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Merged USAID: is it really a bunch of crazy leftists? / Trump Was Absolutely Right to Shut Down USAID

Emily's Cat said:
Two questions...

First - who stopped the trials? Did the US demand that the trial be halted, or did the US withdraw funding? Those are quite different things.

Second - is the US the only country funding this research? If so, why is it on the US to support the entire planet? Why aren't other countries who will benefit footing part of the bill as well?
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Because grants work like that. In the same way EU grants are researching DIFFERENT diseases which will possibly also benefit people outside of the EU. And by spreading such research the world can look into many different things at once.

A hint, the last time a pandemic spread around the world it reached the US as well (and killed millions due to the utterly inept response there). And not because of evil immigrants, but because entitled tourists and business leaders still went abroad, got infected and then came home either hiding their infection of just not noticing it and refusing to self isolate because it would temporarily inconvenience them. And the gods forbid a US citizen do anything that is slightly bothersome to them if it only benefits someone else.

So the next pandemic will reach your country again. And given that your healthcare system is a bad joke, now governed by an idiotic conspiracy theorist denying basic science, perhaps researching preventive cures is (well was) the only way left to prevent a second mass death in your country.
 
At Science-based Medicine David Weinberg wrote, "The conduct of the clinical trial is like the construction stage of building the bridge. If construction stops prior to reaching the other bank, the bridge is useless. It doesn’t matter how noble the intent, how elegant the design, how flawless the construction, or how great the cost; the project has not achieved its goal of providing a conduit from one side of the river to the other. If a clinical trial is terminated prior to the prescribed end, the question the trial was meant to answer will remain unanswered and much, if not all, of the resources invested will have been wasted. Here is where the analogy breaks down. Construction of a bridge may resume and be completed at some time in the future without diminishing the designers’ intent. Not so for a clinical trial. Clinical trials are run according to strict protocols. Compliance with a protocol is never perfect, but total abandonment of the protocol, even for a limited time creates major problems. Once the study is stopped, it may not be possible to resume. Some participants may be unreachable, some may decline to participate due to broken trust with the investigators. Some may have taken medications otherwise engaged in activities that would invalidate their results. Some may have died. Even if all the participants could be assembled, interruption of the experimental treatment would likely make the study outcomes uninterpretable."

Based on the passage above (among others), even if money could be found to replace the cancelled funding, it would have to happen almost immediately for the study to continue. After I linked to the article above, I provided six additional links on clinical trials, and I quoted scientists and bioethicists. Obviously Mr. Musk and Secretary Rubio don't have the expertise to evaluate clinical trials in terms of when it would or would not be ethical to terminate them. Let's hear which experts they consulted, and let's hear their reasons.
 
Lukraak_Sisser said:
Because grants work like that. In the same way EU grants are researching DIFFERENT diseases which will possibly also benefit people outside of the EU. And by spreading such research the world can look into many different things at once.
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Is this the normal approach - that a single country fully supports a single research undertaking? It seems like it would be wiser to have shared funding from many countries, even if the amounts aren't all the same - it would provide some means for continuation in the event that the funding dried up. Trump pulling funding is one way that could happen of course, but it's certainly not the only way. I imagine that any research that was previously funded by Ukraine has gone down the drain in the last few years too. Funding diversification would be a much wiser approach.
 
Emily's Cat said:
Is this the normal approach - that a single country fully supports a single research undertaking? It seems like it would be wiser to have shared funding from many countries, even if the amounts aren't all the same - it would provide some means for continuation in the event that the funding dried up. Trump pulling funding is one way that could happen of course, but it's certainly not the only way. I imagine that any research that was previously funded by Ukraine has gone down the drain in the last few years too. Funding diversification would be a much wiser approach.
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Great idea. Then the US can waste everyone's money by cutting funding on a whim instead of just their own.
 
Up until now it was unthinkable that a western democracy would cut funding at the whims of a single person's say so.
Sure, politics might influence what new grants would be available, but already running ones?
But hey, I'm sure this will ensure more cooperation in the future.
As for Emily Cat's other question. Yes it is common for a single country to support a certain undertaking. If it's known for instance Harvard has gotten a grant to research part X of a disease other countries tend to fund grants to look into other parts or methods. To prevent 6 groups from inventing the wheel. After research is concluded follow up studies tend to look into validity. (simplified of course).
But it's good to see that the current US administrations methods are compared to being invaded by a hostile power.
 
Olmstead said:
Great idea. Then the US can waste everyone's money by cutting funding on a whim instead of just their own.
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??? The US can't cut another country's funding.

Having multiple sources of funding would, at a minimum, allow the researches some bridge time to find additional funding if one were to dry up.
 
Lukraak_Sisser said:
As for Emily Cat's other question. Yes it is common for a single country to support a certain undertaking. If it's known for instance Harvard has gotten a grant to research part X of a disease other countries tend to fund grants to look into other parts or methods. To prevent 6 groups from inventing the wheel. After research is concluded follow up studies tend to look into validity. (simplified of course).
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Thanks
 
Emily's Cat said:
Is this the normal approach - that a single country fully supports a single research undertaking? It seems like it would be wiser to have shared funding from many countries, even if the amounts aren't all the same - it would provide some means for continuation in the event that the funding dried up. Trump pulling funding is one way that could happen of course, but it's certainly not the only way. I imagine that any research that was previously funded by Ukraine has gone down the drain in the last few years too. Funding diversification would be a much wiser approach.
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I'll assume that medical research grants work the same as other scientific grants. There are a couple of starting points:
  • An entity of some sort (like a government agency or other organization) puts out a call for proposals soliciting research in a desired subject area.
  • A researcher/group has an area of research they want to pursue. They then submit it to various entities as potential sponsors for funding.
Either way, either a proposal is funded or it is not. I know of no partial funding mechanism, but in some instances I'm sure it is possible. but normally, research is funded by a single entity.

There is not group or board that divides up research: "This one is for Sweden, this one for Germany, and this one for the U.S." Generally, American researchers will apply for grants in America. German researchers probably apply for grants in Germany.

That said, a simple search shows that drug trials may be a little different in that sometimes there are multiple contributors:
In a meta-study by Hakoum et al. (2017), the reporting of funding sources within 200 clinical trials was assessed. The group found that most clinical studies are funded by just one source, though they ranged as high as 12 independent contributors. 58% of studies were funded by the government, and 40% by private companies, with around a quarter receiving funding from claimed not-for-profit organizations. However, upon further investigation, around half of these non-profit organizations were linked in some way to profit-driven corporations, around half of which again were not reported in the published study.
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https://www.news-medical.net/life-sciences/Who-Funds-Clinical-Trials.aspx
 
Emily's Cat said:
??? The US can't cut another country's funding.

Having multiple sources of funding would, at a minimum, allow the researches some bridge time to find additional funding if one were to dry up.
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That's not what will happen. The project will simply fail, and all the money that has been spent on it will have been wasted. No one sets aside an emergency budget to be used in case of toddler-in-chief.
 
Olmstead said:
That's not what will happen. The project will simply fail, and all the money that has been spent on it will have been wasted. No one sets aside an emergency budget to be used in case of toddler-in-chief.
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In fact, such a scenario would almost certainly likely result in more delays and inefficiencies.

Has the project secured funding? Yes, our grant was accepted.

Has the project secured reserve funding? Oh not yet. That application is still being looked into.

Two sets of vetting will obviously slow things down and involve more manpower.
 
Chris_Halkides said:
On social media I saw someone refer to Musk's algorithms that operate at light speed; this is magical thinking. On a search for light-speed algorithms, I happened upon an essay concerning Musk's management style that may be helpful here and elsewhere:

"2. Delete any part of the process you can​

The second step of Musk's algorithm is all about subtraction—a widely undervalued habit in management. In this case, it is all about deleting any part of the process you can. In fact, it is all about deleting just a bit more than you feel comfortable with. Musk: "You may have to add [parts or processes] back later. In fact, if you do not end up adding back at least 10% of them, then you didn't delete enough.""

Deleting a clinical trial (to take one of many possible examples regarding USAID) then trying to add it back is unethical and stupid.
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Why do I get the impression that the writer of that article only knows how to write bovine excrement?
 
Chris_Halkides said:
Clinical trials were stopped partway through, as one of my previous links discussed in depth. Let me quote the conclusion: "These trials were funded because they had potential to generate data that could improve health and reduce suffering. Running a trial on treatment of tuberculosis in a country with a high rate of tuberculosis has certain efficiencies and results of the study have the potential to improve the health in that country. But the benefits do not stop there. The results may be quite impactful elsewhere. Tuberculosis is prevalent across much of the world. Cases are increasing in the United States. The largest outbreak of tuberculosis on record was reported in Kansas City this year. Trials in the USAID portfolio could have led to the prevention and/or more successful treatment of diseases like tuberculosis, malaria, HIV, cervical cancer, and cholera worldwide. Now they will not. This is the greatest cruelty and waste of all."

It may be that Musk's intention always was to fire a bunch of people and then hire them back, etc. (others may disagree). But his approach, whatever its merits in the business world, have terrible consequences when applied to USAID.
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Most likely that the Galaxy Nazi thought he could pull his usual trick of replacing experts with untrained interns. But USAID is a government agency required to produce useful work, not a scam masquerading as a car manufacturer.
 
I found a pro-trump rant on social media, and I am quoting the last two sentences, along with my response: "For 4 years you watched this country get run into the ground on all fronts and you said nothing! Now, it’s our turn!!!!" To take one example, when Elon Musk fed USAID to the wood chipper (his words), ongoing clinical trials were cancelled before they were completed. In one sense, this is as bad as building 80% of a bridge and then quitting. In other ways, it is worse. A bridge can be completed, but a clinical trial cannot be stopped and then restarted later. Furthermore, there are clear ethical rules about when a clinical trial may be stopped, and Mr. Musk and Secretary Rubio lack the medical knowledge to make such a call. I wish this were the only such example of what "our turn" means in practice.

I also wanted to come back to the issue of the 90 day pause: "Sec. 3. (a) 90-day pause in United States foreign development assistance for assessment of programmatic efficiencies and consistency with United States foreign policy. All department and agency heads with responsibility for United States foreign development assistance programs shall immediately pause new obligations and disbursements of development assistance funds to foreign countries and implementing non-governmental organizations, international organizations, and contractors pending reviews of such programs for programmatic efficiency and consistency with United States foreign policy, to be conducted within 90 days of this order. The Office of Management and Budget (OMB) shall enforce this pause through its apportionment authority."

By 10 March (well before 90 days had transpired), and USAID was 83% gone with the rest moving to the state department. Hmmm....
 
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