Health Freedom Is a Right AND Can Yield More and Faster Therapies

The headline of the article on the front page of the NYT says “No Evidence for Healing Powers,” and goes on to slam unsophisticated right-wingers as irresponsibly pushing ivermectin as a therapy for cancer. In the article the NYT publishes a ludicrous picture from a right-winger’s Facebook page where he has spread veterinary ivermectin cream on his tongue and says “tastes like dead cancer.”

But this is unfair and tendentious caricature. A friend recently sent me an Instagram post by a chiropractor suffering from glioblastoma who has taken ivermectin and mebendazole. He briefly sketches the hypothesized mechanisms for activity of the two drugs, consistent with research published in scientific papers.

Glioblastoma is a serious, often fatal, brain cancer. He had surgery, but knows that surgery often does not cure, so he threw a Hail Mary and took ivermectin and mebendazole. These drugs have long track-records for safety, having been tested and approved for other uses. Doctors can, and have, prescribed drugs for off-label uses for decades.

Decades ago minoxidil was approved as an blood pressure medicine. I asked my then-doctor to prescribe it for me for its rumored effects as a hair loss cure. He did, so I crushed the tablets and somehow applied them to my scalp, which proceeded to itch, but not grow hair. It was a low-risk, modest-chance-of-success experiment. I think I had a right to try it, and that no government or expert had a right to forbid it. (Eventually minoxidil was approved for hair loss and branded Rogaine–which still didn’t work for me.)

In a free country adults should have wide latitude to make decisions about what risks they take; to scuba dive, to drive NASCAR, to go into space, and yes to take ivermectin and mebendazole. And the ludicrous right-winger? Hey, maybe even he has rights.

The NYT headline says there is “no evidence” for ivermectin. Below I cite a survey article that identifies 24 articles published in scientific journals identifying mechanisms by which ivermectin may be effective against cancer. There’s plenty of evidence, just not from randomized double-blind clinical trials (RCTs). But as long-time readers of this blog may remember, I have posted many entries giving useful actionable evidence that takes forms other than RCTs.

“No evidence”? Maybe the NYT was seeking plausible deniability by running its article on April 1st.

Oh, and by the way, allowing health freedom might sometimes result in better and faster therapies. I am currently reading Rethinking Diabetes by Gary Taubes. He tells the story (pp. 346-356) of Richard K. Bernstein, an engineer with Type 1 diabetes who was suffering from various serious ailments from his diabetes, in spite of the doctors saying it was being well-controlled by insulin. In his 40s, he was only expected to live another 10 years. Well he bought a new device that was not supposed to be bought by patients. The medical profession thought patients could not handle the information. (His wife was an MD, so he ‘bought’ it by asking her to buy it for him.) The device allowed him to get frequent readings of his blood sugar, and thereby to better control it, ultimately through changes in diet. When he tried to share what he had learned, he had trouble finding anyone who would take him seriously, so in his 40s he enrolled in medical school, and started publishing papers and books describing his results.

Richard K. Bernstein died on April 15, 2025 at age 90.

[Below are some relevant quotations from a NYT companion piece to the front-page article. The companion piece provides only slightly less tendentious background information on ivermectin.]

(p. A21) . . . there is not evidence to support people taking ivermectin to treat cancer.

. . .

Scientists do not dispute that ivermectin is powerfully effective — against parasites. The drug was such a breakthrough in the fight against tropical parasitic diseases that two scientists who studied it won the Nobel Prize in 2015.

The Food and Drug Administration has approved ivermectin tablets to treat certain parasitic infections, and the agency has authorized ivermectin lotions to kill lice and creams to help with rosacea. Veterinarians also use the drug to prevent and treat parasitic diseases in animals.

. . .

Studies in human cells suggest that the drug may kill certain types of cancer cells in a way that triggers the immune system, said Dr. Peter P. Lee, chair of the department of immuno-oncology at Beckman Research Institute of City of Hope in Duarte, Calif. In mouse studies, Dr. Lee has seen that the drug, on its own, does not shrink breast tumors. But it’s possible that the drug may have benefits for breast cancer when used alongside existing cancer immunotherapy, he said. Researchers are studying a combination of ivermectin and an investigational cancer drug in people with breast cancer.

While some inaccurate social media posts claim that ivermectin can treat cancer because tumors themselves are parasitic, the promise of ivermectin for cancer has nothing to do with its anti-parasitic effect, Dr. Lee said. Rather, it seems that the drug may be able to modulate a signal involved with cancer growth.

But doctors still need larger, randomized clinical trials to better understand whether ivermectin could treat cancer. Just because a drug seems to work in animals doesn’t mean those results will translate into real-world outcomes, Dr. Johnson noted. There are “hundreds of medications that look to be promising in a preclinical setting” every year, he said, adding, “The vast majority of those will never be shown to be effective in humans.”

. . .

Doctors generally view ivermectin as safe at the doses prescribed to treat parasitic infections.

For the full story, see:

Dani Blum. “What Ivermectin Can and Can’t Do, and What the Dangers Are.” The New York Times (Tues., April 1, 2025): A21.

(Note: ellipses added.)

(Note: the online version has the date March 31, 2025, and has the title “What Ivermectin Can (and Can’t) Do.” In the first quoted sentence, the print version says “no evidence” and the online version says “not evidence.”)

The Blum article that I just quoted and cited, is a secondary companion article to a longer front-page article, also on ivermectin:

Richard Fausset. “No Evidence for Healing Powers, but ‘Tastes Like Dead Cancer’.” The New York Times (Tues., April 1, 2025): A1 & A21.

(Note: the online version has the date March 31, 2025, and has the title “Why the Right Still Embraces Ivermectin.”)

The paper cited below reviewed the published scientific literature as of 2020 on the mechanisms through which ivermectin could have anti-cancer effects, finding 24 articles documenting one or more mechanisms.

Tang, Mingyang, Xiaodong Hu, Yi Wang, Xin Yao, Wei Zhang, Chenying Yu, Fuying Cheng, Jiangyan Li, and Qiang Fang. “Ivermectin, a Potential Anticancer Drug Derived from an Antiparasitic Drug.” Pharmacological Research 163 (Jan. 2021): 105207.

Tang and co-authors are optimistic in their summary section quoted below. [In this quote IVM is “ivermectin” and MDR is “multidrug resistance”.]

. . ., the broad-spectrum antiparasitic drug IVM, which is widely used in the field of parasitic control, has many advantages that suggest that it is worth developing as a potential new anticancer drug. IVM selectively inhibits the proliferation of tumors at a dose that is not toxic to normal cells and can reverse the MDR of tumors. Importantly, IVM is an established drug used for the treatment of parasitic diseases such as river blindness and elephantiasis. It has been widely used in humans for many years, and its various pharmacological properties, including long- and short-term toxicological effects and drug metabolism characteristics are very clear. (Tang et al. Jan. 2021, pp. 7-8)

The paper cited below reviewed the published scientific literature as of 2019 on the effect of mebendazole on cancer, and found 26 in vitro studies showing anti-cancer biological effects, 14 in vivo studies showing anti-tumor effects, and six Phase 1 or Phase 2 clinical trials listed in ClinicalTrials.gov.

Guerini, Andrea Emanuele, Luca Triggiani, Marta Maddalo, Marco Lorenzo Bonù, Francesco Frassine, Anna Baiguini, Alessandro Alghisi, Davide Tomasini, Paolo Borghetti, Nadia Pasinetti, Roberto Bresciani, Stefano Maria Magrini, and Michela Buglione. “Mebendazole as a Candidate for Drug Repurposing in Oncology: An Extensive Review of Current Literature.” Cancers 11, no. 9 (Aug. 2019): article #1284.

Gary Taubes’s book, praised by Marty Makary and Siddhartha Mukherjee, and mentioned by me near the end of my commentary, is:

Taubes, Gary. Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments. New York: Knopf, 2024.

[I thank Ivette Locay for sending me a link useful for my commentary.]

George Church Is Optimistic About A.I., but in 2019 Also Was Optimistic He Would Reverse Aging in Dogs by 2022

Steve Lohr had an article in the NYT promoting the possibility that generative intelligence from A.I. will bring us scientific breakthroughs quicker. A new startup called “Lila” is trying to achieve this. George Church of Harvard is onboard.

Back on Sun., Dec. 8, 2019, 60 Minutes on ran a very optimistic segment in which Church says that through his lab’s work on gene editing, age reversal for dogs “might be a couple years away and then that takes another ten years to get through the human clinical trials” (Church as quoted in Pelley 2019).

In Lohr’s recent article, Church is quoted as saying ““I think science is a really good topic for A.I.” (Church as quoted in Lohr, p. B5). The article describes science as basically a mechanical process of trial and error. Some science is like that, like when Gerhard Domagk had his lab crank through hundreds of chemicals to find one (Prontosil) that was a broad spectrum antibiotic. Maybe A.I. could more efficiently crank through a large set of possibilities. The only example of medical advance through A.I. in the article is that “Lila’s A.I. has generated novel antibodies to fight disease” (Lohr, p. B5).

A.I. can combine what is known in novel ways and produce text that is new, but is not necessarily sensible, correct, or useful, let alone a profound leap.

So it is not clear to me how well A.I. could help define and prioritize the possibilities. Lila scientists are feeding their A.I. program scientific literature, presumably weighting differing views by some bibliometric measures, like citations or journal rankings. But often a leap or breakthrough is at first rejected by the top journals, and not heavily cited by the establishment.

I do not see how A.I. could identify those early breakthroughs, much less be the source of them. And making and identifying such breakthroughs are key steps in scientific progress.

I was was pumped when I heard Church’s optimism in 2019 for longevity breakthroughs. But now it is more than five years later, and I have not seen claims of age reversal for dogs, let alone for humans. Maybe Covid delayed progress. Or maybe Church is not a good judge of what is required for scientific breakthroughs. This latter possibility seems more likely given Church’s hyper-enthusiasm for generative A.I.

Steve Lohr’s article is:

Lohr, Steve. “A.I. May Hasten Leaps in Science.” The New York Times (Thurs., March 13, 2025): B1 & B5.

(Note: the online version of the Steve Lohr article has the date March 10, 2025, and has the title “The Quest for A.I. ‘Scientific Superintelligence’.”)

A transcript of the 60 Minutes segment on Church is:

Pelley, Scott. “A Harvard Geneticist’s Goal: To Protect Humans from Viruses, Genetic Diseases, and Aging.” In 60 Minutes. CBS News, (Sun., Dec. 8, 2019).

Immunotherapy Can Succeed as First Line of Attack Against Solid Tumors

About two to three percent of solid tumor cancer patients have tumors with what is called “mismatch mutations.” Researchers at Memorial Sloan Kettering have announced success at using immunotherapy to treat patients with these mutations. Many had their tumors completely disappear. Johns Hopkins oncologist Bert Vogelstein called the results “groundbreaking” (as quoted in Kolata 2025, p. A24).

The cures matter most, but what also matters is that immunotherapy was the first line of treatment, so the patients did not have to suffer the “grisly” side effects that often come with the traditional surgery, radiation, and chemo treatments.

The upside is huge. The downside is that it only works for two to three percent of solid tumor patients, and the drug costs about $100,000 per patient.

Kolata’s article is:

Gina Kolata. “Immunotherapy Drug Spares Cancer Patients From Grisly Treatments.” The New York Times (Weds., April 28, 2025): A24.

(Note: the online version of Kolata’s article has the date April 27, 2025, and has the title “Medicine Spares Cancer Patients From Grisly Surgeries and Harsh Therapies.”)

The academic paper published online in The New England Journal of Medicine is:

Cercek, Andrea, Michael B. Foote, Benoit Rousseau, J. Joshua Smith, Jinru Shia, Jenna Sinopoli, Jill Weiss, Melissa Lumish, Lindsay Temple, Miteshkumar Patel, Callahan Wilde, Leonard B. Saltz, Guillem Argiles, Zsofia Stadler, Oliver Artz, Steven Maron, Geoffrey Ku, Ping Gu, Yelena Y. Janjigian, Daniela Molena, Gopa Iyer, Jonathan Coleman, Wassim Abida, Seth Cohen, Kevin Soares, Mark Schattner, Vivian E. Strong, Rona Yaeger, Philip Paty, Marina Shcherba, Ryan Sugarman, Paul B. Romesser, Alice Zervoudakis, Avni Desai, Neil H. Segal, Imane El Dika, Maria Widmar, Iris Wei, Emmanouil Pappou, Gerard Fumo, Santiago Aparo, Mithat Gonen, Marc Gollub, Vetri S. Jayaprakasam, Tae-Hyung Kim, Julio Garcia Aguilar, Martin Weiser, and Luis A. Diaz. “Nonoperative Management of Mismatch Repair–Deficient Tumors.” The New England Journal of Medicine (April 27, 2025), DOI: 10.1056/NEJMoa2404512.

Tim Friede’s “Daredevilry” in Taking 650 Venom Injections and 200 Poisonous Snake Bites to Help Create a Universal Antivenom “for Humanity”

Back during Covid, over 38,000 adults volunteered to participate in a “challenge” clinical trial of the new vaccines, but such trials were not allowed. In a challenge trial each participant receives the vaccine and then is exposed to the disease. Phase 3 trials for efficacy can be completed much more quickly, with many fewer participants, and at much lower costs, if the trials are “challenge” trials.

We allow people the freedom to dangerous actions for fun or excitement, or to help humanity, like Tim Friede (below) injecting snake venom and letting snakes bite him. Why then did we not allow challenge trials with the Covid vaccine?

Note on another issue, that the researchers are planning in their next step to test their antivenom on dogs who are bitten by snakes. This is a good example of my ideal use of dogs in medical research–where the trial aims at benefits for both the humans AND the dogs.

(p. A1) Over nearly 18 years, the man, Tim Friede, 57, injected himself with more than 650 carefully calibrated, escalating doses of venom to build his immunity to 16 deadly snake species. He also allowed the snakes — mostly one at a time, but sometimes two, . . . — to sink their sharp fangs into him about 200 times.

This bit of daredevilry (one name for it) may now help to solve a dire global health problem. More than 600 species of venomous snakes roam the earth, biting as many as 2.7 million people, killing about 120,000 people and maiming 400,000 others — numbers thought to be vast underestimates.

In Mr. Friede’s blood, scientists say they have identified antibodies that are capable of neutralizing the venom of multiple snake (p. A19) species, a step toward creating a universal antivenom, they reported on Friday [May 2, 2025] in the journal Cell.

“I’m really proud that I can do something in life for humanity, to make a difference for people that are 8,000 miles away, that I’m never going to meet, never going to talk to, never going to see, probably,” said Mr. Friede, who lives in Two Rivers, Wis., where venomous snakes are not much of a threat.

. . .

“This is a bigger problem than the first world realizes,” said Jacob Glanville, founder and chief executive of Centivax, a company that aims to produce broad-spectrum vaccines, and lead author on the study.

Dr. Glanville and his colleagues found that two powerful antibodies from Mr. Freide’s blood, when combined with a drug that blocks neurotoxins, protected mice from the venom of 19 deadly snake species of a large family found in different geographical regions.

This is an extraordinary feat, according to experts not involved in the work. Most antivenoms can counter the venom from just one or a few related snake species from one region.

The study suggests that cocktails of antitoxins may successfully prevent deaths and injuries from all snake families, said Nicholas Casewell, a researcher at the Liverpool School of Tropical Medicine in England.

. . .

There were other mishaps — accidental bites, anaphylactic shocks, hives, blackouts. Mr. Friede describes himself as a nondegree scientist, but “there’s no college in the world that can teach you how to do it,” he said. “I was doing it on my own as best I could.”

Two teams of scientists sampled Mr. Friede’s blood over the years, but neither project led anywhere. By the time he met Dr. Glanville, in 2017, he was nearly ready to give up.

Dr. Glanville had been pursuing what scientists call broadly acting antibodies as the basis for universal vaccines against viruses. He grew up in a Maya village in the Guatemala highlands, and became intrigued by the possibility of using the same approach for universal antivenom.

. . .

The researchers next plan to test the treatment in Australia in any dogs that are brought into veterinary clinics for snakebites. They are also hoping to identify another component, perhaps also from Mr. Friede’s blood, that would extend full protection to all 19 snake species that were subjects of the research.

Mr. Friede himself is done now, however. His last bite was in November 2018, from a water cobra. He was divorced — his wife and children had moved out. “Well, that’s it, enough is enough,” he recalled thinking.

He misses the snakes, he said, but not the painful bites. “I’ll probably get back into it in the future,” he said. “But for right now, I’m happy where things are at.”

For the full story see:

Apoorva Mandavilli. “Man of 200 Snake Bites May Be the Antivenom.” The New York Times (Saturday, May 3, 2025): A1 & A19.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date May 2, 2025, and has the title “Universal Antivenom May Grow Out of Man Who Let Snakes Bite Him 200 Times.”)

The academic article in the journal Cell mentioned above is:

Glanville, Jacob, Mark Bellin, Sergei Pletnev, Baoshan Zhang, Joel Christian Andrade, Sangil Kim, David Tsao, Raffaello Verardi, Rishi Bedi, Sindy Liao, Raymond Newland, Nicholas L. Bayless, Sawsan Youssef, Ena S. Tully, Tatsiana Bylund, Sujeong Kim, Hannah Hirou, Tracy Liu, and Peter D. Kwong. “Snake Venom Protection by a Cocktail of Varespladib and Broadly Neutralizing Human Antibodies.” Cell 188 (2025): 1-18.

Muriel Bristol Was Allowed to Act on What She Knew but Was Unable to Prove or Explain

Muriel Bristol knew that tea tasted better when the milk was poured in first, than when it was poured in after the tea. She knew it but couldn’t prove it and didn’t know why it was true. The world is better when more of us, more often, can act on what we know, but what we can neither prove nor explain. Too often regulations restrict the actions of entrepreneurs to what they can prove and explain, e.g., in the firing of employees.

This slows and reduces efficiency and innovation (not to mention freedom).

(p. C8) [Adam] Kucharski, a mathematically trained epidemiologist, says that the rigor and purity of mathematics has imbued it with extraordinary rhetorical power. “In an uncertain world, it is reassuring to think there is at least one field that can provide definitive answers,” he writes. Yet he adds that certainty can sometimes be an illusion. “Even mathematical notions of proof” are “not always as robust and politics-free as they might seem.”

. . .

. . ., proving what is “obvious and simple” isn’t always easy. Kucharski offers the delightful example of Muriel Bristol, a scientist who always put the milk in her cup before pouring her tea, because she insisted it tasted better. In the 1920s, a skeptical statistician designed a blind taste test to see if Bristol could distinguish between cups of milk-then-tea and cups of tea-then-milk. Bristol got all of them right. In 2008, the Royal Society of Chemistry reported that when milk is poured into hot tea, “individual drops separate from the bulk of the milk” and allow “significant denaturation to occur.” The result is a burnt flavor. Eighty years after Bristol was statistically vindicated, she was chemically vindicated too.

For the full review see:

Jennifer Szalai. “Proving It Doesn’t Necessarily Make It True.” The New York Times (Saturday, May 3, 2025): C8.

(Note: ellipses, and bracketed name, added.)

(Note: the online version of the review has the date April 30, 2025, and has the title “Just Because You Can Prove It Doesn’t Make It True.”)

The book under review is:

Kucharski, Adam. Proof: The Art and Science of Certainty. New York: Basic Books, 2025.

A Rare Antibody in James Harrison’s Blood Protected the Lives of 2.4 Million Australian Babies

I recently purchased from Amazon, but have not read, Good Blood, which describes the discovery of a cure, and the struggle for acceptance of the cure, for the RH disease sketched in the passages quoted below. The disease affected my family, but I am not sure I remember exactly how. I am Rh positive and I think my mother was Rh negative. I think with each child after me, there was increasing risk and worry of possible bad health effects.

According to the Amazon summary for Good Blood, the book also describes the devotion of master blood donor James Harrison, whose recent obituary is quoted below.

Starting at least in the 1960s medical experts were often optimistic that future medical advances would come from designer chemicals enabled by scientific advances in our knowledge of chemistry and biological processes. Taxpayer funding was devoted to that approach in Nixon’s War on Cancer. But fewer medical advances have come from that approach than hoped, and more advances than expected have continued to come from the evolved usable chemicals (sometimes poisons, sometimes antibodies) of plants, animals, and exceptional human beings like Mr. Harrison.

Mao is often misquoted as saying ‘Let a thousand flowers bloom,’ but someone should say it (at least if the cost of planting the flowers is not too high).

(p. A25) James Harrison did not much care for needles. Whenever he donated plasma, he would look away as the tip went into his arm.

But Mr. Harrison was one of the most prolific donors in history, extending his arm 1,173 times. He may have also been one of the most important: Scientists used a rare antibody in his plasma to make a medication that helped protect an estimated 2.4 million babies in Australia from possible disease or death, medical experts say.

“He just kept going and going and going,” his grandson Jarrod Mellowship said in an interview on Monday [March 3, 2025]. “He didn’t feel like he had to do it. He just wanted to do it.”

. . .

Mr. Harrison’s plasma contained the rare antibody anti-D. Scientists used it to make a medication for pregnant mothers whose immune systems could attack their fetuses’ red blood cells, according to Australian Red Cross Lifeblood.

Anti-D helps protect against problems that can occur when babies and mothers have different blood types, most often if the fetus is “positive” and the mother is “negative,” according to the Cleveland Clinic. (The positive and negative signs are called the Rhesus factor, or Rh factor.)

In such cases, a mother’s immune system might react to the fetus as if it were a foreign threat. That can lead babies to develop a dangerous and potentially fatal condition, hemolytic disease of the fetus and newborn, which can cause anemia and jaundice.

. . .

In Australia, scientists from the Walter and Eliza Hall Institute of Medical Research in Melbourne are working to create a synthetic version of the drug using what some have called “James in a Jar,” an antibody that can be made in a lab.

But for now, human donors are essential: The anti-D shots are made with donated plasma, and Mr. Harrison was one of about 200 donors among the 27 million people in Australia, Lifeblood said.

. . .

Mr. Harrison knew the importance of his work firsthand. At 14, he needed a lot of blood transfusions during a major lung surgery. The experience inspired him to donate and encourage others to donate, too.

For the full obituary, see:

Amelia Nierenberg. “James Harrison, Whose Rare Antibodies Helped Millions, Is Dead at 88.” The New York Times (Saturday, March 8, 2025): A25.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the obituary was updated March 7, 2025, and has the title “James Harrison, Whose Antibodies Helped Millions, Dies at 88.”)

The Good Blood book, mentioned above, is:

Guthrie, Julian. Good Blood: A Doctor, a Donor, and the Incredible Breakthrough That Saved Millions of Babies. New York: Harry N. Abrams Press, 2020.

Ramaswamy Avowed That the F.D.A. “Erects Unnecessary Barriers to Innovation”

The New York Times article quoted below worried that if Vivek Ramaswamy succeeded in “slashing regulation” of drugs, his own drug development firm would have benefitted. Maybe so, but that misses the main point–all the rest of us also would have benefitted by medical entrepreneurs being allowed to create more and quicker cures. Presumably The New York Times was relieved when Ramaswamy resigned from DOGE, but I was discouraged.

I was in favor of Elon Musk’s push to reduce the number of federal employees. But I was even more in favor of Vivek Ramaswamy’s push to deregulate innovative entrepreneurs.

[By the way, isn’t it predictable that The New York Times delights in highlighting Roivant’s one failure, but gives only passing scant mention to its six successes?]

(p. A10) Vivek Ramaswamy is the less famous and less wealthy half of the duo of billionaires that President-elect Donald J. Trump has designated to slash government costs.

. . .

At 39, he is one of the world’s youngest billionaires, having made his fortune in the pharmaceutical industry.  . . .

Mr. Ramaswamy, who owns a stake currently valued at nearly $600 million in a biotechnology company he started, has called for changes at the Food and Drug Administration that would speed up drug approvals.

. . .

Since being named to jointly lead DOGE, Mr. Ramaswamy had until recently been posting on Mr. Musk’s social media site X, hinting about where he may look to make changes in the government.

He called for slashing regulation, not just cutting government spending. He pointed to federal workers focused on diversity as potential targets for “mass firings.”

And he has been taking aim at the F.D.A. “My #1 issue with FDA is that it erects unnecessary barriers to innovation,” he wrote on X. He criticized the agency’s general requirement that drugmakers conduct two successful major studies to win approval rather than one.

Mr. Ramaswamy founded his biotechnology company, Roivant Sciences, in 2014, betting that he could find hidden gems whose potential had been overlooked by large drugmakers. The idea was to hunt for experimental medications languishing within large pharmaceutical companies, buy them for cheap and spin out a web of subsidiaries to bring them to market.

The venture is best known for a spectacular failure.

In 2015, Mr. Ramaswamy whipped up hype and investment around one of his finds, a potential treatment for Alzheimer’s disease being developed by one of his subsidiaries, Axovant. Two years later, a clinical trial showed that it did not work, erasing more than $1.3 billion in Axovant’s stock value in a single day.

Mr. Ramaswamy personally lost money on paper on the failure, but thanks to the savvy way he had structured his web of companies he and Roivant weathered the storm. Six products have won F.D.A. approval, and today Roivant has a market valuation of $8 billion.

Mr. Ramaswamy sold some of his Roivant stock to take a large payout in 2020, reporting nearly $175 million in capital gains on his tax return that year. But he is still one of the company’s largest shareholders.

If Mr. Ramaswamy recommends changes that speed up drug approvals through DOGE, that could be good news for Roivant, which is developing drugs that might come up for approval during Mr. Trump’s second term. The faster it can get medicines onto the market, the more valuable the company — and Mr. Ramaswamy’s stake in it — stands to become.

For the full story see:

Rebecca Robbins, Maureen Farrell and Jonathan Weisman. “From Ramaswamy’s High-Profile Perch, a Web of Potential Conflicts.” The New York Times (Thursday, January 16, 2025): A10.

(Note: ellipses added.)

(Note: the online version of the story has the date Jan. 15, 2025, and has the title “Ramaswamy Has a High-Profile Perch and a Raft of Potential Conflicts.” At one point this entry was posted on March 30. I had not noted that another entry had been posted for March 30, so for consistency I moved this entry to April 23.)

If Risks Are Low and Alternatives Few, Let Patients Try Therapies That Lack Proof of Efficacy

I like Dr. Shirvalkar’s decision process quoted below. He says that a patient should be allowed to take a therapy without proof of efficacy, if the costs and risks are low.

This decision process is consistent with my suggestion that the F.D.A. should stop mandating efficacy, and limit itself to only mandating safety, thus greatly reducing the costs of drug development.

(p. D7) Acetaminophen. Acupuncture. Massage. Muscle relaxants. Cannabinoids. Opioids. The list of available treatments for low back pain goes on and on. But there’s not good evidence that these treatments actually reduce the pain, according to a new study that summarized the results of hundreds of randomized trials.

. . .

Aidan Cashin, the paper’s first author and deputy director of the research group Center for Pain IMPACT at Neuroscience Research Australia, said the aim of the study was to identify which first-line treatments for low back pain had any specific effects beyond a placebo, which might merit further study and which may not be worth pursuing.

. . .

One limitation of the type of analysis that Dr. Cashin conducted was that it aggregated data from different studies and different populations in order to emulate one large trial. But in the process, a strong signal from one study that a treatment worked could be diluted amid noise from other studies that may not have been designed as well, he said.

. . .

The evidence for something like heat might be inconclusive, doctors said, but they would still recommend that patients try it. “It’s cheap, it’s accessible, it almost causes no harm,” Dr. Shirvalkar said.

For the full story see:

Nina Agrawal. “Low Back Pain Relief Is Stubbornly Elusive.” The New York Times (Tuesday, March 25, 2025): D7.

(Note: ellipses added.)

(Note: the online version of the story was updated March 24, 2025, and has the title “What Works for Low Back Pain? Not Much, a New Study Says.” Where the versions differ, in the passages quoted above, I follow the online version.)

Pasteur Saw That “Germs Were Everywhere in the Air”

The passages quoted below show how Pasteur respected his audience by finding a clear and compelling way to communicate that “germs” float in the air. The essay quoted below is adapted from Zimmer’s recently released Air-Borne book.

In other parts of Air-Borne, Zimmer discusses how the W.H.O. and the C.D.C. ignored the implications of the findings of Pasteur and others, relevant to the air-borne (aerosol) spread of diseases such as Covid-19.

(p. D8) On the evening of April 7, 1864, in an amphitheater filled with Parisian elites, Pasteur stood surrounded by lab equipment and a lamp to project images on a screen. He told the audience it would not leave the soiree without recognizing that the air was rife with invisible germs. “We can’t see them now, for the same reason that, in broad daylight, we can’t see the stars,” he said.

At Pasteur’s command, the lights went out, save for a cone of light that revealed floating motes of dust. Pasteur asked the audience to picture a rain of dust falling on every surface in the amphitheater. That dust, he said, was alive.

Pasteur then used a pump to drive air through a sterile piece of cotton. After soaking the cotton in water, he put a drop under a microscope. He projected its image on a screen for the audience to see. Alongside soot and bits of plaster, they could make out squirming corpuscles. “These, gentlemen, are the germs of microscopic beings,” Pasteur said.

Germs were everywhere in the air, he said — kicked up in dust, taking flights of unknown distances and then settling back to the ground, where they worked their magic of fermentation. Germs broke down “everything on the surface of this globe which once had life, in the general economy of creation,” Pasteur said.

“This role is immense, marvelous, positively moving,” he added.

The lecture ended with a standing ovation. Pasteur’s hunt for floating germs elevated him to the highest ranks of French science.

For the full essay see:

Zimmer, Carl. “He Showed That Germs Floated in Air.” The New York Times (Tuesday, February 18, 2025): D8.

(Note: ellipsis, and bracketed date, added.)

(Note: the online version of the essay was updated Feb. 18, 2025, and has the title “Louis Pasteur’s Relentless Hunt for Germs Floating in the Air.”)

Zimmer’s essay, quoted above, is adapted from his book:

Zimmer, Carl. Air-Borne: The Hidden History of the Life We Breathe. New York: Dutton, 2025.

Alternatives to Government F.D.A.: Private “High-Quality Third-Party Seals of Approval”

The many label inaccuracies found in the “2022 study” (Crawford et al. 2022) mentioned below would seem to bode ill for the supplement consumer. But if you look at the “new study” you will find that NONE of the 30 supplements they examined had “a third-party certification seal.” This leaves open the plausible possibility that prudent consumers could do well for themselves by limiting their supplement purchases to those with a private third-party certification seal. It would be very useful if someone does another study–this one to confirm or refute my hypothesis that supplements with third-party certification seals had many fewer label inaccuracies. Confirmation would be evidence that the consumer could do well without the F.D.A.’s governmental regulatory mandates.

The relevant quotation from the “2022 study” (Crawford et al. 2022) is:

“No product had a third-party certification seal (ie, naming the third-party company), such as BSCG (Banned Substances Control Group), NSF (National Sanitation Foundation)International, Informed Sport, or USP (US Pharmacopeia), presented on the label” (Crawford et al. 2022, pp. 3 & 5 [all of p. 4 was a table]).”

(p. D7) Supplements claiming to support immunity often contain vitamins and minerals necessary for the immune system. So it isn’t unreasonable to believe that these products could help you sidestep common viral infections or lessen symptoms once you’ve become sick.

In fact, some nutrients such as vitamins A, C, D and zinc are needed to protect against germs, and deficiencies in them raise your risk of becoming sick, said Dr. Mahtab Jafari, a professor of pharmaceutical sciences at the University of California, Irvine.

. . .

It’s hard to firmly state the benefits of immune system supplements because there are few high-quality randomized clinical trials, the gold standard of medical research, assessing their effectiveness, said Dr. Pieter Cohen, an associate professor at Harvard Medical School who studies dietary supplement safety.

And dietary supplements aren’t approved by the Food and Drug Administration before hitting the market.

This means companies can sell products containing ingredients that haven’t been rigorously tested to offer benefits, Dr. Cohen said, and they generally don’t have to prove to the F.D.A. that their products contain what they claim.

A 2022 study analyzing 30 supplements marketed to support the immune system found that more than half had inaccurate labels, 13 were misbranded and nine contained ingredients not listed on the label.

. . .

“You need to have a really healthy dose of skepticism when you’re pulling something off the shelf,” Dr. Ben-Aderet said.

But if you want to give supplements a try, check for high-quality third-party seals of approval from organizations such as U.S. Pharmacopeia or NSF, which test the quality of dietary supplements, Dr. Jafari said.

For the full story see:

Katie Mogg. “Supplements and Claims of Improved Immunity.” The New York Times (Tuesday, February 25, 2025): D7.

(Note: ellipses added.)

(Note: the online version of the story was updated March 3, 2025, and has the title “Can Vitamin C and Zinc Actually Boost Your Immune System?”)

The “2022 study” mentioned above is:

Crawford, Cindy, Bharathi Avula, Andrea T. Lindsey, Abraham Walter, Kumar Katragunta, Ikhlas A. Khan, and Patricia A. Deuster. “Analysis of Select Dietary Supplement Products Marketed to Support or Boost the Immune System.” JAMA Network Open 5, no. 8 (2022): e2226040-e40.

Animals Consume Effective Medicines Without Spending Billions on Phase 3 Clinical Trials

Animals are free to self-medicate and apparently often do so effectively. Isn’t it ironic that our government F.D.A. restricts the freedom of humans to self-medicate?

(p. A13) . . . as Jaap de Roode reveals in “Doctors by Nature: How Ants, Apes, and Other Animals Heal Themselves,” many animals seek out substances to relieve illnesses or battle parasites that drag their health down: . . .

Mr. de Roode, a biology professor at Emory University, chronicles animal self-medication in everything from caterpillars and bees to pigs and dolphins. The drugs take the form of minerals, fungi and especially plants. Often, the drug is ingested for therapeutic reasons, as when chimps eat Velcro-like leaves to scour parasitic worms from their intestines. Many creatures also take drugs prophylactically, to prevent disease. The feline love of catnip, Mr. de Roode suggests, is probably an evolutionary adaptation: The plant deters disease-carrying mosquitoes, so cats with a taste for it ended up more equipped for survival.

. . .

Many plants produce chemicals called alkaloids that taste foul and cause other unpleasant sensations, but can also fight off parasites. After noticing that woolly bear caterpillars infested with fly maggots tend to seek out alkaloid-rich plants, scientists documented—by threading tiny wires into the caterpillars’ mouths—that the infected critters’ taste buds fired far more often when eating these plants than did the taste buds of the uninfected. The bugs’ sensory perception changed to make drugs more attractive. If the consumption of some irregular substance leads to a drop in infection load and alleviates negative symptoms, then, Mr. de Roode convincingly argues, animals are indeed using medicine. Caterpillar, heal thyself.

. . .

Humans can benefit from studying animal medicine, too. Most of our drugs are either plant compounds or derived from plant compounds. But researchers have systematically studied only a few hundred of the earth’s estimated tens of thousands of plant species. To guide researchers’ studies, scientists could note which ones animals consume and concentrate on those. Let Mother Nature do the research and development for us.

For the full review see:

Sam Kean. “Bookshelf; Medicinal Kingdom.” The Wall Street Journal (Friday, March 28, 2025): A13.

(Note: ellipses added.)

(Note: the online version of the review has the date March 27, 2025, and has the title “Bookshelf; ‘Doctors by Nature’: Medicinal Kingdom.”)

The book under review is:

Roode, Jaap de. Doctors by Nature: How Ants, Apes, and Other Animals Heal Themselves. Princeton, NJ: Princeton University Press, 2025.