Last updated Nov 29, 2025

E71: Russia/Ukraine deep dive: escalation, risk factors, financial fallout, exit ramps and more

Sat, 05 Mar 2022 05:32:59 +0000
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economymarkets
If the Russia/Ukraine-related supply and demand shocks prove globally significant in 2022, the Federal Reserve, European Central Bank, Bank of Canada, and Bank of Japan will intervene in a coordinated fashion to provide market liquidity, cushioning most of the global economy from the worst economic consequences of the sanctions on Russia.
if these shocks are really, really, really meaningful globally, I think you're going to see the Federal Reserve and the ECB and the Bank of Canada and the Bank of Japan step in, in a very coordinated way to provide liquidity to these markets. And I think what that has the byproduct of doing is blunting the economic consequences to everybody but the person who is sanctioned.View on YouTube
Explanation
  1. The shocks were globally significant. The IMF and World Bank both concluded in 2022 that Russia’s invasion of Ukraine and the associated sanctions created major global supply and demand shocks, sharply raising energy and food prices, downgrading growth (especially in Europe), and hurting poorer countries worldwide. (imf.org) This satisfies the conditional premise of Chamath’s prediction (that the shocks would need to be “really meaningful globally”).

  2. Major central banks did not respond by jointly adding liquidity; they tightened policy instead.

    • The Federal Reserve raised the federal funds rate from 0–0.25% in January 2022 to 4.25–4.50% by December 2022 (seven hikes) and began quantitative tightening, explicitly noting that the war and sanctions were adding to inflation via higher commodity prices. (en.wikipedia.org)
    • The European Central Bank pivoted from negative rates and asset purchases to rapid hikes starting July 2022, pushing its key rate from -0.5% to around 2% by year‑end and eventually to 4%, in order to fight the inflation surge driven in part by the energy shock from the war. (ecb.europa.eu)
    • The Bank of Canada raised its policy rate seven times in 2022 (a total of 400 bps) and engaged in quantitative tightening, repeatedly citing the war in Ukraine as a factor behind higher global energy and food prices and global inflation—not as a reason to supply extra liquidity. (bankofcanada.ca)
    • The Bank of Japan maintained its existing ultra‑easy stance and yield‑curve control, but this was a continuation of pre‑war policy and COVID programs, not part of a new, Ukraine‑specific, coordinated liquidity injection with the Fed/ECB/BoC. (boj.or.jp)
  3. There was no 2022 Ukraine‑driven, multi‑central‑bank liquidity initiative like Chamath described. The Fed, ECB, BoC and BoJ do have standing U.S.‑dollar swap lines and have used coordinated liquidity actions in other crises (e.g., March 2020 for COVID and March 2023 for banking stress around SVB/Credit Suisse). (federalreserve.gov) But in 2022, in response to the war and sanctions, their major announced actions were interest‑rate hikes and balance‑sheet reduction, not a new joint program to "step in, in a very coordinated way to provide liquidity to these markets."

  4. The economic pain was not “blunted” only for Russia’s counterparties; it was broadly felt. World Bank and IMF analyses show that the war and sanctions significantly hurt emerging Europe and Central Asia (regional output swing from expected +3% to about –4.1% in 2022), contributed to high inflation and energy‑price shocks in Europe, and raised food and fuel prices globally, especially harming poorer households. (worldbank.org) These are substantial negative consequences for many economies besides Russia, contrary to the claim that coordinated liquidity would largely “blunt” the fallout for everyone except the sanctioned party.

  5. Overall assessment. By late 2022, the condition of globally significant shocks was clearly met, yet the specific central‑bank response Chamath predicted—a coordinated liquidity‑providing intervention by the Fed, ECB, BoC, and BoJ that would shield most of the global economy from the sanctions shock—did not occur. Instead, those banks mostly withdrew liquidity to fight inflation, and the economic damage from the war and sanctions spread well beyond Russia. The prediction is therefore wrong.

economygovernment
As a result of the spike in energy prices associated with the Russia/Ukraine crisis, the U.S. (and likely broader developed-world) economy will enter a recessionary contraction, prompting governments/central banks to shift toward more accommodative policies (easier monetary or fiscal stance) within the subsequent 12–18 months (i.e., by late 2023).
We will contract as an economy. The government will have to become more accommodating.View on YouTube
Explanation

Chamath’s prediction tied the Russia/Ukraine-driven energy shock to two concrete outcomes within roughly 12–18 months (by late 2023):

  1. A recessionary contraction in the U.S. (and likely broader developed world).

    • United States: Official BEA data show real U.S. GDP grew 1.9% in 2022 and 2.5% in 2023; measured Q4‑to‑Q4, GDP rose 0.7% in 2022 and 3.1% in 2023, not a contraction. (bea.gov)
    • The NBER, the body that dates U.S. recessions, lists no new peak or recession after the April 2020 trough; there is no declared U.S. recession in 2022 or 2023, even though there were two negative GDP quarters in early 2022. (nber.org)
    • Broader developed world: The European Commission reports euro‑area and EU GDP grew in 2022 (about 3.5%) and remained positive, though weak, in 2023 (around 0.6–1.1%), explicitly noting that the EU “set to avoid recession” despite the energy crisis. (economy-finance.ec.europa.eu)
    • OECD data show OECD‑wide and G7 GDP still expanding (about 0.4% q/q in Q4 2023), with only some member countries in mild contractions, not a broad developed‑world downturn driven into recession. (oecd.org)

    These data contradict the claim that the U.S. economy, and the developed world as a whole, moved into a clear recessionary contraction in that window.

  2. A shift to more accommodative policy within that window.

    • Monetary policy in the U.S.: The Federal Reserve raised the federal funds rate from near 0% in early 2022 to 5.25–5.50% by July 2023, a cumulative increase of over 5 percentage points, as part of an aggressive tightening cycle to fight inflation. (forbes.com)
    • Monetary policy in the euro area: The ECB raised its key interest rates from negative/zero levels in mid‑2022 to around 3–4% by late 2023, again a forceful tightening in response to high inflation. (ecb.europa.eu)
    • Fiscal stance: EU economic reports note that, by 2023, earlier fiscal support (including energy-related measures) was being phased out, while monetary tightening was “working its way through the economy,” not that overall policy was turning more expansionary. (economy-finance.ec.europa.eu)

    In other words, instead of becoming “more accommodating,” policy in major developed economies became substantially more restrictive through late 2023.

Because (a) no official U.S. or broad developed‑world recession materialized over 2022–23 and (b) central banks moved sharply away from accommodative stances during the 12–18 months after March 2022, the core economic scenario Chamath described did not occur. The prediction is therefore wrong overall.

politicseconomy
Following early March 2022, the United States and its allies will continue to add further rounds of economic sanctions on Russia beyond those already announced on Russian crude and other sectors; the sanctions regime will materially intensify over the ensuing months of 2022.
And just to speak on this other point, we have only just begun. Meaning just today, as we started the pod, uh, Biden came out with an incremental new set of sanctions on Russian crude. So we're not at the even in the beginning. We're at the beginning of the beginning.View on YouTube
Explanation

Evidence shows that after early March 2022, the U.S. and its allies repeatedly added new rounds of sanctions on Russia and significantly tightened the overall regime during the rest of 2022.

  • United States: In addition to early‑March orders banning U.S. imports of Russian fossil fuels and certain other goods (EO 14066 and 14068), the Biden administration issued Executive Order 14071 on April 6, 2022, which prohibited all new U.S. investment in Russia and empowered Treasury to ban broad categories of services to Russian persons—a major escalation beyond the initial crude‑oil measures.(en.wikipedia.org) Congress followed with laws statutorily banning imports of Russian energy products and suspending normal trade relations with Russia and Belarus on April 8, 2022.(en.wikipedia.org) These moves materially widened the scope and bite of U.S. sanctions through 2022.

  • European Union and allies: After the first three sanction packages in late February / early March 2022, the EU adopted successive 4th to 9th packages between March 15 and December 16, 2022, each adding new sectoral and individual measures; the Council itself characterizes these as continuously extended and increasing in severity.(en.wikipedia.org) The 5th package (April 8, 2022) added an EU‑wide ban on Russian coal imports, barred Russian vessels from EU ports and most Russian and Belarusian road freight operators from the EU, imposed further export bans on high‑tech goods, and fully blocked four more major Russian banks.(consilium.europa.eu) The 6th package (June 3, 2022) introduced a phased embargo on Russian seaborne crude and refined oil and cut additional key banks from SWIFT, directly targeting one of Russia’s largest revenue sources.(consilium.europa.eu) Later packages, including the 8th (October 6, 2022), expanded import bans (e.g., steel, machinery, vehicles, chemicals) and export controls and began implementing the G7 oil‑price‑cap mechanism.(finance.ec.europa.eu)

  • G7 price cap: On December 5, 2022, the G7 and EU brought into force a coordinated price‑cap regime on Russian seaborne crude oil (and later refined products), restricting access to Western shipping and insurance if Russian oil was sold above the cap.(enlargement.ec.europa.eu) This was another significant tightening of the sanctions architecture relative to early March.

Taken together, these steps show that throughout the ensuing months of 2022 the U.S. and its allies not only continued adding sanctions rounds but also escalated them into a broad, multi‑sectoral regime hitting energy, banking, trade, and investment far more severely than the initial measures on Russian crude alone. That matches Chamath’s prediction that early March 2022 represented only “the beginning of the beginning” and that the sanctions regime would materially intensify over the rest of 2022.

politicsconflict
Russia will not ultimately lose the war in Ukraine to any alternative intervention or opposing force on the ground; Russia will find a way to avoid outright military defeat in Ukraine because of its nuclear deterrent and overall military capability.
any sort of assumption that leads to our belief that an alternative intervention or some other force can ultimately win against Russia? Uh, is is completely false because Russia has thousands of nuclear warheads... I wouldn't kind of take any of this stuff, um, that Russia is going to lose a war, uh, you know, a war on the ground in the Ukraine. I mean, at the end of the day, they've got the ultimate trump card.View on YouTube
Explanation

As of 30 November 2025, the Russo‑Ukrainian war is still ongoing and there has been no clear, final military outcome.

Russia has not suffered an outright military defeat in Ukraine. It continues to occupy large areas of Ukrainian territory and is conducting active offensive operations, including the Pokrovsk, Dobropillia, Novopavlivka, and Kupiansk offensives, as well as territorial gains such as the capture of Kostiantynivka in Sumy Oblast. (en.wikipedia.org) Major Russian missile and drone attacks on Kyiv and other cities also continue, indicating that Russia’s forces remain capable of sustained large‑scale military action rather than having been defeated on the ground. (theguardian.com)

At the same time, there is no settled peace deal that locks in the current situation or formally ends the war. Ukrainian and U.S. officials are discussing potential ceasefire or peace frameworks, including proposals to freeze the conflict along current front lines, but both Russia and Ukraine have not yet agreed to a final settlement. (euronews.com) Because the ultimate outcome of the war (including whether Russia will eventually be forced into a clear military defeat or compelled withdrawal) is still unknown, the claim that Russia will not ultimately lose the war in Ukraine cannot yet be judged as either right or wrong.

politicsconflict
As a result of Western policy around the Ukraine crisis, Russia will be pushed into a long‑term, durable strategic alignment with China, reducing the likelihood of Russia re‑aligning with the West in the foreseeable future.
it's, uh, it's a transition that's happening mainly because of China. So we're in, you know, it seems like what we're doing is pushing Russia irrevocably into into his arms.View on YouTube
Explanation

Evidence since 2022 strongly supports Sacks’ prediction that Western policy over the Ukraine war has pushed Russia into a durable strategic alignment with China and made a near‑term re‑alignment with the West unlikely.

  1. Sharp, sanctions‑driven pivot toward China

    • After the invasion and sweeping US/EU/Japan sanctions, China refused to join Western sanctions and instead expanded trade; China accounted for about 40% of Russia’s imports and bilateral trade hit a record $190B in 2022, then $240B in 2023 and about $245B in 2024, more than double 2020 levels. (en.wikipedia.org)
    • Analyses describe Russia’s economic dependence on China as “deep” and possibly irreversible, explicitly tying this shift to Western sanctions and the 2014–2022 escalation over Ukraine. (worldcrunch.com)
    • Because sanctions largely cut Russia off from dollar/euro finance, Moscow reoriented its financial system toward the yuan: by 2024–2025, yuan dominated FX trading in Russia and roughly 90%+ of Russia‑China trade was settled in rubles and yuan. (sldinfo.com)
      These sources explicitly frame the dependence on China as an unintended consequence of Western sanctions, matching Sacks’ causal claim that Western policy is what “pushes” Russia into China’s arms.
  2. Deepening, explicitly framed long‑term strategic partnership

    • Even before the full invasion, Russia and China announced a “no limits” partnership on 4 February 2022, pledging that their relationship was “superior to political and military alliances of the Cold War era.” (china.usc.edu)
    • Since then, Xi and Putin have repeatedly upgraded and reaffirmed a “comprehensive strategic partnership of coordination for a new era,” signing joint statements and a pre‑2030 economic cooperation plan, and describing the relationship as “strategic, reliable and stable” and “not an ally but better than an ally.” (en.cppcc.gov.cn)
    • Xi’s high‑profile 2023 state visit to Moscow and Putin’s 2024 state visit to China, followed by Xi’s 2025 Victory Day visit to Russia, all highlighted that both sides see the partnership as long‑term and central to their foreign policy. (eng.chinamil.com.cn)
    • European and US officials now routinely refer to a China‑Russia “axis” or strategic alignment as one of the greatest global challenges, underlining that outside observers see a durable bloc, not a tactical fling. (eutoday.net)
      While the relationship is asymmetric and China has sometimes pulled back (e.g., some banks limiting transactions under secondary sanctions), expert work still characterizes it as a consolidated strategic alignment with Russia increasingly the junior partner rather than an autonomous pole. (eurasiaprospective.net)
  3. Russia–West re‑alignment looks very unlikely in the ‘foreseeable future’

    • NATO’s 2022 Strategic Concept formally designates Russia as “the most significant and direct threat” to Allied security, signaling a structural adversarial posture rather than a temporary dispute. (nato.int)
    • The EU has adopted an ever‑expanding series of sanctions packages (now approaching 19 by late 2025), with stated long‑term aims to degrade Russia’s military capacity and permanently reduce its role in Europe’s energy system, including a phased LNG ban through 2027. (eeas.europa.eu)
    • Senior EU and NATO officials in 2025 describe Russia as planning for long‑term confrontation with Europe, reinforcing the view that political normalization is not on the horizon. (apnews.com)
    • The rare Western leaders who talk about eventual “re‑integration” of Russia (e.g., Hungary’s Viktor Orbán) frame it as contingent on a peace deal and major changes in behavior, conditions far from being met. (reuters.com)
      Combined, this suggests that a meaningful Russia‑West re‑alignment in the medium term is improbable, while Russia’s dependence on and coordination with China are already entrenched.
  4. Caveats and why they don’t overturn the prediction

    • The partnership stops short of a formal mutual‑defense alliance, and China has tried to avoid overtly violating Western sanctions or providing acknowledged lethal aid, indicating some limits and hedging. (cnbc.com)
    • The asymmetry means Russia is a junior, dependent partner, and there are frictions over pricing and project terms (e.g., delays over the Power of Siberia 2 gas pipeline), but this still fits Sacks’ broader claim of a “durable strategic alignment,” just on terms increasingly set by Beijing. (cfr.org)

Overall, nearly four years after the prediction, the observable trajectory matches it well: Western sanctions and broader policy over the Ukraine war have made Russia heavily and structurally dependent on China, both governments describe their ties as a long‑term strategic partnership, and Russia’s re‑alignment with the West looks implausible for at least the rest of this decade. That justifies classifying the prediction as right rather than ambiguous or premature.

economygovernment
In response to the economic impact of Russia sanctions and recession risks in 2022, Federal Reserve Chair Jerome Powell, the Biden administration, and allied governments will likely shift to a more accommodative stance, effectively resuming monetary expansion ("money printing") to support the economy while maintaining strong economic sanctions on Russia, with the goal of engineering a soft landing instead of a recession.
I think there could be a real possibility that Powell becomes very accommodative. And, you know, he and Biden and the entire administration come together with Europe and everybody else and say, get the money printer back going, because we are we are going to stand the line on these economic sanctions and we're going to, you know, sort of soft land, the economy here because we think there's recessionary risks afoot.View on YouTube
Explanation

Powell and U.S./allied policymakers did not become more accommodative or restart “money printing” in 2022 in response to Russia sanctions and recession risks.

Key evidence:

  1. Aggressive rate hikes instead of accommodation (2022):

    • The Federal Reserve began raising rates in March 2022 and then executed a rapid series of hikes (including multiple 75 bps moves), taking the federal funds rate from near zero to around 4.25–4.5% by December 2022—its fastest tightening since the early 1980s, aimed at fighting high inflation, not accommodating growth.
  2. Quantitative Tightening (QT), not renewed QE:

    • In June 2022, the Fed started shrinking its balance sheet by allowing Treasuries and MBS to roll off, i.e., reducing its holdings (quantitative tightening), which is the opposite of resuming large-scale asset purchases or “getting the money printer back going.”
  3. Policy stance clearly framed as anti-inflation, not soft-landing-at-all-costs:

    • Powell and the FOMC repeatedly emphasized that restoring price stability was the primary objective, even at the cost of slower growth and higher unemployment. This is a classic restrictive posture, not an accommodative one designed mainly to cushion Russia-related shocks.
  4. Sanctions were maintained without offsetting monetary easing:

    • The U.S. and European allies imposed and then sustained extensive sanctions on Russia (financial sector restrictions, export controls, asset freezes, oil price cap, etc.) through 2022 and beyond, but this was paired with tight monetary policy rather than renewed expansion. Fiscal measures (e.g., IRA, CHIPS) were structural/industrial rather than emergency macro stimulus of the 2020 type.

Given that:

  • The Fed tightened aggressively (higher rates + QT).
  • There was no resumption of QE or broad monetary expansion in 2022 in response to Russia sanctions.
  • The policy goal publicly prioritized controlling inflation, not primarily engineering a soft landing via accommodation.

The core prediction that Powell, Biden, and allies would “get the money printer back going” and become very accommodative to soft-land the economy while keeping sanctions did not materialize.

Therefore, the prediction is wrong.

economy
The combination of sanctions on Russia and associated commodity/financial shocks will cause materially harmful economic impacts on emerging markets in Asia and Africa, leading to a period of significant economic difficulty there lasting for an extended but unspecified period of time (at least many months to a few years after early 2022).
what's going to be very, very difficult is the impact that this has on emerging markets in Southeast Asia, Asia, Africa could be really, really deleterious for some amount of time and sad.View on YouTube
Explanation

Evidence from 2022–2024 shows that emerging and developing economies in Asia and Africa suffered material, prolonged economic harm from the post‑invasion food, fuel, and fertilizer shock linked to the Russia–Ukraine war and associated disruptions (including sanctions and counter‑sanctions).

Key points:

  1. Developing countries—especially Africa—flagged as most exposed very early (March 2022). A UNCTAD rapid assessment, published two weeks after the invasion, warned that the war had triggered rising food, fuel, and fertilizer prices, heightened financial volatility, and mounting trade costs, and stated that the situation was “alarming for developing countries, and especially for African and least developed countries,” many of which were particularly exposed to higher commodity prices and financial‑market effects, with risks of food shortages, inflation‑induced recessions, and civil unrest. UNCTAD rapid assessment

  2. Food and fuel price spikes hit import‑dependent African states hardest. The war and sanctions disrupted grain and vegetable‑oil exports from Russia and Ukraine, which together accounted pre‑war for around 27% of global wheat exports and over half of sunflower oil and seed exports, driving wheat and other staple prices to their highest levels since 2008. This was expected to “most severely affect” countries in MENA and East Africa that rely heavily on imports from the two belligerents, worsening already serious food insecurity in places like Ethiopia, Kenya, Somalia, and South Sudan.(en.wikipedia.org) FAO/WFP and UN analyses show these price shocks deepened the 2022–2023 global food crisis, with tens of millions more in East and West Africa facing acute food insecurity.

  3. Documented crises in specific African and Asian economies.

    • Sub‑Saharan Africa: The IMF reports that Russia’s war and related spillovers on food and energy prices “further aggravated” fragile and conflict‑affected states; Sub‑Saharan Africa was “hit particularly hard,” with consumer prices rising over 20% on average and public debt nearing 60% of GDP, while 123 million people (about 12% of the region’s population) faced acute food insecurity.(meetings.imf.org)
    • Ethiopia/Horn of Africa: Ethiopia relied heavily on grain imports from Russia and Ukraine; the invasion exacerbated an existing food crisis by disrupting supply chains and sharply increasing food prices, worsening famine conditions in northern Ethiopia.(en.wikipedia.org)
    • West Africa: Scholarly and FAO/WFP analyses show the war substantially worsened food security in West Africa, with disrupted grain imports, sharply higher prices, and rising malnutrition in countries like Niger and Mali.(link.springer.com)
    • Pakistan (Asia): Pakistan experienced a major economic and balance‑of‑payments crisis in 2022–2024; among the listed causes is “rising fuel prices due to [the] Russian invasion of Ukraine,” which contributed to surging inflation (nearly 38% in May 2023) and severe cost‑of‑living pressures.(en.wikipedia.org)
    • Sri Lanka (Asia): Sri Lanka’s 2019–2024 economic crisis had many domestic causes but was intensified by the war’s impact on global commodity and fertilizer prices; the 2022–2023 global food crisis description notes that after Sri Lanka reversed its own fertilizer ban, the Russian invasion had driven fertilizer prices so high that they became unaffordable for a country already short on foreign exchange, compounding food shortages and contributing to mass protests and sovereign default.(en.wikipedia.org)
  4. Macro‑level downgrades for emerging markets and commodity importers. World Bank and UN analyses attribute a significant part of the 2022–2023 growth slowdown in emerging market and developing economies (EMDEs) to the war‑induced spike in food and energy prices. The World Bank warned that negative spillovers from the war would more than offset any benefits to commodity exporters, and that oil and gas price surges would cut growth in commodity‑importing developing economies such as China, Indonesia, South Africa, and Turkey.(blogs.worldbank.org) This translated into weaker growth, higher inflation, and tighter financing conditions for many Asian and African EMs over at least 2022–2023.

  5. Duration and severity match an “extended period” of difficulty. The food‑ and fuel‑price shock and its knock‑on effects (inflation, debt stress, reduced growth and investment) persisted well beyond a few months. The UN’s March 2023 economic briefing still highlighted the “lingering war in Ukraine” as a key driver of elevated energy prices, food shortages, and slowed recovery in developing regions.(un.org) Crises in Pakistan and Sri Lanka are dated 2022–2024, with deep economic distress lasting several years rather than being short‑lived.(en.wikipedia.org)

Causally, these outcomes were not due only to Russia sanctions and war‑related commodity shocks; domestic mismanagement, prior debt build‑ups, COVID‑19 scars, and climate‑related disasters also played major roles. But Chamath’s claim was about the direction and materiality of the effect: that sanctions/war‑driven commodity and financial shocks would create “really, really deleterious”, prolonged economic conditions in emerging markets in Asia and Africa. The record from 2022–2024 shows exactly such extended harm across multiple EMs in both regions, consistent with his prediction.

healthtech
Over the long run (on the order of years to a couple of decades after 2022), the per‑patient production cost of cell therapies such as CAR‑T can be reduced to below $5,000.
I think that over the long run, we can get the cost of cell therapies below 5000 bucks.View on YouTube
Explanation

Friedberg was talking about long‑run manufacturing costs for cell therapies like CAR‑T, on the order of years to decades after 2022. As of late 2025, commercial autologous CAR‑T cost of goods per patient is still very high: analyses estimate manufacturing COGS around 95,000 USD per dose or 170,000–220,000 USD per batch, and even optimistic process‑optimization models for autologous therapies project future costs in the tens of thousands, not below 5,000 USD. (appliedcells.com) Emerging work on allogeneic or off‑the‑shelf CAR‑T and CAR‑NKT suggests that, in principle, batch manufacturing could reduce the per‑patient therapy cost to roughly 3,990–10,000 USD or about 5,000 USD in some modeled scenarios, but these are projections or pre‑commercial platforms rather than widely implemented real‑world costs today. (cancerci.biomedcentral.com) Since only about three years have passed since the 2022 prediction and the stated time horizon was up to a couple of decades, and because the claim was about what could be achievable in the long run rather than what would happen by a specific near‑term date, there is not yet enough elapsed time or empirical evidence to say definitively whether costs will fall below 5,000 USD per patient. Therefore the prediction is still in progress and must be rated as inconclusive.

healthscience
In the long run (over the next couple of decades), CAR‑T and related engineered T‑cell therapies will be successfully developed and used clinically not only for cancers but also to treat autoimmune diseases such as lupus and multiple sclerosis (e.g., by targeting B cells or Epstein–Barr virus), as well as other specific pathogens, in a targeted manner.
down the road, we could use Car-T to destroy, um, lupus or to destroy antibodies, B cells that are producing antibodies that are fundamentally causing autoimmune conditions, including what we talked about a few weeks ago, multiple sclerosis. Given that we now have a strong belief that if you can get rid of the EBV, the Epstein-Barr virus, from your body, you can wipe that out. So so car T can, in the long run, be harnessed not just for cancer, but autoimmunity and potentially other pathogens in the body in a really targeted way.View on YouTube
Explanation

Only about 3.5 years have passed since the March 2022 prediction, which was explicitly framed as a decades‑long forecast (“down the road… in the long run, over the next couple of decades”). That time horizon has not elapsed, so we cannot yet definitively judge whether CAR‑T and related T‑cell therapies will become established, routine treatments for autoimmune disease and specific pathogens.

However, developments so far are strongly directionally consistent with what Friedberg described:

  • Autoimmune diseases (including lupus): A 2024 New England Journal of Medicine case series of 15 patients with severe systemic lupus erythematosus (SLE), idiopathic inflammatory myositis, or systemic sclerosis found that a single CD19 CAR‑T infusion led to clinical remission in all patients and allowed complete discontinuation of immunosuppressive therapy, with follow‑up up to 29 months.(ovid.com) A 2024 Phase 1 trial of BCMA–CD19 “compound” CAR‑T in lupus nephritis reported medication‑free remission and durable depletion of disease‑causing autoantibodies in nearly all treated SLE patients, with follow‑up up to 46 months.(ovid.com) Reports from European centers indicate ~100–200 autoimmune patients worldwide (including SLE and other autoimmune cytopenias) have received CAR‑T with often striking remissions, but experts emphasize high cost and lack of long‑term safety data.(welt.de) Multiple companies (e.g., CRISPR Therapeutics’ CTX112, Allogene’s ALLO‑329, Fate’s FT819, IASO’s Eque‑cel) are now running or initiating trials of CAR‑T for a range of autoimmune indications, confirming substantial investment in this direction.(ir.crisprtx.com)

  • Multiple sclerosis and other CNS autoimmunity: Several early‑phase clinical trials are testing CD19‑ or BCMA‑targeted CAR‑T products in progressive and relapsing MS (e.g., KYV‑101, Eque‑cel, NEX‑T). Trial listings from UCSF and Yale describe Phase 1 studies of CD19 CAR‑T in treatment‑refractory or progressive MS, and an MS‑focused review in 2025 notes six ongoing CAR‑T trials in MS and related disorders.(clinicaltrials.ucsf.edu) Early data presented at the 2025 American Academy of Neurology meeting showed KYV‑101 to be generally well tolerated with preliminary efficacy signals in progressive MS.(multiplesclerosisnewstoday.com) Separately, IASO Bio reported in Cell the first clinical evidence that its anti‑BCMA CAR‑T (equecabtagene autoleucel) can be safe and effective in progressive MS.(prnewswire.com) This matches the specific diseases (e.g., MS) Friedberg mentioned as targets.

  • Pathogen‑targeted T‑cell therapies (HIV, EBV, etc.): Multiple Phase 1/2 studies are using CAR‑T against HIV, such as the UCSF‑led LVgp120duoCAR‑T trial aiming for long‑term ART‑free control, with patients already dosed and follow‑up ongoing through 2029.(cirm.ca.gov) Animal and translational studies (e.g., PD‑1–targeted CAR‑T in SIV/HIV models) further support the concept of using engineered T cells to clear infected reservoirs.(fredhutch.org) In the EBV space, an engineered EBV‑specific T‑cell product (tabelecleucel/Ebvallo) is already approved in Europe for EBV‑positive post‑transplant lymphoproliferative disease, and the FDA’s 2025 refusal was based on manufacturing issues rather than lack of efficacy.(reuters.com) While not always classical CAR‑T, these are clearly “related engineered T‑cell therapies” directed at specific pathogens, as the prediction envisioned.

  • Regulatory status as of late 2025: Despite these advances, no CAR‑T therapy is yet approved anywhere for an autoimmune disease or for chronic viral infections; all marketed CAR‑T products remain in oncology indications (hematologic malignancies and, more recently, some solid tumors).(en.wikipedia.org) Autoimmune and infectious‑disease uses are still confined to early‑phase trials, case series, and compassionate‑use settings.

Given (1) the explicitly long, decades‑scale horizon and (2) the fact that current evidence shows promising proof‑of‑concept but not yet widespread, established clinical adoption or regulatory approval in autoimmunity or infections, there is not enough time or outcome data yet to call the prediction clearly right or wrong. The trajectory so far supports the plausibility of his claim, but the ultimate success or failure by his stated time horizon remains undetermined.