China's Clinical Trial Boom(asimov.press)
asimov.press
China's Clinical Trial Boom
https://www.asimov.press/p/china-trials
121 comments
The administration is also pressing for a 55% budget cut to the National Science Foundation. The NSF is the primary funding agency for engineering, physics, mathematics, chemistry and computer science, among many other fields. If there's any doubt about the seriousness of that situation, the director has resigned over it. When some worried that US world leadership in physical and life sciences may be surpassed in a generation, I doubt anyone realized it could happen in one year.
https://www.science.org/content/article/nsf-director-resign-...
https://www.science.org/content/article/nsf-director-resign-...
>I doubt anyone realized it could happen in one year
I mean China has been modernizing their academics for a long time. See "Double First-Class Construction" [0]. But it's worth remembering that they did a lot of damage during the Cultural Revolution.
0. https://en.wikipedia.org/wiki/Double_First-Class_Constructio...
I mean China has been modernizing their academics for a long time. See "Double First-Class Construction" [0]. But it's worth remembering that they did a lot of damage during the Cultural Revolution.
0. https://en.wikipedia.org/wiki/Double_First-Class_Constructio...
The Cultural Revolution was pretty bad but it did put an end to religion and superstitious customs. Visit India and you will understand what Mao's goals were.
(European countries killed off 1000 years of Christianity in a single generation at the same time Mao did his giant leap experiment).
(European countries killed off 1000 years of Christianity in a single generation at the same time Mao did his giant leap experiment).
> The Cultural Revolution was pretty bad but it did put an end to religion and superstitious customs
This is actually a pretty interesting point. Most of the semi-religious customs that were killed off still live on in Malaysia - to the point where I was surprised at how un-chinese China was when I visited.
This is actually a pretty interesting point. Most of the semi-religious customs that were killed off still live on in Malaysia - to the point where I was surprised at how un-chinese China was when I visited.
> (European countries killed off 1000 years of Christianity in a single generation at the same time Mao did his giant leap experiment).
Are you talking about the two world wars or something that occurred in the 1960's & 70's?
Are you talking about the two world wars or something that occurred in the 1960's & 70's?
China has a highly unique language for foreigners to acclimate to. While I salute the effort for and commitment to higher education, I’m not sure this will bring the boon they’re hoping for.
I would have suggested that they create a high-quality course for introducing westerners to their language instead. It’s the sort of thing that everyone takes for granted that it exists but often doesn’t (where is the Wheelock’s for Spanish these days?) Tonality, pictography, and a highly analytic morphology are all high barriers for any language learners, let alone all three at once.
I would have suggested that they create a high-quality course for introducing westerners to their language instead. It’s the sort of thing that everyone takes for granted that it exists but often doesn’t (where is the Wheelock’s for Spanish these days?) Tonality, pictography, and a highly analytic morphology are all high barriers for any language learners, let alone all three at once.
There is a ton of easily available content for learning Chinese.
In terms of government-sponsored resources, the Chinese government has created the Hanyu Shuiping Kaoshi (HSK) tests, and has written standard textbooks for them that are pretty decent. All sorts of third parties have written their own textbooks oriented towards the HSK tests as well.
> highly analytic morphology are all high barriers for any language learners
Analytic morphology is what makes spoken Chinese so easy to learn, in my opinion. There's almost none of the complexity found in Indo-European languages, like number, case, gender and tense. The main barriers to learning Chinese for Westerners are:
* It's not Indo-European, so the vocabulary is almost entirely new.
* Tonality, though this is about the same level of difficulty as memorizing noun genders in Indo-European languages.
* The writing system. Memorizing a few thousand relatively arbitrary characters is difficult.
In terms of government-sponsored resources, the Chinese government has created the Hanyu Shuiping Kaoshi (HSK) tests, and has written standard textbooks for them that are pretty decent. All sorts of third parties have written their own textbooks oriented towards the HSK tests as well.
> highly analytic morphology are all high barriers for any language learners
Analytic morphology is what makes spoken Chinese so easy to learn, in my opinion. There's almost none of the complexity found in Indo-European languages, like number, case, gender and tense. The main barriers to learning Chinese for Westerners are:
* It's not Indo-European, so the vocabulary is almost entirely new.
* Tonality, though this is about the same level of difficulty as memorizing noun genders in Indo-European languages.
* The writing system. Memorizing a few thousand relatively arbitrary characters is difficult.
Switching Chinese universities to English would be a lot more efficient, no?
AI has made real time translation very feasible, I don’t think Chinese will be much if a language barrier for foreign students and researchers in the near future. You can do it all in a local model with a moderately powerful mobile GPU. We are almost at the point where you put some ear buds in your ear and some glasses could handle reading…etc…
Indeed, now is the moment to step on the gas in biotech. The past 15 years have been nothing short of extraordinary in the field. We finally have the tools needed to effectively measure biology, manipulate biology, and increasingly predict biology. More recently, we have been able to turn more and more problems into computational problems.
With all of this coming together, we should be accelerating both public and private investment in biotechnology because we're getting closer and closer to transformative therapies. But...we're failing to rise to the occasion and meet the moment.
With all of this coming together, we should be accelerating both public and private investment in biotechnology because we're getting closer and closer to transformative therapies. But...we're failing to rise to the occasion and meet the moment.
Could you give some examples/directions for interesting things that have popped up in the period you're mentioning? Sounds like a fun time.
The entire class of "biologics" drugs only came about in the past 15 years thanks to advances in sequencing and biotech. They are the mainstays of treatment for dozens of serious dermatologic, rheumatologic, and GI diseases, not to mention they directly cured multiple cancers.
Not op, but I’m in the field and can give you some things to read about:
- CAR-T
- CRISPR
- PRIME editing
- Base editing
- Modified mRNA
- PD-1 inhibitors
- On the cusp of personalized cancer vaccines
- ADCs
- Structure correctors
- Targeted protein degraders
- siRNAs
These have all really hit their stride in the past 15 years. Guess where all of them initially came from? Random ass government-funded academic research. Sure, you can split hairs with me on the 15 years and NIH/NSF etc funding, but it’s basically true. We are killing the golden goose…
- CAR-T
- CRISPR
- PRIME editing
- Base editing
- Modified mRNA
- PD-1 inhibitors
- On the cusp of personalized cancer vaccines
- ADCs
- Structure correctors
- Targeted protein degraders
- siRNAs
These have all really hit their stride in the past 15 years. Guess where all of them initially came from? Random ass government-funded academic research. Sure, you can split hairs with me on the 15 years and NIH/NSF etc funding, but it’s basically true. We are killing the golden goose…
Delivery vectors for nucleic acid have really progressed too. Peptide design and screening (also high throughput tools in general) have developed and led to great advances in peptide conjugates, such as peptide radioligands.
Are any of these technologies profitable currently?
Unsure if you’re genuine or trying to be edgy, but I’ll bite—-yes, most of them make significant profits currently.
Sorry, I am not involved with biotech. Genuinely curious.
Edit. My impression of bio tech is that upfront costs are high and timeline for commercialization is long, and the only real biotech firm that I am aware of is Theranos. So I am probably coming from a place of ignorance.
Edit. My impression of bio tech is that upfront costs are high and timeline for commercialization is long, and the only real biotech firm that I am aware of is Theranos. So I am probably coming from a place of ignorance.
Ah yea, biotech has been around for a while now and almost all best selling drugs are biotech drugs now a days.
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Tools wise cheap sequencing is a big one.
biotech, outside of curing most illnesses (except trisomy of 21 or others) is a very touchy field that most politicians would steer clear
Fascinating, then, how the head of DOGE has deep financial interests in China. It’s really not out of bounds to suggest that his benefactors could’ve pulled some strings to kneecap the US.
Never attribute to malice what is equally explained by incompetence, and these morons have been openly saying this is what they want to do for years.
We’re so unbelievably fucked.
We’re so unbelievably fucked.
But it's not equally explained by incompetence. One does not accidentally orchestrate such a clean handoff to their competitor.
No. No. That no longer applies, and I would argue never applies to a publicly funded entity like the federal government. When you're spending public dollars there is zero difference between incompetence and malice.
This administration has shown that it absolutely isn't incompetent. It's getting stuff done. Which means it's malice. Guaranteed. We're watching a self made disaster where few will profit, but will profit ENORMOUSLY.
This administration has shown that it absolutely isn't incompetent. It's getting stuff done. Which means it's malice. Guaranteed. We're watching a self made disaster where few will profit, but will profit ENORMOUSLY.
The public officials have a vested interest in appearing incompetent, for legal reasons. Examine the incentives to understand the behavior.
Without commenting on the cuts themselves, this article suggests its regulatory reform that is needed to keep up.
eastbound(2)
China's population is almost twice that of the US and EU combined. If what you're lacking for is patients, there's no better place to go to.
Not only that, but we're also a lot more obsessed with patient privacy. If somebody dies of cancer, there's no headline news about them dying of a cancelled trial, even if that's actually what happened. If patient data leaks, there's both a PR nightmare and legal consequences for the institution. That drives priorities.
I wouldn't be surprised if (some) Chinese researches are allowed to SELECT * from citizens where disease = 'bone_cancer', whereas researchers in the US have to send people to waiting rooms in hopes of catching an eligible patient[1]. Unless this gets changed, things won't get better.
We really need to start optimizing for min(deaths) instead of min(bad_pr) or min(outrage). That's a genuinely hard problem in a democratic society that respects the right to free speech (which, to be clear, is a very good society to live in IMO). In a way, it's a good problem to have.
[1] is a really good and accessible overview of why drug trials are so hard and what could be done to make them easier, it's worth checking out for anybody who wants to dive deeper into the subject.
[1] https://www.complexsystemspodcast.com/episodes/drug-developm...
Not only that, but we're also a lot more obsessed with patient privacy. If somebody dies of cancer, there's no headline news about them dying of a cancelled trial, even if that's actually what happened. If patient data leaks, there's both a PR nightmare and legal consequences for the institution. That drives priorities.
I wouldn't be surprised if (some) Chinese researches are allowed to SELECT * from citizens where disease = 'bone_cancer', whereas researchers in the US have to send people to waiting rooms in hopes of catching an eligible patient[1]. Unless this gets changed, things won't get better.
We really need to start optimizing for min(deaths) instead of min(bad_pr) or min(outrage). That's a genuinely hard problem in a democratic society that respects the right to free speech (which, to be clear, is a very good society to live in IMO). In a way, it's a good problem to have.
[1] is a really good and accessible overview of why drug trials are so hard and what could be done to make them easier, it's worth checking out for anybody who wants to dive deeper into the subject.
[1] https://www.complexsystemspodcast.com/episodes/drug-developm...
One of the leading researchers in MRI methods development has been doing collaborative work in China for many years. About 5 years ago I was chatting with him about how he's in China so much lately and he told me that the great thing about China is he can get an idea rolled out en masse to over 100 scanners(!!) and have multiple hundreds of case results in various different diseases in less than a month(!!!). This is shocking speed and quantity of data as these things go. Who wouldn't prefer to work in that environment?
I strongly disagree. There is no need for humans to be immortal, and there is nothing wrong with tacking healthcare research to public opinion at a bare minimum. If nothing else, it helps ensure our medical care doesn’t veer too far off track.
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please consider revisiting this post when/if you or a loved one are on the receiving end of a terminal illness diagnosis. which i don’t wish on anyone.
as someone who lives in that perspective, and has lots many loved ones to such diseases.. I wonder if you have ever really considered the prospect of immortality and the implications.
A lot of our worldly meaning is derived from the fact that the clock is ticking. Death of progenitors increases the quality of life for the offspring in almost every single metric, more so for long-lived species that require little protection past a certain growth milestone, and personally I see it as a specific 'human arrogance'; if someone had the idea of "Let's make all the field mice immortal" the first opinion would be "that's ridiculous, the ecosphere would be thrown entirely out of balance, the entire predatory chain would be upheaved."... but when we talk about human immortality it always falls back to "Well, don't you miss dear old Grandma serf?"
I miss her dearly, but the fact of the matter is that the world wouldn't survive long without a death/life cycle for its' inhabitants, and I think that should include the ones that are the most dangerous to the world at large.
p.s. if you need a laymen excuse : i've read enough scifi dystopia tales that begin with the concept of human immortality and the gradual fall of every single moral barrier or raison d'etre ; I don't think that premise is too far from what may happen if humanity is ever given a choice against death.
A lot of our worldly meaning is derived from the fact that the clock is ticking. Death of progenitors increases the quality of life for the offspring in almost every single metric, more so for long-lived species that require little protection past a certain growth milestone, and personally I see it as a specific 'human arrogance'; if someone had the idea of "Let's make all the field mice immortal" the first opinion would be "that's ridiculous, the ecosphere would be thrown entirely out of balance, the entire predatory chain would be upheaved."... but when we talk about human immortality it always falls back to "Well, don't you miss dear old Grandma serf?"
I miss her dearly, but the fact of the matter is that the world wouldn't survive long without a death/life cycle for its' inhabitants, and I think that should include the ones that are the most dangerous to the world at large.
p.s. if you need a laymen excuse : i've read enough scifi dystopia tales that begin with the concept of human immortality and the gradual fall of every single moral barrier or raison d'etre ; I don't think that premise is too far from what may happen if humanity is ever given a choice against death.
i am sorry to hear about the losses you’ve had to endure. i feel it’s an over-large step to go from which factors should guide research to whether humanity should seek immortality. if a child is stricken with glioblastoma before they’ve had a chance to experience life, i would argue that it would be positive and humane for society to have developed the tools to give that young life a chance and their family some hope.
My mother died when I was on the verge of turning my life around. There are new developments in treating the cancer - glioblastima - than there were at the time. She was worried sick about me and knew I was on the right path, but never actually saw me succeed. I think about it a lot.
I still fully believe we need to start discussing how long we want to live. Along-side maybe getting to show my mom my fortunate outcome, Putin could be up for another 25 elections.
We shouldn’t arrive at that moment without an answer to that question.
Besides, death comes for us all. It’s the most natural thing of all. We should be less scared of it, and instead use it to understand we have a limited time we must make the most of.
I still fully believe we need to start discussing how long we want to live. Along-side maybe getting to show my mom my fortunate outcome, Putin could be up for another 25 elections.
We shouldn’t arrive at that moment without an answer to that question.
Besides, death comes for us all. It’s the most natural thing of all. We should be less scared of it, and instead use it to understand we have a limited time we must make the most of.
thank you for sharing this story and i hope the miracles in glioblastoma treatment continue to astound. i do agree that it’s fundamental to live life knowing there are no guarantees and that we must therefore make the best of every allotted bit of time. there is a famous saying about science progressing one funeral at a time because new perspectives sometimes require that the old guard step aside before they can take hold.
This might just be the dumbest thing I heard all day.
I have a family member who got cancer in their 50's and they've now lived 25 years longer than how long they would have lived without healthcare research. They would have been dead if it was 10 years earlier and the research wasn't where it was.
They literally gained a third of a lifespan just because someone decided to spend money on research. They would have never seen their kid get married or have their own kids.
Now multiply that by hundreds of thousands if not millions who have the same diagnosis.
Nobody's trying to be immortal, we're just trying to live the fullest lives possible and give ourselves a good amount of healthy years.
If you think healthcare is a waste of money I am not sure what you think is more important than your health, maybe an AI app to create shareholder value?
I have a family member who got cancer in their 50's and they've now lived 25 years longer than how long they would have lived without healthcare research. They would have been dead if it was 10 years earlier and the research wasn't where it was.
They literally gained a third of a lifespan just because someone decided to spend money on research. They would have never seen their kid get married or have their own kids.
Now multiply that by hundreds of thousands if not millions who have the same diagnosis.
Nobody's trying to be immortal, we're just trying to live the fullest lives possible and give ourselves a good amount of healthy years.
If you think healthcare is a waste of money I am not sure what you think is more important than your health, maybe an AI app to create shareholder value?
So much of policy success comes down to doing obvious and reasonable things, and most of the problem is how to incentivize making those choices. For all China's flaws, they've figured this out.
The best news here is that we might finally have a prosaic means to escape our modern-era applied biotech stagnation, the same way solar has appeared as a means to kick the feet out of traditional energy sources. China is pretty new to being an R&D powerhouse, but there are few more worthy causes.
The best news here is that we might finally have a prosaic means to escape our modern-era applied biotech stagnation, the same way solar has appeared as a means to kick the feet out of traditional energy sources. China is pretty new to being an R&D powerhouse, but there are few more worthy causes.
The best outcome for the current China/U.S conflict is lots of peaceful competition that forces each society to innovate.
Well during the Cold War with U.S./USSR conflict there was a lot of competition that heralded many new technologies, especially the dual use technologies that are good for both civilian and military uses. I can imagine something happening again if the U.S. had good leadership.
The problem is that the U.S. has bad media focused on being "right" over actual truth. (See Fox News and the many far-right "alt news" organizationns.) This lack of care for the truth is the foundation the U.S. political system rests on top of. Without fixing that foundation, U.S. leadership will continue to either be terrible, or terribly constrained. Add in unlimited political funding from anonymous people/organizations, and the situation is only more impossible to fix. Good U.S. leadership is a pipedream, unfortunately.
One of the parties involved already decided they don't event wanna try to compete.
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China’s success is not because of the policies but rather despite of them. Though not sure how sustainable these successes would be.
How on earth can you possibly claim that when China was a peasant society that was dicked over for a hundred years by western powers addicting them to opium? Obviously their careful planning and industrialization strategy is working.
>China was a peasant society that was dicked over for a hundred years by western powers addicting them to opium?
I think one should really try to study the actual dynamics of the Qing Dynasty instead of relying on frankly infantilizing stereotypes.
I think one should really try to study the actual dynamics of the Qing Dynasty instead of relying on frankly infantilizing stereotypes.
I imagine you'd point out that the Qing collaborated to some extent with the imperialists, and that's why the collaborationist monarchy needed to be overthrown, something the nationalists and the communists agreed on.
In America, the (false but popular) narrative is that the reason for the revolution was the British tried to tax us on tea, and that was enough to overthrow their regime lol There were plenty of loyalists in America too.
In America, the (false but popular) narrative is that the reason for the revolution was the British tried to tax us on tea, and that was enough to overthrow their regime lol There were plenty of loyalists in America too.
That's one factor, but really, the Qing themselves being considered foreign minority (Manchu) that enacted a highly authoritarian and regimented society that forced cultural customs to the majority, then didn't have the strength or success to justify such oppresive policies probably had more to do with it. And then you've got famine, increasing banditry, corruption and then you're ripe for the loosing the mandate of heaven. Most of this has to do with failures of domestic policy than foreign intervention.
In any case with Opium, Qing estimates themselves only measured around 1% of the population to engaged with the drug, and domestic production actually became more competive than imports at around the 1900s. Nor was the average peasant actually able to realistically afford opium at the time. A large moral panic yes, but USA probably consumes more drugs as a percentage of the population today.
Even with regards to trade, the problem is that Qing had basically no idea or control over any of their finances. Many historians today believe that opium was not really the most signficant factor in heavy trade deficit, but a wider issue of domestic artisans being unable to compete against cheap mass manufactured foreign goods, but we don't know because the Qing didn't even know themselves.
That is to say, it's more accurate to say that Chinese peasants were being dicked over by the Qing (and the Ming beforehand), and foreign imperialism was the symptom, rather than cause of their structural problems. They were authoritarian, corrupt, could not modernize, didn't have control of their finances, all of these factors would have led to their collapse regardless of foreign actions, only that foreign actions revealed the extent of the rot.
In any case with Opium, Qing estimates themselves only measured around 1% of the population to engaged with the drug, and domestic production actually became more competive than imports at around the 1900s. Nor was the average peasant actually able to realistically afford opium at the time. A large moral panic yes, but USA probably consumes more drugs as a percentage of the population today.
Even with regards to trade, the problem is that Qing had basically no idea or control over any of their finances. Many historians today believe that opium was not really the most signficant factor in heavy trade deficit, but a wider issue of domestic artisans being unable to compete against cheap mass manufactured foreign goods, but we don't know because the Qing didn't even know themselves.
That is to say, it's more accurate to say that Chinese peasants were being dicked over by the Qing (and the Ming beforehand), and foreign imperialism was the symptom, rather than cause of their structural problems. They were authoritarian, corrupt, could not modernize, didn't have control of their finances, all of these factors would have led to their collapse regardless of foreign actions, only that foreign actions revealed the extent of the rot.
There is no careful planning. Just take a look at the waste, the debts and the rapid policy changes. It is more like industrial Darwinism at scale. The main fuel was mainly WTO , export and slavery labor. The industrialization in my opinion is a by product of that process.
The current Chinese government has demonstrated a better capacity for long term planning than any European or North American country.
It's not like it's a secret, either. Their plans are public. You can read them, every five years, as they're released.
It's not like it's a secret, either. Their plans are public. You can read them, every five years, as they're released.
This is a highly propagandized view of China. Their industrial strategy was to get western capitalists to support industrializing the country by offering cheaper labor, but without surrendering control of the country to them, but now wages have risen quite substantially and their country is industrialized.
The western capitalists are now pissed that china didn't "liberalize" and let them take control of the country and are attempting to retaliate. This is why you have imbibed this propaganda that they created.
The western capitalists are now pissed that china didn't "liberalize" and let them take control of the country and are attempting to retaliate. This is why you have imbibed this propaganda that they created.
>The western capitalists are now pissed that china didn't "liberalize" and let them take control of the country and are attempting to retaliate. This is why you have imbibed this propaganda that they created.
And this is surely a well balanced opinion and not one shaped by highly ideological forces...
There is nothing particularly wrong with what OP is saying, with the deflationary price wars happening it's very clear they rely on open exports markets to stave off unemployment against their insufficient domestic demand. That itself is only a possibility in a world of free trade fostered in USA, not in a world of mercantalism pre 1945. The ironic thing is that they themselves are trying to suppress the development of India next up in the value-chain.
Anyways, Chinese economists themselves agree for the urgent need to shift to consumption today rather than double down on manufacturing, something that should have done decades ago like Western economists have been urging.
And this is surely a well balanced opinion and not one shaped by highly ideological forces...
There is nothing particularly wrong with what OP is saying, with the deflationary price wars happening it's very clear they rely on open exports markets to stave off unemployment against their insufficient domestic demand. That itself is only a possibility in a world of free trade fostered in USA, not in a world of mercantalism pre 1945. The ironic thing is that they themselves are trying to suppress the development of India next up in the value-chain.
Anyways, Chinese economists themselves agree for the urgent need to shift to consumption today rather than double down on manufacturing, something that should have done decades ago like Western economists have been urging.
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- China had cheaper labor. They also have/had slave labor. Cheaper labor != slave labor. And China’s slave labor is a tiny proportion of their total labor and probably not comparable to American slave labor (ie prisoners).
But today, China’s is one of the more expensive labor forces in Asia and yet it continues to dominate manufacturing because of the incredible supply chain they’ve setup and the skill and expertise they have.
- “The debts” - That’s a bit rich considering the U.S. is the largest debtor nation in the history of the world. And debts are not inherently bad, so I’m not sure what your point is. In fact, it’s essential for a growing entity.
- “The Wastes” - Any marginally ambitious effort will have failures. One needs to look at the aggregate, and China, which has pulled a record number of people out of poverty in record time is by all measures had one of the most successful outcomes.
- “The fuel was WTO” - I’m not sure what the complaint is here. Free trade under the WTO has made nearly every nation in the world immensely more wealthy than they would have been otherwise. And yes, this includes China. But it also includes the U.S. which is the richest society in the history of this planet, and until a few months ago was increasing its lead over China. It’s likely the attacks on the WTO and free trade in general by the current U.S. administration will isolate it from world trade and help China close the gap in GDP instead.
- “export” - Yes, an export economy made China richer. On the flip side, it also made Americans immensely richer. Now, the fact that Americans chose to spend that wealth by concentrating it among the richest members of its nation is not a choice China is responsible for.
- “rapid policy changes” - Thisnis not a bad thing as long as the policy changes are thoughtful changes in response to actual changes in our knowledge, unlike whatever the F the U.S. is doing right now.
But today, China’s is one of the more expensive labor forces in Asia and yet it continues to dominate manufacturing because of the incredible supply chain they’ve setup and the skill and expertise they have.
- “The debts” - That’s a bit rich considering the U.S. is the largest debtor nation in the history of the world. And debts are not inherently bad, so I’m not sure what your point is. In fact, it’s essential for a growing entity.
- “The Wastes” - Any marginally ambitious effort will have failures. One needs to look at the aggregate, and China, which has pulled a record number of people out of poverty in record time is by all measures had one of the most successful outcomes.
- “The fuel was WTO” - I’m not sure what the complaint is here. Free trade under the WTO has made nearly every nation in the world immensely more wealthy than they would have been otherwise. And yes, this includes China. But it also includes the U.S. which is the richest society in the history of this planet, and until a few months ago was increasing its lead over China. It’s likely the attacks on the WTO and free trade in general by the current U.S. administration will isolate it from world trade and help China close the gap in GDP instead.
- “export” - Yes, an export economy made China richer. On the flip side, it also made Americans immensely richer. Now, the fact that Americans chose to spend that wealth by concentrating it among the richest members of its nation is not a choice China is responsible for.
- “rapid policy changes” - Thisnis not a bad thing as long as the policy changes are thoughtful changes in response to actual changes in our knowledge, unlike whatever the F the U.S. is doing right now.
Just a walk in a random big city in China reveals how fast they are progressing. The speed of things changing is ridiculous. In almost every field they are getting better. And fast. Thats what you can achieve when your country has 40 years of mass production experience. The thing I hope most for is that China gets its own high performing chips so that companies like Nvidia really get a competitor.
Interestingly the allure to visit China and see the progress is becoming more compelling. Meanwhile people are afraid to visit the USA.
If you check my post history, I kept encouraging HN posters to go to China to see for themselves. The vast majority of commenters here have never been to a China or have never been recently. It’ll change how they see China instantly.
The problem with many HN commentators on China is that they view China through a western news propaganda filter. Therefore, they think China must be stealing or cheating to get ahead. If they go see for themselves, the moment they step off the plane, they’ll see that major Chinese cities are 5-10 years ahead of any US city. In other words, China is leading in many areas, not stealing or cheating. They have no reason to steal when they’re leading already.
The problem with many HN commentators on China is that they view China through a western news propaganda filter. Therefore, they think China must be stealing or cheating to get ahead. If they go see for themselves, the moment they step off the plane, they’ll see that major Chinese cities are 5-10 years ahead of any US city. In other words, China is leading in many areas, not stealing or cheating. They have no reason to steal when they’re leading already.
This video by a guy who used to live in China and returned to Shenzhen really surprised me . It's incredible to see how some Chinese cities are today. So many electric cars, incredible metros, drone delivery and more.
https://www.youtube.com/watch?v=VItBlmlWE4U (20 min )
I have no connection with this person at all. Just to make that clear.
https://www.youtube.com/watch?v=VItBlmlWE4U (20 min )
I have no connection with this person at all. Just to make that clear.
I was in Shenzhen in 2018. I returned in 2023. I was absolutely shocked at the difference.
It truly felt like China was 5-10 years ahead of any US city.
It truly felt like China was 5-10 years ahead of any US city.
I was just in Beijing, and the electric cars are real, like teslas but with fewer features to keep costs down (which is fine honestly). The traffic was still bad, maybe even worse, and the metro network, greatly expanded since I left in 2016, was super crowded even off peak (they could build 2X the lines and still not go past demand!). Alipay worked mostly and I didn’t need to use cash once (like before, when I had to pay 20k 3 months rent with a lot of 100 RMB bills!), the convenience stores all had self checkout, all the grocery stores to, the McDonald’s has take out lockers… I didn’t see any drones or self driving cars there, but I’ve used latter at least in SF that it wouldn’t turn my head.
I’m still not exactly in love with it, I was happy to get back to Seattle (too crowded and the pace of life was a bit hectic, I’m getting old), but the change was definitely there, especially compared to my first trip to Beijing in 1999.
I’m still not exactly in love with it, I was happy to get back to Seattle (too crowded and the pace of life was a bit hectic, I’m getting old), but the change was definitely there, especially compared to my first trip to Beijing in 1999.
You don’t really see much if China through the western media, so I don’t really get that western propaganda at all. CNN just doesn’t talk about China enough to provide any picture of it (sort of like those “I don’t think of you at all meme”). I lived in Beijing for 9 years (2007-2016) and did 6 months languages study in 2002, my first visit being in 1999. There were of course scam artists back then and I’ve gotten scammed a few times (eg an original iPhone repair that I didn’t watch close enough). I don’t think those people exist much anymore in 2025, compared to 2008.
The face thing is still annoying to me and the GFW frustrates me to no end (no, VPN to get around it don’t grow on trees). However, compared to the crap going on in America China is looking very appealing at this point. Of course, my view of China is biased by being mostly Beijing, if you visit southern cities they are much more organized and nicer (I haven’t been to any other city than BJ since 2015 or so). I urge anyone visiting China to consider skipping Beijing.
The face thing is still annoying to me and the GFW frustrates me to no end (no, VPN to get around it don’t grow on trees). However, compared to the crap going on in America China is looking very appealing at this point. Of course, my view of China is biased by being mostly Beijing, if you visit southern cities they are much more organized and nicer (I haven’t been to any other city than BJ since 2015 or so). I urge anyone visiting China to consider skipping Beijing.
The material engineering for advanced chip and jet turbine production are the two things that China has had to build from scratch, so it will take it a bit longer to reach parity in the west. They get either performance or price down right now, but not both at the same time. Maybe 5 or 10 years? Everything else they have the engineering skill to advance quickly.
Interesting piece, but I think it is helpful to highlight some points not addressed that provide meaningful context. Though the US system is not perfect, I think we need to acknowledge the US does have a robust, enviable biomedical / regulatory ecosystem, and lots of thought and effort have gone into curating the system that we all enjoy today. To engage with a select few of the points made:
1) Author cites that China introduced priority review mechanisms, conditional approvals, and accelerated timelines to streamline approval pathways. They fail to mention that the US helped pioneer these same mechanisms and that they are currently, actively, in use. We DO have priority review vouchers to incentivize investment in orphan disease, conditional approval pathways, and breakthrough designations for drugs addressing unmet needs to name a few. The US has been, and continues to be an innovator on these topics and credit should be given here - this stuff isn't new to us and there is a rich history of attempts to incentivize innovation ranging from offering prizes for cures to disease, to purchasing experimental therapeutics in advance of approval to ensure sponsors have the cashflow to continue development.
2) Regarding acceptance of foreign data, whose data do you think the rest of the world wants to use by designing their policies the way they have? Many countries are willing to accept foreign data because that includes data generated in the US, where historically and presently, standards are very high and the research infrastructure is well-supported (recent events notwithstanding). One need only look at the story of Dr. Frances Kelsey and thalidomide to understand why the US has gone to great lengths to ensure a high bar that is carefully maintained by its own FDA's standards. This is NOT to say great data isn't generated elsewhere and there are examples where ex-US data has been used to support US approval of promising drugs (particularly in areas of significant unmet need, for example, neurodegenerative disease), but there is rhyme to the reason that goes beyond the argument that the US is antiquated in its approach. That said, one can acknowledge there is a geopolitical component that may wax and wane in relative importance depending on the current political climate.
3) Citing the Lunar trial actually highlights the robustness of the US biomedical enterprise rather than detracts from it - that trial was conducted in patients with stage IV NSCLC after they progressed on platinum therapy. In the US during the enrollment period, ICIs like pembro were being approved as first-line monotherapy displacing platinum-based therapies. So the problem there is when practice changes, you're going to 1) have a harder time finding patients that are progressing on the thing that is no longer first line and 2) remember the intervention arm was ICI + TTF...so you can't intervene when people have already received the drug class that is part of your intervention. Saying they couldn't enroll because of bad infrastructure is like saying the apple store is bad at enrolling customers with dead Iphone 10s to trial your combo therapy when most of the people they see have Iphone 15s. You need to enroll then where most people coming through have iphone 10s and this is precisely why they enrolled a significant proportion of patients ex-US because the standard of care elsewhere had not yet changed.
Props to the author for bringing up the important question of US competitiveness in drug development. But let us not forget that we have an enviable biomedical apparatus for a reason - the US has a strong track record of high standards and innovation because we have a good many rigorous, scientifically-minded folks who work on improving it all the time. It's not perfect, but if we don't call out the good, pioneering work that has been done here, then people may feel justified in questioning if anything has been done at all. One should not get the impression we're just waiting around to get hyperdunked or just lucked into the good things we do have.
1) Author cites that China introduced priority review mechanisms, conditional approvals, and accelerated timelines to streamline approval pathways. They fail to mention that the US helped pioneer these same mechanisms and that they are currently, actively, in use. We DO have priority review vouchers to incentivize investment in orphan disease, conditional approval pathways, and breakthrough designations for drugs addressing unmet needs to name a few. The US has been, and continues to be an innovator on these topics and credit should be given here - this stuff isn't new to us and there is a rich history of attempts to incentivize innovation ranging from offering prizes for cures to disease, to purchasing experimental therapeutics in advance of approval to ensure sponsors have the cashflow to continue development.
2) Regarding acceptance of foreign data, whose data do you think the rest of the world wants to use by designing their policies the way they have? Many countries are willing to accept foreign data because that includes data generated in the US, where historically and presently, standards are very high and the research infrastructure is well-supported (recent events notwithstanding). One need only look at the story of Dr. Frances Kelsey and thalidomide to understand why the US has gone to great lengths to ensure a high bar that is carefully maintained by its own FDA's standards. This is NOT to say great data isn't generated elsewhere and there are examples where ex-US data has been used to support US approval of promising drugs (particularly in areas of significant unmet need, for example, neurodegenerative disease), but there is rhyme to the reason that goes beyond the argument that the US is antiquated in its approach. That said, one can acknowledge there is a geopolitical component that may wax and wane in relative importance depending on the current political climate.
3) Citing the Lunar trial actually highlights the robustness of the US biomedical enterprise rather than detracts from it - that trial was conducted in patients with stage IV NSCLC after they progressed on platinum therapy. In the US during the enrollment period, ICIs like pembro were being approved as first-line monotherapy displacing platinum-based therapies. So the problem there is when practice changes, you're going to 1) have a harder time finding patients that are progressing on the thing that is no longer first line and 2) remember the intervention arm was ICI + TTF...so you can't intervene when people have already received the drug class that is part of your intervention. Saying they couldn't enroll because of bad infrastructure is like saying the apple store is bad at enrolling customers with dead Iphone 10s to trial your combo therapy when most of the people they see have Iphone 15s. You need to enroll then where most people coming through have iphone 10s and this is precisely why they enrolled a significant proportion of patients ex-US because the standard of care elsewhere had not yet changed.
Props to the author for bringing up the important question of US competitiveness in drug development. But let us not forget that we have an enviable biomedical apparatus for a reason - the US has a strong track record of high standards and innovation because we have a good many rigorous, scientifically-minded folks who work on improving it all the time. It's not perfect, but if we don't call out the good, pioneering work that has been done here, then people may feel justified in questioning if anything has been done at all. One should not get the impression we're just waiting around to get hyperdunked or just lucked into the good things we do have.
Competing with it is a problem for conservativism. Some admittedly loose reasoning:
Conservativism preserves currently widely accepted structures, including ideas, by ridiculing and excluding new ones; social structures, by outlawing / persecuting / demonizing new ones as a threat to 'our traditions' and 'way of life'; businesses, through tariffs and other anti-competitive measures - the House GOP is considering a bill that reduces antitrust powers, for example; existing economic sectors, by government picking winners and funding them, limiting the economy to what is popular and that the government already understands, such as manufacturing; etc.
Remember the land of the individual, of personal freedom, of opportunity, that by its culture generated invention and innovation that other places, without that culture, couldn't match. What China, which is limited by central control, is doing is copying well-established innovations - a biotech industry that relies on clinical trials. Cutting edge stuff - decades ago.
What has made the US successful is creating, innovating, and moving on to the next thing - things the government and most of the public are far behind on. Look at the boom in the IT industry over the last several decades (also no longer cutting edge except in limited ways).
How can that happen now? The US has currently embraced relatively extreme conservatism. People are afraid to offer challenging ideas, and make their money from rent and from squeezing revenue from old ideas (the stereotypical private equity model). They can't go anywhere except by pleasing the oligarchy, now including the government.
Conservativism preserves currently widely accepted structures, including ideas, by ridiculing and excluding new ones; social structures, by outlawing / persecuting / demonizing new ones as a threat to 'our traditions' and 'way of life'; businesses, through tariffs and other anti-competitive measures - the House GOP is considering a bill that reduces antitrust powers, for example; existing economic sectors, by government picking winners and funding them, limiting the economy to what is popular and that the government already understands, such as manufacturing; etc.
Remember the land of the individual, of personal freedom, of opportunity, that by its culture generated invention and innovation that other places, without that culture, couldn't match. What China, which is limited by central control, is doing is copying well-established innovations - a biotech industry that relies on clinical trials. Cutting edge stuff - decades ago.
What has made the US successful is creating, innovating, and moving on to the next thing - things the government and most of the public are far behind on. Look at the boom in the IT industry over the last several decades (also no longer cutting edge except in limited ways).
How can that happen now? The US has currently embraced relatively extreme conservatism. People are afraid to offer challenging ideas, and make their money from rent and from squeezing revenue from old ideas (the stereotypical private equity model). They can't go anywhere except by pleasing the oligarchy, now including the government.
> Remember the land of the individual, of personal freedom, of opportunity, that by its culture generated invention and innovation that other places, without that culture, couldn't match. What China, which is limited by central control, is doing is copying well-established innovations
They don’t seem to be limited by it at all and in many areas of high tech innovation they are years ahead.
It’s very hard to argue that their EV market, for instance, is not an example of competitiveness driving innovation, which is supposedly the hallmark of the free market.
They don’t seem to be limited by it at all and in many areas of high tech innovation they are years ahead.
It’s very hard to argue that their EV market, for instance, is not an example of competitiveness driving innovation, which is supposedly the hallmark of the free market.
Their EV market is pretty competitive, and they have multiple brands all releasing EVs. Nio, BYD, and Xpeng come to mind. Compare to the US, where we only have one EV maker with a decent market share (Tesla) which has stagnated in innovation. My argument is that where China has succeeded, it has done so by adopting Western values like free-market competition (see the reforms of Deng Xiaopeng) and where the West has failed, it is due to monopolization and stagnation/decadence.
Relying too much on free-market competition is what is causing the west to stagnate. Left on their own, markets will produce monopolies and won't invest in expensive and risky basic research, or really anything of value where that value can't be captured by a single profit seeking entity. China is using free markets more as a tool when it makes sense and not treating it as an intrinsic value like the west has been. China has used subsidies and carefully controls that no businesses get to a monopoly position, which allows markets to function more efficiently and directs their power to things that make sense for the nation as a whole instead of just a single company or industry.
To boil down our discussion to one point, perhaps it is "competitive markets" that are necessary for success, and not necessarily "free markets".
While agree with the whole analysis, I do wonder if most/enough/all the ones supporting the regime change in US are really conservatives ("embraced extreme conservatism") or they just feel/are "left behind" hence they want any change. People might not care who is in power (although they will suffer the consequences), but if after 4 years they do not live better they will say "let's change" - without really checking what is the alternative...
In the end, alternation of rulers is probably on average healthier than having the same guys over and over, but it is no guarantee of success.
In the end, alternation of rulers is probably on average healthier than having the same guys over and over, but it is no guarantee of success.
That hypothesis goes back to Trump's first election. I think it appeals to fears and stereotypes that working-class white people are fundamentally racist and don't care about democracy and freedom, which is why it makes a strong impression - people remember it and repeat it. IIRC, the data from the elections doesn't support it (but I don't have the data).
I think Trump's real powerbase is a wealthy elite, including those who have great influence over the business world and, most critically, over the flow of information, including on Facebook, Instagram, and X.
I think Trump's real powerbase is a wealthy elite, including those who have great influence over the business world and, most critically, over the flow of information, including on Facebook, Instagram, and X.
> I think Trump's real powerbase is a wealthy elite
If you look at the breakdown of any Trump approval/disapproval poll, you'll see who the powerbase is. The billionaires are disposable supplicants, they got on the Trump train late and he doesn't really trust them as far as he can throw them.
If you look at the breakdown of any Trump approval/disapproval poll, you'll see who the powerbase is. The billionaires are disposable supplicants, they got on the Trump train late and he doesn't really trust them as far as he can throw them.
> The billionaires are disposable supplicants, they got on the Trump train late and he doesn't really trust them as far as he can throw them.
That's true of everyone. The billionaires are not disposable, however; they are essential to his power.
That's true of everyone. The billionaires are not disposable, however; they are essential to his power.
I personally think you're right. I think that in general a lot of people want change for the sake of change if they're unhappy (or often even if they're happy).
486sx33(1)
What’s new? America is cooked.
China is having a boom in everything, not just in clinical trials.
If you follow the economic news China has some severe structure problems that it’s going to have to solve.
Huge debt overhang, much of it “hidden” that is dragging down growth
The real estate problem still isn’t solved and a big reset of prices is going to have a big impact on the economy
China placed a big bet on “key industries” under the theory “supply first then we find demand” which isn’t panning out well with tariffs
This is showing up in the stock market which rent saw a 50% decrease
And economic growth has been a weak 5% when they need 9-11% if they hope to avoid the middle income trap
All while the population is rapidly aging and shrinking at the same time
Huge debt overhang, much of it “hidden” that is dragging down growth
The real estate problem still isn’t solved and a big reset of prices is going to have a big impact on the economy
China placed a big bet on “key industries” under the theory “supply first then we find demand” which isn’t panning out well with tariffs
This is showing up in the stock market which rent saw a 50% decrease
And economic growth has been a weak 5% when they need 9-11% if they hope to avoid the middle income trap
All while the population is rapidly aging and shrinking at the same time
[deleted]
buyucu(1)
[deleted]
There’s no evidence that “Chinese trials” or intentional testing on humans caused the outbreak. Investigations by the World Health Organization and independent scientists have not found proof of deliberate origin.
You seem like a bot given 1 comment in 3 years and it was about this. Your AI misinterpreted the GP and responded to something not asked.
If China actually makes pharmaceutical breakthroughs, the West should immediately steal them and invalidate any claims of patents. They do not respect US intellectual property rights
The west actually had quite some deals with them recently. If not for the trade war there could’ve been a lot more. To some extent it is like the Temu vibe.
..with what industrial scale? It would work for internal markets maybe but I figure the Chinese industrial base applies to more than plastic toys
Copying pharmaceuticals is ridiculously easy. Only patents protect them
I guess the open nature of theft would make it harder to do artifical scarcity so many manufacturers are prone to
https://www.cbsnews.com/amp/news/nih-layoffs-budget-cuts-med...