very high and the research infrastructure is well-supported (recent events notwithstanding). One need only look at the story of Dr. Frances Kelsey and thalidomide to understand why the US has gone to great lengths to ensure a high bar that is carefully maintained by its own FDA's standards. This is NOT to say great data isn't generated elsewhere and there are examples where ex-US data has been used to support US approval of promising drugs (particularly in areas of significant unmet need, for example, neurodegenerative disease), but there is rhyme to the reason that goes beyond the argument that the US is antiquated in its approach. That said, one can acknowledge there is a geopolitical component that may wax and wane in relative importance depending on the current political climate.

3) Citing the Lunar trial actually highlights the robustness of the US biomedical enterprise rather than detracts from it - that trial was conducted in patients with stage IV NSCLC after they progressed on platinum therapy. In the US during the enrollment period, ICIs like pembro were being approved as first-line monotherapy displacing platinum-based therapies. So the problem there is when practice changes, you're going to 1) have a harder time finding patients that are progressing on the thing that is no longer first line and 2) remember the intervention arm was ICI + TTF...so you can't intervene when people have already received the drug class that is part of your intervention. Saying they couldn't enroll because of bad infrastructure is like saying the apple store is bad at enrolling customers with dead Iphone 10s to trial your combo therapy when most of the people they see have Iphone 15s. You need to enroll then where most people coming through have iphone 10s and this is precisely why they enrolled a significant proportion of patients ex-US because the standard of care elsewhere had not yet changed.

Props to the author for bringing up the important question of US competitiveness in drug development. But let us not forget that we have an enviable biomedical apparatus for a reason - the US has a strong track record of high standards and innovation because we have a good many rigorous, scientifically-minded folks who work on improving it all the time. It's not perfect, but if we don't call out the good, pioneering work that has been done here, then people may feel justified in questioning if anything has been done at all. One should not get the impression we're just waiting around to get hyperdunked or just lucked into the good things we do have.

What’s new? America is cooked.

Just a walk in a random big city in China reveals how fast they are progressing. The speed of things changing is ridiculous. In almost every field they are getting better. And fast. Thats what you can achieve when your country has 40 years of mass production experience. The thing I hope most for is that China gets its own high performing chips so that companies like Nvidia really get a competitor.

Interestingly the allure to visit China and see the progress is becoming more compelling. Meanwhile people are afraid to visit the USA.

Competing with it is a problem for conservativism. Some admittedly loose reasoning:

Conservativism preserves currently widely accepted structures, including ideas, by ridiculing and excluding new ones; social structures, by outlawing / persecuting / demonizing new ones as a threat to 'our traditions' and 'way of life'; businesses, through tariffs and other anti-competitive measures - the House GOP is considering a bill that reduces antitrust powers, for example; existing economic sectors, by government picking winners and funding them, limiting the economy to what is popular and that the government already understands, such as manufacturing; etc.

Remember the land of the individual, of personal freedom, of opportunity, that by its culture generated invention and innovation that other places, without that culture, couldn't match. What China, which is limited by central control, is doing is copying well-established innovations - a biotech industry that relies on clinical trials. Cutting edge stuff - decades ago.

What has made the US successful is creating, innovating, and moving on to the next thing - things the government and most of the public are far behind on. Look at the boom in the IT industry over the last several decades (also no longer cutting edge except in limited ways).

How can that happen now? The US has currently embraced relatively extreme conservatism. People are afraid to offer challenging ideas, and make their money from rent and from squeezing revenue from old ideas (the stereotypical private equity model). They can't go anywhere except by pleasing the oligarchy, now including the government.

> Remember the land of the individual, of personal freedom, of opportunity, that by its culture generated invention and innovation that other places, without that culture, couldn't match. What China, which is limited by central control, is doing is copying well-established innovations

They don’t seem to be limited by it at all and in many areas of high tech innovation they are years ahead.

It’s very hard to argue that their EV market, for instance, is not an example of competitiveness driving innovation, which is supposedly the hallmark of the free market.

While agree with the whole analysis, I do wonder if most/enough/all the ones supporting the regime change in US are really conservatives ("embraced extreme conservatism") or they just feel/are "left behind" hence they want any change. People might not care who is in power (although they will suffer the consequences), but if after 4 years they do not live better they will say "let's change" - without really checking what is the alternative...

In the end, alternation of rulers is probably on average healthier than having the same guys over and over, but it is no guarantee of success.

I personally think you're right. I think that in general a lot of people want change for the sake of change if they're unhappy (or often even if they're happy).

China is having a boom in everything, not just in clinical trials.

If you follow the economic news China has some severe structure problems that it’s going to have to solve.

Huge debt overhang, much of it “hidden” that is dragging down growth

The real estate problem still isn’t solved and a big reset of prices is going to have a big impact on the economy

China placed a big bet on “key industries” under the theory “supply first then we find demand” which isn’t panning out well with tariffs

This is showing up in the stock market which rent saw a 50% decrease

And economic growth has been a weak 5% when they need 9-11% if they hope to avoid the middle income trap

All while the population is rapidly aging and shrinking at the same time

You seem like a bot given 1 comment in 3 years and it was about this. Your AI misinterpreted the GP and responded to something not asked.

If China actually makes pharmaceutical breakthroughs, the West should immediately steal them and invalidate any claims of patents. They do not respect US intellectual property rights

The west actually had quite some deals with them recently. If not for the trade war there could’ve been a lot more. To some extent it is like the Temu vibe.

kek