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Comment by TheAceOfHearts | Hacker News Reader

So much for consumer choice and free markets. I wonder why there aren't more attempts at consolidating regulatory information across countries.

If some sunscreen or baby food is available in Europe I'd feel pretty comfortable using it, but I'm denied the opportunity to do so. It would be great if these kinds of items were made available for purchase with some sort of disclaimer. My guess is that in both the cases of sunscreen and baby food, regulations are in place in order to protect local national interests.

Something that I've always found a bit concerning is when there are major inconsistencies between global regulatory agencies. There's demographic differences to account for, but how is it possible to arrive at such drastically different conclusions? And if you arrive at drastically different conclusions, someone is probably going to be more correct while the other is going to be more wrong.

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The fact that the regulatory agencies in different countries consistently come to different decisions is a good indicator that their decisions are not science based.

Because science is the same in different jurisdictions.

The common explanation is the great asymmetry in bad press if an agency kills 1000 people by approving something dangerous vs if it kills 1000 people by not approving something beneficial.

You're making a universalist assumption (all people are the same). But people are different in different countries, both genetically and culturally. They have different activities, diets, sun exposure, diseases, and so on, on average.

And all drugs have benefits and side effects.

So it's not out of the question that some drugs are more worthwhile for some populations than others, and regulators made different decisions for good reasons. It's going to depend on the specifics. So you can't make a generic argument as a shortcut to show that something must be wrong.

That said, there's more life than averages. I think it would be great to allow people to buy drugs that were approved in a different country.

Science only provides information. It doesn’t tell you how to use it.

Say a product kills 1 in 100,000. Different cultures will assess the risk very differently, especially depending on circumstances.

While that's true in general, there are different ethnic groups in different countries, and it might be possible this may have some differences in some cases.

Even with things like Covid, different ethnic groups (i.e. Pasifika / Māori in NZ compared to European ethnic groups) were more susceptable to issues, due to a variety of reasons.

There are some counter examples, like Thalidomide, and in a field where regulators (used to) trust each other and just accept what other countries' regulators said, aviation, the 737 Max (which nobody tested properly because the FAA didn't do their job and let Boeing self-certify, meanwhile EASA and other air regulators accepted the FAA's stamp of approval, not knowing it wasn't worth anything).

Also, different regulators have different thresholds - for instance many things that pass in the US food-wise wouldn't in the EU - be it chlorinated chickens, "false"/misleading labels, etc., and vice versa in some hilarious cases like Kinder Surprise (banned in the US because non-edibles inside food aren't acceptable to the FDA, meanwhile in the EU people just... teach their kids that you open it to get the toy, and eat the rest).

Sometimes the problem is more that the data is not really solid yet, so the risk/reward tradeoff is less obvious. Also the agencies may not be seeing the same data (in itself, a problem).

> but I'm denied the opportunity to do so.

regulatory capture is the phrase that comes to mind.

Thalidomide is the counter example.

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