Category: Health

F.D.A. Does Not Always Decide Based on the Current Consensus of Scientists

The episode mentioned below illustrates that the F.D.A. in practice is not the purely scientific, objective body that it is sometimes portrayed to be in theory.

(p. 29) Susan F. Wood, a women’s health expert who resigned in protest from the Food and Drug Administration in 2005, accusing the agency of knuckling under to politics by not approving over-the-counter sales of the morning-after pill known as Plan B, died on Jan. 17 [2025] at her home in London. She was 66.

. . .

An F.D.A. advisory panel voted 28-0 in 2003 that the pill was safe for nonprescription use. But senior agency officials disregarded precedent and refused to approve over-the-counter sales.

For the full obituary, see:

Trip Gabriel. “Susan F. Wood, Who Quit F.D.A. Over Delay of Plan B, Dies at 66.” The New York Times, First Section (Sunday, February 9, 2025): 29.

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

(Note: the online version of the obituary was updated Feb. 8, 2025, and has the title “Susan F. Wood, Who Quit F.D.A. Over Contraception Pill Delay, Dies at 66.”)

If Corn Syrup Hurts Health Then Government Should Stop Subsidizing Corn Farming and Stop Quotas on Sugar Imports

Every semester for many years I would conclude my micro principles class discussing the ill effects of the U.S. government imposing quotas on the importation of sugar. I would point out that the quotas increase the price of sugar for American consumers. Since corn syrup is a substitute for sugar, the increase in the price of sugar will increase the demand for corn syrup.

To support the ill effects of corn syrup, I used to cite a commentary by Michael Waldholz:

In a speech to the International Congress on Obesity last summer, George Bray, a recognized expert on weight gain, said high fructose corn syrup is a “ticking bomb” in our diet because it is more readily converted into fat than other sugars. Unlike other sugars, fructose doesn’t trigger the release of insulin, which controls sugar consumption by telling the brain to send out a feeling of fullness. (Waldholz 2003, p. D3)

It would be interesting to check the current state of the evidence on whether Bray’s claim is true. But if so, then it provides support for Robert F. Kennedy, Jr.’s current initiative against corn syrup, which was discussed in a full-page article in the NYT in December 2024.

Paradoxically, the U.S. government increases the consumption of corn syrup in multiple ways. In my principles classes I pointed out the indirect effect of sugar quotas. The NYT article also points out the subsidies for corn production.

Kennedy wants to ban the use of corn syrup products in federally subsidized school lunches and ban their purchase using federal food stamps. He should also lobby his boss to end federal subsidies for corn production and end the federal quota program on sugar.

The WSJ commentary on corn syrup is:

Waldholz, Michael “Let’s Subtract ‘Added Sugar’ from Our Diets.” The Wall Street Journal (Thurs., Feb. 20, 2003): D3.

(Note: the online version of the Waldholz commentary has the same date as the print version and has the title “Let’s Ditch ‘Added Sugar’ From Our Regular Diets.”)

The NYT article on corn syrup is:

Jonathan Weisman. “Kennedy’s Crusade Comes to Trump Country.” The New York Times (Weds., December 11, 2024): A11.

(Note: the online version of the NYT article has the date Dec. 10, 2024, and has the title “Kennedy’s War on Corn Syrup Brings a Health Crusade to Trump Country.”)

Feds Waste at Least $4.3 Billion in Duplicate Payments to States Where Medicaid Recipients No Longer Reside

Do taxpayers know how much government fraud and inefficiency they are paying for? Hopefully DOGE can clean up these duplicate (and sometimes triplicate and more) payments. If the Wall Street Journal is capable of finding multiple payments, then surely the government itself can find and stop them.

(p. A1) Health insurers got double-paid by the Medicaid system for the coverage of hundreds of thousands of patients across the country, costing taxpayers billions of dollars in extra payments.

The insurers, which are paid by state and federal governments to cover low-income Medicaid recipients, collected at least $4.3 billion over three years for patients who were enrolled—and paid for—in other states, a Wall Street Journal analysis of Medicaid data found.

The patients were signed up for Medicaid in two states at once, in many cases following a move from one to the other. Most were getting all their healthcare services through one insurer in one state, even though Medicaid was paying insurers in both states to cover them.

Private insurers oversee Medicaid benefits for more than 70% of the about 72 million low-income and disabled people in the program. The companies get paid each month for each person they cover. They aren’t supposed to get paid if a patient leaves for another state.

. . .

(p. A9) The Journal’s analysis turned up some cases in which individuals were signed up in five or more states.

. . .

The Journal’s analysis used detailed Medicaid data, obtained under a research agreement with the federal government, to identify duplicate payments to managed-care companies. The analysis examined where double-enrollees got their medical care each month, using that as an indication of their state of residence.

. . .

“There is very little incentive for the managed-care organization to check eligibility,” said industry consultant Kevin Bagley, the former director of Nebraska’s Medicaid program. Bagley and other Medicaid experts said it is difficult for states to claw back payments from managed-care companies for covering relocated enrollees, largely because it can be unclear exactly when they left.

Sometimes a single insurance company covered the same person in more than one state. During the period covered by the Journal’s analysis, Centene insured about 25,000 people a year, on average, in two different states at the same time. For those people, the company was paid at least $151 million extra. Elevance received $48 million extra for covering the same person twice, and UnitedHealth got $53 million.

One Centene supervisor urged some of the company’s case managers in February to keep Medicaid recipients enrolled after they moved. “Please DO NOT close cases when you learn a member has moved out of state,” the supervisor said in a Microsoft Teams message. “If the member shows eligible and are out of state, they can still can [sic] utilize some of the benefits.”

Centene’s spokesman said the company is required to maintain coverage for members until the state decides whether to disenroll a beneficiary.

The inspector general for the federal Department of Health and Human Services examined the issue of double payments several years ago in a study looking only at people enrolled in multiple state-paid managed care plans in August in 2019 and 2020.

The results led the team of investigators to conclude that taxpayers were wasting about $1 billion a year, said John Hagg, assistant inspector general for audit services at the oversight agency.

“It should be low hanging fruit,” said Hagg. “The data is there showing it is a problem. This is ripe for correction.”

For the full story see:

Christopher Weaver, Anna Wilde Mathews, and Tom McGinty. “Medicaid Spent Billions Covering Same Patients Twice.” The Wall Street Journal (Fri., March 28, 2025): A1 & A9.

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

(Note: the online version of the WSJ article has the date March 26, 2025, and has the title “Taxpayers Spent Billions Covering the Same Medicaid Patients Twice.” The passages quoted above omit the subheadings that appear in the print, but not the online, version of the article.)

Rampant Fraud in ‘Skin’ Bandages Paid by Medicare

A “quirk” in the Medicare law allows ‘skin’ bandage firms to charge, and have Medicare pay them, exorbitant prices. Are such quirks accidents or intentional? Medicare rules are so voluminous and obscure that few have an incentive to look carefully at the details. But the firms selling ‘skin’ bandages had an incentive. Entrepreneurs within these firms saw an opportunity and seized it. But they are what William Baumol called “destructive entrepreneurs.” Their energy and talent works against the general good.

Since patients are not paying, they have little incentive to reveal the fraud. So the taxpayers are robbed. In a system where the patients are the payers they would have an incentive to reveal fraud, and to seek alternatives to over-priced medical therapies.

But what of the poor, you ask? Susan Feigenbaum proposed an insurance system where patients would receive lump sum payments for different ailments. Then poor patients could be payers, and have the incentives of payer.

(p. 1) Seniors across the country are wearing very expensive bandages.

Made of dried bits of placenta, the paper-thin patches cover stubborn wounds and can cost thousands of dollars per square inch.

Some research has found that such “skin substitutes” help certain wounds heal. But in the past few years, dozens of unstudied and costly products have flooded the market.

Bandage companies set ever-rising prices for new brands of the products, taking advantage of a loophole in Medicare rules, The New York Times found. Some doctors then buy the coverings at large discounts but charge Medicare the full sticker price, pocketing the difference.

Partly because of these financial incentives, many patients receive the bandages who do not need them. The result, experts said, is one of the largest examples of Medicare waste in history.

Private insurers rarely pay for skin substitutes, arguing that they are unproven and unnecessary. But Medicare, the government insurance program for seniors, routinely covers them. Spending on skin substitutes exceeded $10 billion in 2024, more than double the figure in 2023, according to an analysis of Medicare data done for The Times by Early Read, a firm that evaluates costs for large health companies.

Medicare now spends more on the bandages than on ambulance rides, anesthesia or CT scans, the analysis found.

. . .

(p. 19) . . . experts in health care costs said the spike had been driven . . . by sellers and doctors taking advantage of Medicare’s pricing rules. The government will reimburse any price that a company sets for brand-new skin substitutes, even if it is far above the market average. The higher the price, the larger the doctors’ cut.

And the bigger the bandage, the more they can charge. For one patient in Nevada, Medicare spent $14 million on skin substitutes over the course of a year, according to billing records reviewed by The Times. The wound of a patient in Washington State persisted after Medicare paid $6 million for the coverings. A man in Texas got $1.3 million of bandages despite having no wound at all. Health executives trying to ferret out suspicious spending identified these patients and shared their stories with The Times.

As the Trump administration — and particularly the new Department of Government Efficiency run by Elon Musk — aims to shrink the federal purse, profligate Medicare spending is a ripe target, experts said.

Companies have billed Medicare for hundreds of thousands of urinary catheters that doctors never ordered. Other schemes have peddled urine tests and knee braces. In 2023, a federal watchdog agency flagged skin substitute spending as wasteful for both taxpayers and Medicare enrollees, who ultimately pay the costs with higher premiums.

“It’s the patients, it’s the taxpayers — unfortunately everyone is footing a part of the bill for this outsized spend,” said Dana Rye, an executive with Duly Health and Care, a Chicago-based medical group where payments for skin substitutes have risen 1,400 percent since 2022.

. . .

Five years ago, the most expensive skin substitute cost $1,042 per square inch, while some were as cheap as $45. Today, the three most expensive products on the market each cost more than $21,000. (Samaritan Biologics, a company in Memphis that sells the three products, did not answer questions about why they cost so much.)

Companies can set such high prices because of a quirk in Medicare pricing rules, industry experts said. For the first six months of a new bandage product’s life, Medicare will set the reimbursement rate at whatever price a company chooses. After that, the agency adjusts the reimbursement to reflect the actual price paid by doctors after any discounts.

To circumvent the reimbursement drop, some companies simply roll out new products.

In April 2023, Medicare began reimbursing $6,497 for every square inch of a bandage called Zenith, sold by Legacy Medical Consultants, a company in Fort Worth, Texas. Six months later, Zenith’s reimbursement fell to $2,746.

That month, October 2023, Medicare began reimbursing $6,490 for a new Legacy product, a “dual layer” bandage called Impax.

Marketing materials for the two products use identical photographs and similar language. The company describes both products as providing “optimal wound covering and protection during the treatment of wounds.”

Since 2022, spending on Zenith and Impax has exceeded $2.6 billion, according to Early Read’s analysis.

. . .

A cottage industry of doctors and nurses make house calls to treat wounds. Some skin substitute companies pitch themselves to wound care doctors by offering a cut of the rising bandage prices.

Dr. Caroline Fife, a wound care doctor from Texas who often writes about industry excesses, shared on her blog last year an email she received from an undisclosed skin substitute company. The company boasted that other doctors had developed “a healthy revenue stream” from its bandages and that a patch smaller than a credit card “would generate a little over $20,000 for your practice.”

Some companies offer doctors a “bulk discount” of up to 45 percent, according to doctor interviews and contracts reviewed by The Times. But doctors then collect a Medicare reimbursement for the full price of the product.

For the full story, see:

Sarah Kliff and Katie Thomas. “‘Skin’ Bandages Cost Medicare, And Doctors Get a Cut of Billions.” The New York Times, First Section. (Sun., April 13, 2025): 1 & 19.

(Note: ellipses added.)

(Note: the online version was updated April 14, 2025, and has the title “Medicare Bleeds Billions on Pricey Bandages, and Doctors Get a Cut.”)

The article by William Baumol praised in my initial comments is:

Baumol, William J. “Entrepreneurship: Productive, Unproductive, and Destructive.” The Journal of Political Economy 98, no. 5, Part 1 (Oct. 1990): 893-921.

The article by Susan Feigenbaum praised in my initial comments is:

Feigenbaum, Susan. “Body Shop’ Economics: What’s Good for Our Cars May Be Good for Our Health.” Regulation 15, no. 4 (Fall 1992): 25-31.

“A.I.s Are Overly Complicated, Patched-Together Rube Goldberg Machines Full of Ad-Hoc Solutions”

A.I. can be a useful tool for searching and summarizing the current state of consensus knowledge. But I am highly dubious that it will ever be able to make the breakthrough leaps that some humans are sometimes able to make. And I am somewhat dubious that it will ever be able to make the resilient pivots that all of us must sometimes make in the face of new and unexpected challenges.

(p. B2) In a series of recent essays, [Melanie] Mitchell argued that a growing body of work shows that it seems possible models develop gigantic “bags of heuristics,” rather than create more efficient mental models of situations and then reasoning through the tasks at hand. (“Heuristic” is a fancy word for a problem-solving shortcut.)

When Keyon Vafa, an AI researcher at Harvard University, first heard the “bag of heuristics” theory, “I feel like it unlocked something for me,” he says. “This is exactly the thing that we’re trying to describe.”

Vafa’s own research was an effort to see what kind of mental map an AI builds when it’s trained on millions of turn-by-turn directions like what you would see on Google Maps. Vafa and his colleagues used as source material Manhattan’s dense network of streets and avenues.

The result did not look anything like a street map of Manhattan. Close inspection revealed the AI had inferred all kinds of impossible maneuvers—routes that leapt over Central Park, or traveled diagonally for many blocks. Yet the resulting model managed to give usable turn-by-turn directions between any two points in the borough with 99% accuracy.

Even though its topsy-turvy map would drive any motorist mad, the model had essentially learned separate rules for navigating in a multitude of situations, from every possible starting point, Vafa says.

The vast “brains” of AIs, paired with unprecedented processing power, allow them to learn how to solve problems in a messy way which would be impossible for a person.

. . .

. . ., today’s AIs are overly complicated, patched-together Rube Goldberg machines full of ad-hoc solutions for answering our prompts. Understanding that these systems are long lists of cobbled-together rules of thumb could go a long way to explaining why they struggle when they’re asked to do things even a little bit outside their training, says Vafa. When his team blocked just 1% of the virtual Manhattan’s roads, forcing the AI to navigate around detours, its performance plummeted.

This illustrates a big difference between today’s AIs and people, he adds. A person might not be able to recite turn-by-turn directions around New York City with 99% accuracy, but they’d be mentally flexible enough to avoid a bit of roadwork.

For the full commentary see:

Christopher Mims. “We Now Know How AI ‘Thinks.’ It Isn’t Thinking at All.” The Wall Street Journal (Saturday, April 26, 2025): B2.

(Note: ellipses added.)

(Note: the online version of the commentary has the date April 25, 2025, and has the title “We Now Know How AI ‘Thinks’—and It’s Barely Thinking at All.”)

A conference draft of the paper that Vafa co-authored on A.I.’s mental map of Manhattan is:

Vafa, Keyon, Justin Y. Chen, Ashesh Rambachan, Jon Kleinberg, and Sendhil Mullainathan. “Evaluating the World Model Implicit in a Generative Model.” In 38th Conference on Neural Information Processing Systems (NeurIPS). Vancouver, BC, Canada, Dec. 2024.

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.