There is no discrepancy, idiot.
The first part says when the use of a surrogate marker is appropriate. Namely, for serious diseases that have no good treatments and when the surrogate marker is reasonably likely to be able to predict a clinical effect.
The second part deals how efficacy is determined, in other words, how the surrogate marker is used. Namely, the surrogate marker is used with the same higher standard expected of a normal trial. The new practice is using the surrogate marker but the old practice of how to run a clinical trial and analyze the results still exist.
The language isn't that difficult. I have no idea how you're able to perform your job with this level of reading comprehension and inability to put your bias aside and to only consider the facts.
You are an embarrassment to your profession and I suggest you stop writing letters trying to explain something to people you consider your equal. You really come off as a complete doofus.