Brownstone Institute
The Most Important Meeting in the History of the World That Never Happened

From the Brownstone Institute
BY
There was a brief moment in Spring 2020, just a few days into “15 Days to Slow the Spread,” when we had a chance to change our trajectory. A distinct inflection point where if we had done just one thing differently, and caught the crazy COVID coaster before it got locked in its tracks, things could have turned out very differently over these last three plus years.
In the third week of March a secret emergency meeting was scheduled to take place between President Donald Trump, the COVID Task Force, and eight of the most eminently qualified public health experts in the world. This elite group of scientists was slated to present the highest-level decision-makers in our government with an alternative POV to lock down; a much-needed second opinion on national turtling.
We didn’t know it at the time, but this would have been the most important meeting of the COVID-19 era. But it never occurred.
What happened?
This has been a nagging question ever since July 27, 2020 when BuzzFeed News broke the news in an article by Stephanie M. Lee: “An Elite Group Of Scientists Tried To Warn Trump Against Lockdowns In March.” In her article Ms. Lee framed this aborted meeting as a dodged bullet, and the scientists as unhelpful meddlers, but for many of us the fact that there even was an attempted meeting like this was extremely heartening.
Because for months we had been led to believe that this novel, authoritarian response was unanimous, that “the science was settled” and yet here we find out that some of the most famous scientists in the world didn’t quite agree with “the science.” Not only that, but they had major issues with the process, they questioned the data, and they were extremely concerned about the downstream, long-term effects to our society from locking down. But Lee’s article didn’t even attempt to answer the one big glaring, nagging question left in her article: “Why?”
If you remember back to Late Winter/Early Spring 2020 the entire connected world went from “Hey, no big deal,” to “Hey, what’s going on in Italy?” to “Holy shit, we’re all gonna die!” in a matter of just a few weeks. COVID mania quickly captured us all, and by early March we were suddenly armchair experts on cytokine storms and case counts, and even your aunt Glenda posted that “Flatten the Curve” Washington Postarticle on Facebook and suddenly we found ourselves on March 15, 2020 watching in slack-jawed horror as Trump, Fauci, and Birx stood up there, telling us their bright idea was to shut down the entire country. For just two weeks they said. To protect our hospitals from “the spike” they said. If we didn’t, they said, two million people would surely die.
And who were we to argue? They had a powerpoint presentation with logos and charts, the laughable Imperial College London model, and of course the force of government behind them.
The national reaction was… curious. Some of us, but not nearly enough, were horrified; viscerally and vehemently opposed to this entire concept on scientific, moral and legal grounds. But we were grossly outnumbered. The vast majority of the population was really scared, and poll after poll indicated they were in favor of these unprecedented, draconian measures. Some of our fellow humans even seemed downright giddy at the prospect of hunkering down indefinitely, until it was “safe” to come out; whatever the shifting daily definition of “safe” was, and whatever the ultimate societal cost.
Although lockdown was presented to us that day as a fait accompli, some of us were undeterred. We spoke up to our friends, families, and coworkers and spoke out on social media, writing letters, holding protests, doing whatever we could to to reason, educate, even plead with our local representatives, leaders and opinion-makers not to continue down this novel path. But to no avail. “Shut up,” they said.
We were just normies, after all, and at the time there were very few actual “experts” on our side. Luckily for us, one of those few was John Ioannidis, an immensely respected physician, scientist, statistician, mathematician, Stanford professor, and writer who was renowned for his works in–get this–epidemiology and evidence-based medicine. Ioannidis was the perfect voice to counter the runaway COVID-19 pandemic response narrative.
And speak up he did. On March 17, 2020 Ioannidis published a groundbreaking STAT article “A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data.” He asked aloud what many of us were wondering privately: would this fiat public health response be a “once-in-a-century evidence fiasco?”
In his article Ioannidis pointed out that all the COVID data to date was actually “of very bad quality,” and we were making monumental decisions daily based on dangerously unreliable information. He also pointed out that the chances of dying for those infected (the Infection Fatality Rate) had to be be much lower than the ridiculous 3.4 percent Case Fatality Rate (CFR) publicly announced by the WHO; his working theory being that many more people had been infected without noticing it, or without being tested.
Ioannidis’ rational and well-reasoned POV in STAT ran squarely against the official narrative, and garnered immediate pushback from “the establishment.” Thankfully, John Ioannidis is a rare brave person, so he promptly ignored the narrative police and submitted his case directly to the top: President Donald J. Trump.
In his letter to the White House Ioannidis warned Trump against “shutting down the country for a very long time and jeopardizing so many lives in doing this” and he requested an emergency meeting to provide all the key stakeholders in the Executive Branch a much-needed second opinion, delivered from a “diverse panel of the top experts in the world.”
This was his letter:
“Dr Ioannidis (bio below) is assembling a group of world renowned scientists who can contribute insights to help solve the major challenge of COVID-19, by intensifying efforts to understand the denominator of infected people (much larger than what is documented to-date) and having a science- and data-informed, targeted approach rather than shutting down the country for very long time and jeopardizing so many lives in doing this. The aim is to identify the best way to both save more lives and avoid serious damage to the US economy using the most reliable data, since the infection rate may be off by a very large factor versus the number of currently documented cases. The scientists are willing to come to the White House personally or join by video conference.”
The proposed panel consisted of:
Jeffrey Klausner, MD MPH – Professor of Clinical Population and Public Health Sciences at USC currently (was Professor at UCLA in 2020).
Art Reingold – Professor of Epidemiology in the School of Public Health at Berkeley.
Jay Bhattacharya, MD, PhD – Professor of Medicine at Stanford University, research associate at the National Bureau of Economics Research.
James Fowler, PhD – Professor of Infectious Diseases and Global Public Health at UCSD
Sten H. Vermund, MD, PhD – Dean of the Yale School of Public Health (2017-2022)
David L. Katz, MD, MPH – founder of Yale University’s Yale-Griffin Prevention Research Center.
Michael Levitt, PhD – Nobel Prize Winner, Professor of Structural Biology at Stanford.
Daniel B. Jernigan, MD, MPH – Director of the Influenza Division in the National Center for Immunization and Respiratory Diseases (NCIRD) at CDC.
On amazingly short notice, Ioannidis had managed to assemble a literal COVID dream team. These scientists were the real deal: actual bonafide “experts” in a landscape of cosplayers and clout chasers.
When I asked Ioannidis about his historic effort to have an open dialogue with the White House and COVID Task Force in March 2020 he replied to me by e-mail:
“The effort was to create a team with top scientists in epidemiology, public health, health policy, population sciences, social sciences, social networks, computational modeling, healthcare, economics, and respiratory infections. We wanted to help the leadership and the Task Force. The Task Force had stellar, world-caliber scientists like Fauci, Redfield, and Birx, but their otherwise amazing expertise did not cover specifically these areas.”
To that end, John Ioannidis didn’t just pick names out of a hat, he curated this group for maximum positive impact. This was not only an extremely talented group, it was an extremely diverse group. They didn’t all agree on what the response to COVID should be, either. But in the interest of faithfully representing all possible angles and views, Ioannidis insisted they take part. In fact Reinhold and Vermund were recruited by Ioannidis precisely because they didn’t agree with him on how to handle things, and none of the eight were political actors. Despite insinuations to the contrary.
“I have absolutely no clue what the members of the team voted! And it really does not (should not) matter.”
The idea of an emergency White House meeting like this was especially radical because at that time any discussion to the contrary was considered taboo. But lockdown was the most important public health decision in modern human history: one that would potentially affect the future of the entire planet. So why not take a moment to hash it out, with some of the smartest and most qualified people on the planet, and make sure we were making the correct decision?
As of March 24, 2020 the calendars had been aligned and this landmark meeting seemed to be a “go.”
“Request has gone in officially, waiting to hear…”
Then… nothing.
Radio silence.
Finally, on March 28 Ioannidis emailed the group:
“Re: meeting with the President in D.C. Have kept asking/putting gentle pressure, I think our ideas have infiltrated the White House regardless, I hope to have more news on Monday…”
Although Stephanie M. Lee of Buzzfeed News insinuated this was Ioannidis’ way of claiming victory, when asked about it he was keen to clarify:
“I am self-sarcastic here, as it was apparent that we were NOT being heard and other people in the team were also self-sarcastic in saying that our proposal had hit on a wall and bounced.”
So that the heck happened between March 24 and March 28? How did this historic meeting go from “on” to “Oh, never mind?”
What on earth could’ve nuked it?
Or… who?
“I initially communicated myself with a White House person, there is no need to create trouble for that person by naming, I believe that person made a well-intentioned effort, even if it did not work. I don’t know if the message did reach Trump or not and I have no clue who cancelled the meeting and why it came to naught.”
A benign answer could simply be that “Shit happens.” After all, people cancel meetings all the time, especially Presidents and their handlers in the middle of a political and public health maelstrom.
But the meeting could have also been canceled for a host of other reasons, especially political ones, and there were in fact a few key events that occurred in those key 4 gap days that may have had an impact:
March 24, 2020 Trump murmured his famous “Open by Easter” viral bite in a walking ‘n talking interview with Fox’s Bill Hemmer. Which, interestingly, is often confused with Trump wanting to open “early,” when in fact Easter 2020 landed on April 15: a full 15 days past the promised end of the first official “15 Days.” So in effect Trump was already promising to extend the lockdown:
TRUMP: …I’d love to have an open by Easter. Okay?
HEMMER: Oh, wow. Okay.
TRUMP: I would to have it open by Easter. I will — I will tell you that right now. I would love to have that — it’s such an important day for other reasons, but I’ll make it an important day for this too. I would love to have the country opened up and just raring to go by Easter.
HEMMER: That’s April 12th. So we will watch and see what happens.
TRUMP: Good.
Also on March 24, 2020 India officially declared a national 21-day lockdown, which was longer than our puny #15Days, and their lockdown would affect over 1.3 billion people as opposed to our few hundred million. This was framed as “India takes COVID super-seriously,” of course.
On March 25th, 2020 the US Senate passed the CARES Act, a stonking $2.2 trillion economic “stimulus bill” which promised to go directly to adversely affected individuals, businesses, schools and hospitals and never ever ever be wasted, misappropriated, or brazenly stolen by ne’er-do-wells.
Prince Charles tested positive for COVID-19 on March 25th, 2020 as well. And he died. No, wait, my bad, he experienced mild symptoms and self-isolated with servants at his residence in Scotland.
On March 26, 2020 three pretty big-deal things happened. One, the US Department of Labor reported that 3.3 million people filed for unemployment benefits, making it the highest number of initial jobless claims in American history at the time. It was a big story at the time. But what also happened on March 26, 2020is that the US became “the country with the most confirmed COVID cases,” officially surpassing China and Italy for that coveted top spot.
March 26, 2020 also featured the WHO’s virtual “Extraordinary Leaders’ Summit on COVID-19” where World Health Organization Director-General Tedros announced:
“We are at war with a virus that threatens to tear us apart – if we let it. Almost half a million people have already been infected, and more than 20,000 have lost their lives. The pandemic is accelerating at an exponential rate…Without aggressive action in all countries, millions could die. This is a global crisis that demands a global response…Fight hard. Fight like hell. Fight like your lives depend on it – because they do. The best and only way to protect life, livelihoods and economies is to stop the virus…Many of your countries have imposed drastic social and economic restrictions, shutting schools and businesses, and asking people to stay at home. These measures will take some of the heat out of the epidemic, but they will not extinguish it. We must do more.”
Could any of these happenings have caused the Trump camp to say, “We’re good. Thanks for the offer anyway, nerds?”
Who knows.
But the next explanation is far more interesting, and more conspiratorial: was there someone in or near the White House that put the kibosh on this thing? Did Fauci and/or Birx convince Kushner to tell Meadows to tell Trump to tell his secretary to nix the meeting?
Hmmmm. If only there was a way to find this out.
“Indeed, I would be the first to love to know what happened!”
In the aforementioned BuzzFeed article “An Elite Group Of Scientists Tried To Warn Trump Against Lockdowns In March” author Stephanie Lee presented only a select few “obtained” emails, to make her case.
So I “obtained” the same emails via FOIA to the public universities, and, really, there’s nothing in those emails than a group of mutually-respected peers desperately trying to coordinate and contribute to this burgeoning national disaster; these were all people desperately trying to do the right thing for the country, and the world. They just wanted to help.
For what it’s worth, these emails are an incredible time capsule documenting the events and societal tenor of that important time, and are presented here, in their entirety. Whatever caused this critically important meeting to be canceled, it’s now quite apparent that it would’ve been better had that meeting taken place.
Because even under the most gracious definitions of “lockdown” our public health reaction to COVID was a colossal mistake. A massive abysmal failure, based on any neutral metric. Lockdown failed on stopping the virus, it failed on overall health outcomes, it failed on the economy, it failed on “equity,” it failed our kids and perhaps most tellingly it failed our principles. In the future there will be entire sections of libraries dedicated to the mind-boggling extent of the destruction caused by these panicked, pseudoscientific public-health decisions. Decisions that were forced on us, without even so much as a show vote.
Much less a proper discussion. And that’s what this meeting would have been: a discussion. An opportunity to expose the Leader of the Free World to a different and better set of ideas on how to handle the COVID-19 pandemic. The fact is that, in the third week of March 2020, we were all unceremoniously denied a basic medical, human right: an informed second opinion.
Brownstone Institute
Net Zero: The Mystery of the Falling Fertility

From the Brownstone Institute
By
If you want to argue that a mysterious factor X is responsible for the drop in fertility, you will have to explain (1) why the factor affected only the vaccinated, and (2) why it started affecting them at about the time of vaccination.
In January 2022, the number of children born in the Czech Republic suddenly decreased by about 10%. By the end of 2022, it had become clear that this was a signal: All the monthly numbers of newborns were mysteriously low.
In April 2023, I wrote a piece for a Czech investigative platform InFakta and suggested that this unexpected phenomenon might be connected to the aggressive vaccination campaign that had started approximately 9 months before the drop in natality. Denik N – a Czech equivalent of the New York Times – immediately came forward with a “devastating takedown” of my article, labeled me a liar and claimed that the pattern can be explained by demographics: There were fewer women in the population and they were getting older.
To compare fertility across countries (and time), the so-called Total Fertility Rate (TFR) is used. Roughly speaking, it is the average number of children that are born to a woman over her lifetime. TFR is independent of the number of women and of their age structure. Figure 1 below shows the evolution of TFR in several European countries between 2001 and 2023. I selected countries that experienced a similar drop in TFR in 2022 as the Czech Republic.

So, by the end of 2023, the following two points were clear:
- The drop in natality in the Czech Republic in 2022 could not be explained by demographic factors. Total fertility rate – which is independent of the number of women and their age structure – dropped sharply in 2022 and has been decreasing ever since. The data for 2024 show that the Czech TFR has decreased further to 1.37.
- Many other European countries experienced the same dramatic and unexpected decrease in fertility that started at the beginning of 2022. I have selected some of them for Figure 1 but there are more: The Netherlands, Norway, Slovakia, Slovenia, and Sweden. On the other hand, there are some countries that do not show a sudden drop in TFR, but rather a steady decline over a longer period (e.g. Belgium, France, UK, Greece, or Italy). Notable exceptions are Bulgaria, Spain, and Portugal where fertility has increased (albeit from very low numbers). The Human Fertility Project database has all the numbers.
This data pattern is so amazing and unexpected that even the mainstream media in Europe cannot avoid the problem completely. From time to time, talking heads with many academic titles appear and push one of the politically correct narratives: It’s Putin! (Spoiler alert: The war started in February 2022; however, children not born in 2022 were not conceived in 2021). It’s the inflation caused by Putin! (Sorry, that was even later). It’s the demographics! (Nope, see above, TFR is independent of the demographics).
Thus, the “v” word keeps creeping back into people’s minds and the Web’s Wild West is ripe with speculation. We decided not to speculate but to wrestle some more data from the Czech government. For many months, we were trying to acquire the number of newborns in each month, broken down by age and vaccination status of the mother. The post-socialist health-care system of our country is a double-edged sword: On one hand, the state collects much more data about citizens than an American would believe. On the other hand, we have an equivalent of the FOIA, and we are not afraid to use it. After many months of fruitless correspondence with the authorities, we turned to Jitka Chalankova – a Czech Ron Johnson in skirts – who finally managed to obtain an invaluable data sheet.
To my knowledge, the datasheet (now publicly available with an English translation here) is the only officially released dataset containing a breakdown of newborns by the Covid-19 vaccination status of the mother. We requested much more detailed data, but this is all we got. The data contains the number of births per month between January 2021 and December 2023 given by women (aged 18-39) who were vaccinated, i.e., had received at least one Covid vaccine dose by the date of delivery, and by women who were unvaccinated, i.e., had not received any dose of any Covid vaccine by the date of delivery.
Furthermore, the numbers of births per month by women vaccinated by one or more doses during pregnancy were provided. This enabled us to estimate the number of women who were vaccinated before conception. Then, we used open data on the Czech population structure by age, and open data on Covid vaccination by day, sex, and age.
Combining these three datasets, we were able to estimate the rates of successful conceptions (i.e., conceptions that led to births nine months later) by preconception vaccination status of the mother. Those interested in the technical details of the procedure may read Methods in the newly released paper. It is worth mentioning that the paper had been rejected without review in six high-ranking scientific journals. In Figure 2, we reprint the main finding of our analysis.

Figure 2 reveals several interesting patterns that I list here in order of importance:
- Vaccinated women conceived about a third fewer children than would be expected from their share of the population. Unvaccinated women conceived at about the same rate as all women before the pandemic. Thus, a strong association between Covid vaccination status and successful conceptions has been established.
- In the second half of 2021, there was a peak in the rate of conceptions of the unvaccinated (and a corresponding trough in the vaccinated). This points to rather intelligent behavior of Czech women, who – contrary to the official advice – probably avoided vaccination if they wanted to get pregnant. This concentrated the pregnancies in the unvaccinated group and produced the peak.
- In the first half of 2021, there was significant uncertainty in the estimates of the conception rates. The lower estimate of the conception rate in the vaccinated was produced by assuming that all women vaccinated (by at least one dose) during pregnancy were unvaccinated before conception. This was almost certainly true in the first half of 2021 because the vaccines were not available prior to 2021. The upper estimate was produced by assuming that all women vaccinated (by at least one dose) during pregnancy also received at least one dose before conception. This was probably closer to the truth in the second part of 2021. Thus, we think that the true conception rates for the vaccinated start close to the lower bound in early 2021 and end close to the upper bound in early 2022. Once again, we would like to be much more precise, but we have to work with what we have got.
Now that the association between Covid-19 vaccination and lower rates of conception has been established, the one important question looms: Is this association causal? In other words, did the Covid-19 vaccines really prevent women from getting pregnant?
The guardians of the official narrative brush off our findings and say that the difference is easily explained by confounding: The vaccinated tend to be older, more educated, city-dwelling, more climate change aware…you name it. That all may well be true, but in early 2022, the TFR of the whole population dropped sharply and has been decreasing ever since.
So, something must have happened in the spring of 2021. Had the population of women just spontaneously separated into two groups – rednecks who wanted kids and didn’t want the jab, and city slickers who didn’t want kids and wanted the jab – the fertility rate of the unvaccinated would indeed be much higher than that of the vaccinated. In that respect, such a selection bias could explain the observed pattern. However, had this been true, the total TFR of the whole population would have remained constant.
But this is not what happened. For some reason, the TFR of the whole population jumped down in January 2022 and has been decreasing ever since. And we have just shown that, for some reason, this decrease in fertility affected only the vaccinated. So, if you want to argue that a mysterious factor X is responsible for the drop in fertility, you will have to explain (1) why the factor affected only the vaccinated, and (2) why it started affecting them at about the time of vaccination. That is a tall order. Mr. Occam and I both think that X = the vaccine is the simplest explanation.
What really puzzles me is the continuation of the trend. If the vaccines really prevented conception, shouldn’t the effect have been transient? It’s been more than three years since the mass vaccination event, but fertility rates still keep falling. If this trend continues for another five years, we may as well stop arguing about pensions, defense spending, healthcare reform, and education – because we are done.
We are in the middle of what may be the biggest fertility crisis in the history of mankind. The reason for the collapse in fertility is not known. The governments of many European countries have the data that would unlock the mystery. Yet, it seems that no one wants to know.
Author
Brownstone Institute
FDA Exposed: Hundreds of Drugs Approved without Proof They Work

From the Brownstone Institute
By
The US Food and Drug Administration (FDA) has approved hundreds of drugs without proof that they work—and in some cases, despite evidence that they cause harm.
That’s the finding of a blistering two-year investigation by medical journalists Jeanne Lenzer and Shannon Brownlee, published by The Lever.
Reviewing more than 400 drug approvals between 2013 and 2022, the authors found the agency repeatedly ignored its own scientific standards.
One expert put it bluntly—the FDA’s threshold for evidence “can’t go any lower because it’s already in the dirt.”
A System Built on Weak Evidence
The findings were damning—73% of drugs approved by the FDA during the study period failed to meet all four basic criteria for demonstrating “substantial evidence” of effectiveness.
Those four criteria—presence of a control group, replication in two well-conducted trials, blinding of participants and investigators, and the use of clinical endpoints like symptom relief or extended survival—are supposed to be the bedrock of drug evaluation.
Yet only 28% of drugs met all four criteria—40 drugs met none.
These aren’t obscure technicalities—they are the most basic safeguards to protect patients from ineffective or dangerous treatments.
But under political and industry pressure, the FDA has increasingly abandoned them in favour of speed and so-called “regulatory flexibility.”
Since the early 1990s, the agency has relied heavily on expedited pathways that fast-track drugs to market.
In theory, this balances urgency with scientific rigour. In practice, it has flipped the process. Companies can now get drugs approved before proving that they work, with the promise of follow-up trials later.
But, as Lenzer and Brownlee revealed, “Nearly half of the required follow-up studies are never completed—and those that are often fail to show the drugs work, even while they remain on the market.”
“This represents a seismic shift in FDA regulation that has been quietly accomplished with virtually no awareness by doctors or the public,” they added.
More than half the approvals examined relied on preliminary data—not solid evidence that patients lived longer, felt better, or functioned more effectively.
And even when follow-up studies are conducted, many rely on the same flawed surrogate measures rather than hard clinical outcomes.
The result: a regulatory system where the FDA no longer acts as a gatekeeper—but as a passive observer.
Cancer Drugs: High Stakes, Low Standards
Nowhere is this failure more visible than in oncology.
Only 3 out of 123 cancer drugs approved between 2013 and 2022 met all four of the FDA’s basic scientific standards.
Most—81%—were approved based on surrogate endpoints like tumour shrinkage, without any evidence that they improved survival or quality of life.
Take Copiktra, for example—a drug approved in 2018 for blood cancers. The FDA gave it the green light based on improved “progression-free survival,” a measure of how long a tumour stays stable.
But a review of post-marketing data showed that patients taking Copiktra died 11 months earlier than those on a comparator drug.
It took six years after those studies showed the drug reduced patients’ survival for the FDA to warn the public that Copiktra should not be used as a first- or second-line treatment for certain types of leukaemia and lymphoma, citing “an increased risk of treatment-related mortality.”
Elmiron: Ineffective, Dangerous—And Still on the Market
Another striking case is Elmiron, approved in 1996 for interstitial cystitis—a painful bladder condition.
The FDA authorized it based on “close to zero data,” on the condition that the company conduct a follow-up study to determine whether it actually worked.
That study wasn’t completed for 18 years—and when it was, it showed Elmiron was no better than placebo.
In the meantime, hundreds of patients suffered vision loss or blindness. Others were hospitalized with colitis. Some died.
Yet Elmiron is still on the market today. Doctors continue to prescribe it.
“Hundreds of thousands of patients have been exposed to the drug, and the American Urological Association lists it as the only FDA-approved medication for interstitial cystitis,” Lenzer and Brownlee reported.
“Dangling Approvals” and Regulatory Paralysis
The FDA even has a term—”dangling approvals”—for drugs that remain on the market despite failed or missing follow-up trials.
One notorious case is Avastin, approved in 2008 for metastatic breast cancer.
It was fast-tracked, again, based on ‘progression-free survival.’ But after five clinical trials showed no improvement in overall survival—and raised serious safety concerns—the FDA moved to revoke its approval for metastatic breast cancer.
The backlash was intense.
Drug companies and patient advocacy groups launched a campaign to keep Avastin on the market. FDA staff received violent threats. Police were posted outside the agency’s building.
The fallout was so severe that for more than two decades afterwards, the FDA did not initiate another involuntary drug withdrawal in the face of industry opposition.
Billions Wasted, Thousands Harmed
Between 2018 and 2021, US taxpayers—through Medicare and Medicaid—paid $18 billion for drugs approved under the condition that follow-up studies would be conducted. Many never were.
The cost in lives is even higher.
A 2015 study found that 86% of cancer drugs approved between 2008 and 2012 based on surrogate outcomes showed no evidence that they helped patients live longer.
An estimated 128,000 Americans die each year from the effects of properly prescribed medications—excluding opioid overdoses. That’s more than all deaths from illegal drugs combined.
A 2024 analysis by Danish physician Peter Gøtzsche found that adverse effects from prescription medicines now rank among the top three causes of death globally.
Doctors Misled by the Drug Labels
Despite the scale of the problem, most patients—and most doctors—have no idea.
A 2016 survey published in JAMA asked practising physicians a simple question—what does FDA approval actually mean?
Only 6% got it right.
The rest assumed that it meant the drug had shown clear, clinically meaningful benefits—such as helping patients live longer or feel better—and that the data was statistically sound.
But the FDA requires none of that.
Drugs can be approved based on a single small study, a surrogate endpoint, or marginal statistical findings. Labels are often based on limited data, yet many doctors take them at face value.
Harvard researcher Aaron Kesselheim, who led the survey, said the results were “disappointing, but not entirely surprising,” noting that few doctors are taught about how the FDA’s regulatory process actually works.
Instead, physicians often rely on labels, marketing, or assumptions—believing that if the FDA has authorized a drug, it must be both safe and effective.
But as The Lever investigation shows, that is not a safe assumption.
And without that knowledge, even well-meaning physicians may prescribe drugs that do little good—and cause real harm.
Who Is the FDA Working for?
In interviews with more than 100 experts, patients, and former regulators, Lenzer and Brownlee found widespread concern that the FDA has lost its way.
Many pointed to the agency’s dependence on industry money. A BMJ investigation in 2022 found that user fees now fund two-thirds of the FDA’s drug review budget—raising serious questions about independence.

Yale physician and regulatory expert Reshma Ramachandran said the system is in urgent need of reform.
“We need an agency that’s independent from the industry it regulates and that uses high-quality science to assess the safety and efficacy of new drugs,” she told The Lever. “Without that, we might as well go back to the days of snake oil and patent medicines.”
For now, patients remain unwitting participants in a vast, unspoken experiment—taking drugs that may never have been properly tested, trusting a regulator that too often fails to protect them.
And as Lenzer and Brownlee conclude, that trust is increasingly misplaced.
- Investigative report by Jeanne Lenzer and Shannon Brownlee at The Lever [link]
- Searchable public drug approval database [link]
- See my talk: Failure of Drug Regulation: Declining standards and institutional corruption
Republished from the author’s Substack
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