FDA Direct: Who Buys the Spin — Hook, Line and Sinker?

 
Welcome back, everybody.

Good to see you, Dr. Prasad, Dr. Jain-Nagpal.

And we are going to just have fun today.

I don't know if we have any specific.

We were having fun reading some headlines from a particular paper.

Oh, yeah.

We'll get into that.

We'll get into that.

But lots going on.

You saw the National Priority Review initial group of products.

And so that was exciting.

I think that's something that everyone's looking forward to, getting the review times down to one to two months.

The holy grail of drug regulation to get our turnaround time much faster for companies.

And, you know, I'm a little bit biased in CBER because I think, you know, not to be too critical of my other agencies, but I think we got one of the most exciting products on the list, DB-OTO.

Yeah, that comes out of CBER.

It comes out of CBER.

And that's for?

It's for children and young adults who have a deficiency of a certain protein required for hearing, otoferlin.

And it is a gene therapy that has impressive results in restoring hearing for people who are very deaf or congenitally deaf.

And it's, from a biology standpoint, it's so interesting because we take two gene therapy vectors and the gene is too big to fit into one.

So part of it comes in one, part of it comes in the other.

And it reconstitutes the protein in vivo.

And these kids go from being almost utterly deaf to being able to hear at certain decibel levels that are meaningful for their lives.

And this is really a transformational therapy.

And so we're super excited about it in CBER.

And we're excited that it's making the list, combining gene therapy, a device, going into the cochlea.

It's got everything.

I mean, that's exactly what your vision was, right, Commissioner?

Right, really these game-changing innovations and products. That sounds like a game changer.

We're into the pipeline.

We're talking to the reviewers on the front lines and asking them, are you seeing anything that's a game-changer, that's a potential amazing therapy?

Of course, you don't know when you're looking at a phase one or phase two.

But people can see early on signs of a real game-changing therapy.

And so we want to know early.

We want to facilitate.

We want to increase communication with the company.

We want to eventually have some of our streamlined reforms that are taking the final BLA-NDA application down to a month or two for a review time.

Eventually, we want to take those reforms downstream and go to the IND, phase one, phase two.

And so between the steps, there's a lot of idle time, and there's probably an opportunity for continuous trials and endpoints in the cloud at some point.

But this is the initial step.

It's going to take a large bureaucratic process that may involve people, and it's going to convene people and say, hey, we're going to do this on a different timeframe.

Speaking of timeframe, I don't know if this made it your way.

But in working with the team on talking with the companies around their products, we did hear from a couple companies, oh, wow, we may have to staff up to meet your timeline.

So in short, the government may start moving faster than some of these companies.

Well, so that's a great point.

It's a partnership between the company and the FDA.

And I think for really transformative products, we want to guide them to market, to get it to patients as quick as possible.

And you're absolutely right because we can do our part very quickly.

We need them to staff up, do their part quickly so that we can get this to the market ASAP.

It was kind of funny.

We reach out to the companies.

First of all, the nominations for the products that get the National Priority Review Voucher come from the divisions.

And the divisions put them forward, and then we have a committee that looks at them.

And then we reach out to some of these companies, and we say, hey, are you up for this?

You're going to need to be available for a quick turnaround time if we have a question about the clinical trial, about the draft label.

It's not going to be one of these things where we send a draft label, and then a month later you get back to us, and then a month later we get back to you.

Not in this pilot program.

It's like varsity sports, like you're lucky to be picked, but you've got to put in the hours.

Like, you know, it's not a joke.

Yeah, you've got to work for it.

Well, a couple companies, not a couple, two, said, I guess that's a couple, they said, we're going to have to staff up and just make sure we're ready to go for this sort of rapid.

They're scared, you know?

I mean, it's summer vacations.

You know, you don't want to cut into that.

I think they're just so not used to it.

There's a broken system that takes forever here.

It works.

It's much better than the pre-user fee days.

And I think companies have just become accustomed to it.

The same is true for the page length.

You know, you're always about this page length.

You mean, like, for the applications?

Yeah, it's getting up to like pages of documents to read and executive summaries that are 

What is a summary when it's pages?

That's a summary, you know?

So we're trying to get that down to a manageable, limited length.

And, you know, like that old Mark Twain quote, "I'm sorry I wrote you such a long letter.

I didn't have time to write a short one."

Sometimes you can get to the point in very quickly.

And that's another place in which bureaucracy just begets bureaucracy.

That's a much deeper topic that applies to all aspects of society and life when people just cannot concisely explain what they're trying to do.

But we're going to try to make things efficient.

Yeah.

Not cut any corners on safety.

So that's exciting.

Yeah, the deafness medication, one of many.

And it was hard, you know, to come down with some of these decisions for some of the divisions.

Some of the divisions had a couple products they wanted.

And so we'll have a second batch and a third batch.

And hopefully we'll keep going.

It's a rolling process.

We'll keep going.

And I think we're learning a lot in this pilot phase.

And the review teams are really excited from the ones I've talked to.

Well, that's the key, right?

Because if you socialize it and get their input, and then they're coming up saying, hey, I have some ideas on how we can make this happen, then it's going to work.

If you just say, hey, we're all switching the entire review process to this new system, then it's not going to work.

That's how you fail.

Yeah, you start small, you pilot, you get some successes.

And honestly, you show people it's possible.

I mean, so many people have a mental block in their mind of what's possible and what's not possible.

And the moment you show somebody that it's possible, that floodgate is open.

Speaking of mental block, some people have been watching too many direct-to-consumer pharma ads.

And there are some issues with some of these ads.

And so we announced the biggest crackdown in a generation on these ads.

The FDA had been increasingly lax in enforcing their regulations that say you can't create a misleading impression.

You have to present a fair balance of information.

There's also a regulation that says you can put the side effects and adverse events on a separate website or at another place and just send people there.

We're going to close that loophole so that you do have to put the adverse events in the actual ad.

But we should clarify what we mean by a misleading ad, right?

And I think the kind of the singing and dancing part, right, is you see these ads and you see these patients.

I mean, I don't even know what the drug is.

They're just at the movie theater singing and dancing.

Like, what are they selling me?

And marching.

Yes.
They're marching in some fake town to, I don't know, where they're going.

They're going somewhere, maybe to the pharmacy.

And, like, we also have to be clear that, of course, we believe in freedom of speech of the companies.

The companies have the corporate speech.

There's no doubt about that.

But it's when your advertisement crosses into the clearly misleading and deceptive advertisements that FDA has long had the role of being the arbiter of and needing to enforce these regulations.

But until recently, until your crackdown, I think it had been neglected for many cycles.

And you sent, what, letters?

Yeah, I sent about cease and desist letters and another letters warning the industry.

And for context, though, I mean, last year it was only zero.

And the year before, it was one.

Wow.

Yeah.

And, you know, before we got here, there were zero FDA podcasts a year.

Now they're 

Is that right?

Yeah.
I don't even follow.

I don't think there was a podcast.

But look at the reception, you know.

One, The Wall Street Journal News writes how the

There's two papers, The Wall Street Journal is two news papers.

Of course, yeah.

There's the newspaper, which has Accountable to Facts and News.

And there's the Opinion Desk, which is the opinion of a handful of people who happen to staff the Opinion Desk.

And there's a firewall.

A little bit of entertainment, too, right?

Yeah.

They just, they have their, they have a certain ideology, a certain viewpoint.

And I like how the news desk writes how the FDA is taking aim at the surreal world of TV drug ads.

The agency's crackdown represents a significant rise in scrutiny of pharmaceutical ads.

And I think largely a very favorable news story.

Very positive news story.

Because people want this.

It's a bipartisan issue.

Bipartisan.

% of doctors want to see some action on these direct-to-consumer ads because they're distorting the doctor-patient relationship.

Yeah, people coming into the office asking for things that don't apply to them because they watched a misleading ad.

Yeah, they're never advertising the biosimilars or the generics, right?

No, no, no, no.

It's always the branded.

And then, meanwhile, the Opinion Desk, HHS tries to stifle corporate speech.

RFK Jr. and Marty McCary want to regulate pharma ads so they're no longer feasible.

Wow, that's not what you want.

Not that they're no longer feasible, that they're accurate and give you some useful information.

So the newspapers, you're talking about the Wall Street Journal, same Wall Street Journal, although some people will say you get two newspapers for the price of one.

There's only one I want to read.

Let me guess, the News Desk.

The News Desk, yeah.

So the Opinion Desk and the news side is kind of like Dr. Jekyll and Mr. Hyde sometimes, which is what they accuse us of.

So the Wall Street Journal Opinion Desk hates the FDA, historically.

I mean, I don't think they believe in an FDA, honestly.

I think they think we shouldn't exist.

The market should just decide all products.

Yeah, I think they have that pure libertarian view.

We had that pre-

And unfortunately, a series of high-profile incidents have given the FDA the initial authority to regulate safety, and then later in the s, the authority to regulate efficacy because of missteps, I think.

I mean, I've seen some kind of nuances or, sorry, texts saying that they think AI could do your jobs effectively.

Why do you even need human reviewers?

Well, we embrace AI.

The commissioner has ELSA, which is, I think, the first ever embrace of AI at this agency.

And I think prior to us, AI was taboo or banned in this agency.

But having said that, AI is a tool to help humans work better, and humans and AI work much better together than letting AI run the show.

How would they even have a podcast with AI?

Would you want to watch that podcast, AI podcast?

No, but in all seriousness, I mean, to your point, I mean, they write as if, you know, I wrote this down.

Are we, you know, are you both mugging, torpedoing, slow rolling, ignoring, clear benefits?

I mean, these words are.

And also that I'm the FDA's Grim Reaper, and I'm a Bernie Sanders acolyte in MAHA drag.

Are you going to be Grim Reaper for Halloween?

I was going to go with the acolyte in Halloween than the drag.

It's amazing.

I used to write for the Opinion Desk at the Wall Street Journal, and I still have a.

Traitor.

No, just kidding.

I still have a good relationship there with some of the editors.

The most negative media coverage we have received is from the Opinion Desk at the Wall Street Journal, that small group of editors that writes their own opinion pieces.

And most of their pieces are along two themes.

One, that we really shouldn't have an FDA.

And number two, that the sob story of some pharmaceutical company that they're getting, they buy hook, line, and sinker.

And I get that story to me all the time, because the story of my life is I'll walk down the street, and somebody will say, oh, you're at the FDA.

There's a drug that cures cancer and Alzheimer's, and it also happens to work for Lyme disease and chronic fatigue syndrome.

And it's a natural botanical.

Botanical?

You haven't yet botanical.

And it is unfortunately being held up at the FDA over some ridiculous bureaucratic red tape process.

And then I'll be like, this sounds a little strange, so get a little review of the file.

And you find out it has no effectiveness in any of its pre-specified endpoints in the clinical trial.

It doesn't work.

And it was only tried against one of those many conditions.

The rest were false claims.

And they have five sterility manufacturing violations.

Yeah, and that's something that people don't know.

What are the sterility conditions, the manufacturing conditions, the potency issues in some of these files?

But you get to look in the file, and you know that.

And there's no way in heck the Wall Street Journal opinion editors know what's in that file.

They don't know if there are sterility manufacturing violations.

So they take the line of the lobbyists of the companies, and they sell it to the world in their pages.

Hook, line, and sinker.

And a lot of times it's the exact same themes, and it's the same pieces that the lobbyists are sending to members of Congress, which then get forwarded on to us.

We're going to always stand on the side of science.

I like this.

It's like Prasad is, quote, following through on his campaign to block a specific immunotherapy for patients with advanced melanoma.

I never had a campaign to block any immunotherapy.

I don't even think that falls.

I don't think you're not even the primary review team.

Well, on that particular file, we have something called the Oncology Center of Excellence, and they take the lead in the oncology files.

I mean, you know, I'm flattered at the idea that I got the time to read all the files here and keep track of everything.

I'm flattered at that idea.

But we have people who are working in different groups, and different people take the lead on different things.

And certainly there's no one person here who makes all the regulatory decisions.

So they're blaming you for a non-approval of a drug that doesn't even fall under you.

It falls under a different sector.

But my only grievance is the choice of photograph they use.

The Albert Einstein photograph.

Yeah, so there was one photograph of me on the official website where I had crazy hair.

We quickly got a haircut and posted a better photo, but they insist on using the crazy-haired photo.

And that photo is no longer on any government website.

That was your initial one when you were coming in from academia as the Albert Einstein.

And so it's swapped out.

So they're not using the newer photo.

They went back, and they always use the Albert Einstein hair one.

You know, it says a lot.

The photo says it all, right?

You don't even need to read the article.

Just look at the photo.

But I think I have a warm smile in the photo for what it's worth.

I feel like at least the smile was a good smile.

Yeah.
I actually prefer the Albert Einstein hair.

You prefer the—no, come on.

You were the one who got me the hair.

You told me to get the haircut.

Well, personally, I prefer the Albert Einstein hair.

I see, I see.

But for—
For regulation.

For the masses.

Yeah.
I think people want to see the—

Yeah, buttoned up.

Either way, I don't think you look like a grim reaper.

Yeah, either way, it's not a grim reaper.

Here's a perfect example.

Josh just handed this to me.

So here's a story about Jim O'Neill, the Deputy Secretary of Health.

And this is the photo that they have of him in an elevator, in a crammed dark elevator,

where he's looking down.

Now, there are millions of photos about him of him on the Internet, including his official

government website photo, which is freely available for anyone to use because it's a

government website.

So, no, don't use his government photo where he looks good.

Let's try to find a photo where he's in a cramped elevator.

It's like the paparazzi took him.

The paparazzi took this photo from a distance with a telescoping lens.

Like, I've never seen Jim O'Neill not in a suit.

Yeah, I mean, he's—

He sleeps in a suit.

I think he sleeps in a suit.

It's like you don't need to read the article.

You look at the photo, and you know where this heavy bias is coming from, and that kind

of says it all.

I want to go back to the point about the drug that you weren't even responsible for, right?

Well, yes.

I'm not the primary decision maker on this file.

Yeah.
So there are headlines here that say, drug approvals hit an FDA wall.

And what's interesting about this article—

Wall Street Journal Opinion Desk.

Wall Street Journal Opinion Desk.

Almost always.

Always.

And there's several other headlines around, you know, the drug approval, or we're slowing

down, we're not approving enough, yada, yada, yada.

But in this particular one, they quote numbers about our drug approval counts that are false,

and they make the whole article about CBER and your area division, but the numbers that

they're citing are for CDER.

Not the right numbers.

Yeah.

Not the right numbers.

So we're extrapolating.

There have only been —they're talking about new drug approvals—in the first seven

months of this year.

Not true.

There's not been 

Here's what Biospace says.

The Jeffries Group counted total approvals between CDER and CBER, and extrapolated to

by the end of a number that would fit squarely into the range of to over

the past five years.

Quote, the bottom line is, we didn't sense anything drastically alarming or different compared

to prior years.

And that's a non-Wall Street Journal article.

This is the Jeffries Analyst.

So these are people who have skin in the game.

Yeah.
You know, they're actually putting their money on the line in this, you know.

But the opinion desk feels differently.

So I remember this piece now.

Drug approvals hit an FDA wall, okay?

And of course, there's some photo that you can tell where they're coming from by just

looking at the photo.

So they say there have only been new drugs approved in the first seven months.

So the number is not correct.

And they go on to use that number to say we're on track for one of the lowest numbers

in history.

The number was not on that date.

It was 

And so we sent the Wall Street Journal a correction saying, hey, you got the number incorrect.

We verified it.

There have been 

And by the way, that puts us on track for one of the most drug approvals in a year in

FDA history, probably one of the top three in FDA history.

And so they refused to publish the correction.

It would change the whole narrative.

Yeah, it changed the narrative.

You know, and I completely think that, obviously, from all of our rhetoric and from the priority

review and from a number of things we're doing on the CMC front, industry analysts can

see that we're actually trying to ease and guide successful products to market.

That is our goal.

We're not a wall.

We're actually a conduit to bring successful products faster to patients who need it.

I think they have their own narrative.

I do think, though, that at the same time, this idea that the drug approvals is the sole

metric of how good a job we're doing.

It's not the sole metric.

We've increased transparency.

Commissioner's released hundreds of CR letters, hundreds and hundreds of complete response

letters, which often are an invitation to resubmit, sometimes, or a denial.

explains our thought process.

We try to do a good job in speeding the good drugs to market, but also a good job in helping

companies that aren't quite there yet or have unsuccessful drugs to understand what they

need to do better to get across the finish line.

And it's really both how fast we are and how responsive and the quality of our decisions

that I think is the best it's ever been.

Look, it's an exciting time at the FDA.

Our goal is more cures and meaningful treatments for the American public and healthier food for

children.

And you're going to see more exciting stuff because of our proactive approach going to

the review teams and asking them, you know, what's in the pipeline that looks really potentially

promising.

Yeah.

You were going to read something there.

You got some more fun.

I mean, these quotes are just, yeah, I mean, it's.

Well, I got another one, which was the whole, I think it was an article I was reading about

how the FDA is under tremendous political pressure.

Oh, you're overturning decisions.

Yeah.

From whom?

It's like, yeah, from whom, you know.

So I think I take issue with that in a number of ways.

One is that, I mean, to some degree, I think what people need to recognize is that all federal

agencies are ultimately accountable through political processes.

The American people decide what federal agencies are supposed to do in our lives, and they do

that through elected representatives.

So to some degree, of course, government will be political.

At the same time, our decisions here on a daily basis are % scientific, and we are not under

any undue political influence to make these decisions.

In fact, when we feel even a whiff of pressure that way, the commissioner pushes back and

pushes back hard to make sure we're making the right calls.

Well, also, you know, there's legal, there's laws that we have to follow, right?

And so I actually was looking this up because, you know, you read these headlines and you're

like, what are they, you know, does the Wall Street Journal not want us to follow the law?

And so there's this whole, you know, I don't want to read this whole long piece, but I'll

abbreviate.

The FDA's review of a drug application is statutorily constrained to consideration of

the safety and efficacy of the drug's proposed use, the appropriateness of the proposed

labeling, and the adequacy of manufacturing methods, which I think the manufacturing point

is something that we don't, you know, most people don't even realize, right?

So you legally have to follow the law on this.

Where does politics come into this?

Yeah.

If anything, I mean, the biggest political decision in the last quarter century at the

FDA was made in the Biden administration when the Biden administration wanted to mandate

a COVID-vaccine for all ages.

And to accomplish that goal and to mandate a booster, they needed a biological licensing agreement

and they had to push that through FDA.

That resulted in the resignation of Gruber and Krause, who were the former vaccine reviewers.

So that to me was the most overt political act with an impact on people's lives.

People lost their jobs or they're forced to get a vaccine.

I can't...

Just to be clear, they said we're not on board with this for young, healthy children.

They could have written our framework, Marty, because their framework, actually, back in

their framework was COVID boosters make a lot of sense for the elderly and for

the immunocompromised, they don't make a lot of sense for younger, healthier people.

And then we wrote that framework in this journal.

And so there's intense political interference by the White House that ended up resulting in

the ouster of the two top vaccine officials in the vaccine center, the director and the

deputy director.

And that was incredible, overt political pressure that by the Biden White House that resulted

in this sort of, you know, fireworks.

And it's...

This is not our opinion.

This is the results of the House judiciary hearing and investigation on this issue.

So yes, there has been incredible political pressure in the Biden administration.

And I have a charge from the president, do what's right, go bold, don't worry about the

corporations and the lobbyists.

That's the commission that I have.

Now, just to be clear, you said that, you know, we do sometimes get lobbied.

What we're referring to, and let me be very specific, members of Congress will get hit

up by these companies.

These companies will spend millions of dollars lobbying members of Congress to try to influence

the FDA.

And they don't even know about these drugs.

They, of course, get a one-sided version, sometimes with false claims made by the companies.

And a few Wall Street Journal editorials to boot.

Oh, sure.
They'll get the Wall Street Journal to buy their story, hook, line, and sinker.

And so then they can attach a Wall Street Journal opinion desk, not the news part, and then

they'll forward it to me.

And I'll sometimes reply and say, thank you for this information.

Our scientific review process is independent and lives within the FDA.

And then they'll sometimes, on occasion, say, well, the lobbyist is really annoying.

What do I tell them?

And I'll tell them, you let them know that the scientific review process is independent.

And we have been more transparent about that scientific review process than ever in FDA

history because all of our decisions are now public.

So if somebody has an issue, they can look at the CR letters and find out exactly.

And if we look, if we don't approve a drug, the public deserves to know why, and they deserve

to know good reasons why.

And on the few occasions where someone in Congress asks us to sort of walk through the science

behind the decision-making, invariably, the congressperson's like, oh, my God, I didn't

see it that way.

I didn't even know all these intricacies to it.

It seems like you're all doing a great job.

You know, that's really what we hear.

It's amazing to me that the kind of these external people you're talking about are suddenly

scientists.

And they seem to understand the nuance of the data and the disease state and all of this.

Well, I'll tell you who really appreciates us standing up for the independent scientific

review process here.

And that is our reviewers, our teams.

They've seen political interference.

They saw it in the Biden administration.

They've seen it throughout the history of the FDA.

Off and on, it's been captured in part in sections of the FDA by the industry it's supposed

to regulate.

They don't like it.

I mean, why is that appealing to anybody?

They work hard on those reviews, work hard on a review for a year, and then be told by

some manager, no, no, we decided we're going to go ahead and just do this anyway or not

do it anyway.

It's humiliating.

They don't want to do that.

I've had some scientific reviewers say that they're interested in a leadership role here,

you know, being a manager or something.

But they don't want to have to deal with any sort of nonsense.

And we've given them those assurances.

You're not going to.

And you know who else benefits from the FDA scientific rigor?

The American people and the companies.

Because the FDA brand means something.

It means it works.

It's safe.

If the benefits outweigh the risks in the intended population, it means something.

And if the Wall Street Journal editorial board got what they really wanted and everything

was approved, it would mean nothing.

The FDA label would mean nothing.

And then the consumer would have to rely on a third party, like a Consumer Reports or

a LEED certificate, you know, some third party to endorse which of these drugs actually work

and I should take.

And the FDA brand would have been spilt.

So I think they don't recognize they actually want to preserve the brand, the means that

it means that this works and that the benefits outweigh the risks.

I know both of you have talked about when you're treating patients, the idea of false

hope too, right?

And sometimes there are these ineffective drugs that are on the market relative to the

actual kind of what the patient is facing with the disease.

Can you talk about that?

Because I think that nuance is lost.

I mean, in oncology, they often say a drowning man will reach for the blade of a sword, which

means that when you're desperate, and we all understand what it's like to have a family

member or see a patient who's in a desperate time, and you would do anything to help that

person, but you have to be very careful that somebody who's very desperate and facing

something that's very grim can even reach for the blade of a sword, something that'll

just cut their hand and not save their life.

And that's why we have these regulations to shield people from making choices that can

even be worse than death or even worse than the disease.

And there have been products that cause demyelination of nerves or severe pain or a toxicity that's

even worse than the disease itself.

And that's one of our duties.

That's what we take most seriously, that safety part of this.

Yeah.

And the plausible mechanism pathway is something I think people are going to read in two weeks

or so.

Um, yes, it's coming in the New England Journal.

Three, New England, yeah, but we're not supposed to say it's coming out per the Journal's rules, not

per our rules, but you know what?

Our lawyers are taking so many antacids right now.

They're just pumping down the Tums as they're watching these.

Well, I mean, I think that that's because I think in government, I think there's an attitude

that the role of government is to tread so lightly, you never stir up a lawsuit.

But the truth is, we view it, the goal of the FDA is to do the right thing.

And sometimes that means you'll ruffle feathers and sometimes that means you'll take on litigation.

Our attorneys, of course, counsel us to avoid this and we don't want to get into it unnecessarily.

But if it means doing the right thing, I think we're willing to do it.

Well, when we went down and met with some of the people that are in charge of sending

enforcement letters out for direct-to-consumer pharma ads that do not meet the regulation,

we found a group of individuals demoralized.

Browbeaten.

They had all these letters stacked up they couldn't mail out.

Yeah, the lawyers told them, well, you know, they basically, they were acting lawyerly on

them and be like, well, we have issues with this and well, there's concerns here.

And they just give them a hard time for every little thing they're trying to do to do

their jobs.

They didn't really feel like they had a sort of directive from above to get this done.

And so they sent out literally zero letters last year.

And initially my thought was, well, maybe they're not working.

You know, maybe they should be working harder.

And then we actually did a deep dive.

No, these are amazing people.

They were completely demoralized.

They were being blocked.

They had a list ready.

They knew every drug that was in violation.

Now they were telling me how happy they are that they've been able to send these out.

But, you know, Marty and I have a couple of lawyers we really like, because when we talk

to them, their answer is, here's how you can get that done.

You know, it's not no, it's here's how you get it done.

Yeah, legally.

Legally.

That's my favorite attorney.

Yeah.

But change is hard, to your point, right?

And so, you know, you have to ruffle some feathers to get to the right outcome.

So I hear.

All right, good.

So anything, so we had a, I didn't realize this was going to turn into a Wall Street Journal

opinion desk bashing session.

But it is frustrating when you issue a factual correction and they refuse to print it in that

one case, a correction that would have changed the trajectory of the entire message.

I didn't even read to my favorite line, Prasad wields more power than Anthony Fauci ever

did.

Oh, my God.

Wow.

I didn't know that, Marty.

I didn't know I wield more power than Fauci.

You control all the biodefense labs around the world.

All of it, yeah.

Oh, my gosh.

That's a lot of power.

That's a lot of power, yeah.

You don't get the same salary as he does.

No, I don't, actually.

All right, anything else, Sanjula?

We could spend hours unpacking it, but I think we should land there.

I think we've had enough fun with the...

They know where to find my picture.

My level of analysis of these articles is usually just looking at the photograph.

Yeah, I think that's a good clue.

That tells you everything.

All right, folks, we'll do it again.

Thanks so much, and good to see you guys.

Good to see you.