Where Are the Scientist-Advocates and Civic-Scientists?

The flattening in support for biomedical research as well as other research fields in the United States over the last decade is having serious consequences for American science and scientists.
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The flattening in support for biomedical research as well as other research fields in the United States over the last decade is having serious consequences for American science and scientists. Ultimately, we need a new generation of scientist-advocates and policy experts if we expect to reverse this trend.

The losses are real. The most recent news is that through sequestration there is a looming $1.6 billion cut to the budget of the National Institutes of Health (NIH), by far the largest public funder of biomedical research. Since 2003, the NIH budget has risen only 15 percent to just over $30 billion. Even before sequestration (taking inflation into account) the NIH provides 20 percent less in support for biomedical research annually than it used to 10 years ago.

The workhorse of NIH grant mechanisms for supporting many U.S. biomedical researchers is a type of funding known as the NIH R01 grant. Today 10 years of reductions in our research support translates into funding today for only one in seven of such grants that are approved. These long odds trap U.S. scientists on a treadmill of seemingly endless NIH R01 grant applications. This is most unfortunate at a time when scientific discoveries in biomedical research are making tremendous progress at understanding the molecular and genetic basis of disease, which is leading to advances in diagnostic tools and innovative therapies. Gains in public support for the physical and engineering sciences over the last five years from the National Science Foundation (NSF) have been similarly modest.

The consequences of the scarcity of funding for the next generation of young PhD and MD scientists and graduate students are predictable: Many young people are exploring alternative careers or leaving science altogether, while some of the best and brightest minds are seeking greener pastures in Europe or Asia. This loss is especially disheartening because it is this new generation that shows an unusual commitment to public service and enormous potential for channeling their scientific knowledge towards the social good.

Still another possible consequence of flat-line NIH funding was revealed by a 2011 analysis from the science metrics organization, Thomson Reuters, which found that the impact of scientific papers coming out of the U.S. (as measured in the number of citations) has dropped just behind Great Britain and Germany for the first time in anyone's memory.

The leadership position of American biomedical science -- still the envy of the world -- is no longer assured. NIH advocacy alone has not been able to persuade the U.S. Congress to significantly expand its investments in biomedical research (beyond a one-time economic stimulus in 2009).

There are several reasons for a decade of leveling U.S. government investments in the nation's biomedical research enterprise, but an important factor undoubtedly is a disturbing lack of knowledge about scientists and U.S. science institutions on the part of the American public. According to a poll led by the Washington, D.C.-based Research!America, almost two-thirds of Americans cannot name a living scientist. Almost as many could not name an institution or organization where biomedical research is conducted. The overwhelming majority of the respondents could not identify the NIH or its role in supporting biomedical research.

Ultimately, the U.S. biomedical scientific community itself must shoulder some of the blame for this current state of affairs. We have clearly done an inadequate job of informing the American public about our activities, our successes and our contributions to the nation's health. We have an inadequate cadre of scientist-advocates and public policy experts, who serve as "civic-scientists." Indeed, very few scientists and physicians serve as public advocates for their fields. Few commit the time and develop the skills to speak to lay audiences and write articles in non-scientific journals.

One reason for the dearth of advocates is the inherent structure of U.S. medical and public health schools, where promotion and advancement depend on publication of research discoveries in scientific journals, success in obtaining grants from the NIH and other sources, or clinical activities with the generation of clinic or hospital-based revenue. There is simply no credit given for an opinion piece in a major paper or magazine, an appearance on national television or radio, briefings on Capitol Hill, or using social media -- the tools of the trade for advocates and policy experts. Ultimately, our profession implicitly or sometimes explicitly discourages direct outreach to the lay public, sometimes viewing such behavior as frivolous or even a form of grandstanding.

We scientists need to change our culture to make public advocacy and science policy essential activities that will be increasingly needed in order to preserve the integrity of American biomedical science. Medical and public health schools need to partner with U.S. schools of public affairs and policy or schools of communications, many of which are located on the same or adjacent campuses. We need to look to the major think tanks for new and innovative programs of science advocacy and policy. We need to establish new career paths that contribute to science policy.

If we act now, it will not be too late to establish a fresh and energetic cadre of civic scientist-advocates and policy experts as a basis for larger initiatives to educate the public and U.S. Congress on what we do and why it is so essential. Given the heightened and unprecedented level of interest and commitment to public service among this new generation, if we build an appropriate infrastructure they will almost certainly join and pitch in.

Peter Hotez, M.D. Ph.D. and Neal Lane Ph.D. are fellows of the James A. Baker III Institute for Public Policy at Rice University. Prof. Hotez is also dean of the National School of Tropical Medicine at Baylor College of Medicine and Texas Children's Hospital endowed chair in Tropical Pediatrics; and Prof. Lane is the Malcolm Gillis University professor at Rice University and past director of the White House Office of Science and Technology Policy in the Clinton Administration and past director of the National Science Foundation.

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