While doing somewhat-routine reporting on this year’s Senate Appropriations Committee bills, Paul Goldberg, editor and publisher of The Cancer Letter, quickly realized that he was seeing a full bipartisan rejection of President Donald J. Trump’s plan to defund and therefore dismantle biomedical research in the United States.
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In this episode of In the Headlines, Paul, Jacquelyn Cobb, associate editor, and Claire Marie Porter, reporter, discuss the GOP-led turn of events that reversed the Trump administration’s cuts to NIH, as well as the very public departure of Vinay Prasad from FDA following a snowballing of attacks on his political purity led by Laura Loomer.
“Basically what we learned is that instead of cutting NIH, the Senate is actually giving NIH a raise, and the House has essentially an allocation that does not reflect the president’s priorities of cutting NIH by 40%. God knows why,” Paul said.
The bill represents one of the first pieces of good news for NIH and other federally funded biomedical and health research institutions since Trump’s inauguration.
“We are impartial, we cover science. But we believe in science. We believe in spending money for science,” Paul said. “We believe in all of this, or else we should be doing something else.”
Stories mentioned in this podcast include:
- GOP-led Congress rejects Trump’s plans to gut medical research Senate bill gives NIH a $400 million raise
- Vinay Prasad falls from grace at FDA upon flunking Trump political purity test MAHA leaders agree on one point: COVID was mishandled. Is that enough to run science-based agencies?
- U.S. News & World Report expands evaluation of outcomes in cancer subspecialties
- USPSTF doesn’t lean right or left—it’s about data, not politics
- UPenn study supports continued use of ODAC voting
This episode was transcribed using AI transcription services. It has been reviewed by our editorial staff, but the transcript may be imperfect.
The following is a transcript of this week’s In the Headlines, a weekly series on The Cancer Letter podcast:
Jacquelyn Cobb: This week on The Cancer Letter Podcast…
Paul Goldberg: Laura Loomer didn’t have a whole lot of difficulty finding whatever she wanted, including famously the voodoo doll. What’d you think of that, Claire? The voodoo doll?
Claire Marie Porter: Yeah. Well, so she had already written this really lengthy kind of critique rife with screenshots of past ex posts proving that Prasad was anti-Trump and a Bernie Bro and catastrophically unvetted or something like that. I think she used that language. She wrote an exclusive post on her website, Loomered. And the image is this AI-generated Trump voodoo doll side by side with Prasad’s face. And what she had done was unearth one of his podcasts, the Plenary Session, from 2021, where he joked about cursing and stabbing a Trump voodoo doll. And yeah, she was basically like, “Is this the guy? Is this the guy that we want here? Does he align with MAHA? Does he align with his administration?” And the day after that post came out, he resigned.
Paul Goldberg: You are listening to The Cancer Letter Podcast. The Cancer Letter is a weekly independent magazine covering oncology since 1973. I’m your host, Paul Goldberg, editor and publisher of The Cancer Letter.
Jacquelyn Cobb: And I’m your host Jacquelyn Cobb, associate editor of The Cancer Letter. We’ll be bringing you the latest stories, groundbreaking research and critical conversations shaping oncology.
Paul Goldberg: So let’s get going.
Jacquelyn Cobb: Hello everyone. How’s it going?
Claire Marie Porter: Hi.
Paul Goldberg: Great.
Jacquelyn Cobb: So fun to have the three of us on here. It’s packed house. Love it. How has been the last couple of weeks without me on here? I’ve been missing it.
Claire Marie Porter: I think it was as goofy as usual. When Sarah kind of sat in and watched. She was like, “Oh, okay. I get it. You guys are funny. You guys like to laugh. Okay, I can do this.”
Jacquelyn Cobb: Yeah, it’s not quite so serious.
Claire Marie Porter: It’s a comedy show.
Paul Goldberg: We try to be funny.
Jacquelyn Cobb: We try. Yeah. Yeah. I don’t know how often I’m successful, but we do our best. All right. I’ll take us through last week’s headlines. Paul wrote a story as it was breaking about the GOP led rejection of Trump’s NIH cuts. It was basically one of the first pieces of good news for NIH funding since Trump’s inauguration. And to actually say it, we’re going to dive into more later in the podcast, but the Senate bill gives NIH a $400 million raise, which is not what any of us were expecting. So really fun to finally have some good news on that end. Claire wrote a story about Vinay Prasad exiting FDA following Trump’s quote, right hand juggernaut, unquote Laura Loomer labeling him a, again, quote, Trojan horse of the administration’s Make America Healthy Again initiative. Sarah wrote a story about this year’s US News and World Report Cancer Hospital rankings. And Barnett Kramer, former director of NCI’s Division of Cancer Prevention, wrote a story about the apolitical nature of USPSTF.
This week’s cancer policy section featured a UPenn study that supported the continued use of binary voting at the Oncologic Drug Advisory Committee, or at their meetings, adding to an ongoing conversation about the role of voting in advisory committee meetings at FDA. And yeah, so today we’ll be talking about both Claire and Paul’s story, hence they’re both here. And we’ll start with Paul. Your story was an absolute doozy. It started as a cancer policy story, and then as you were reporting, you were like, wait, it needs to be a story. And then on Thursday, I’m going to ask what happened on Thursday, but you were like, no, this actually needs to be the lead. So I had love to hear about how that sort of evolved last week.
Paul Goldberg: Oh, my God. So there is really nothing especially exciting about a Senate report on the spending bill. I mean, really, it’s a total, all right, we got to have it. We’ll do a story. No big deal. And I started working on it on July 31st in the morning trying to put it all together. Boring. No, not boring. Yeah, you do it. You bang it out, you move on. It’s fine. I’ve done maybe, how many of these? Two per year. One for House, one for Senate at least. So well, sometimes we assign, sometimes I don’t get to do them, which is fine too. Actually a little bit better for me. I don’t mean to belittle this stuff. It’s essential to have, but it’s routine.
So I’m sitting there and I’m trying to make sense of it, and we’ve been getting good signals from the hill, but they’re just little signals. Although one of them was kind of big, which was the size of the allocation on the House side, but it’s still a signal. It’s still just one thing, we have no idea. And then suddenly, in the middle of the day of July 31st, I’m starting to realize, my God, this is some of the best Washington work in the generation done by people in the cancer community. Some strategy, some stuff that at some point, it’s a story for another day how it happened. But the fact that it happened, it was unmistakable that these things don’t just happen. Okay? There’s a lot of work that goes into it. But basically what we learned is that instead of cutting NIH, both the House and Senate, well, the Senate is actually giving NIH a raise, and the House has essentially an allocation that does not reflect the president’s priorities of cutting NIH by 40%. God knows why. And these are Republicans.
Plus, there’s a letter from 14 moderate Republicans, I call them moderate because they signed the letter. May disagree, but the letter basically says to OMB, “Hey, turn loose the money you are holding back from NIH for FY25.” So we’re basically, what this probably means is that FY26 appropriations will almost certainly, if I were a betting man, which I’m not, and I certainly wouldn’t be betting on the field I cover. I certainly do not have any inside knowledge here, but I think I’ll still bet that what’s going to happen is we’re going to end up with a CR in October, and the CR is going to flat fund NIH at FY25 level, which is exactly 40% better than a 40% cut that the administration has in mind. So a sigh of relief as far as I’m concerned.
Jacquelyn Cobb: I know.
Paul Goldberg: Because we are impartial. We cover science, but we believe in science. We believe in spending science, money for science. We believe in all of this, or else we should be doing something else.
Jacquelyn Cobb: Yeah, seriously. Yeah. I mean, it’s funny that I haven’t been here that long, but it’s funny to be breathing a sigh of relief for flat funding. Normally that’s not very exciting, but this year it’s different.
Paul Goldberg: Yeah. There’s future. Time for a quick break. Let’s hear from our sponsors. Coming to you from Nashville, it’s Stand Up To Cancer. Join us for one night with one goal: beat cancer. Tune in Friday, August 15 at 8:00 or 7:00 central on ABC, CBS, Fox, and NBC. For more ways to watch, visit standuptocancer.org/show.
Jacquelyn Cobb: I was wondering if you could tell me about the other things that were included in the bill besides the actual funding that the field is sort of, was nervous about, I guess, and protesting in different capacities.
Paul Goldberg: Well, yeah. There’s the 15% flat funding for indirect costs. That’s not there. There was the reorganization of NIH, which was cutting it back, the numbers of institutes. It’s not there. There were huge cuts to CDC. Not there. My God, when all of that, all the stars kind of started aligning and I started to understand what happened. I said, holy mackerel. And you guys were witnessing this because I was kind of coming unglued because I’m realizing that this tiny story is actually not tiny at all.
And it was going to be buried somewhere. Not buried, but it’s actually, it was going to be in a very good place, but still, it’s not the lead. And I’m starting to realize, my God, this is work. I better confirm all of my hunches, and it’s the lead. So it just got pushed up, up, up, up. And I actually, to be really brutally honest, and maybe it’s too much information, I bought this bike. It was my birthday, and I bought this really good bike. And I was going to actually just take lunch break and go pick it up at this bike shop. But I couldn’t do that.
Jacquelyn Cobb: Oh, I didn’t know that, Paul. I’m sorry.
Paul Goldberg: Yeah, it was their birthday proper. And I was, how you say, feeling a little frustrated about having to…
Claire Marie Porter: And this bike has its own narrative arc across the podcast the past couple of weeks. I think we’ve all been waiting to see and hear, maybe get a little video of Paul riding his-
Paul Goldberg: Oh, I can show you the bike.
Claire Marie Porter: Gear grinder or whatever it’s called.
Jacquelyn Cobb: Gravel grinder.
Claire Marie Porter: Gravel grinder.
Paul Goldberg: Gravel grinder.
Claire Marie Porter: It sounds like a type of coffee machine.
Paul Goldberg: Yeah.
Jacquelyn Cobb: Oh, it is?
Claire Marie Porter: No, that’s what it sounds like.
Paul Goldberg: Yeah. It’s- like
Claire Marie Porter: Like a gravel, right?
Jacquelyn Cobb: Yeah, true.
Claire Marie Porter: I’d never heard of it before. I was like, is this a new Chemex product?
Jacquelyn Cobb: Yeah. What is different about, why is it not just a gravel bike to really get off it?
Paul Goldberg: It is a gravel bike. That’s exactly the same thing. It’s not a mountain bike.
Jacquelyn Cobb: I get you. So it’s like a hybrid. Is that the-
Paul Goldberg: Well, you could call it a hybrid. A generation ago you might’ve called it a hybrid. You might have called it a cyclocross bike sometime ago as well. But when you say cyclocross at a certain kind of bike shop, you show your age. It’s not the proper terminology. And you’ve got to be cool at a cool bike shop when you’re buying a bike.
Jacquelyn Cobb: It’s a requirement.
Paul Goldberg: It’s a requirement. So you have to say gravel grinder, and they say, got it.
Jacquelyn Cobb: That’s good to know.
Paul Goldberg: Your new gravel grinder. And so it was really… I’ve taken it out. I’ve been playing with it all weekend. It’s been great.
Jacquelyn Cobb: Oh, that’s awesome. Okay. I’m glad you got that, because I know that the story also threatened to ruin your birthday dinner too, so I’m glad that you were able to have your birthday dinner and also got to play with your gravel grinder.
Paul Goldberg: I mean, I knew it as a huge present because we are a part of this community. To us, you cut a cancer center, it hurts. We are invested in this, so I was really tired and surprised and feeling real pressure from the story.
Jacquelyn Cobb: But ultimately very happy that you were writing it.
Paul Goldberg: Ultimately it was such a relief to get it out and to let the world know, to let our readers know that, my God, you didn’t have to look for other jobs. You don’t have to drive an Uber.
Claire Marie Porter: Why was no one else reporting on this? Do we know?
Paul Goldberg: Because I picked it up. I figured it out. I lined the-
Claire Marie Porter: You broke the news.
Paul Goldberg: … pieces. Yeah. I mean, I aligned the pieces. I mean, I was awake. Okay? I’m not saying anybody else was asleep, but I’m not sure I’ve seen anyone really say what all of this means, because this is just one of the spending bills. We have the readership that cares about the spending bill.
Jacquelyn Cobb: Yeah, definitely.
Paul Goldberg: There’s also a defense part of the bill. There’s a lot to the Senate.
Jacquelyn Cobb: Is there anything else that you want to talk about this story before we shift to Prasad?
Paul Goldberg: No, I think we should shift to Prasad as soon as possible.
Jacquelyn Cobb: You would say that.
Paul Goldberg: I mean, I’m one of the Prasad watchers, so it was really interesting what happened. And that story too was really quite a monster. And Claire did such a lovely job of it, of telling it.
Claire Marie Porter: Thank you.
Jacquelyn Cobb: Well, I, you shifted to that on Tuesday or Wednesday too, right? We were working on a different story earlier in the week. So you got that done fast.
Claire Marie Porter: Something like that. Yeah. I mean, Monday, we were talking about the fact that Laura Loomer had come for him and sunk her talons into him and kind of conjecturing on what that might mean or what the fallout could be. And then, yeah, sure enough.
Paul Goldberg: Yeah, so as soon as he was out, we both saw, oh my God, this is all of us. So this is a big story. And Claire, since joining The Cancer Letter, also became a Prasad watcher.
Claire Marie Porter: It’s my beat.
Jacquelyn Cobb: Oh, did you ever imagine that in journalism school?
Claire Marie Porter: Never imagined that.
Paul Goldberg: To be a Prasad watcher?
Claire Marie Porter: No.
Paul Goldberg: Why?
Claire Marie Porter: It wasn’t on my 2025 Bingo card, as the kids say.
Jacquelyn Cobb: Well, Claire, can you walk us through sort of what actually happened, just so people who haven’t read the story?
Paul Goldberg: Let’s even start with who Prasad is.
Jacquelyn Cobb: Yeah, seriously.
Claire Marie Porter: Sure. I mean, I, quote unquote, got to know Prasad since joining The Cancer Letter, but I think you’ve talked to him. He’s been featured before. I came in when he joined FDA as CBER director, reported on that. It was kind of, well, it was a surprise in some ways, and I guess not so much of a surprise in other ways. A lot of these folks all have one thing in common, and it’s this COVID era solidarity. And Vinay was a big part of that in 2021, big pandemic critic. And his opinions are all out there. They’re all over the internet, definitely like a public contrarian, cyber iconoclast personality.
And so the way we were framing this story is that it feels a bit karmic, almost like a cautionary tale. Less than three months into his job as CBER director, and also his promotion as Chief Scientific and Medical Officer, a new job. He had three jobs, three big jobs, now he has none. He is opinionated and frankly, pretty insensitive online, and that kind of guarantees enemies. So we kind of saw his own ideology almost come back around to do him dirty. And there’s kind of a trifecta of things that happened, and I can launch into what actually happened. It was a really busy week, a really bad week for Prasad. And all of this kind of transpired within over the course of a few days. But if you wanted to talk more about who he was coming into CBER, feel free Paul.
Paul Goldberg: I first met him when he was a fellow at NIH, at NCI. And then his name started showing up more and more in very interesting contexts because he’s almost like a journalist in a sense, except he’s opining more than most journalists. And for a while, a lot of people liked working with him, people I respect, because it’s really nice to have access to a naysayer, because it makes everybody better to have a naysayer on among your advisors, friends or what have you. I mean, he and I spoke, but we were never really friends, but we could very well have been. He’s a friend of many of my friends. And actually, Barry Kramer was one of the people who trained him briefly. Barry Kramer, who wrote that piece of U.S. Preventive Services Task Force. In a way, Barry raised a whole sort of cadre of naysayers and skeptics, and really myself included in that number, even though I’ve never been formally trained by him, but my friend Otis was. And Vinay as well.
So a lot of people really liked him. But then something was happening, and I’m not sure it was wrong, really. He did not want to take a… I mean, he took very aggressive stances all the time, maybe too much so. To some extent it was almost like, but is it wrong for somebody who is opinionated and is doing what is now online journalism to be doing that? I don’t know. I’ve disagreed with him in a number of occasions and quite publicly. And if you look at The Cancer Letter, we’ve done a lot on this. So there’s all of this stuff that he writes, but if you reach into this body of work that is Prasad’s body of work, you’ll find everything in it, every direction. So in a way, it was Laura Loomer didn’t have a whole lot of difficulty finding whatever she wanted, including famously, the voodoo doll. What’d you think of that, Claire? The voodoo doll?
Claire Marie Porter: Yeah. Well, so she had already written this really lengthy, kind of critique rife with screenshots of past ex posts proving that Prasad was anti-Trump and a Bernie Bro and catastrophically unvetted or something like that. I think she used that language. She wrote an exclusive post on her website, Loomered, and the image is this AI-generated Trump voodoo doll side by side with Prasad’s face. And what she had done was unearth one of his podcasts, the Plenary Session, from 2021, where he joked about cursing and stabbing a Trump voodoo doll. And she, yeah, she was basically like, “Is this the guy? Is this the guy that we want here? Does he align with MAHA? Is he aligned with his administration?” And the day after that post came out, he resigned.
Paul Goldberg: Well, yeah. And if you think about it, you were the one who actually pointed this out, if you really listened to what he says, and you link to that, he says, “I’m mad. I’m really mad. I’m really mad that COVID is happening. This is really terrible. What do I do? Do I build a Trump voodoo doll?” And then they just keep on going.
Claire Marie Porter: Yeah, yeah.
Paul Goldberg: [inaudible 00:20:47].
Claire Marie Porter: It was clearly a joke. Yeah, I mean, taking it out of context to me, it’s a little petty, but that’s kind of her.
Paul Goldberg: No, but I don’t know if either one of us would be caught talking about voodoo dolls of any sort. Right?
Claire Marie Porter: Yeah. Well, that’s the thing about Prasad that makes him special, I think, is that he has been consistent to the end. He is never shied from expressing his public opinions. As far as we know, he didn’t do any social media cleanup before joining FDA. It’s all there.
Paul Goldberg: Because of that narrow consensus that you mentioned.
Claire Marie Porter: Yeah.
Paul Goldberg: I don’t think anybody really objected to what he was doing at FDA. Some people did, I’m sure. He was [inaudible 00:21:35].
Claire Marie Porter: Yeah. I mean, his main accomplishment was limiting COVID vaccine availability. So I think that angered some Dems. But the big thing, other than Laura Loomer, which is big enough itself, she’s kind of the final boss, I think for a lot of people, was this rep to therapeutics kind of debate that he was embroiled in pretty publicly. That started long before he’d joined FDA. You know, Republican Senator Rick Santorum was coming for him online and allegedly wielding some political influence to again, call him a Bernie Bro and unfit for the job.
Paul Goldberg: Well, he also accused him of being a Chinese communist.
Claire Marie Porter: He did, yeah.
Paul Goldberg: There’s a little bit of that going on as well.
Claire Marie Porter: Yeah. Prasad’s been called a lot of names. And then again, he’s called a lot of people, a lot of names too.
Paul Goldberg: So yeah, it’s interesting, because I was trying to feel some compassion, and I guess I kind of do for him.
Claire Marie Porter: Yeah.
Paul Goldberg: But then again, that whole body of work that he has left behind means that he’s unlikely to be ever named to any political office by either party. So what was also interesting is Marty Makary really liked him, and you can see why. Because as I said before, here’s a guy who is a naysayer who is going to clean up your thinking. It’s like a filter, and it’s really cool. The other thing that’s happening is that the new appointee to CBER director, Dr. Tidmarsh.
Claire Marie Porter: Acting. Yeah,
Paul Goldberg: Acting. It becomes acting at CDER, which means, to my mind, and nobody else’s probably. Well, that’s not true. I’m sure a lot of people, well, I know a lot of people are thinking about it, but I’ll just say it because that way I can actually sort of take responsibility for saying this. It’s an opportunity for FDA to do something that really needed to be done a long time ago, which has reorganized based on diseases or disease groups as opposed to what they are right now. Because really nobody in the right mind right now, had the world not been created the way it was, would’ve broken up FDA into CDER and CBER.
Jacquelyn Cobb: Yeah.
Paul Goldberg:
Right? Because people get diseases, to quote Rick Pazdur. People do not get biologics or small molecules. In essence, it’s an opportunity to make it better and to make Oncology Center of Excellence actually happen as a physical entity as opposed to a virtual entity it currently is. And then others as well. It would be a huge opportunity.
Marty Makary has this podcast, and we’ve seen the name Prasad appear on his podcast. And it’s very clear that the two of them really enjoy kind of bouncing off each other, bouncing ideas off each other, because Vinay is an interesting guy to bounce ideas off. He’s just a great screen, and this is going to be a huge loss for Makary in a way. You could see it. And it’s also unclear whether it weakens him in the administration, because he stood up for Vinay all through this episode, even after the first Loomering. And even after the second Loomering, he said, “Yeah, well, he can’t be here, but he’s still really a smart guy. One of the…” What was the term he used, Claire?
Claire Marie Porter: Oh, one of the greatest minds of our generation, I think. A genius.
Paul Goldberg: Yeah.
Claire Marie Porter: Yeah, yeah.
Jacquelyn Cobb: Scientific mind. Yep.
Claire Marie Porter: Greatest scientific-
Jacquelyn Cobb: Impeccable scientist. I think one of the greatest scientific minds of our generation.
Claire Marie Porter: Yeah.
Paul Goldberg: So I don’t know if I agree with that, but nobody really cares whether I agree or disagree with that, nor anyone should. But I mean, he’ll be missed by Makary. And my question is whether Makary has been weakened politically because of this, and my guess is yes.
Jacquelyn Cobb: Yeah.
Claire Marie Porter: Well, he’ll be missed by me too. I mean, who am I going to write about now? The Prasad’s gone. My only beat at The Cancer Letter. Just kidding.
Paul Goldberg: No, no. He’ll be back. We’ll be seeing him as a public intellectual. He will not be lost.
Claire Marie Porter: Okay. That’s true, that’s true.
Paul Goldberg: So you’re still needed.
Jacquelyn Cobb: You still have a job.
Paul Goldberg: Still have a job.
Jacquelyn Cobb: All right. Thank you everyone. I think we’re all covered. Did we miss anything, Claire, on Vinay?
Claire Marie Porter: I don’t think so.
Jacquelyn Cobb: All right.
Paul Goldberg: Well, thank you very much.
Jacquelyn Cobb: Well, thank you both. I’ll see you next week.
Claire Marie Porter: Thank you.
Paul Goldberg: Thank you.
Claire Marie Porter: Bye.
Jacquelyn Cobb: Thank you for joining us on The Cancer Letter Podcast, where we explore the stories shaping the future of oncology. For more in-depth reporting and analysis, visit us at cancerletter.com. With over 200 site license subscriptions, you may already have access through your workplace. If you found this episode valuable, don’t forget to subscribe, rate and share. Together, we’ll keep the conversation going.
Paul Goldberg: Until next time, stay informed, stay engaged, and thank you for listening.
