Robert Califf

Listening and talking on a plan for the future of American science Tales from the road

So hard to know the right approach to this. Thoughtful discussion by someone who has "been around the block".

open.substack.com/pub/holdenth...

The proposed destruction of the USDA: it's deja vu all over again. - Food Politics by Marion Nestle The USDA has just announced a plan for reorganization that will move most of the agency out of Washington, DC, as flagrant an act of self-destruction as can be imagined.

Humpty Dumpty -- USDA. Dr. Nestle's book will be an important one.

www.foodpolitics.com/2025/07/the-...

YouTube video by MicrobeTV Beyond the Noise #75: Mercury rising

A useful summary of the history of thimerosal and an update on what is happening now. A lot to worry about here.

www.youtube.com/watch?v=zwAW...

Opinion | Doctors Have Lost Their Mount Olympus of Medicine

Highly recommended reading from a front line clinician.

www.nytimes.com/2025/07/28/o...

Pediatricians, Profit, and Thimerosal Two vaccine stories this week, and why both reveal something deeper about trust, access, and process.

With all the people profiteering on unproven "treatments" its a shame that this nonsense about pediatricians continue to have to be addressed, but it does.

communityimmunity.substack.com/p/pediatrici...

The nuances are important. Glad Dr Nestle focuses on this part of it.

www.foodpolitics.com/2025/07/week...

The Promise of Real-World Data for Research — What Are We Missing? | NEJM Real-world data could help advance disease prevention and treatment, enhance quality of care, and empower patients to improve their health. But various challenges continue to impede their utilization.

Hope these thoughts will stimulate enhanced effort to evolve to a learning health system.

www.nejm.org/doi/full/10....

Is RFK Jr. calling the shots? Who can get a flu shot this fall, as of now? Kennedy signed off on a bogus recommendation from his new vaccine advisory committee, but has so far left votes flu and RSV shots in limbo.

This well-done attempt to explain vaccine coverage makes a good case for health care as a right instead of something handled through byzantine mixes of private and public insurance.

open.substack.com/pub/insideme...

RFK Jr wants us to eat more protein (and fats) - Food Politics by Marion Nestle RFK Jr wants us to eat more protein, but we really don't need any more.

What next? "protein madness"?

www.foodpolitics.com/2025/07/rfk-...

Gene Modification and Rare Diseases in Children The dramatic success of a recent attempt at gene editing to treat a genetic disorder in an individual baby, followed by the formation of a new institute at UCSF and Stanford with funding from the Chan...

Practical issues that may stand in the way of medical "miracles" for rare diseases.

substack.com/home/post/p-...

President Trump says sucrose is better than HFCS (both are glucose plus fructose) - Food Politics by Marion Nestle The President of the United States says Coke should switch from high fructose corn syrup (HFCS) to cane sugar. Both are glucose plus fructose.

There is plenty of important work to do for the cardiometabolic mess we have created, but Marion Nestle says this isn't it!

www.foodpolitics.com/2025/07/2768...

RFK Jr.’s Cruelest Cut of All Robert F. Kennedy Jr. just eliminated U.S. vaccine funding for the world’s children. Why?

Speaks for itself.

open.substack.com/pub/pauloffi...

Evaluating the impact of two decades of USAID interventions and projecting the effects of defunding on mortality up to 2030: a retrospective impact evaluation and forecasting analysis USAID funding has significantly contributed to the reduction in adult and child mortality across low-income and middle-income countries over the past two decades. Our estimates show that, unless the a...

Difficult to fathom the impact based on this modeling.

www.thelancet.com/journals/lan...

Evidence-Based Policy or Policy-Based Evidence? Today I want to call attention to something I see as a major flaw, common among political policy makers, that is causing concern regarding the current leadership of the Department of Health and Human ...

Some thoughts on how health policies are developed. Beef tallow makes fries healthy?

substack.com/home/post/p-...

The likelihood of harm far outweighs the likelihood of benefits for these untested products--buyer beware! I wonder about the doctors who administer these unproven drugs--without "adequate and well controlled clinical studies" we may never know the harm done (or the objective measure of benefit).

The Peptide Craze The Surge in Use of Off-Label and Non-FDA Approved Peptides

Well done summary. One point i'd emphasize--9 out of 10 drugs that enter human clinical trials either have risks that outweigh benefits, have no efficacy or can't be manufactured reliably and safely.

open.substack.com/pub/erictopo...

Large language models as disrupters of misinformation - Nature Medicine As patients move from WebMD to ChatGPT, Thomas Costello makes the case for cautious optimism.

This is an interesting take on LLMs and the RCT in vaccine hesitancy is fascinating.

www.nature.com/articles/s41...

A plague death, floods’ health impact, vaccine injuries hearing at Senate today, Covid still low, and more The Dose (July 15, 2025)

seful update from YLE

open.substack.com/pub/yourloca...

Taking the Highway to Better Health for America For many years, leaders in medicine, research, and public health have sounded the alarm over the fact that the U.S.

Some thoughts on the public health "fork in the road". Do we focus on what works like other high income countries with better healthy life expectancy or do we embrace unproven remedies?

substack.com/home/post/p-...

Mercury Rising A CDC Advisory Committee just made the same mistake it did 25 years ago. And it’s only the beginning.

I'm sure Dr. Offit wishes he was spending his time on exciting new frontiers in vaccine development, but these reminders of history and revisionist history are highly valuable. One day this will all have to be put back together again.

open.substack.com/pub/pauloffi...

YouTube video by MicrobeTV Beyond the Noise #73: Senator Cassidy's line(s) in the sand

Dr. Offit continues to sound the alarm.

www.youtube.com/watch?v=XJkK...

Changes in Physical and Mental Health After the End of SNAP Emergency Allotments This cross-sectional study uses data from the Behavioral Risk Factor Surveillance System to examine how Supplemental Nutrition Assistance Program emergency allotments impacted physical and mental heal...

Seems like a bad idea to cause more food insecurity and physical disability.

jamanetwork.com/journals/jam...

Since i've been out of government I've gotten a lot of feedback from front line clinicians that support staff are under-supported and much needed and administrators are growing while front line clinicians are declining. Hope to see more reporting and data on these!

I looked at the comments and there is a robust discussion about both topics. It would be instructive to see a similar display on these issues.

The graphics and text of this article are excellent. I was disappointed that the issues of aides and home health workers (what's happened to their pay?) and the proliferation of administrators and claims processers was not addressed.

www.nytimes.com/interactive/...

No, the FDA did not actually fully approve Moderna's pediatric Covid-19 vaccine yesterday. Despite media headlines, a narrow approval was granted, which will make Moderna's vaccines far less available to children than they have been until now.

Good topic for a public airing.

open.substack.com/pub/insideme...

Medicaid cuts: The how and why Plain language translation of what the heck happened and where this will go

Sadly, I agree with most of this and it is nicely described and illustrated. Its clever to position the "hits" after the mid-term elections. This causes a challenge of how to describe the issue when its not being felt yet.

yourlocalepidemiologist.substack.com/p/medicaid-c...

Inside the Collapse of the F.D.A.

Some thoughts about FDA that merit discussion.

www.nytimes.com/2025/07/08/m...

Measles reaches highest number since elimination. Start of a Covid wave? Incoming Medicaid cuts, GAVI, and some good news The Dose (July 7)

concise update

open.substack.com/pub/yourloca...

but I start from the perspective that if we want to ingest something to improve our health, it would be best to know from empirical "adequate and well-controlled clinical studies" about the benefits and risks for real health outcomes.