How is discussion on HN different from the leadership levels at FDA?
Very different. Decisions with enormous health implications, enormous financial implications, are made at FDA.
At HN, most people are here to learn, here to understand more.
Vinay Prasad is a fraud, completely unfit for the leadership role he was placed into, making baffling and arbitrary decisions on his own, overturning those with far more experience, knowledge and expertise.
If a HN comment gets things wrong, a few people might be misinformed, if they are credulous enough to not double check things.
When the FDA makes decisions like they have been making, thousands to millions of peoples' lives are worse off, and billions in capital is wasted.
Discussion forums of all sorts are incredibly valuable, even when they get things wrong. I have lots of complaints about the overhyping of, say, CRISPR, especially on HN, but whatever, it's a far far higher signal-to-noise than a random person I meet around town. Mention you work on drug development for big pharma to the random person and they think you're evil, at least HN is less likely to have that basic misconception.
> Vinay Prasad is a fraud
What’s with him being allowed to continue to practice at the University of California [1]?
[1] https://vinayakkprasad.com/
That is a good question, and I'm sure many of the people at UCSF are asking similar questions. However, his sort of misconduct is not the type that would usually violate tenure protections. Beyond the minor CV fibbing, without some evidence that he actually, say, solicited a bribe from Moderna, it's unlikely that he can face any sort of official sanction.
The fraud is in his supposed thrust towards better scientific rigor when he is so sloppy with major decisions of life and death.
Just as the comment up there says that HN comments that are critical and misinformed get a lot of attention and upvotes, Prasad has been highly critical and misinformed about scientific research, and his stint at the FDA has exposed that his critiques are much like that top-level HN comment that doesn't get things quite right.
> not the type that would usually violate tenure
How can one tell whether he has tenure?
For normal research universities, like UCSF, the titles of Professor and Associate Professors have tenure. Assistant Professors are tenure-track, meaning that they have the chance to get tenure. Prasad has the title of Professor.
One can make the argument that Prasad has his title of Professor due to the stature he gained with his ill-founded contrarianism and subsequent notoriety. He was promoted in 2022 at the somewhat astonishing age of 39, at a time when his actual scientific output was not particularly high
The whole thing is kind of fascinating. Some of his "skeptic" fellow travelers like Cifu and Mandrola still carry water for him. Presumably he has a champion in Bob Wachter who also likes to fly the "contrarian" flag.
COVID really brought out a lot of crazies from UCSF and Stanford
I really wonder what's up with that. Also remember the crazy Stanford guys.. did something flip in their brain or were they just always like that?
Would you say Prasad’s public-health misconduct rises to the level where creating a statutory change to what permits firing under tenure makes sense?
I would say that the US has had enough destruction of institutions and few enough institutional protections of individuals.
I can dislike someone’s stance while at the same time recognizing that others benefit from the same protections.
If protections are reduced, the process will be weaponized.
> If protections are reduced, the process will be weaponized
This is a valid concern. So is moral hazard from a lack of accountability. I’m trying to figure out how those balance.
One way they should balance in a functioning society is that while tenure would protect you from negative repercussions within the walls of an academic institution, a Congress with any semblance of seriousness and care toward the American people would ensure you never set foot inside a policy-making institution.
> he is so sloppy with major decisions of life and death
To be clear, the FDA regulates marketing claims. “Is the label accurate?”
Major decisions about life and death are between the doctor and the patient, not the FDA.
It sounds like you’re taking an expansive view of this government agency’s mandate. People will push back on this at the ballot box, even if they can’t put it to words themselves.
Far more significantly, the FDA regulates what is allowed to be marketed as treatment at all, an influence that extends heavily into what types of validation studies are performed, etc.
Such decisions, what treatments are available, are far more widespread and momentous than any individual decision between a doctor and a single patient, because they affect all conversations between doctors and patients.
> It sounds like you’re taking an expansive view of this government agency’s mandate
It sounds like you don't know what the FDA does in practice. It is not my supposed "view" it is the basic factual reality of the FDA for decades and decades. (And if you are asking for my view, I believe it has the appropriate level of control of the industry, having developed products directly under their regulation. My personal experience with the FDA, and the experience of all the people I know in similar situations, has been with a very astute and scientifically meritous institution, that worked hard to make sure that products see fair and rapid evaluation. At least, up until what I have seen under Vinay Prasad.)
The FDA regulates which drugs make it to market which is itself an extremely powerful force (excessively so) on conversations between you and your doctor.
In the case of vaccines, FDA's decisions can quite obviously make a difference in whether we have a rampant lethal pathogen roaring through our schools and killing our children and elderly... or not.
It's pedantic to the point of being outright false to say the FDA is not involved in major decisions of life and death. Silly take.
> Mention you work on drug development for big pharma to the random person and they think you're evil
this is how Martin Shkreli described his work of identifying drug patents to buy that he could jack up the prices on. If that's the extent of the description you gave, I think random people would be right to first think you are doing something evil
I’m curious why you claim he’s a fraud, I just learned about him from this thread.
Prasad, to the extent he had a reputation before, was for critiquing the scientific practice as inadequate, which would hope that he'd bring the idea of rigor to his stint at the FDA. Instead, we see quite the opposite:
- This baffling Moderna decision, which is so bad that many in the industry assumed it was from a failed bribe solicitation
- Linked in this article is the "truly evil" decision requiring sham brain surgery in the placebo arm for a Huntington Disease trial https://arstechnica.com/health/2026/06/truly-evil-fda-reject...
- Prasad holding a defamatory PR event about the company producing the HD candidate treatment, and only talking "on background" to hide his identity, which is sleazy and unethical "The criticism apparently struck a nerve with Prasad. The FDA held a press briefing later Thursday in which an unnamed “senior FDA official”—who identified himself as a hematology-oncologist—launched into a diatribe against UniQure, saying its “failed therapy” was supported by “distorted and manipulated” data. As for Woodcock’s comments, the official said he “expect[s] better” from her." https://arstechnica.com/health/2026/03/trumps-divisive-fda-v...
- His first ouster and reinstatement last year, over a unilateral Duchenne muscular dystrophy decision, severely lacking in scientific rigor and analysis
- Lied on his CV about being on a highly prestigious council he was not on (The Cancer Letter is not a random YouTube channel, it's high quality cancer research journalism) https://www.youtube.com/watch?v=pCASAb7J-LE&t=41
As is often the case with such contrarians and critics, their own critiques apply most aptly to themselves.
Nah, by 2021 Prasad's reputation had gone into the shitter
I actually think he's just grifting and the notoriety he achieved went to his head. His pre-2020 takes were better reasoned and at least worth engaging with. I could see his takes shifting with popular misinformation ideas in real time as it contributed to his success
IMO this is worse than if he were just wrong. I think he knows better, but then he talked himself into a box, and doesn't have the people and political skills to survive on a bigger stage.
> Lied on his CV about being on a highly prestigious council
You called this “minor CV fibbing” above. If he was lying about this when he applied for tenure, wouldn’t that be Cause?
This is usually modulated by whether the fib is about something "material".
In fact, he probably would have had the same decision with or without the claim which is the essence of "not material".
My own personal take is that the lying is crucial, however.
Totally agree. I’m an outsider—from finance, where I thought the bar was already low. I’m asking if this a material fib or commonplace in medicine.
People making decisions at the FDA should also be actively learning and understanding more all the time.
That should be their primary objective.
> Decisions with enormous health implications, enormous financial implications, are made at FDA.
Yes, I started writing that and didn't finish the sentence (see my edit near the end of the GP).
But I don't let HN off the hook: The attitude I described in the GP represents and perpetrates the same outlook that politically supports or tolerates this behavior from the FDA. HN users generally legitimize that approach rather than discrediting it.
> Mention you work on drug development for big pharma to the random person and they think you're evil
I think that's paranoid: The random person won't know what that means. Few who know will also know or care about the social implications. Of those who do, only some will be knee-jerk critical of big pharma, and fewer still of research rather than the business side. It's also a victim perspective: Big Pharma has enormous power; punching up at power by questioning, criticizing, and being skeptical (or even cynical) is not at all the same thing as punching down at the vulnerable. If someone wants the power and resources and salary of Big Pharma, benefitting from its enormous power, the pushback and reputation impact comes with it (though the latter is usually positive - great resume material and credibility).
Imagine being able to shut down discussion at the FDA because a few anonymous randos pushed a "flag" button when they saw something they disagreed with.
Apparently, the ‘fuck your feelings’ crowd DOES care about some ‘feelings’
They were actually clear about this, it's only your feelings that don't matter, not feelings in general.
In their minds there are two classes of people, and all of politics and law is about establishing the hierarchy. For the in group, the law is meant to protect and not bind, and the out group for which the law exists to bind but not protect.
It's clear in the language about "criminals" too. Actual convictions and clear corruption in the in group politicians? That's A-OK. An immigrant that is showing up for an official hearing? Time to be whisked away and treated with cruel and unusual punishment, whether or not their bureaucratic forms were filled out perfectly. (In particular I'm thinking of the immigration raid where South Korean professionals were helping to set up a battery factory and treated with chains as if they were violent criminals)
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At HN, most people are here to learn, here to understand more.
There's a substantial "learn and understand" cohort, but there are other factions. At the start of the pandemic, there were 2 posters explicitly here to proselytize Trump style conservatism. I'm reasonably certain there was an anti-vaxx voting ring 2020-22, and I suspect there's remnant Elon fanboy and MAGA coordinated voting.
I'd love to be proved wrong on these things.
Oh they are still here, last time I had a good chuckle was the group arguing that The Pope Is A Democrat. "You know your brain is pickled when..."