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Joshua Gottheimer Office of Speechwriting OEOB 196 #6 1. Background for Morgan State 2. Consumer Fraud 3. MIT Speech Briefing Binder 4. CFR Binder 5. SOTU HHS Background Material For Morgan State Speech Background Material Morgan State speech Jack Gibbons Assistant to the President For Science and Technology 456-7116 (o) 540/353-5409 OSTP/Jeff Smith (6-6047) Science in the National Interest OSTP S&T Report Progress in Health Progress in Agriculture NBAC Building Public Trust Glenn Bill (S.193) Human Subject Abuse Varmus - Human Subject Protection Satcher - Human Subject Protection Tuskegee Legacy Report Gulf War Scientific Freedom S&T and Economy Returns to R&D Supporting R&D Technology in the National Interest Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a tabbed divider. Given our digitization capabilities, we are sometimes unable to adequately scan such dividers. The title from the original document is indicated below. 5/8 memo Divider Title: 5/8 memo OSTP DRAFT 5/8/97 Possible Approach for Morgan State I) Our commitment to science and technology Reiterate strategy of fiscal responsibility, streamlining government while at the same time protecting investments in education and research. The enduring Federal commitment to science, to technology, to learning, to research is the key to our future, essential to our economy, health, environment, security. Our strategy is working. It's gratifying that Congress is moving with us. The pace of science, and the resulting technological advances, is accelerating so rapidly that textbooks are frequently obsolete before they're printed. Humankind places a tremendous premium on (a) an increasingly sophisticated base of skilled human resources and knowledge, (b) a well-functioning and resilient natural resource system. As populations grow and economic activities expand, our hopes for sustained progress -- sustainable development hinge on human ingenuity. With global linkages growing stronger, the rapid movement of people, goods, information has permanently altered commerce, national security, demographics and health. The cost of "natural" disasters that can be greatly lessened through S&T now amounts for the U.S. alone to about $1 billion per week; how the potential of enormous impacts of global climate change can be lessened with timely action; the opportunity to capitalize on the revolutions in biology and biomedicine to improve human health, agriculture, etc.] II) Health and Disease Evidence abounds of the returns from scientific research and potential for the future. Today's doctors treat symptoms. The human body and its ailments are so complex that it may be that we are better at diagnosing and curing what is wrong with our cars than with ourselves. We need to give our doctors a toolbox as good as a mechanic's. Tomorrow's doctors will have the tools to predict and prevent. Understanding the chain of events that cause disease offers real insight into what can be done to cure it, or preferably, prevent it from occurring in the first place. There is growing optimism regarding new drugs to treat AIDS or a vaccine to prevent its spread. Chronic, debilitating diseases such as diabetes, high blood pressure, arthritis and sickle cell anemia may succumb to innovative new therapies. III) Ethics Our ethics must be as good as our science. In American tradition, freedom of scientific inquiry is likened to freedom of speech and holds very great respect. There is a practical dimension to this attitude in that allowing scientific opportunity to guide research directions has proven benefits (examples of unpredicted payoffs and those in unrelated fields). Knowledge, in and of itself, is value-neutral; but knowledge may be used for good or evil. The very success of science and the technology that emerges from it is a distinct form of power that must be nurtured and governed with a watchful eye. We acknowledge the need for societal governance of the use of science and technology, but we also acknowledge the imperative that such governance be thoughtful and careful, that liberty and privacy (respect for persons, beneficence and justice), for example, be protected. It is a complex line. Our choices carry great weight. That is why federal oversight is necessary in some cases to ensure that societal values, informed by cultural/religious views, are not trumped, while at the same time continuing our tradition of freedom of scientific inquiry. It is for this reason that the President created NBAC. Accounts of past abuses of the human subjects of research (Tuskegee, radiation) and the desire to prevent abuse from ever occurring again, along with the increasing power of technology to work with the forces of nature, joined to form an imperative need for continuing thoughtful prospective governance of our Nation's biomedical and behavioral research enterprise. IV) Policy Extension of NBAC charter Diabetes initiative Long-term goal for R&D support. Strengthening our S&T investments will reap ample rewards. We must all be the constituency of the future. Others The gulf between the cultures of science and politics. Their different time perspectives. Ozone depletion, global warming, loss of biodiversity have long time constants. While it may take two decades for Nobel recognition or five decades for climate change, political change often comes about in hours or days. We are in the formative stages of coupling the physical, biological and social sciences in the pursuit of global knowledge. C.P. Snow's admonition that we must bridge the gap between our cultures of natural science and social science if we are to effectively tackle the research challenges and opportunities ahead. The challenge is to build those bridges not only to the next century, but across the cultural divides that we must not allow to separate us. What we need from a writing perspective: Science/esp. life sciences- - what their importance will be Ethics issues - religious perspective - problem areas in the part e.g., Tuskegee. -good gs. of "scare headliner." Research + the importance of basic research. minority science issues. What we need here are journal articles, books, speeches, reports, fact sheets, etc. This does not really policy refor to the initiatives. FACTS & ANECDOTES need: 5/8 CHECKLIST from Machod Woldenan increased importance of science (statistics & ancedates, this past mestering century and facture. specific examp les of progress were made in recent Z years, esp. on medicine and health. 3 specific predictions /supportions re: future (new technologies, cures, breakthroughs) fin h 1H cleater Golder Brocthics - Garenance to I rescordi examples of misure in past-Tushegee, - radiation are ones we know- - others? NBAC. economy R.g., high tech indentries that are increasing importance of science & tech to our (Steeplitz) now leading in world competition, #of jobo. AIRS (CEA-Lyn) 6 ALSO... speeches/essays by. Gibbons, Gone, Varmus, Satcher (Reotes.) 7 gleen other Presidents (e.g., Eisenhower, postSputmik Kennely) waterfacom religiousfigues-Pope? 7 Freeden of Scentfir lugury Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a tabbed divider. Given our digitization capabilities, we are sometimes unable to adequately scan such dividers. The title from the original document is indicated below. Science in the National Interest Divider Title: Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a publication. Publications have not been scanned in their entirety for the purpose of digitization. To see the full publication please search online or visit the Clinton Presidential Library's Research Room. . Science in the National Interest OF MISIDENT OFTHE SEAL UNUM SEXTS THE UNITED THE UNITED President William J. Clinton Vice President Albert Gore, Jr. Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a tabbed divider. Given our digitization capabilities, we are sometimes unable to adequately scan such dividers. The title from the original document is indicated below. OSTP S & T Report Divider Title: THE WHITE HOUSE WASHINGTON To The Congress of the United States: A passion for discovery and a sense of adventure have always driven this Nation forward. These deeply rooted American qualities spur our determination to explore new scientific frontiers and spark our can-do spirit of technological innovation. Continued American leadership depends on our enduring commitment to science, to technology, to learning, to research. Science and technology are transforming our world, providing an age of possibility and a time of change as profound as we have seen in a century. We are well-prepared to shape this change and seize the opportunities SO as to enable every American to make the most of their God-given promise. One of the most important ways to realize this vision is through thoughtful investments in science and technology. Such investments drive economic growth, generate new knowledge, create new jobs, build new industries, ensure our national security, protect the environment, and improve the health and quality of life of our people. This biennial report to the Congress brings together numerous elements of our integrated investment agenda to promote scientific research, catalyze technological innovation, sustain a sound business environment for research and development, strengthen national security, build global stability, and advance educational quality and equality from grade school to graduate school. Many achievements are presented in the report, together with scientific and technological opportunities deserving greater emphasis in the coming years. Most of the Federal research and education investment portfolio enjoyed bipartisan support during my first Administration. With the start of a new Administration, I hope to extend this partnership with the Congress across the entire science and technology portfolio. Such a partnership to stimulate scientific discovery and new technologies will take America into the new century well-equipped for the challenges and opportunities that lie ahead. The future, it is often said, has no constituency. But the truth is, we must all be the constituency of the future. We have a duty - to ourselves, to our children, to future generations - - to make these farsighted investments in science and technology to help us master this moment of change and to build a better America for the twenty-first century. William 1. Cinton Chapter 1 CIENCE: THE ENDLESS RESOURCE Underpinning Our Nation's Economic Well-Being, Health, and National Security "Cutting back on research at the dawn of a new century where research is more important than it has been for even the last fifty years would be like cutting our defense budget at the height of the Cold War." unpredictability -President Bill Clinton hroughout time, humans have pondered the basic research on the way liquids pass through holes nature of the universe and the laws that order it, would lead to improved fuel injection systems for seeking to understand our world and our place in cars, ink-jet printers, and artificial heart valves; the cosmos. Curiosity and the quest for understanding basic studies of the attitudes and behaviors of tens punctuate all human growth and learning, beginning of millions of military personnel over decades would with our childhood questions: "What is it?" "How does lay the foundation for many of today's high-perfor- it work?" "What happens if ?" Basic (or fundamen- mance business management practices; tal) research seeks to answer these and other questions in all scientific fields. Basic research usually does not engineering experiments on microelectromechanical have a specific practical benefit in mind; it simply systems would create a billion-dollar industry pro- helps us understand the way things are and generates viding acceleration sensors for automobile air bags, new ideas and questions about the unknown. It has and many other products; taught us about the evolution of the physical universe, fundamental research on magnetism would trans- the evolution of life, and a wealth of other topics. form our society, making our information age possi- Inevitably, however, the results of basic research ble through tape recorders, video cassette recorders, are prerequisites for many advances that substantially and everything else that records and stores informa- improve our lives. No one could anticipate that: tion; or early studies of the DNA molecule would lead to decades of research in basic physics and chemistry genetic engineering to develop new and effective would provide the sophisticated tools essential for drugs, more productive crops, and more nutritious molecular biology, genome sequencing, and advanced foods; medical diagnosis and treatment. ultra-precise atomic clocks invented to test the laws Although it is virtually impossible to predict specifi- of physics would become the heart of the Global cally how today's basic research results will eventually Positioning System - now a multi-billion-dollar improve our quality of life, or to imagine the new business used for navigation, emergency rescue, industries and markets that will emerge, there is no racking commercial vehicles, and perhaps soon for question that such improvements and industries will air traffic control; arise. America's scientists and engineers are working Science and Technology Shaping the Twenty-First Century 11 Technologies/Industries Derived from Fundamental Science SUBSTANCE EXAMPLE SCIENCE TECHNOLOGIES/INDUSTRIES MATERIALS SCIENCE MATERIAL CRUDE OIL TRANSPORTATION, CONSTRUCTION: MANUFACTURING, MEDICINE CHEMISTRY CHEMICALS/PHARMACOLOGY MOLECULE BENZENE ATOMIC PHYSICS LASERS, TRANSISTORS, COMPUTERS ATOM CARBON CARBON NUCLEAR PHYSICS NUCLEAR POWER, MRI, NUCLEAR NUCLEUS NUCLEUS MEDICINE support Basis you admin NS/ ONS QUARK PHYSICS UNKNOWN HIGH-ENERGY PHYSICS UNKNOWN Basic science studies matter at all levels of aggregation, from the materials we experience everyday down to their most fundamental constituents. This progress leads to new scientific and technical knowledge and, years later, to innovative products and lucrative commercial markets. These advances have generated millions of high-skilled, high-wage jobs and significantly improved the quality of life for Americans. in universities, industrial laboratories, research insti- OUR NATIONAL GOALS FOR SCIENCE tutes, and national laboratories on important research. Their results will transform our lives in the twenty-first To advance America's interests in science, mathemat- century, just as we now reap the harvest from past discov- ics, and engineering, the Administration set forth the eries. Our children and grandchildren will look back with following goals in its 1994 science policy statement, the same wonder we experience today at the myriad ways Science in the National Interest: frontier basie has advanced society. To sustain leadership across the frontiers of scien- The Administration's commitment to basic research tific knowledge. derives from a clear and positive vision for the future prosperity of our nation and a strong belief that by creat- To enhance connections between fundamental ing knowledge and a well-educated citizenry, we gain the research and broad national goals. power to shape our future. Therefore, the Administration To stimulate partnerships that promote invest- has championed Federal investments in science and tech- ments in fundamental science and engineering and nology, stressing repeatedly that science fuels technol- effective use of physical, human, and financial ogy's engine - the engine of economic growth that cre- resources. ates jobs, builds new industries, and improves our stan- dard of living. Moreover, a significant component of Fed- To produce the finest scientists and engineers for erally sponsored research is performed in colleges and the twenty-first century. universities, where young scientists and engineers are To raise the scientific and technological literacy of trained in the process of creating new knowledge. all Americans. 12 Science and Technology Shaping the Twenty-First Century nieving these goals will ensure that our nation the dominant sponsor of the nation's long-term, basic has the specialized human resources as well as the research portfolio. The Administration has embraced modern infrastructure needed for cutting-edge science this role by continuing to support the basic science pro- and technology. The science and technology enterprise grams of the National Institutes of Health (NIH) in the weaves a vast and variegated fabric of knowledge, Department of Health and Human Services (HHS), the ideas, devices, and questions that covers a broad range National Science Foundation (NSF), the Department of of human curiosity and innovation. Energy (DOE), and the National Aeronautics and Space This report is organized around these science policy Administration. These programs are vital to our nation's goals, and this chapter focuses on leadership in the gen- future, as are those at the Department of Defense eration of fundamental knowledge that defines basic (DOD), and the Departments of Agriculture (USDA), science. The chapters on technology, health, environ- Commerce (DOC), Interior (DOI), and other Federal ment, and national security capture the partnerships agencies with targeted missions. Between FY 1993 and and connections that harness new knowledge, helping the Administration's FY1998 budget request, Federal us reach those overarching national goals. The chapter investment in basic research has risen from $13.36 bil- on human resources addresses the production of the lion to $15.30 billion - an increase of 14.5 percent. world's best scientists and engineers, and the need to This diversity of Federal sources of research funding improve public literacy in science and technology. and the rich variety of institutions and organizations conducting the research are two of the strengths con- tributing to U.S. leadership across the scientific fron- SUSTAINING LEADERSHIP ACROSS THE tiers. Universities and colleges - where education pro- FRONTIERS OF SCIENTIFIC KNOWLEDGE ceeds synergistically with the creation of new knowl- edge - consistently perform about one-sixth of all Leadership across the frontiers of scientific knowledge Federally funded R&D, and over half of our basic is not merely a cultural tradition of our nation - today research. Federal laboratories, nonprofit research an economic and security imperative. Creative institutes, and industrial firms are also major players. : working in diverse fields generate new knowl- The laboratories of DOE, NIH, NASA, and USDA, par- - rich in wonder and often leading to unexpected ticularly, are deeply integrated into America's funda- applications. The range of our research spans all major mental science enterprise in their mission areas. Rich fields of science and engineering and is one of its most in human talent and engineering capability, these Fed- powerful attributes. eral laboratories are renowned for unique, state-of-the- There is a solid consensus that maintaining the art scientific facilities, instruments, and other human resources and modern infrastructure essential resources, operated for and made available to the for scientific leadership is a fundamental Federal national scientific community. Of course, a major com- responsibility. Thus, public funding of research and ponent of the R&D portfolios of these laboratories, as development traditionally has enjoyed strong, biparti- well as those of DOD, DOC, and other agencies, serves san support. Government investments provide world- their overriding missions to ensure national security, class facilities, promote scientific breakthroughs and and to promote technological progress, health, envi- interdisciplinary linkages among the major science and ronmental quality, and food supply as described in the engineering fields, and train talented people to tackle other chapters of this report. emerging scientific challenges. As corporate R&D labo- Most important, the people actively engaged in the ratories have increasingly favored applied research and quest to understand the unknown power our innova- development projects likely to improve competitiveness tion system. They recognize, pursue, and exploit break- in the near term, the Federal government has become throughs, no matter where in the world they are made. America's Best: Our 1993-1996 Nobel Prize Winners In each of the last four years, American scientists funded by the U.S. government have won Nobel prizes. These awards reflect the enormous dividends of specific research investments included years ago in our national research and development portfolio by the National Science Foundation, the National Institutes of fealth, the Department of Energy, and the Department of Defense. Science and Technology Shaping the Twenty-First Century 13 Nobels Nobel Prize Winners 1993-1996 1993 NOBEL PRIZE IN PHYSICS awarded jointly to: Russell A. Hulse, Princeton University, Princeton, NJ, and Joseph H. Taylor, Jr., Princeton University, Princeton, NJ, for the discovery of a new type of pulsar, a discovery that has opened up new possibilities for the study of gravitation NOBEL PRIZE IN CHEMISTRY awarded for contributions to the developments of methods within DNA-based chemistry with one-half to: Kary B. Mullis, La Jolla, CA, for his invention of the polymerase chain.reaction (PCR) method and one-half to: Michael Smith, University of British Columbia, Vancouver, Canada, for his fundamental contribu tions to the establishment of oligonucleiotide-based, site directed mutagenesis and its development for protein-studies. NOBEL PRIZE IN PHYSIOLOGY OR MEDICINE awarded jointly to: Richard J. Roberts, (U.K.), New England Biolabs, Beverly, MA, and Phillip A. Sharp, Massachusetts Institute of Technology, Cambridge, MA, for their discoveries of split genes. BANK OF SWEDEN PRIZE IN ECONOMIC SCIENCES IN MEMORY OF ALFRED NOBEL awardedijointly to: Robert W. Fogel, University of Chicago, Chicago, IL, and Douglass C. North, Washington University, St. Louis, MO, for having renewed research in economic history by applying economic theory and quantitative meth- ods in order to explain economic and institutional change. 1994 NOBEL PRIZE IN PHYSICS awarded for pioneering contributions to the development of neutron scat tering techniques for studies of condensed matter with one-half to: Bertram N. Brockhouse, McMaster University, Ontario, Canada, for development of neutron spectroscopy and one-half to: Clifford&G Shull, Massachusetts Institute of Technology, Cambridge, MA, for the development of the neutron diffraction technique. NOBEL PRIZE IN CHEMISTRY awarded to: George A. Olah, University of Southern California, for his contribution to carbocation chemistry. NOBEL PRIZE IN PHYSIOLOGY OR MEDICINE awarded jointly to: Alfred G. Gilman, University of Texas Southwest Medical Center, Dallas, TX, and Martin Rodbell, National Institute of Environmental Health Sciences, Research Triangle Park, NC, for their discovery of G-proteins and the role of these proteins in signal transduction in cells. BANK OF SWEDEN PRIZE IN ECONOMIC SCIENCES IN MEMORY OF ALFRED NOBEL awardedjointly to: John C. Harsanyi, University of California-Berkeley, Berkeley, CA, John F. Nash, Princeton University, Princeton, NJ, and Reinhard Selten, Rheinische Friedrich Wilhelms Universität, Bonn, Germany, for their pioneering analysis of equilibria in the theory of non-cooperative games. 14 Science and Technology Shaping the Twenty-First Century 1995 NOBEL PRIZE IN PHYSICS awarded for pioneering experimental contributions to lepton physics with one-half to: Martin L. Perl, Stanford University, Stanford, CA, for the discovery of the tau lepton, and one-half to: Frederick Reines, University of California-Irvine, Irvine, CA, for the detection of the neutrino. NOBEL PRIZE IN CHEMISTRY awarded jointly to: Paul J. Crutzen (Netherlands), Max Planck Institute for Chemistry, Mainz, Germany, Mario J. Molina, Massachusetts Institute of Technology, Cambridge, MA, and Sherwood F. Rowland, University of California-Irvine, Irvine, CA, for their work in atmospheric chemistry, particularly concerning the formation and decomposition of ozone. NOBEL PRIZE IN PHYSIOLOGY OR MEDICINE awarded jointly to: Edward B. Lewis, California Institute of Technology, Pasadena, CA, Christiane Nüsslein-Volhard, Max Planck Institut für Entwicklungsbiologie, Germany, and Eric F. Wieschaus, Princeton University, Princeton, NJ, for their discoveries concerning the genetic control of early embryonic development. BANK OF SWEDEN PRIZE IN ECONOMIC SCIENCES IN MEMORY OF ALFRED NOBEL awarded to: Robert E. Lucas, Jr., University of Chicago, Chicago, IL, for having developed and applied the hypothesis of rational expectations, and thereby having transformed macroeconomic analysis and deepened our understanding of economic policy. 1996 NOBEL PRIZE IN PHYSICS awarded jointly to: David M. Lee, Cornell University, Ithaca, NY, Robert C. Richardson, Cornell University, Ithaca, NY, and Douglas D. Osheroff, Stanford University, Stanford, CA, for discovery of superfluidity in helium-3. NOBEL PRIZE IN CHEMISTRY awarded jointly to: Robert F. Curl, Jr., Rice University, Dallas, TX, Richard E. Smalley, Rice University, Dallas, TX, and Sir Harold W. Kroto, University of Sussex, Brighton, U.K., for their discovery of fullerenes. NOBEL PRIZE IN PHYSIOLOGY OR MEDICINE awarded jointly to: Peter C. Doherty (Australia), St. Jude's Hospital Memphis TN, and Rolf M. Zinkernagel, University of Zürich, Switzerland, for their discoveries concerning the speci- ficity of the cell mediated immune defense. BANK OF SWEDEN PRIZE IN ECONOMIC SCIENCES IN MEMORY OF ALFRED NOBEL awarded to: James A. Mirrlees, University of Cambridge, U.K., and William Vickrey, Columbia University, New York, NY, for their fundamental contributions to the economic theory of incentives under asymmetric information. Science and Technology Shaping the Twenty-First Century 15 For example, in the mid-1980s European scientists discovered high-temperature supercon- ductors. Immediately, Ameri- can investigators with the req- uisite expertise turned their energies with great success to extending and exploiting this discovery, both in terms of fun- damental understanding and engineered applications. Given the growing linkages among the scientific and tech- nical disciplines, it is impossi- ble to predict what expertise will be indispensable for future developments. As with any investment portfolio, cer- tain areas will be emphasized at any given time because of special opportunities for progress and impact. The Fed- eral portfolio, however, must remain broad-based and accommodate the high-risk investments that may have enormous long-term impact. It is increasingly evident that the major fields of science and engineering mutually catalyze one another - strengthening the fabric of science and, with it, the entire science and tech- nology enterprise. By advanc- Scientific breakthroughs spur new technologies that, in turn, enable improved scien- ing all frontiers of knowledge, tific capabilities to explore the unknown. It was not until the mid-1980s that physics under- creative American scientists standing, niobium purity, and ultraclean manufacturing and processing techniques made it feasible to build a superconducting electron accelerator needed to explore the innermost and engineers, along with structure of the atom's nucleus. The world's largest assembly of superconducting accelerator their students, enrich the pre- cavities is now at the Department of Energy's Thomas Jefferson National Accelerator Facil- sent and shape the future. ity in Newport News, Virginia. BASIC RESEARCH FUNDING BY AGENCY BASIC RESEARCH PERFORMERS FEDERAL BASIC RESEARCH PORTFOLIO FY 1998 Budget Request $15.3 Billion FY 1995 $14.2 Billion FY 1995 $14.2 Billion NSF Federal Laboratories Biological & Medical Sciences Engineering. DOE Computer Solence & Mathematics Other NIH Other Industry Social & Behavioral NASA Sciences Universities Environmental Non-Profits & Colleges Sciences Physical Sciences DOD Source: NSF Science and Source: NSF Science and USDA Source: OMB Others Engineering Indicators, 1996 Engineering Indicators, 1996 16 Science and Technology Shaping the Twenty-First Century eries that inspire our children and society GERMANY at large. This ability to uncover and understand nature's secrets is a uniquely UNITED STATES human accomplish- ment. Only the Fed- eral government can UNITED KINGDOM supply the truly "patient capital" for FRANCE the long-term invest- CANADA ment in basic ITALY research. The human infra- structure - creative scientists and engi- neers, trained at the research frontier and able to move boldly in response to new opportunities and challenges - posi- tions America at the forefront of the nondefense R&D/GDP ratios of both Japan (2.7 percent) and Germany (2.4 percent) consid- "brainpower indus- erably exceeded that of the United States (2.0 percent) in 1993 and have done so for years. The non- tries" of the future. defense R&D ratio of France matched the ratio of the United States; the ratios of the United King- Such industries - dom (1.9 percent), Canada (1.5 percent), and Italy (1.3 percent) were somewhat lower. high technology, health-care technol- In this time of constrained resources, some have ogy and biotechnology, business technologies, multime- argued that less emphasis should be placed on basic dia technologies, and others - increasingly support research, since its results are typically available to any- expansion of our export economy. America's economic one in the world. Japan, for example, has developed resilience, as demonstrated in the rapid recovery of our strong market positions for some products, particularly leadership in semiconductors over the last five years, is consumer electronics, for which American scientists did clearly tied to our strength in science and technology, much of the original research and development. The especially the basic and applied research capacity and Administration rejects this simplistic argument. The human capital that spring from our research universi- dominance of our basic research enterprise is a core ties. Indeed, it is noteworthy that Japan's decision to American strength that must be preserved. This enter- dramatically increase research funding emphasizes prise, in addition to producing new knowledge that is strengthening its research universities. indeed appropriable by others, generates the physical Competitive advantages clearly accrue to nations and human infrastructure that underlies our national fashioning the future through investments that innovation system and our society's resourcefulness in return new, basic knowledge. Although our total the face of rapid technological change. investment in non-defense research and develop- We also must remember that basic research repays ment remains the highest in the world, it is only 75 society in the near term through newsworthy discov- percent that of Japan and 85 percent of Germany's as a fraction of Gross Domestic Product (GDP). We must not let our position erode and thus compro- (Left) The diversity of Federal sources of basic research mise our future. ding, and the variety of institutions and organizations lucting the research contribute to U.S. leadership across scientific frontiers spanned by the Federal scientific and technical research portfolio. Science and Technology Shaping the Twenty-First Century 17 Mediane Lakthroughs with impacts comparable to those of the transistor, optical fiber, and solid- state laser. Continued progress and innova- tion in materials research lies at the heart of our scientific and technological future. FROM MOLECULES TO MEDICINE The human genome is the complete set of genetic instructions found in the nucleus of most cells on 23 pairs of chromosomes that THE VISIBLE are long strands of HUMAN DNA. Each gene is a PROJECT Images derived from the segment of DNA that arries the blueprints National Library of Medicine's Name a specific molecule, Visible Human Data Set usually a protein. When there is a mis- "Visible Humans" have transformed the teaching and practice of medicine. A 59-year-old take in the order of female and a 39-year-old male donated their bodies to science, and became immortalized as the first digitized cadavers, available to the public and the medical community over the Internet. Images chemical bases that obtained from computerized tomography, magnetic resonance imaging, and high-resolution pho- comprise the DNA cod- tographs were compiled into a database, providing complete, anatomically correct, three-dimensional ing for a specific pro- views. The uses of these "recyclable" bodies include rehearsal of surgery, repeated dissection, comput- tein, that protein may erized crash testing, and numerous other medical simulations. be altered, missing, or ineffective in the family members carrying the error. genetic component. By developing and making widely The methods for locating such disease genes include available the tools for locating and rapidly sequencing the construction of detailed maps to identify the posi- genes, the Human Genome Project - an ambitious tion of the gene on a chromosome, sequencing the DNA international research effort - is accelerating the in the area where the gene is localized, and comparing progress of molecular medicine. the gene sequence in individuals who have the disease The Human Genome Project, funded by NIH, DOE, with those who do not. For a newly isolated gene, the and several international partners, is helping scien- researcher can quickly gather from on-line databases tists gain a genetic understanding of disease and also everything that has already been determined about its of healthy processes, such as growth, development, identity, function, and protein product. and how the immune system recognizes a foreign Over many years, the list of human diseases that invader. Once the genetic basis of a disease is discov- result from known defects in a single gene has grown ered, scientists have a better chance of defeating it. to about 4,000. Many of these conditions are rare and One example is prevention based on detection of a afflict only a fairly small number of people; sickle cell genetic predisposition to an inherited disorder such as disease is an exception, affecting more than 50,000 colon cancer. Individuals who inherit certain muta- individuals in the United States. However, it has also tions on chromosomes 2 or 3 have a 70 to 80 percent ecome clear that many complex afflictions, such as chance of developing a particular type of colon cancer. cardiovascular disease, diabetes, Alzheimer's disease, They may benefit from eating a high-fiber, low-fat diet some forms of cancer, and other diseases, have a strong and from scheduling annual colon exams starting at Science and Technology Shaping the Twenty-First Century 23 THE NATIONAL SCIENCE FOUNDATION'S NEW MAJOR SCIENTIFIC FACILITIES National Nanofabrication Users Network (Nodes in California; New York; Pennsylvania; Washington, D.C.); operational in 1994. Network providing electronic access to fabrication equipment and expertise on nanoscale materials and devices. Gemini Observatories (Hawaii, Chile); to be completed in 2000. New-generation 8-meter optical/infrared telescopes with matching facilities in Northern and Southern Hemispheres. National Radio Astronomy Observatory/Greenbank Telescope (West Virginia); to be completed in 1998 World's largest and most versatile steerable radio telescope National Optical Astronomy Observatories (NOAO)/WIYN Telescope (Arizona); completed in 1993. Tele- scope for optical and infrared astronomy. NOAO/Global Oscillation Network (worldwide); completed in 1995. Network of telescopes to monitor the Sun. National Astronomy and Ionosphere Center (Puerto Rico); to be completed in 1997. Upgrade for planetary astronomy and upper atmosphere studies. National High Magnetic Field Laboratory (Florida; New Mexico); began operations in 1993. Science and engineering research on materials. Cornell Electron Storage Ring (New York); to be completed in 1999. Upgrade for high energy physics and synchrotron radiation experiments. Laser Interferometer Gravitational Wave Observatory (Louisiana and Washington); to be completed in 2001. Will study gravitational waves to test Einstein's theory of gravitation and to open a new type of astronomy. age 30, an age considerably younger than that recom- learning skills and interaction modes. Merely being mended for the general population. able to read, write, and calculate is no longer sufficient. Another disease that can now be detected by testing Everyone needs to master the skills required to extract a blood specimen is cystic fibrosis, the most common and integrate relevant information and use it for com- lethal hereditary disease among Caucasians. The first plex decision-making and problem-solving. human gene therapy trials are under way in Federally The Federal government has supported much of the approved clinical trials. Understanding the course of research on how humans learn, process information, cystic fibrosis at its most elementary level already has and then use that information to solve problems. Recent led to the development and approval of a drug that decades have seen dramatic advances in our under- dramatically lessens its severity and improves the standing of human learning, from the level of neuro- quality of life for those suffering from it. chemistry and brain structure to the whole person. The ethical, legal, and social issues associated with Neuroscientists, engineers, and computer scientists human genome research are being addressed in paral- have developed new tools to provide insights into how lel with the scientific exploration and in a manner human memory organizes different kinds of informa- that encourages maximum public involvement. In tion. Psychologists and linguists are characterizing cog- addition, President Clinton established the National nitive phenomena and mental processes ever more thor- Bioethics Advisory Commission and charged it to con- oughly. Artificial intelligence researchers have repli- sider as one of its first priorities the appropriate use cated mechanisms for learning and decision-making and management of genetic information. Our policies that have widespread applicability. Education and regulations need to keep pace with knowledge researchers have developed cognitive-based methods that promises such great rewards in disease preven- that significantly improve students' thinking skills tion and cure. through research-based teaching. Engineers and com- puter scientists have developed intelligent systems that LEARNING AND HUMAN POTENTIAL can learn from their environments and operate complex systems safely and reliably. All this progress has appli- The current revolution in information and communica- cations in education reforms, medicine, psychotherapy, tions technologies is creating demands for new human and management. 24 Science and Technology Shaping the Twenty-First Century Health Chapter 5 HEALTH Improving Health Through Research for Better Medical Care and a Safe and Abundant Food Supply "Our strategy for continuing to improve America's health, safety, and food emphasizes investing in the fundamental research necessary to assure our future well-being, promoting prevention in the areas of both health care and environmental protection, and educating Americans so they can improve their own health and safety decisions." - President Bill Clinton mproving the health of our nation's citizens contin- Protection Agency (EPA), and the Departments of ues to be a major goal of our Federal investment in Energy (DOE), Defense (DOD), Veterans Affairs (VA) science and technology. Starting in 1862 with the and Commerce, sponsor research programs that con- financial support for our Land Grant institutions and tribute greatly to improving the health and food secu- State Agricultural Experiment Stations (SAESs), and rity of all Americans. through the establishment in 1887 of the laboratory In addition to improved health, this Federal invest- that became the National Institutes of Health (NIH), ment contributes to an economically robust agriculture the United States has developed a system of intra- and health care industry. The production of food and and extramural support for health-related research fiber is the nation's largest industry, accounting for that is the envy of the world. Clearly, Federal support about 15 percent of Gross Domestic Product (GDP) for biomedical and agricultural research has resulted and approximately 16 percent of all civilian jobs in the in enormous improvements in the overall health and U.S. economy. Our nation's agricultural exports con- well-being of our nation's citizens. Today, average life tribute over $100 billion in business activity with a expectancy of 76 years is 60 percent greater than the positive trade balance of approximately $20 billion. typical life expectancy of 47 years nearly a century Likewise, health care and related activities are esti- ago. Much of that increase is due to better food, better mated to account for up to one trillion dollars in sanitation, and medical advances including vaccina- annual expenditures in the United States, with 7.4 tions to reduce or eliminate many childhood diseases. percent of the U.S. workforce making its living in the Federal funding for biomedical and agricultural health care industry. research is multifaceted. Although the primary per- Even though our past investment strategy has been formers are university and Federal scientists sup- enormously successful, the economic, scientific, and ported by the Department of Health and Human Ser- social context for future science and technology invest- vices (HHS) and the Department of Agriculture ments in health has changed dramatically in the last USDA), other Federal agencies, such as the National decade. With these changes, it is imperative that we Science Foundation (NSF), National Aeronautics and reassess our Federal investments and make changes Space Administration (NASA), the Environmental to reflect new realities. Science and Technology Shaping the Twenty-First Century 95 In health care, major shifts are occurring in the age THE ADMINISTRATION'S COMMITMENT distribution of the U.S. population. For example, in 1990, 12.5 percent of our citizens were age 65 and TO BIOMEDICAL RESEARCH older. In 2030 half of the baby boomers will reach This Administration has strongly backed biomedical 65, resulting in over 20 percent of the nation falling research investments. Since 1993, the NIH budget has in the 65 and older age category. (U.S. Census been increased by $2.4 billion (23 percent), represent- Bureau projections). This will increase the preva- ing significant new investment in biomedical research, lence of diseases that are associated primarily with in an era of constrained budgets. This commitment rec- the elderly, such as some types of cancer, ognizes the need for stability to protect our long-term Alzheimer's disease, and osteoporosis. Shifts also investment in the biomedical sciences. Living cultures are occurring in how healthcare is financed, with or animal strains must continue to be fed, patients more and more people participating in managed enrolled in clinical trials must be cared for, and the care programs. We must determine the impact this search must be continued for better methods for pre- will have on basic and clinical research that under- venting, diagnosing, and treating disease. The Admin- lies future medical advances. In an attempt to keep istration continues to sustain this critical investment down costs of long-term care, as well as improve the in order to reap the benefits of better health and qual- overall quality of life, greater attention is now being ity of life. given to research leading to better methods of pre- venting diseases. NEW APPROACHES TO In agriculture, growing environmental and human health concerns coupled with new trade agreements UNDERSTANDING DISEASE PROCESSES and commodity price support policies require the Federal government to reassess its science and tech- Scientific and technological breakthroughs are provid- nology priorities and strengthen its partnerships ing new approaches to solving many of the long-stand- with the states and private sector. In order to keep ing mysteries of life and its damaging diseases. We agribusiness strong and to ensure a safe and reli- now have very powerful tools, developed through able food supply, the Federal government must advances in computing, instrumentation, and recombi- maintain its research investments that produce new nant DNA techniques, to help us understand what hap- knowledge to improve environmental and human pens when normal biological processes go awry. We are health and expand economic opportunities. beginning to apply this knowledge to developing ambi- In February 1996, President Clinton released a tious strategies to bolster our natural protection sys- report of the National Science and Technology Council tems and speed recovery. These tools have myriad entitled, Meeting the Challenge: A Research Agenda for applications that may lead to new disease treatments America's Health, Safety, and Food. This report takes and new methods of disease prevention. Learning how into account the numerous changes that we are experi- healthy cells, organs, and organ systems operate when encing in both heálth care and agriculture. It offers research strategies to contain health care costs while preserving access to high quality health care services, Using tools emerging to develop sustainable agriculture and environmental from the Human Genome Project, an management, and to contribute to our national secu- international team rity by enhancing international disease surveillance tracked the gene for and access to food. hereditary nonpolypo- The breadth and diversity of our Federally sup- sis colon cancer to a ported research activities related to improving health region of chromosome 2. Gene-based therapies range from fundamental research in molecular biology may be designed to to crop breeding programs for improved pest resis- augment the immune tance. This chapter highlights a number of the Admin- system's response to istration's accomplishments spanning the breadth of cancer or to boost the our health-related research portfolio, and describes effectiveness of chemotherapeutic key areas of opportunity that merit enhanced support agents. consistent with the strategic goals articulated in Meet- ing the Challenge. 96 Science and Technology Shaping the Twenty-First Century y are fully functional allows us to attempt to repli- for a fusion cofactor; in effect, the defect was a lifesaver. cate, or add back defective pieces when necessary. For HIV was unable to gain entry into the immune system example, radiation or the sun's rays can damage DNA because the cells lacked the needed receptor protein. within the cell's nucleus, sometimes leading to skin and NIH-supported basic biomedical research on HIV other cancers. If we can recreate DNA repair mecha- has allowed researchers to elucidate the viral life cycle nisms, perhaps we may be able to prevent such damage and identify three specific enzymes critical to HIV in the future. replication. One of these critical enzymes is HIV pro- Although disease has always been part of life, certain tease. This enzyme is involved late in the HIV replica- behaviors and activities associated with the modern world tion process at the stage of viral particle formation, present numerous new health challenges. For example, release, and maturation. greater use of modern transportation can rapidly spread X-ray crystallography and structure-based drug infectious disease, unhealthy diets can led to osteoporosis design programs have been used to determine both the and other diet-related diseases, and smoking can result in structure of HIV protease and other molecules that cancer and heart disease. A greater understanding of the might inhibit its activity. Preventing viral replication behavioral factors and related activities underlying many would potentially stop the spread of infection from conditions may lead to more effective methods of interven- HIV-infected cells to uninfected cells, ultimately halt- tion and prevention. ing disease progression in the patient. HIV protease inhibitors are achieving dramatic results in some HIV/AIDS AIDS patients. Acquired immunodeficiency syndrome (AIDS) is now the ALZHEIMER'S DISEASE leading cause of death among Americans aged 25-44. As of June 1995, more than 500,000 cases of AIDS had been Alzheimer's disease (AD) already affects four million reported in the United States. It is estimated that over 20 Americans and that number will increase dramatically "ion people world wide might be infected with the as the baby boomers reach the age of highest risk. NIH an immunodeficiency virus (HIV). Researchers must scientists have identified four genes that play a role in swer some very basic questions about how the virus this devastating illness. Defects in either of two of behaves within the context of the human immune system these genes, PS1 and PS2, may be responsible for up to before they can hope to design effective therapeutic and 80 percent of a subtype of AD that strikes before age protective measures. 65. Recent progress in the field of protein structural HIV infection is so different from the majority of infec- biology is being applied to better understand neurode- tious diseases that scientists must develop innovative and generation and other diseases of the aging nervous sys- diverse approaches to learning how the virus functions tem, including AD. Sophisticated imaging technologies and how the body responds to it. In most cases of infec- are being used to develop structural maps and to visu- tion, the immune system recognizes that a microorganism alize molecular interactions in the aging brain. Under- has invaded or damaged body cells and quickly destroys standing the functional consequences of changes in the the intruder. In the case of HIV, however, the target of the 3-D structure of brain proteins has the potential to virus is a type of cell known as CD4; a part of the identify new treatments for AD and other neurodegen- immune system itself. CD4 cells are named for a protein erative disorders. receptor on the cell surface which is used by HIV to bind to the cell. Researchers have recently confirmed that the NEW PREVENTIVE STRATEGIES CD4 receptor is not sufficient for the virus to fuse with and infect the immune cells. NIH-supported scientists AGAINST DISEASE AND DISABILITY and others have recently discovered two cell surface pro- teins, fusin and CCR5, that act as "cofactors," or corecep- It is obvious that preventing disease is preferable to tors, with CD4 that assist HIV in binding to and infecting treating it after it occurs. Disease and disability pre- immune cells. vention offer the patient and the community-at-large These discoveries are important for developing new better quality of life and the economic benefits atten- anti-HIV drugs to block or interfere with the binding of dant to higher productivity. Ideally, prevention mea- HIV to the receptors. At the same time, they may also sures also incur lower health care costs, as in the case 'ain why some people are seemingly immune to HIV, of vaccines. Some prevention measures, such as edu- pite repeated exposure. Scientists have determined cation, may be more costly or involve greater effort, that two such individuals had inherited defective genes but the scales are tipped in their favor in terms of Science and Technology Shaping the Twenty-First Century 97 Pertussis Vaccine - Collaborations between NIH-supported scientists, vaccine manufacturers, and investiga- tors around the world recently have resulted in a new class of vaccines for pertussis, or whooping cough, which each year claims 350,000 lives worldwide, primarily infants. The pertussis vaccine type that has been the "gold standard" for nearly 50 years is made from whole, killed pertussis-causing bacteria. It is extremely effective, but has been associated with adverse effects more frequently than any other vaccine in general use for infants. Many years of collaboration between NIH-supported basic scientists and the pharmaceutical industry have led to the development of so-called acellular pertussis vaccines that use only parts of pertussis bacteria instead of the whole organism. NIH-supported trials have demonstrated that three new acellular pertussis vaccines markedly reduce the frequency of side effects without diminishing the vaccines effectiveness Rotavirus Vaccine - NIH intramural scientists recently developed and patented the first vaccine against rotavirus, the cause of infections that annually result in an estimated 130 million cases of diarrhea in infants and children. Moderate to severe dehydration occurs in 18 million of these episodes, and more than 870,000 children world-wide die as a consequence. In the United States alone, rotaviral infections incur costs of $500 million annually in doctor visits and hospitalizations. The new vaccine protects against four different strains of human rotavirus. Clinical trials have shown the vaccine to safely achieve significant reductions in the inci- dence of rotavirus diarrhea. It is 80 percent protective against severe rotaviral disease and completely effective in preventing dehydrating illness. Routine childhood vaccination against rotavirus could quickly alleviate this major public health problem. Hemophilus influenzae type b Vaccine - The vaccine against Hemophilus influenzae type b (Hib) menin- gitis provides the means to completely eliminate this disease from the United States within the next few years. For years, this disease had devastated our children, affecting 15 to 20 thousand of them each year, almost as many as polio at its peak. Hib killed 10 percent and left one third deaf and another one third mentally retarded, making it this country's leading cause of acquired mental retardation. Fortunately, two NIH scientists were instrumental in developing a safe and effective vaccine which, together with three other licensed Hib vac- cines, has reduced the incidence of Hib by 95 percent since their use began in 1988. With greater use across the country, we have the hope of completely eliminating Hib meningitis. societal benefits. For these reasons, prevention stages of life includes reducing sudden infant death research is a high priority and spans the full range of syndrome (SIDS) and early diagnosis of osteoporosis. biomedical and behavioral research. The latest tech- In addition, bionutrition, including the genetic basis nologies, such as protein engineering and recombi- of eating disorders and pathological consequences of nant vaccine development as well as social and behav- particular diets, has become an important area for ioral sciences, are being put to good use in erecting study in prevention of disease. effective barriers against disease and disability. Rising health care costs increase the importance of EMERGING INFECTIOUS DISEASES research to prevent disease and minimize the impact of illness and injury. New preventive strategies To ward off pathogenic microbes, we are critically against disease involve investigations of emerging dependent on research to identify infectious diseases infections, as well as the prevention and treatment of and to provide improved drugs and new vaccines. drug and alcohol abuse. Vaccines against cancer and Both basic and clinical research are key, as the speed infectious diseases such as HIV, otitis media (ear- with which we develop the new antibiotics, new vac- aches), herpes, chicken pox, pneumococcus, Shigella cines, and effective treatments will depend upon our and Salmonella, are being studied. Prevention also understanding of the human immune system and the entails the behavioral, genetic, and environmental ever-growing number of pathogens that threaten aspects of risk assessment. The control of transmis- human health. Research must also focus on the rela- sion of infectious disease by, for example, microbicide tionships and linkages among disease and climate, or behavioral changes, is an important aspect of pre- ecological change, population growth, and human vention research. Prevention research across all behavior. 98 Science and Technology Shaping the Twenty-First Century Vaccines are our strongest form of preventive medicine. Scientists supported by the National Institutes of Health have developed new vaccines for pertussis, rotavirus, and Hemophilus influenzae type b. The latter vaccine provides the means to completely eliminate this disease from the United States in the next few years. BETTER HEALTH THROUGH VACCINES Since Vice President Gore announced the Presi- New recombinant DNA tools, advanced gene transfer tech- dent's policy directive on emerging infectious dis- niques, and monoclonal antibody production are greatly eases (EID) in July 1996 (see vignette on Combat- improving public vaccination efforts. Vaccines now in devel- ting Ebola Hemorrhagic Fever, Chapter 3), the opment will provide greater protection for our nation's chil- National Science and Technology Council launched dren against a wide range of infections and will lead to a number of new research initiatives. To expand reduced disease and lower health care costs. For example, EID research, for example, NIH has funded ten development of a vaccine against otitis media is under way. international EID training awards and provided Such a vaccine would benefit millions of American children funding to expand four ongoing research and train- who suffer from this often chronic disease, which is respon- ing efforts related to EIDs. The VA and DOD are sible for more than $3.5 billion worth of visits to doctors' investing jointly in research on emerging offices, clinics, and emergency rooms annually. pathogens. NASA is supporting an NIH effort to In response to a comprehensive evaluation of the NIH study emerging viral diseases using remote sensing, AIDS research program, NIH has established an AIDS and the Centers for Disease Control and Prevention Vaccine Research Committee, a highly distinguished are cooperating with NIH on epidemiologic surveys. group of outside advisors in immunology, virology, and NIH also has initiated long-term programs to study vaccinology. The committee, chaired by Nobel Laureate hepatitis C, hantavirus, the infectious origins of David Baltimore, will address key scientific questions in stric ulcers, and Lyme disease. NIH and DOD are vaccine development, including new vaccine designs, operating on the synthesis and testing of a new efforts to understand the mechanisms of protection in ani- drug against the Ebola virus. mal models, and potential new targets for vaccines. Science and Technology Shaping the Twenty-First Century 99 c CRAYOLA® CHROMOSOMES 1 2 3 4 5 "Toto, I have a feeling we're not in Kansas anymore We must be over the rainbow." Nearly 60 years after Dorothy left grey Kansas for the vibrant land 6 7 8 9 10 11 12 of Oz, wizards of a different sort have concocted a powerful new way to visualize the full set of human chromosomes in a rainbow of col- 00 ors. The new technique, called "spectral karyotyping," translates 13 14 15 16 17 18 computer-gathered light waves into a full-color palette and assigns each chromosome its own distinct hue. With all 23 pairs of human chromosomes identified by a different color, scientists can more eas- 19 20 21 22 X Y ily examine the entire set of chromosomes for changes that could lead to a disease, such as missing or extra pieces, or parts from This image shows the full complement of 23 different chromosomes that have swapped places The technique pairs of human chromosomes, each painted a dif could prove to be extremely valuable in diagnosis of disease based ferent color using the new labeling technique on chromosomal alterations. called "spectral karyotyping." "The value of chromosome examination in understanding the changes that take place during disease progression could be greatly enhanced if we could study the entire genome at once, and clearly distinguish genetic material belonging to one chromosome from that of another," said National Human Genome Research Institute scientist Thomas Ried, who led one of two groups that developed the technique. David Ward led a Yale University team in creating a different method that reached the same endpoint in chromosome analysis. The power of the current diagnostic techniques is limited in examining whole chromosome sets, called karyotypes, for changes, because the methods rely on chemical stains that reveal only shades of gray. Pieces moved from one chromosome to another - a process called "translocation" that is often associated with dis- ease - cannot easily be detected. And in diseased cells containing several badly distorted chromosomes, tracking the multiplication or exchange of genetic material is often impossible with conventional black-and- white banding. Chromosome banding was first developed in the early 1970s, when it was observed that each human chromosome portrayed a characteristic pattern of bands when exposed to chemical stains. This allowed researchers to identify and sort out human chromosomes under the microscope not only by their size but also by their characteristic staining patterns. PREVENTING DISABILITY AMONG OLDER AMERICANS lems - are nearly 8-fold more likely to be involved in automobile accidents or traffic violations compared to Preventive health care for older Americans has a high those with no risk factors. payoff. More than $108 billion is spent annually on long- term care for the elderly in the United States. Research showed a 44 percent reduction in serious falls Researchers are studying risk factors for disability, among older persons through the use of interventions improving screening processes to identify at-risk popula- focused on physical risk factors, such as bone fragility, tions, and designing and evaluating interventions specifi- muscle weakness, use of sedatives or multiple medica- cally targeted to at-risk individuals. The research is pay- tions, and balance and walking problems. ing off: Elderly patients who were cared for in a special hospi- Three short tests of physical performance abilities can tal unit that focused on rehabilitation, prevention of strongly predict the occurrence of disability as much as disability, and preparation for the patient's return to four years in advance. home were significantly more able to perform basic Older persons with three selected risk factors - such as activities of daily living and less likely to need insti- mental impairment, low physical activity, and foot prob- tutionalized long-term care than individuals who 100 Science and Technology Shaping the Twenty-First Century As staining techniques evolved, scientists used them to link chromosome changes to disease; missing bands indicated a deletion of genetic material, as in some inherited diseases, whereas extra bands, or translocations, indicated altered or additional genetic material, as is the case in many cancers. Higher-resolution molecular techniques for visualizing chromosome regions, particularly fluorescence in situ hybridization, or FISH, later improved the process. FISH uses DNA probes labeled with fluores cent dyes to identify specific chromosomal regions. Spectral karyotyping is a new way to interpret data from FISH experiments and has distinct advantages over conventional microscopy. Ried and his coworkers applied spectral imaging, a technology used in remote sensing devices, to chromosomes isolated from cells. First, they applied different molecular "paints" to the chromosomes. The wavelengths of light, or emission spectra, emitted by each c painted chromosome provided a unique "thumbprint" for that chromosome. Although to the eye, the thumbprints are diffi cult to distinguish from one chromosome to the next, comput- ers rapidly detect differences in emission spectra and assign each chromosome its own easy-to-see color. In a spectral kary- otype from a healthy cell, for example, computers translate the emission spectrum for chromosome 1 into yellow, chromosome 2 red, 3 gray, 4 turquoise, and so on. mar1 mar2 mar3 mar4 mar5 mar6 Spectral karyotyping has already been applied successfully to analysis of cells from leukemia patients. Ried collaborated 3₈ 13 with Janet Rowley from the University of Chicago to locate a 17 predicted chromosomal abnormality. In the process, several 14 4 additional translocations were identified. These types of stud- 14 14 2 8 ies will improve scientists' understanding of the genetic basis 4 6 4 8 12 3 of cancer and may ultimately assist the development of new 8 12 13 methods for cancer treatment and prevention. In addition to its role in identifying chromosome changes related to the progression of disease, the authors report that This technique highlights broken and spectral karyotyping may be valuable in comparing genomes rearranged chromosomes in a breast cancer cell line, a method that may lead to early diagno- from different species to determine how genetic composition sis of disease. evolved over hundreds of thousands of years. received standard hospital care. This was accom- the discovery of human disease genes and are now plished without increasing in-hospital or post-dis- widely used by researchers. For example, obesity genes, charge costs. genes for aging, neurological disease genes, and cancer genes, such as BRCA-1 and 2, are being identified and GENETIC MEDICINE characterized. Once the consequences of altered genes are understood, rational therapies may be able to be Genetic medicine is the application of DNA technologies designed. Gene therapy to replace missing or defective to the diagnosis, treatment, and prevention of disease. It genes, is one such approach that is under investigation. also includes analysis of complex diseases such as dia- It has proven difficult to insert genes that operate prop- betes and assessment of genetic risk. The mapping and erly and produce adequate protein products. sequencing of entire genomes (human, as well as yeast, Most complicated diseases of modern life - cancer, "m, fruit fly, and mouse) are critical components of heart disease, diabetes, arthritis, and a host of neu- tic medicine. The technological tools developed in ropsychiatric disorders - seem to result from the activ- ent years mapping techniques, various methods for ities of several genes and the interactions between the sequencing the genome, and others - have accelerated human body and its environment. The direct causes of Science and Technology Shaping the Twenty-First Century 101 these disorders have been difficult to discover. this technology to the understanding of disease. The Research at the NIH Center for Inherited Disease Cancer Genome Anatomy Project seeks to define all the Research will specialize in applying computer-based genes that play a critical role in the development of technology and robotics to conduct large-scale, rapid cancer. The project will develop high volume, cost effec- genetic analysis of these diseases, leading to the identi- tive technologies to analyze the molecular mechanics of fication of the genes involved. Developments are cur- cancer cells and put those technologies in the hands of rently under way to enable simultaneous analysis of clinical researchers. Coupling these technologies with thousands of DNA strands on a single silicon chip. clinical investigation will provide a better understand- These micro-machines greatly speed up research and ing of the basis of disease, as well its detection, diagno- lower its cost. sis, prognosis, development of treatments, and selec- tion of therapy. CANCER GENETICS December 1996 marked the twenty-fifth anniversary of Breast Cancer - In 1995, in the United States the war on cancer. Since 1971, scientists have discov- alone, 182,000 new cases of breast cancer were diag ered the causes of many cancers and have proven that nosed. Forty-six thousand women died from the dis- cancer can be cured. Today, more than ten million of ease. Health care costs of breast cancer exceed $12 our family members, friends, neighbors and coworkers billion per year. In an extension of the exciting dis owe their lives to cancer research. Cancer survivors are covery in 1994 of a gene that confers susceptibility, alive today and enjoy a better quality of life because to breast and ovarian cancer, NIH scientists and col- the years of research in prevention, diagnosis, and laborators discovered a specific mutation in the treatment methods have given doctors better informa- BRCA-1 gene in nearly 1 percent of samples of blood tion and more accurate tools. America's youth have from women of Ashkenazi Jewish descent. This find received the greatest benefit from this country's invest- ing identifies a particular subgroup of the popula- ment in cancer research. For example, most cases of tion that may benefit from genetic testing for the childhood leukemia are now curable. Death rates from BRCA-1 mutation. Epidemiologists have hypothe children's cancers have declined by more than 62 per- sized that this mutation may account for as much as cent. Cancer research has also brought about dramatic 16 percent of breast and 39 percent of ovarian can- improvements in the survival rates for adults. The cers among Ashkenazi Jewish women age 50 and death rate for testicular cancer, for example, has under. Studies of families with inherited alterations declined 66 percent and five-year survival is now 95 of BRCA-1 suggest that more than half of the percent. Today, most Hodgkin's disease patients can be women who inherit mutations in BRCA-1 will be cured. diagnosed with breast cancers by age 50, and more Gene-based therapies are one class of exciting new than 85 percent will have breast cancer by age 70. approaches under investigation in cancer treatment. These methods are designed to augment the immune system's response to cancer or to boost the effectiveness of chemotherapeutic agents. They may involve admin- istration of genes for immune factors, either in the OBESITY patient or in cells taken from the patient and then returned. Another method is to give the patient genes In the United States, obesity is second only to tobacco as a that will increase the tumor's sensitivity to an anti- risk factor for disease and accounts for about 300,000 cancer drug, thus reducing harmful side effects on nor- deaths per year and an economic cost of $50-$100 billion. mal cells. Yet another technique involves the use of Obese individuals suffer increased risk for numerous drug-resistance genes that protect the vulnerable bone chronic diseases, such as diabetes mellitus, cardiovascular marrow from highly toxic chemotherapy. Important disease, hypertension, gallbladder disease, and certain goals for the future include the development of better cancers. Fortunately, opportunities to attack obesity at viral vectors for delivering genes to their intended tar- the molecular level have multiplied. NIH-supported scien- get cells and regulating production of the introduced tists have made important new discoveries regarding the genes' protein products. obese (ob) gene, its protein product (leptin), its receptors, A new project of the National Cancer Institute (NCI) and its interactions with other regulators of energy expen- provides another exciting example of the application of diture and food intake. 102 Science and Technology Shaping the Twenty-First Century This year, the diabetes (db) genetic mutation in the Studies related to Alzheimer's disease in addition to mouse and the fatty (fa) mutation in the rat (which cause those in genetics will focus on: diabetes in these animals) have been shown to be muta- different aspects of the theory that components of the tions of the leptin receptor gene. This is crucial evidence amyloid plaques that characterize AD trigger an inflam- of the link between diabetes and obesity. matory immune response that is the actual cause of Although it appears unlikely that leptin deficiency neurodegeneration; causes obesity in most humans, the discovery of leptin and its receptor has already deepened our understanding different approaches to determine whether proteins of metabolism, and will continue to lead to fundamental known as kinases, which have an important role in research in the relationship between food intake, energy normal cell function, also contribute to the formation expenditure, and the regulation of body weight. of the abnormal protein filaments and plaques seen in Alzheimer's; and BIOLOGY OF BRAIN DISORDERS understanding of the process by which amyloid is deposited in brain blood vessels, as a part of AD or the normal aging process. As we are past the midway point in the Decade of the Brain, it is appropriate to highlight research and progress in the neurosciences. This discipline recently Stroke - Four out of five strokes suffered by a joined other areas in reaping the benefits of modern biol- half million Americans each year are caused by a ogy by coming one step closer to deciphering the molecu- blood clot that blocks blood flow to the brain lar basis of memory and behavior. Two NIH-funded With the brain starved for oxygen and other groups, using different but related genetic techniques, nutrients, damage follows quickly, often with dev- reported advances in understanding how mice create a astating consequences. Researchers recently dis- tal map of a new environment. Using sophisticated covered that the clot-dissolving drug TPA is an toring equipment, researchers are able to detect effective emergency treatment for this type of vity in individual brain cells as the mice investigate stroke when given within three hours of initial their surroundings. From these data, a map of the cells symptoms. Given the narrow window for adminis- responsible for forming memory about space and time tering the drug after a stroke, the challenge now can be constructed. This work illustrates the interdisci- is to alert physicians about this finding and, more plinary nature of neurobiology, marrying genetics with critically, to educate the public about the symp- electronics to analyze cellular and biochemical processes toms of stroke and the importance of seeking as they occur in living organisms. emergency help. The biology of brain disorders encompasses studies of the basic biology, chemistry, and anatomy of the brain, including the physiology of the neuron, its receptors and the neurotransmitters that are responsible for relaying ACADEMIC HEALTH CENTERS AND THE messages between cells. This area of research extends studies that seek to understand the development of the CHANGING HEALTH CARE normal brain and the changes in development which may ENVIRONMENT underlie brain disorders. The research employs animal models, neuro-imaging, and clinical studies in an effort to Academic health centers (AHCs), medical schools, understand many disorders, such as pain, addiction, men- affiliated hospitals, and schools of allied health pro- tal illness, neurodevelopmental disorders of children, neu- fessions are the principal places in the United States rodegenerative disease, diseases of the aging brain, and for combining medical technological development, damage to the sensory system. basic and clinical biomedical research, and clinical New or expanded NIH-supported research programs education. In AHCs, education, research, and patient within this area include studies on the development of care are inextricably intertwined; patients are able the nervous system, which have implications for the to receive innovative medical care using the most ability of the adult brain to repair and reorganize itself modern techniques and can participate in research wing injury from stroke, trauma, or degenerative activities, and medical education is conducted. AHCs lesses such as Parkinson's disease; and studies also provide a disproportionately large share of this related to spinal cord injury and neuroregeneration. country's care of the indigent and uninsured. Science and Technology Shaping the Twenty-First Century 103 PEREGRINE: BETTER TREATMENT FOR CANCER PATIENTS Cancer patients may soon receive dramatically more effective radiation therapy as researchers refine and test a revolutionary new tool for analyzing and planning treatments. The program, known as Peregrine, draws on technologies originally developed by the national laboratories for military applications - and turns them to life- saving use. Peregrine addresses a straight-forward problem: Doctors have had no accurate means with which to assess how radiation travels through the body. Each year, roughly one third of the 300,000 cancer patients doctors hope to cure by radiation therapy die because the radiation failed to kill the original tumor. Improving the success of radiation therapy is exceedingly difficult because without reliable, detailed information showing how radiation is transported through tissues of different type and density, such as bone and lung, a physician trying to cure cancer tumors with radiation is like a surgeon operating in a dimly lit theater The Peregrine program takes advantage of increases in the speed and performance of computers, sophisti- cated computational techniques, and comprehensive nuclear and atomic physics databases residing in the national laboratories. It is being developed by scientists at the Lawrence Livermore National Laboratory, in col- laboration with colleagues in medical physics and radiation oncology, and is expected to be commercially avail- able within two years. It will provide doctors better information about where radiation is directed in the body, greatly improving the therapy's effectiveness, raising the prospect of saving as many as 100,000 lives each year in the United States alone. Treatment planning based on Peregrine begins with a computer-aided three-dimensional (CT) scan that pro- vides information about the exact location, composition, and density of the tumor and sensitive organs. These data are subjected to a sophisticated computational technique known as Monte Carlo that calculates the proba- bilities of random molecular interactions. The method enables doctors to track the path of an x-ray as it moves through the body, interacting with atoms much as balls in a pinball machine bounce randomly as they encounter obstacles in their path. The result is a detailed three-dimensional model that simulates the physical processes involved in radiation transport. Current methods of calculation only approximate radiation dose distribution to the patient, which can result in underdosing of the tumor. In the tumor shown here, for example, current methods of calculation assured the radiation oncologist that the entire tumor would be treated. But Peregrine calculations show that the prescribed radiation targeted only a fraction of the tumor, making the treatment less effective. Inaccurate dose calculations can have other unintended consequences, causing radiation to be directed where it is not needed, potentially damaging healthy cells. Peregrine will allow clinicians to administer more precisely System-wide changes in the financing and delivery A decrease in the ability of AHCs to subsidize of health care are having substantial effects on basic research and teaching costs would have a negative and clinical research and medical education in AHCs. impact on the nation's research infrastructure and Patient care costs historically have been higher at on the training of the next generation of researchers AHCs because of the added research and education and clinicians. missions. Yet, the latter are clearly an important and broadly distributed public good for the future of qual- In November 1995, the President's Committee of ity health care in this country. The marketplace Advisors on Science and Technology wrote to the Presi- changes are raising important issues with respect to dent relaying their concerns about the future vitality of the ability of AHCs to attract the patient base needed our AHCs. The research and educational capacity of to support their research and education missions: our AHCs will continue to be a factor in the Adminis- tration's efforts to improve our health care system. It is A decrease in the ability of AHCs to attract research important to continue to evaluate data to determine subjects would affect the rate at which new treat- what impact recent changes in the health care system ments are developed, tested, and applied. are having on AHCs. 104 Science and Technology Shaping the Twenty-First Century Planned Treatment: lung Tumor- What they were treating What they thought they were doing Actual Treatment- What they really did Tumor Target Volume Target Volume Curative dose level Curative dose level Cancer patients may soon receive dramatically more effective treatment through Peregrine. This revolutionary new technique is used to target radiation on tumors more precisely than current methods, and raises the odds of survival of the hun dreds of thousands of cancer patients treated every year, while reducing harmful side effects. In a planned lung tumor treat- ment using current techniques, the Peregrine calculation (right panel) shows that the intended dose misses much of the tumor. The Peregrine program will allow more precise planning of radiation therapy. targeted beams of radiation, giving them the confidence they need to treat tumors more aggressively, while mini- mizing risk to healthy cells. Monte Carlo techniques have long been recognized as the best way to calculate dose distributions for radiation therapy, but such calculations often took hundreds of hours. Recent advances in computational techniques and computer architecture mean dose calculations now take only minutes, not days. Peregrine brings high-speed, zhly accurate, and high resolution Monte Carlo treatment planning to desktop computers through simple net- rk connections, much like file servers in an office environment. Cost should thus not be a limiting factor for ospitals who want to utilize the new treatment planning approach. Researchers currently are examining Peregrine's application to a variety of patients and tumor types, includ- ing tumors of the lung, head and neck, larynx, and breast. So far, researchers have assessed how well the method would work using data only from patients who have already completed their radiation treatment. Once cleared by the Food and Drug Administration, physicians will be able to use it for patients preparing to undergo treatment, raising the odds of survival for hundreds of thousands of cancer patients, while reducing harmful side effects. FOOD AND HUMAN HEALTH NUTRITION There is a direct link between our health and the food Nutrition plays a pivotal role in optimizing health and we eat. Poor diet is a significant underlying contribu- productivity, while reducing the risk of diet-related dis- tor to illnesses that lead to death. In addition to the eases. The annual cost in the United States of treatment critical relationship between diet and health, it is esti- and care for individuals with diseases linked strongly to mated that each year millions of individuals become ill diet, such as cardiovascular disease, obesity, osteoporo- and that thousands of people die from eating food con- sis, and cataracts, exceeds $200 billion. Fortunately, over taminated with microbial pathogens such as Salmo- the last half of this century, we have witnessed remark- nella and E. coli O157:H7. Research supported by the able improvements in the dietary patterns of the U.S. Federal government in the area of diet and nutrition population and those of several other western industrial- and food safety has greatly improved the overall ized nations. Most notably these changes have brought health of our nation's citizens. However, additional about a decline in deaths from coronary heart disease, research is needed to guide efforts to improve the diets the leading cause of death in the United States. How- Americans and to ensure that our food supply is free ever, poor diet continues to be a leading contributing fac- m harmful pathogenic microorganisms. tor to numerous illnesses. Science and Technology Shaping the Twenty-First Century 105 TOUGHER STANDARDS FOR SAFE MEAT In July 1996, President Clinton announced sweeping reform of the nation's food safety rules, for the first time bringing science to the task of meat and poultry inspection. The new sanitation standards and requirements for scientific tests are designed to reveal the presence of deadly bacteria, and to maintain food safety from "farm to table." While previous methods for inspecting meat and poultry were based on how the food looks, feels, or smells; the new methods rely on technology to detect the bacteria E. coli and Salmonella, which are invisible without a microscope: A similar program for seafood inspection was adopted a year earlier. The heart of the reform is a Hazard Analysis and Critical Control Points, or HACCP (pronounced "hazup"), sys- tem. Unlike many federal regulations, the new rules do not dictate specific steps industry must take. Instead, packers and slaughterhouses are required to identify points in the process, such as cutting and grinding, where contamination can occur, and then come up with remedies that prevent the contamination. To verify that the pre- ventive steps-are effective, slaughterhouses and plants that produce raw, ground meat and poultry are required to meet standards for Salmonella, and also to conduct microbial testing for generic E. coli (a form of E. coli that is common in the intestinal tracts of food animals). E. coli often indicates fecal contamination, which is the main pathway for contamination of meat and poultry. The inspection reforms reflect recommendations during the past decade by external bodies including the National Academy of Sciences, the General Accounting Office, and the National Advisory Committee on Microbio- logical Criteria for Foods. Like many observers, they urged modernizing the inspection system to address the growing hazards presented by microbial pathogens. For all our technological advances, the inspection system was virtually unchanged for nearly a century, since muckrakers in the early 1900s exposed filthy conditions in the nation's meat packing plants. In response, the government set up a manual system that relied on the senses of fed- eral inspectors to protect the public from unsafe food. Over the years, only incremental changes were made. Then, in 1993 tragedy struck people who ate undercooked fast food hamburgers at a restaurant in the western United States. Four children died from the outbreak, and hundreds became ill. The nation's - and the President's - attention was riveted on the threat posed by deadly strains of E. coli, in this case E. coli O157:H7. It was clear that the inspection procedures needed to be revamped, and government and industry began to work together in earnest to devise an effective system. As the changes are phased in over the next few years, industry and scientists will continue to need additional, and more reliable, informa- tion, and faster, more accurate test results. Advances in biotechnology promise to provide earlier detection of contamination. Scientists from the U.S. Department of Agriculture have trimmed the time required to detect disease- causing bacteria on meat from the typical 48 hours to just five minutes. They have also developed tests specifically to detect hemor- rhagic E. coli O157:H7 in less than eight hours, compared to the traditional three-day test. None of this negates personal responsibility for handling raw meat and poultry safely, and for making sure it is well-cooked before it is served. But the progress is real.As President Clinton observed in announcing the inspection reforms, "Parents should know that when a teenager bor- rows the car to get a fast food hamburger, the New scientific technology reforms meat and poultry inspection. hamburger should be the least of their worries. Microbial testing will be implemented in the Hazard Analysis and Our new food safety initiative will give families Critical Control Points program that requires the development and the security to know that the food they eat is as implementation of rapid tests to detect microorganisms. The two light safe as it can be." areas are a deadly strain of E. coli O157:H7 among colonies on non- pathogenic strains. 106 Science and Technology Shaping the Twenty-First Century /e still have much to learn about the prevention impact of food-borne illnesses in this country is $6-9 billion. or management of diet-related diseases. In particu- The safety of the wide variety of food we consume each day lar, we need to develop a better understanding of starts with its production on farms, ranches, ponds, lakes, nutrient-gene interactions so that we can produce and oceans, and ends at the table. Further research into food healthier food and better detect and prevent nutri- production, harvesting, and handling practices that will tion-related disease. An expanded human nutrition reduce human exposure to microbial pathogens, chemicals, knowledge base will lower health care costs and and biotoxins - as well as into improved methods to detect raise the effectiveness of federal food assistance pro- and survey these hazards - can eliminate or significantly grams, such as food stamps. Since the causes of mal- reduce an important cause of illness in the United States. nutrition and nutrition-related disease within the Enhancing our strong research program in food safety United States are complex, it is important that will further ensure public health and safety and reduce nutrition-related research include a multidiscipli- the prevalence of food-borne diseases. However, we also nary perspective. need a system that integrates prevention, detection, and The development of science-based programs that intervention throughout the food production cycle, mak- promote healthier eating habits will remain a high pri- ing use of technological advances in food processing and ority for the Administration. One such effort, based on packaging, and pest control. Such a research program a three-year tria) involving 96 elementary schools in will build the scientific foundation for sound food safety four states, has shown that children can be taught regulation and policy, spur innovation in food safety and behaviors that may protect them against heart disease. production, and help educate consumers to improve their Schools successfully lowered the fat content of school food safety practices and increase their understanding of lunches, and physical education instructors increased the relative risks and benefits. the amount of vigorous exercise. Students reported Scientists are developing new ways to reduce the micro- lower daily caloric intake from fat at home. This pro- bial contamination of food products. Hazard Analysis and gram worked equally well among ethnically diverse Critical Control Point (HACCP) systems are one such ulations and represents a cost-effective, easily approach. HACCP is based on the premise that for overall mented program that can have profound positive reduction of microbial pathogen contamination of food, it cts on children's eating habits and activity levels. is better to reduce the level of pathogen contamination at key points in the food production, slaughter, and process- ing pathways rather than to simply inspect the finished Fat Substitutes - The Federal government con- processed product. The Administration has established tributes to the development of a more healthful food over the last two years new regulations that require the supply - food that is more nutritious and low in implementation of HACCP principles for meat, poultry, fat. For example, Z-Trim, a new no-calorie, high- fish, and shellfish. Research and disease surveillance are fiber fat replacement developed by U.S. Department needed to guide the implementation of HACCP. In particu- of Agriculture (USDA) scientists, could soon find a lar, research must be conducted that generates data place in foods such as cheese products, hamburger, needed to conduct quantitative risk assessments. and baked goods. Z-Trim is made from low-cost agri- The Departments of Agriculture, Health and Human cultural byproducts such as hulls of oats, soybeans, Services, and the Environmental Protection Agency peas and rice, or bran from corn or wheat. The hulls have begun a comprehensive food safety initiative or bran are processed into microscopic fragments which will provide an integrated federal strategy to and purified, then dried and milled into an easy- help ensure the microbiological safety of our nation's flowing powder. When the fragments absorb water food supply. Key elements to this initiative are they swell, forming a gel that provides foods with an improved research, surveillance, risk assessment, and enjoyable smooth texture like that of fat. education, all done in full cooperation with state gov- ernments and the private sector. FOOD SAFETY SUSTAINABLE FOOD AND The Centers for Disease Control and Prevention estimate that FIBER PRODUCTION as many as 6.5 million cases of food-borne illnesses occur 'ally in the United States, and that these illnesses con- Agricultural productivity in the United States has te to approximately 9,000 deaths. USDA's Economic grown dramatically at a rate of nearly 2 percent per Research Service estimates that the annual overall economic year. Production has more than doubled since 1950 Science and Technology Shaping the Twenty-First Century 107 while total input use (use of energy, water, fertilizers, An excellent example of an integrated approach to etc.) has actually fallen slightly over this same period. natural resource management is the USDA Forest Ser- However, due to the new economic, environmental, and vice's Wine Spring Basin demonstration project in health demands being placed on our food and fiber pro- North Carolina's Nantahala National Forest. It encom- duction systems, we need to reassess our science and passes about 4,500 acres and contains a mix of hard- technology investments in agricultural research. wood forest types, streams with native brook trout, and Maintaining and enhancing rates of growth in food old growth timber stands. The purpose of the project is and fiber productivity in this new environment will be to develop, test, and demonstrate ecologically based con- the major science and technology challenge for agri- cepts and technologies to restore the native mixed pine cultural and natural resource scientists in the twenty forest, its diverse understory, and stream habitats, as first century. well as to achieve a sustainable forest community. Early Global food security remains a challenge for the project development has centered on reintroduction of next century. Significant uncertainties, however, fire under prescribed conditions, testing improved remain in projections of future world food require- regeneration techniques for oak forest, restoring stream ments and the ability of poor countries to achieve sus- habitats with addition of woody debris, and a socioeco- tainable economic and agricultural development. Sci- nomic assessment of public attitudes and values. entific and technical advances that improve agricul- Our coastal waters are as productive as the richest tural productivity can help combat the human and American farmland. Significant strides have been social deterioration associated with hunger and made in restoring the living marine resource habitat poverty. In addition to traditional aid programs, U.S. value to areas that have been degraded through cata- support for international agricultural research cen- strophic events such as oil spills or ship groundings, or ters helps build the research infrastructure in many as a result of cumulative human activities, such as regions of the world with persistent food production water diversions or land use changes. Projects eventu- problems. U.S. Land Grant universities train signifi- ally benefiting upwards of 48,000 acres of coastal wet- cant numbers of agricultural scientists from the lands were initiated or under way by the end of 1996. developing world, who in turn contribute to their As part of the efforts to recover Pacific salmon popula- national research programs. Working with other tions, removal of barriers to fish migration and restora- nations to develop the scientific tools and infrastruc- tion of historic spawning streams have been under- ture they need to provide for the nutritional needs of taken, in many cases by members of the fishing indus- their own people, the United States can help alleviate try displaced as a result of reduced harvest levels due the pain of hunger that afflicts 800 million people to habitat losses and other factors. These restorations daily. generally represented partnerships among Federal, state, and local governments, tribes, industry, and non- INTEGRATED MANAGEMENT OF FARMS, RANGE- governmental organizations. LANDS, FORESTS, AND COASTAL WATERS ENVIRONMENTAL QUALITY Our nation's farms, rangelands, forests, and coastal waters must be managed in a fashion that allows for Reducing negative impacts on the environment or even their long-term, sustainable use for production purposes improving its overall health is now a major consideration while preserving other vital functions, such as habitat for for American food and fiber producers. This is a signifi- wildlife, watershed protection, and recreation. To achieve cant shift from our traditional approach to farming and sustainable production practices, we should view our forestry in past decades. Since the end of World War II, farms and forests as integrated systems with a variety of farming was geared toward optimizing production using inputs and outputs. Scientific knowledge, generated chemical pesticides and fertilizers or through manage- through research, has been and will continue to be the ment techniques that may have solved one problem but most important factor in any sustainable production sys- often created other, more serious ones. Excessive tillage tem. Greater scientific understanding of the inter-relat- to control weeds, for example, often led to unacceptable edness of the multiple components of our nation's food rates of erosion of valuable topsoil. Forestry was prac- and fiber production systems, ranging from geochemical ticed in many cases with little regard for endangered and biological to social and economic interactions, will species or the water quality of streams and rivers. Today help farmers and natural resource managers understand we are investing in science and technology to produce what is necessary to maintain or restore the economic, more from our food and fiber production systems while social, and natural attributes of the system. protecting our environment. 108 Science and Technology Shaping the Twenty-First Century Tillage and Global Change: Keeping organic mat- ter tucked away in soil - where it is needed most for agricultural productivity - benefits the earth and the atmosphere. As organic matter is plowed up, carbon dioxide loss from the soil into the air dramat- ically increases. Measurements of a range of soil types, tillage methods, and climatic conditions indi- cate that deep plowing results in a much greater loss of carbon dioxide than all other forms of tillage. Such information is vital in quantifying the effects of tillage on soil quality and productivity and provides data for validating agriculture's role in global warm- ing. These findings offer agricultural producers a way to help counteract global change by altering their cultivation practices. Protecting surface and ground water from contamination by agricultural activities requires knowledge of land use, soil properties and hydrogeology as exemplified by the Mahantango Water Quality - Water pollution from agricultural Creek watershed near Klingerstown, Pennsylvania. chemicals must also be prevented. Combining wet- lands, ponds, and underground irrigation could neered crops may be environmentally beneficial in result in water conservation and bigger yields for many circumstances, a continuing strong research pro- farmers. USDA scientists built such a system in gram is important to identify and minimize any poten- Ohio to demonstrate the benefits of recycling runoff tial long-term negative impact this technology may and drainage water from fields. It reduces sediment have on the environment. -d agricultural chemical flow to streams, improves er quality, enhances wildlife habitat, increases etland acreage, and improves crop yields. The wet- GLOBAL MARKETS AND TRADE lands remove sediment and agricultural chemicals from field runoff. The water is then stored in a pond Recent trade agreements such as GATT and NAFTA are until it is needed to irrigate a field. Finally, it is creating significant opportunities to expand interna- pumped back through underground pipes to reduce tional markets for U.S. agricultural products. However, water stress in crops. The overall result is that less with the increased trade liberalization, U.S. agriculture pesticide and fertilizer runs off into surface waters. faces a transition away from a system of commodity price supports to market-driven pricing. To succeed in this new environment, U.S. farmers will have to rely on the latest information and newest technology. Economic Precision farming, such as site specific application research also is needed to support decision-making at of pesticides and fertilizers, holds considerable promise multiple levels from what to plant on the family farm to for the future. Using powerful tools such as the global negotiations of international trade agreements. positioning system, scientists are developing techniques Where are the most promising growth markets for to accurately place agricultural chemicals where they U.S. agricultural products? Will developing countries are needed most. Current methods of chemical applica- achieve sustainable agricultural practices or economic tion are more "broad brush," with chemicals being development that allows them to participate in world applied throughout an entire field. New precision farm- trade markets? Or will they stumble, fostering condi- ing techniques will reduce costs by eliminating unneces- tions for hunger, malnutrition, and political unrest? sary chemical application, and will protect the environ- How can we overcome unfair trade barriers to U.S. ment by reducing the amount of chemicals applied. agricultural products? These questions must be New biotechnology-derived crops also have the capa- addressed if agriculture and its related activities are to bility to improve management practices. For example, continue to be major contributors to our nation's econ- plants are being developed that require fewer applica- omy. Only through scientific and technological ; of pesticides, that require less tillage (therefore advances, coupled with sound economic decision-mak- ucing soil erosion), and that require less irrigation. ing, can our nation's farmers successfully compete in While new genetic traits and the use of genetically engi- global markets. Science and Technology Shaping the Twenty-First Century 109 USDA has developed new models to aid in assessing Using science and tech- complex trade interactions. These models effectively nology to control pests measure and evaluate tariff barriers to trade and esti- is one goal of the Depart- ment of Agriculture's inte- mate the economic consequences of freer trade for U.S. grated pest management agricultural producers and consumers. This allows econ- research. The brown citrus omists to identify such key growth markets for U.S. aphid is just one example agriculture as China, Korea, Indonesia, Mexico, and of a new pest that is Saudi Arabia. Further, USDA research shows that threatening U.S. agricul- tural production. growth in demand for U.S. exports is likely to be greater for high-valued products, such as processed foods and meats, than for bulk commodities. Such analysis not only identifies opportunities for U.S. agricultural exporters, but provides forward-looking information that PLANT HEALTH AND INTEGRATED can smooth out world prices when unexpected events PEST MANAGEMENT disrupt world markets. Farmers generally lose 10 to 30 percent of their crops to ANIMAL HEALTH pests, costing them nearly a third of their production. In addition to existing pests, farmers are continually chal- lenged by new pests such as the Karnal bunt fungus, Animal diseases cost the United States billions of dol- new races of the fungus causing potato late blight, sweet lars each year, which is why the USDA supports potato whitefly with associated gemini viruses, and the research addressing the health concerns of important brown citrus aphid with the associated citrus tristeza livestock, poultry, and aquatic species. Much of the virus. These and other pests not only reduce profitability research conducted by the biomedical programs of the but often threaten export markets. The sweet potato NIH, DOD, and VA is directly relevant to improving whitefly has become a devastating pest of cotton, vegeta- animal health. New vaccines, drugs, and other bles, melons and ornamentals in the United States, approaches to disease prevention need to be continu- causing an estimated $500 million in crop losses annu- ously added to the veterinarian's disease fighting ally in this country. In Imperial County, California, arsenal. alone, crop losses to sweet potato whitefly have been Production practices that result in healthy food estimated at $100 million. USDA scientists have teamed animals not only improve agricultural profitability with USDA's Animal and Plant Health Inspection Ser- and the well-being of the animals, but also improve vice, Texas A&M University, and private industry to human health. Animal pathogens may play a larger develop an EPA-approved fungal pathogen that kills up role in human health than previously thought. Some to 90 percent of whiteflies in vegetables and melons. human health concerns, such as E. coli O157:H7 or Large-scale cooperative field tests have begun to refine Salmonella infection, can be drastically reduced pest management strategies that use the pathogen in through improved animal health. Recent data indi- conjunction with other biological controls. The fungal cate a degenerative disease of the human nervous pathogen reduces producers' dependence on chemical system may have been transmitted from cattle pesticides and contributes to USDA's target of 75 per- infected with bovine spongiform encephalopathy cent of U.S. agricultural acreage being under integrated (BSE), also known as "mad cow disease." Unknown in pest management (IPM) practices by the year 2000. the United States, it has had a devastating effect on The goal of USDA's IPM research is to reduce the the British beef industry. USDA scientists have use of synthetic pesticides by placing greater emphasis developed a new test for the prion protein believed by on natural controls, host resistance, cultural practices, some to be linked to BSE. This test may be a promis- biological controls, and biopesticides. The aim is to pro- ing tool to test live animals for the presence of duce high-quality food and agricultural products, while scrapie (a related disease of sheep) or BSE. Scientists maintaining farmers' profitability and protecting at the National Institute of Neurological Disorders human health and the environment. Research at Texas and Stroke have also developed an assay for trans- A&M University has saved the economy $1.5 billion missible spongiform encephalopathies for use in per year and spared the environment from 17.3 million humans and non-human mammals. Ensuring the pounds of insecticides alone. At the same time, 20,000 safety of the American beef supply will help keep new jobs in Texas are associated with IPM. One IPM U.S. agriculture competitive in world markets. program in the Rio Grande Valley for carrots destined 110 Science and Technology Shaping the Twenty-First Century baby food, soup, and frozen foods reduced insecti- America. Therefore, we need to continue to rely on other cide use by 66 percent while increasing individual farmer profits by $22,000. countries for valuable germplasm, which underpins our nation's crop and livestock improvement efforts. We More than 40,000 farmers have significantly reduced must preserve the incredibly diverse gene pool of all their use of chemical pesticides on row crops, fruits, and plants and animals now in existence, or we risk missing vegetables. USDA scientists, working with their counter- important future opportunities for progress. Preserva- parts in the Land Grant university system, have pro- tion of existing genetic diversity is integral to improving vided farmers with science-based information on new our crops and livestock. Future work in germplasm pest management practices that meet agricultural pro- preservation and maintenance must focus on improving duction, human health, and environmental goals. Fortu- access to existing worldwide collections and identifying nately, recent scientific advances, such as in molecular gaps that exist in these collections. biology and computer science, hold great promise for fur- A future challenge is to establish international agree- ther improvements in approaches to pest management. ments that ensure access to genetic resources. For Where effective tactics have been developed, they are example, potato germplasm maintained in one country widely and rapidly implemented by farmers. IPM meth- should be accessible to the global research community so ods are used on about half of all fruit and nut, vegetable, that new traits, such as resistance to the fungus that and major field crop acreage in the United States. causes late blight, can be incorporated into potato culti- vars in areas threatened by this pathogen. Although countries have rights over genetic resources within their IPM in Oregon has been proven to reduce greatly the borders, the Administration believes that open access to amount of pesticides applied to crops. Twenty thou- such resources is important to improve agricultural sand acres of Oregon apples have gone from a maxi- species critical to global food security. mum of three miticide applications per year to less Research leading to improved storage and regenera- than one under IPM. Each application costs growers tion of germplasm in a manner that ensures its genetic per acre. Determining the pest status on a regular integrity is of paramount importance. We must also con- is of 6,000 acres of pears in southern Oregon has tinue to develop appropriate databases that document elped eliminate 18 pounds of active pesticide ingredi- germplasm availability, quality, and traits. To enhance ent per acre for a savings of more than $600,000 per germplasm traits that contribute to improved productiv- year. An Oregon mint IPM program adds $500,000 to ity and environmental sustainability, we should encour- the value of the crop, since processors will not buy pep- age multidisciplinary research approaches that combine permint oil with pesticide residues. the traditional tools of breeding and selection with the new tools of molecular genetics. The public and private sectors need to collaborate on research, development, GENETIC RESOURCES and technology transfer to ensure an adequate flow of improved germplasm for major food and fiber species. The genetic base of some important food species is Over a century of genetics research and breeding has led dangerously narrow. This is particularly true of fish and to many successful improvements in plants and animals. shellfish stocks used in aquaculture farming, including Virtually every foodstuff and many forest species have catfish, shrimp, oysters, and salmonids. For example, the benefited from such improvements. Recent developments ancestry of most of the farmed catfish stocks in the south- in genetic manipulation and the rapid mapping of genes ern United States can be traced to a single source of fish are opening new possibilities, from improved disease in Oklahoma. This greatly increases the chance of suscep- resistance, to better taste, to longer shelf life. Access to tibility to new or reemerging diseases and limits the pos- genetic resources, such as gene sequencing and mapping sibility of genetic improvements through breeding. data, and genetic material, such as cloned genes, novel strains, wild relatives and other plant, animal and micro- bial germplasm, are vital to the future health of Ameri- In 1995, the National Plant Germplasm System, can agriculture and forestry. The development of econom- under the auspices of USDA's Agricultural Research ically, environmentally, and nutritionally important traits Service, distributed approximately 120,000 samples of will be possible only if the scientific community has seed and clonal germplasm to both U.S. (85,000 sam- ly access to needed genetic resources. ples) and foreign (35,000 samples) requestors. he majority of agriculturally important species pro- duced in the United States did not originate in North Science and Technology Shaping the Twenty-First Century 111 GENOMICS INVESTING IN A BALANCED Gene maps are powerful tools with which to genetically AGRICULTURAL RESEARCH PORTFOLIO improve plants, livestock, and other beneficial organisms. Such maps and their associated DNA markers are useful Agricultural research supported by the federal govern- for improving the accuracy of selection of desirable new ment requires a balanced science and technology portfo- genotypes, moving new genes into populations, and char- lio that encompasses a broad range of activities from acterizing potentially valuable germplasm populations. fundamental to applied and developmental research. USDA scientists, working in collaboration with Private sector research spending in agriculture has researchers from State Agricultural Experiment Stations, grown more rapidly than that of the public sector and have produced genetic maps of important animals (cattle, now accounts for more than the combined level of fed- swine, sheep, and poultry) and plants (corn, soybean, eral and state funding. While private sector research loblolly pine, wheat and others), which can be accessed spending has taken over an increasing share of the electronically. developmental research (that portion of research that In general, the quality of these maps must be promises adequate economic returns to investors), the improved before their full potential can be brought to opportunities for developmental research and continu- bear on new crop and breed development. The focus of ing technology advances depend on advances in USDA research in the area of animal genome mapping research funded by the Federal government and primar- for the next five years will be on the development of ily conducted by the USDA's Agricultural Research Ser- markers for use in selection schemes for each of the live- vice and State Agricultural Experiment Stations. stock species. For plant gene mapping efforts, continued As in other research areas, the Administration has work is needed on improving the resolution of various made a clear commitment to enhancing the quality and maps and on the isolation of genes that confer desirable accountability of Federally funded agricultural research. traits. In addition, considerable effort needs to be given to Rigorous peer-review, the hallmark of American science, database development and the development of libraries of has been promoted annually by the Administration large genome fragments to facilitate gene identification through the budget-setting process; science programs and isolation. that are based on merit review with peer evaluation are Intellectual property rights associated with genetic a priority. The new Fund for Rural America, supported resources need to be addressed. While promoting technol- by the President and established in the Federal Agricul- ogy transfer and application in major crops, such as corn ture Improvement and Reform Act of 1996, has strong and wheat, patenting genetic resources and methods of merit-review provisions. These provisions are written genetic modification may actually impede the commer- into the program's authorizing language and will be cialization of biotechnology-derived minor crops, such as implemented through peer evaluation. The National vegetables. Companies holding patents on enabling Research Initiative (NRI) utilizes excellent competitive biotechnologies and genes may not be inclined to issue peer-review procedures. Peer review procedures used by licenses for minor uses. We need to ensure that breeders other USDA research programs (intramural and for- of minor crops have access to the genetic resources and mula funds) are being assessed to determine how they techniques needed to maintain the competitiveness of the can be improved. minor crops industry. SUPPORT FOR FUNDAMENTAL AGRICULTURAL RESEARCH The livestock gene maps developed at the U.S. Meat Animal Research Center in Clay Center Increased support for fundamental research programs in Nebraska, have over 1,300 markers for cattle, 1,100 molecular and cellular biology, physiology, and ecology for swine, and 500 for sheep. The poultry map devel- has expanded our understanding of fundamental oped in cooperation with Michigan State University processes such as pathogenesis, genetic disorders, nutri- has over 600 markers, and is being integrated with tion, photosynthesis, nitrogen fixation, and evolution. the United Kingdom's poultry map. Better understanding of these and other biological processes leads directly to a more secure and economi- USDA is supporting research, through the cally competitive food and fiber supply. In addition to National Research Initiative and the Agricultural basic research in the biological sciences, it is important Research Service, on gene mapping, identification, to recognize the important contributions that research in and characterization of over 40 crop species. chemistry, physics, engineering, and social sciences 112 Science and Technology Shaping the Twenty-First Century ke in agriculture through the development and adop- tion of new enabling technologies and instrumentation. Urea is widely applied as a nitrogen fertilizer There is a clear need to maintain our Federal investment because of its cost-effectiveness, ease in han-dling, in the full range of agriculture-related science and tech- and high nitrogen content. However, it is not effi- nology activities, but investments in fundamental ciently used by plants. Most of what is applied to research are expected to generate the highest yield. fields is degraded by soilborne microorganisms into Therefore, the Administration will continue to provide volatile ammonia, which is often toxic to plants. strong support for the NRI and other programs support- USDA's National Research Initiative has supported ing fundamental agriculture research. research on the enzyme responsible for the degrada tion, urease, to determine how the enzyme works as well as its molecular structure. A better understand SUPPORT FOR APPLIED AGRICULTURAL RESEARCH ing of urease sets the stage for developing safe, effec tive inhibitors of the enzyme to improve the efficient Agricultural problems often are based on specific soil, use of urea by plants. climate, or production systems that are unique to a par- ticular region of the country. Therefore, much applied Ethylene is a chemically simple gas that acts as a agricultural research needs to be conducted at the local plant hormone, regulating multiple plant processes or regional level, and funding should be based on priori- ranging from stem elongation to root growth and fruit ties set regionally or locally. In addition to USDA's geo- ripening. Work on the ethylene signal transduction graphically dispersed intramural programs, support of pathway supported by the Department of Energy's applied research has been achieved primarily through Division of Energy Bio-sciences has led to the first state support and through various formula programs isolation of a plant hormone receptor. These studies where Federal funds are distributed directly to State show that plants sense this gaseous hormone through Agricultural Experiment Stations. Although this system a combination of proteins that resemble signal trans- Tederal support for applied research has substan- duction pathways previously described in bacteria y leveraged Federal investments, it has come under and yeast. Genetic manipulation of these proteins will wing stress because Federal formula funds have not provide new tools for modifying plant growth and grown as fast as research costs and because research development for increased crop and biomass produc- funds have declined in some states. tivity. Several steps could be taken, and in some cases are under way, to improve the effectiveness of the current The Departments of Energy and Agriculture and formula-based funding programs. State Agricultural the National Science Foundation have cooperated to Experiment Stations are downsizing. Downsizing fund the effort to sequence the entire genome of the requires careful attention to priorities, with most insti- flowering plant Arabidopsisthaliana. When com- tutions supporting existing specific areas of excellence. pleted, this will be the first complete DNA sequence Severe reduction or elimination of programs is forcing for any flowering plant. Arabidopsis is the leading institutions to take a more regional approach to model organism for the study of genetic traits that addressing the needs of their clientele. Often, they rely relate to plant growth and development and therefore on expertise found in a neighboring state. In addition to to traits related to crop productivity. The goal is to downsizing, experiment stations are improving their use complete the sequence by the year 2004. of formula funds through creative local funding mecha- nisms. For example, some experiment stations have established competitive peer-reviewed funding programs with their formula funds. Others use these funds to sup- by the President and established in the Federal Agricul- port young investigators or special projects ture Improvement and Reform Act of 1996, has strong As in other research areas, the Administration has merit-review provisions written into the program's made a clear commitment to enhancing the quality and authorizing language, which will be implemented accountability of Federally funded agricultural research. through peer evaluation. The National Research Initia- Rigorous peer-review, the hallmark of American science, tive (NRI) utilizes excellent competitive peer-review has been promoted annually by the Administration procedures. Peer review procedures used by other ugh the budget setting process; science programs USDA research programs (intramural and formula .t are based on merit review with peer evaluation are funds) are being assessed to determine how they can be a priority. The new Fund for Rural America, supported improved. Science and Technology Shaping the Twenty-First Century 113 Mentring/ mindies Although our research universities remain In most science fields, women receive a dispropor- unmatched, there have been numerous indications that tionately smaller number of degrees than men. By the stress on these institutions is increasing. The sources of early 1990s, women were awarded 28 percent of the stress are varied, reflecting the broader societal trans- doctorates in science and engineering combined, with formations affecting many institutions. Given the impor- great variations by broad field - one of every two tance of the research universities and of the strong uni- awarded in the social and behavioral sciences, one in versity-government partnership aimed at advancing sci- four in the natural sciences, one in ten in engineering. ence and technology in the national interest, the Predictably, this translates into under-representation of Administration is heeding a call from the President's women in the academic workforce, again with wide Committee of Advisors on Science and Technology variations by field and institution type. At research and (PCAST) for a government-wide policy and administra- doctoral institutions, women represent 35 percent of tive review of the partnership. That partnership - the non-science and engineering faculty. Among science extending deep into the past century, when the Land and engineering fields, women's faculty presence Grant universities were founded - has been trans- ranges from less than 6 percent in engineering and 8 formed over the last half century into the core element percent in the physical sciences to over 20 percent in of our world-leading science and technology enterprise. the biological and social sciences and over 40 percent in A multi-agency task force convened under the aus- psychology. The picture in 1993 is similar in compre- pices of the National Science and Technology Council hensive and liberal arts institutions and in public and (NSTC) will: (1) identify major stresses in the areas of two-year institutions, except that the women are better research, education, and administrative regulations; and represented in all fields. (2) determine what the Federal government's role Participation of racial and ethnic minorities and per- should be in addressing issues raised by this examina- sons with disabilities leaves much room for improve- tion. The task force findings and recommendations will ment and continued policy considerations. At all degree be presented in the summer of 1997. levels in U.S. science and engineering, African- The study may also review the mechanisms used to Americans, Hispanics, and Native Americans remain support graduate students, since the Federal govern- under-represented. In any given year of this decade, ment supports 20 percent of those enrolled in U.S. insti- minorities awarded the Ph.D. in a science or engineer- tutions. Since the late 1960s, the form of graduate sup- ing field still number in the tens. The trend in minority port has shifted significantly from fellowships and admissions and degree awards is not encouraging. traineeships, to research assistantships. Each of these Thus, the pool of prospective faculty is not increasing mechanisms vests responsibility for the graduate train- fast enough. ing experience in different system participants. The Today, the science and engineering workforce hardly portability of fellowships is attractive to the recipients, reflects the face of America. But by 2010, about half of while assistantships delegate responsibility for the grad- America's school-age population will be from minority uate research experience to faculty principal investiga- groups, emphasizing the importance to the nation of tors. Traineeships provide funds to departments or pro- broader participation in science and engineering grams with the expectation that a cadre of faculty will careers. Expanding such participation will require share responsibility for training new Ph.D.s, typically in drawing on and developing talent at all stages of educa- emerging interdisciplinary research specialties or in tional preparation leading to advanced study. For areas of national need as identified by Federal agency example, only a small fraction (perhaps one-eighth) of missions. The optimal mix for developing the nation's all high school graduates have the mathematics and scientific and engineering human capital needs to be science preparation that would permit advanced study revisited. in a technical field; for under represented minorities, As we work to develop the finest scientists and engi- the fraction is only half as much. neers for the twenty-first century, human resources pol- The work of individuals and organizations to inspire icy must move beyond simply the supply and demand of and mentor young people, and offer role models is cru- personnel and address the composition of the science cial. To recognize this, the annual Presidential Awards and engineering workforce. Achieving diversity through- in Science, Mathematics, and Engineering Mentoring out the ranks of the scientific and technical workforce were established in 1996. Ten individuals and six orga presents a formidable challenge; the number of women nizations were honored for their outstanding mentorin and minorities in science and engineering, relative even efforts that have encouraged significant numbers of to professions such as medicine and law, remains low. minorities, women, and disabled persons to succeed in We need to draw upon the full talent pool. these fields. 124 Science and Technology Shaping the Twenty-First Century The first recipients of the Presidential Awards for Excellence in Science, Mathematics, and Engineering Mentoring. At the White House in September 1996, the honorees included ten individuals and six institutions that have been exemplary in their encouragement of minorities, women, and people with disabilities to pursue careers in scientific and techni- cal fields. Président Clinton noted that they would "serve as examples to their colleagues and will be leaders in the national effort to train the next century's scientists, mathematicians, and engineers." PRESIDENT OF THE OF THE THE UNITED 1996 PRESIDENTIAL AWARDS FOR EXCELLENCE IN SCIENCE, OF SEAL STATES MATHEMATICS, AND ENGINEERING MENTORING INDIVIDUALS INSTITUTIONS Martha G. Absher, Duke University, Durham, NC Columbia University Double Discovery Center, Howard G. Adams, National Institute on Mentoring, New York, NY Georgia Institute of Technology, Atlanta, GA Dartmouth College Women in Science Project, Diola Bagayoko, Hanover, NH Southern University, Baton Rouge, LA National Action Council for Minorities in Joaquin Bustoz, Arizona State University, Tempe, AZ Engineering, Inc. (NACME), New York, NY Carlos G. Gutierrez, California State University-Los New Mexico MESA, Inc., Albuquerque, NM Angeles, Los Angeles, CA Oregon Graduate Institute of Science & Janet S. Herman, University of Virginia, Technology Saturday Academy Program, Charlottesville, VA Portland, OR Susan J.S. Lasser, Clemson University, Clemson, SC University of Maryland Baltimore County, Melvin B. Robin, Science High School, Newark, NJ Baltimore, MD Walter S. Smith, University of Akron, Akron, OH Richard A. Tapia, Rice University, Houston, TX 126 Science and Technology Shaping the Twenty-First Century TELL THEM, "YES, IT'S POSSIBLE." As a poor, Mexican American child, Richard Tapia knew he excelled in math and science, but how his technical abilities could lead him out of inner city Los Angeles seemed uncertain. "I just needed some one to tell me, Yes, it's possible.' Tapia, now director of Rice University's Department of Computational and Applied Mathematics recalls several teachers who went the extra mile and encouraged him to "take your talent and love of math, and make a career out of it." While building impressivetacademic and professional achieve- ments, including nomination by President Clinton to the National Science Board that governs the National Science Foundation (NSF), Tapia has never forgotten that one positive statement can change someone's life forever. In addition to teaching and research, Tapia began.and now directs all outreach programs.of the NSF-funded Center for Research on Parallel Computation at Rice In less than ten years, these pro- grams have trained and encouraged more than 750 students and 700 teachers, especially under rep- resented minorities and women, to pursue careerstina mathematics-and science He is as comfortable speaking to a class of second-graders as to a gradu- ate school seminar.All the while, he is urging,his network of teachers, students, and community lead- ers to interact with each other to make the world better place. Today, the importance of role modeling and men-r toring is recognized at the highest levels. In 1996, Tapia, along with nine other individuals and six institutions, received a Presidential Award for Excellence in Science, Mathematics, and Engineering Mentoring. The awards are bestowed by the White House Office of Science and Technology Policy through the National Science and Technology Council. They recognize outstanding mentoring Honored for his mentoring efforts, Richard Tapia efforts and programs that enhance the participation of Rice University is flanked by Neal Lane, National of individuals from groups under-represented in Science Foundation Director (L) and John Gibbons, these fields, namely minorities, women, and persons Assistant to the President for Science and Technology. with disabilities. effect of social policy changes on child well-being mary, and elementary grades, and how their experi- and service delivery and data sources needed to ences relate to their likelihood of succeeding in school monitor change. The study would encompass both a birth and kinder- garten cohort. Longitudinal Studies. The 1998 budget requests Long-term follow-up studies of children provide the additional funding for an Early Childhood best means for assessing how child development in "nor- Longitudinal Study (ECLS), which is to provide a com- mal" conditions compares to what occurs in adverse con- prehensive and reliable set of data that may be used ditions, and how childhood and adolescent interventions to describe and better understand children's prepara- can best be targeted to the childhood antecedents of tion for school, key transitions during their educa- adult disease to prevent or delay the onset of problems in tional careers, their experience in kindergarten, pri- adult life. 132 Science and Technology Shaping the Twenty-First Century Tapia's example is remarkable, but it is not unique. He and his co-recipients share President Clinton's belief that the nation's future prosperity depends on producing the finest scientists and engineers for the twenty-first century, and that we cannot afford to ignore the talents of people who may be outside the economic and social mainstream. Another award winner, Martha Shumate Absher, firmly believes that outreach is done one individual at a time. Absher is director of outreach for the NSF Engineering Research Center for Emerging Cardiovascular Technologies at Duke Universitv. She recalls a deaf undergraduate student she met when she visited Washington, D.C. to interview Gallaudet University candidates for her summer program. He was a "superb computer scientist," shè recalls, but he was discouraged and worried about how to support his wife and the child they were expecting. He needed a job and was considering dropping out of school. She arranged a paid research internship for him in industry for one semester and, after the baby was born, brought the young father to Duke for the summer program. "He did a wonderful job," and was inspired to apply to the University of Maryland Computer Science Department, where he is now enrolled. Without her program's support, "who knows if he could have contin- ued?" Absher muses. "He might have been lost to the whole educational sys- tem." Absher's program provides laboratory research experience, and develops mentoring relationships with students from six universities, including Gallaudet and five Historically Black Colleges and Universities. Students from her program often become mentors to other students. She concentrates on fol- low-up because students who face challenges, such as disabilities, are often unable to turn one positive experience into continued career development. Absher and Tapia believe that government support has literally changed the lives of students who otherwise would be unable to make the move from high school to undergraduate school to graduate school. Both express surprise that their award has made a difference to them but say that the personal recogni- Martha Shumate Absher of tion, and the visibility brought to their programs, helps them toward their goal Duke University was honored at a White House ceremony for of developing a pool of highly trained scientists and engineers that reflects our her outstanding efforts to encour- diverse population. Especially for those students who must overcome long odds age minorities and persons with to pursue a technical career, mentors such as Tapia and Absher can be all- disabilities to pursue scientific important figures because they believe it when they say, "Yes, it's possible." and technical careers. Scientific research must be linked to policy. The children to provide systematic research input to Administration will establish, under the joint auspices policy development, and to assist in outcome eval- of the Domestic Policy Council and the National uation. We owe this to our children, our families, Science and Technology Council, a multi-agency work- and our nation as a sound investment in the ing group to help shape the Federal research portfolio national interest. on the health, education, and well-being of American Science and Technology Shaping the Twenty-First Century 133 Moreover, during the Florio years, New So Florio's advice to President Clinton that failed '70s socialist policies, are withholding painful, messy and may cost lives, but these Jersey experie a. sharp drop in property he shouldn't underestimate the impact of millions in desperately needed assistance until small dictators have a way coming en- values, leaving owners with the worst of cuts is well-intentioned. After all, in New ,leles changes or is replaced. The absence of trenched. all possible wo falling property values and sey, tax cuts have put $1.2 billion back into democracy thus undermines the very goals The longer the inevitable ontation is rising property taxes. paychecks of working men and women, have the international community seeks to pre- delayed, the higher will be the ultimate price Since I assumed office, the state budget has helped create 140,000 new jobs and have kept serve. in violence and suffering. risen 3 percent, a noteworthy accomplishment property tax increases at some of the lowest Asrat and his followers-despite state- in'a state in which, historically, the budget has levels in years. None of that should be underes- ponsored murders, frame-ups, torture, arrests The writer is an American adviser to the All doubled every six years. timated. and "disappearances"-have pledged them- Amhara People's Organization, an The former governor is disingenuous at best selves to nonviolence. This rarity in African opposition party in Ethiopia. and misleading at worst when he claims that my The writer is governor of New Jersey. Jessica Mathews Jack, We can walksome Gibbar of this The Aliens Among Us (Science 23 Aug, mumary Same ten into GW your Crisis in Scienc supposed requirements for life. Some archaeons Last month, headlines blared the apparent more about the surface of the moon than about In can live at zero degrees centigrade. Others Earth's deep oceans. We do not know to within discovery of fossils of bacterial life from Mars. thrive above the temperature of boiling water. a factor of 10 how many species live with us Reporters couldn't write enough about it. Phi- Another can survive more than a million rads of (most of the uncertainty involves the number of losophers and clergy pondered the ultimate radiation, making it the likely victor had the insects) or, therefore, what percentage are be- mysteries on uncounted talk shows. Cold War ever erupted in nuclear holocaust, ing lost. giNo surprise in all that, I guess, though the All this would be enough to stop us in our Environmentalists agonize over the resulting depth of our cosmic loneliness was strikingly mental tracks with the realization of how little dilemma: They fear that greater public aware- evident in how little attention was paid to the we know about life on Earth, even if the archaea ness of what we don't know might encourage in- discoverers' cautions about the uncertainty in their claim or to the fact that, if real, these comprised only a few, peculiar organisms. As it action rather than be understood as the reason were fossils of life that existed billions of years turns out, living under our noses on this planet for greater precaution in human activities that we think we know so well is a previously unrec- could be changing who knows what. That a spe- ago. What is surprising, weird in fact, is how little ognized form of life that accounts for an eye- cies can create a continent-sized hole in the popping one-third to one-half of all the biomass stratosphere and not realize it for more than a attention was paid to the more recent an- on Earth, much of it in the oceans. decade is reason to worry about what we might nouncement of the discovery of a new form of There are several dimensions to this. First, inadvertently do next. life here on Earth, one whose chief author be- BY MARGARET SCOTT of course, is the tremendous excitement, mys- The final irony in our enormous excitement lieves opens a wholly new view of the uni- verse." Media that headlined the Mars story tery and scope of discovery that lies ahead in about extinct life on Mars and indifference to joined by a third. Textbooks will have to be re- the natural sciences. Biology is going to be the new life on Earth is that the archaea, with their buried the Earth story or ignored it. The announcement was of the sequencing of written. The gene sequence proved a 20-year- revolutionary science of the next century, as preference for extreme conditions and their in- the entire genome of a strange organism dis- old hypothesis that until now has been consid- physics has been for this one. Genome sequenc- dependence of the sun's energy, are the perfect ered highly controversial, if not downright nut- ing will provide a more powerful tool for under- candidate for alien life. "I would be surprised," covered near a place on the ocean floor where ty. standing the origin of life than the hit-or-miss says Craig Venter, leader of the gene-sequenc- superheated water pours out of a vent. This ec- More than half of the genes of this amazing search for fossils. Behavioral science and molec- ing team, "if we don't find organisms similar to centric beast flourishes at near boiling tempera- tures under pressures of 200 atmospheres, far organism turned out to be unrelated to any pre- ular genetics will converge, yielding unimagined this at some stage on other planets." Perhaps viously known genes, a staggering result. Even insights. Ecology is now only in its infancy. archaea or something like them on a falling me- beyond the sun's reach. All it needs to live is ni- trogen) carbon dioxide and hydrogen, from odder, while some are closely related to bacteri- There's no end to the mind-bending possibili- teor from Mars first seeded Earth's primeval al genes, others, that direct the cell's informa- ties. You thought that natural gas was a fossil hot oceans. Perhaps these organisms will be which it makes methane (natural gas). tion processing, are similar to eukaryote genes, fuel? Well, the genes of this organism and other Earth's first colonists to other planets. Its gene sequence revealed that this methan- ococcus is in fact a member of a previously pos- even to human genes. Archaea, it seems, par- methane-producing archaeons might make it One thing we know for sure. We don't need tulated form of life called archaea. The two liv- take of both the known domains and may be ei- possible to produce natural gas as a renewable tc look to outer space for heroic science: ther their common ancestor or a giant step on energy supply. There's plenty right here. ing domains that schoolchildren are taught the way to the discovery of the root of life. Discovery of the archaea also underlines, in a about-prokaryotes, bacteria with no nucleus; and eukaryotes, complex organisms from yeast In this kingdom are creatures that seem like way no sane person can ignore, the scope of The writer is a senior fellow at the Council pure science fiction. They violate many of the what we don't know about our planet. We know on Foreign Relations. to humans whose cells have a nucleus-are now Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a tabbed divider. Given our digitization capabilities, we are sometimes unable to adequately scan such dividers. The title from the original document is indicated below. Future Support for R & D Divider Title: Possible paragraph on vision of future support for R&D "I have often stated my concern that high leverage investments in America's future, such as science, research, and education be sustained. In the long term, our economy, environment, health, and security depend on making such commitments. Until we complete our task of balancing the budget, however, we must constrain spending even on our best investments. I hope that by the turn of the century, Federal support for science will begin roughly to track GDP growth. Meanwhile, we will continue to focus on providing a constant purchasing power for research and make further gains through productivity increases." Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a tabbed divider. Given our digitization capabilities, we are sometimes unable to adequately scan such dividers. The title from the original document is indicated below. FY98 R & D Budget Overview Divider Title: THE WHITE HOUSE Office of Science and Technology Policy February 6, 1997 Contact: Tim Newell (202) 456-6020 FOR IMMEDIATE RELEASE STATEMENT BY THE ASSISTANT TO THE PRESIDENT FOR SCIENCE AND TECHNOLOGY JOHN H. GIBBONS FY98 R&D BUDGET OVERVIEW Good morning, and thank you for joining us to discuss the science and technology investments in the FY98 budget request that the President is releasing today. Today marks an anniversary of sorts for me. This is my fifth annual appearance before you to present President Clinton's R&D budget request. More importantly, and more LC the point, the President's FY98 budget marks the fifth year in a row that President Clinton DES called for increases in science, technology and education investments. Two days ago, in his State of the Union speech, President Clinton stated clearly his convictions, saying that, "to prepare America for the 21st century, we must harness the powerful forces of science and technology to benefit all Americans." This budget, as have his past four budgets, delivers on President Clinton's commitment to maintain critical science and technology investments as a priority while balancing the budget. To provide you with some context, let me introduce OMB Associate Director T.J Glauthier to review the President's overall FY98 federal budget strategy that will be presented later this morning. (Glauthier remarks) Now, as in past years, I would like to take just a few minutes to review the highlights of the R&D budget request: The President's FY98 budget increases total federal research and development funding by more than $1.6 billion over 1997, to roughly $75 billion (as traditionally reported). This is the fifth year in a row that President Clinton has proposed to increase research and technology unding, at the same time that he has cut the budget deficit and has put our country on track for a balanced budget. 1 The President's FY98 budget boosts funding for basic research. The budget proposes $15.3 billion for basic research, an increase of $418 million (3 %) over 1997. This includes, for example, a 4% increase for R&D at the National Science Foundation on the civilian side, and a 5% increase in defense basic research. Basic research funded by the Department of Energy is slated to increase by more than 4 %. In the outyears, basic research is projected to increase steadily by nearly 5% to the year 2002. The President's FY98 budget strengthens university-based research. University- based research is key to America's future; it provides new knowledge and new technology, while at the same time training the next generation of scientists and engineers. We are proposing to increase university-based research by $289 million, to a total of $13.3 billion in FY98. The President's FY98 budget provides major new support for technologies that ensure that America benefits from the revolution in information technology. Investments in computing and communications R&D are increased by 10 %, to $1.1 billion. This includes a 3-year, $300 million Next Generation Internet initiative. This initiative will create the foundation for the networks of the 21st century by connecting more than 100 U.S. universities and national labs at speeds that are 100 - 1,000 times faster than today's Internet - with an ability to transmit voice, video and virtual reality in a secure and reliable fashion. The FY98 budget also provides $205 million for the Department of Energy's Accelerate: Strategic Computing Initiative (ASCI), a critical part of our Science-based Stockpile Stewardship program. This program is producing new generations of the world's fastest supercomputers. which will be available for both civilian and defense applications. The FY98 Budget provides significantly increased support for programs that will bring the power of modern information technology to classrooms throughout America. The budget includes $524 million for research and development in education technology. This includes $75 million for the Technology Innovation Challenge Grants program that funds competitive grants for consortia of schools, businesses, universities, and other organizations W develop innovative applications of innovative technology. In addition to these R&D programs. the budget more than doubles, to $425 million, the funding for the President's $2 billion, 5- year Technology Literacy Challenge Fund designed to stimulate public-private partnerships focused on fully integrating education technology into teaching and learning. 2 The President's FY98 budget increases investment in technologies essential for ensuring continued US economic leadership and job creation. A 6% increase in civilian applied researchfensures that the U.S. will benefit from a continuing flow of technological advances. The budget boosts investments in critical technology initiatives like the Advanced Technology Program at the Department of Commerce, which gets a 22% increase over FY97 (to $275 million), and provides a 36% increase for the Manufacturing Extension Partnership program that operates in close cooperation with state governments to ensure that our nation's small and mid-sized companies are able to compete worldwide with state-of-the-art technology. Funding for the Partnership for a New Generation of Vehicles initiative is increased 7%, to $281 million*, and funding for the construction and building technologies initiative is increased 15%. The budget ensures that information technology is used effectively. Examples include $36 million for the Department of Commerce's Telecommunications and Information Infrastructure Assistance Program (TIIAP), and $250 million for the Intelligent Transportation System (TTS) initiative. The ITS is critical for reducing congestion, improving the safety. and mitigating environmental impacts of our nation's highway system. The President's FY 98 budget includes tax incentives to encourage private sector investment in research and technology. The budget proposes a one year extension in the Research and Experimentation tax credit. In addition, benefits of the Foreign Sales Corporation tax credit would be extended to computer software producers whose products are licensed for reproduction abroad. The President's FY98 budget increases funding for environmental research. Science and technology investments are critical for enhancing environmental quality, and this budget funds vital research needed to ensure clean air, pure water, and safe food. The FY98 budget allocates $5.3 billion for environmental research, a four % increase over FY97. This funding supports a broad research agenda, including sustainable use of natural resources. preservation of biodiversity, ecosystem management and restoration, social and economic dimensions of environmental problems and environmental technologies. The largest component is $1.9 billion for understanding and predicting global climate change and its regional impacts. This budget invests in the highest quality research aimed at understanding our most challenging problems, coupled with development of technology to enable better environmental protection at lower cost. The budget allocates $115 million for the STAR Program (Science To Achieve Results), a 21 % increase over 1997 for this multi-agency program that awards research grants and fellowships on the basis of rigorous peer review. The budget increases support for research on the health effects of airborne particulate matter by 37 % over FY97. to $26 million. We have increased solar and renewable energy research programs at DOE by $60 million, or 22 %, to enable clean energy sources for the 21st century. Funding for energy efficiency and pollution-prevention R&D increases $97 million, for a total of $517 million. 3 The President's FY98 budget provides increased support for health, food and safety research. The budget for the National Institutes of Health (NIH) contains a 2.6 % increase, primarily going to investigator-initiated, peer-reviewed research grants. This increase will fund high priority research areas such as HIV/AIDS-related illnesses, breast cancer and other women's health issues, minority health initiatives, disease prevention research and spinal cord injury research. The FY98 budget also contains an increase of $43 million to enhance the safety of our nation's food supply. The President has requested a 38 % increase in the USDA's National Research Initiative for support of investigator-initiated, peer-reviewed research grants. To protect our health from the threat of new infectious diseases, the President's budget calls for 2 34% increase for CDC's emerging infections surveillance and response programs to $59.5 million. The President's FY98 budget continues the President's strong support for the nation's civil space program. The budget maintains funding for the International Space Station program at $2.1 billion; strengthened commitment to Mission to Planet Earth at $1.42 billion (a 4% increase over FY97); and solid support for the X-33 Reusable Launch Vehicle program ($330 million) and aeronautics initiatives ($456 million). In addition, NASA's space science budget has been augmented by $1 billion over the next five years. The overall out year projections for NASA in the President's FY98 budget represent 2 significant improvement over the FY97 estimates, which had the agency dropping to $11.6 billion by FY00. Under the FY98 run out, the NASA budget will go from $13.5 billion in FY98 to $13.2 billion in FY00, then remain at that level through FY02. In total, NASA's five-year budget has been increased by $2.7 billion compared to last year, to provide 2 stable planning environment. The President's FY98 request continues to support the investments in research and technology that ensure our nation's security. We are emphasizing investments which sustain our military defense capabilities, prevent conflict before it occurs, and address other global threats to the well-being of our nation. The budget maintains our long-term investments in the science and technology base and our commitment to advancing our defense capabilities efficiently and cost-effectively. We are requesting a 5% increase in defense-related fundamental research, which includes an 8% increase in the basic research budget of the Department of Defense to $1.16 billion. He are also continuing our support of defense R&D which also leverages innovation in the commercial sector through the Dual-Use Applications Program (DUAP). The request for DUAP is $225 million. 4 We are maintaining our priority for investments that will help to control the spread of nuclear weapons and the materials used to make them. The FY98 budget requests a 16% increase in the Cooperative Threat Reduction Program to $382 million. This U.S.-Russia cooperative program has proven to be a critical investment in helping the states of the former Soviet Union sequester, dismantle and destroy Cold War era nuclear and chemical weapons. We are also requesting a funding increase of 21 % to $137 million to strengthen the control and accounting of the materials that can be used to make nuclear weapons, to prevent these materials from misuse. We are requesting $1.4 billion for the Department of Energy's Stockpile Stewardship Program. This program is designed to support the research needed to assure the reliability and safety of our nuclear stockpile without nuclear testing. It underpins our commitment to the Comprehensive Test Ban Treaty, which was signed by the President last September. We are also requesting $1.3 billion for the construction of facilities needed for this program which includes $900 million for the National Ignition Facility. This sums up the S&T highlights in the FY98 budget -- I would refer you to individual agency briefings and budgets for more details. Before taking your questions, there are two additional points I would like to make. First, there have been many well-publicized predictions -- fears may be a better description - within the science community that balancing the budget would require deep cuts in civilian research programs -- cuts on the order of one-quarter to one-third over the next five years. Every one of my years in this office, I have heard rumors of the imminent demise of our nation's S&T enterprise. This year is no different. In fact, in the years between 1998 and 2002, the President's plan will preserve civilian research funding while completing the job of balancing the budget. The President's baseline outyear budget plan proposes civilian R&D to grow by 2% (nominal) between 1998 and 2002. This represents a solid investment, given the fact that the budget will eliminate the deficit (and actually produce a surplus) over the same time period. Above this base, I fully expect some increases-including those required to launch exciting new initiatives-to be realized each year, at the time that year's budget request is prepared and submitted to Congress. Second, the 1996 elections capped a year of sometimes-acrimonious debate on the role of Federal support for science and technology. That debate may well continue, but what emerged is clear: The American public and the vast majority in Congress support a strong federal research program to produce new jobs and economic growth, protect the environment. improve health care, and educate our children for the 21st century. 5 It is time to put that debate behind us and rebuild the historical bipartisan support for 2 strategy to maintain America's world leadership in science and technology into the 21st century. We need to put our disagreements aside and look for the common ground we once shared, the common commitments to keep America the world's undisputed leader in S&T while bringing the budget to balance. I and my colleagues in the Administration look forward to working with the Congress on a bipartisan basis to achieve this. Thank you. *Previous versions of this statement contained an incorrect funding figure for the Partnership for a New Generation of Vehicles initiative. $281 million is the correct figure. 6 Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a tabbed divider. Given our digitization capabilities, we are sometimes unable to adequately scan such dividers. The title from the original document is indicated below. Progress in Health Divider Title: Progress #2 # 2 inner-city areas is about 50 percent. Public health measures require an immunization rate of 80 to 90 percent of all children to prevent the spread of outbreaks. IMMUNIZATION One of the greatest public health success stories for children is development of vaccines against the infectious diseases of childhood. Work continues today to develop more vaccines and assure that they are used for maximum benefit. NIH- and FDA-supported research has led to the creation of important vaccinations that have been instrumental in reducing childhood illness. For example, Hemophilus influenza type b meningitis used to infect 15,000 children yearly, and was the leading cause of acquired mental retardation in the United States. The vaccine these agencies developed has nearly eliminated the disease in just six years. NIH serves as the lead agency within the Public Health Service on the Children's Vaccine Initiative, a global effort launched in 1990 to accelerate the development of safe, inexpensive, orally administered vaccines. Work is under way on redesigning existing vaccines and developing new vaccines against rotavirus diarrhea, pneumococcus, meningococcus, Shigella dysentery, and other diseases. CDC research showed that linking immunization services with WIC clinics could significantly increase immunization coverage of low-income children. In 1994, CDC and USDA developed a coordinated strategic plan to improve the immunization and general health status of WIC participants under two years of age. CDC also helped to develop immunization registries, a critical tool to achieve the National Goal for the Year 2000 of having at least 90 percent of two-year-old children fully up-to-date with their recommended immunizations. These and related efforts have brought us to the highest levels of immunization of children in the Nation's history. 9 I. Introduction B y the mid-1950s, the threat of infec- re-emerging threats in the United States tious diseases appeared to be receding include multi-drug resistant TB, antibiotic- in the United States. Deaths from resistant staphylococcal, enterococcal, and infection, commonplace in our grandparents' pneumococcal infections, and diarrheal time, were no longer a frequent occurrence. diseases caused by the parasite American physicians used fast-acting, effec- Cryptosporidium parvum and by certain tive drugs to combat often fatal bacterial strains of Escherichia coli bacteria. In fact, diseases such as meningitis and pneumonia. only one antibiotic remains consistently The incidence of childhood diseases such as effective against common hospital-acquired polio, whooping cough, and diphtheria, was staphylococcal infections. Meanwhile, the declining due to the use of vaccines. Mean- number of new antibiotics introduced into the while, in other parts of the world, chemical U.S. market has declined; not one new pesticides like DDT were lowering the incidence of malaria, a major killer of chil- dren, by controlling populations of parasite- carrying mosquitoes. Savings Due voccination As it turned out, our collective - and Smallpox. The befieits quite understandable -euphoria did not take the Smallpox Eradication Broer into account the extraordinary resilience of been substanti the countries in microbes, which have a remarkable ability to the world preventive and evolve, adapt, and develop resistance to drugs treatment facilitie for are (11) in an unpredictable and dynamic fashion. longer needed The cost The United Moreover, disease-carrying insects have States for the success ful T3 year campaign developed resistance to pesticides in a very toleradidate smallpo throughout the short time. world was $30 million Since Today, most health professionals agree @smailpox eradicated 1977 the that new microbial threats are appearing in nine has the United significant numbers, while well-known "Statestevery illnesses thought to be under control are re- Polio. Once acommon causelof emerging. Most Americans are aware of the adisabilitie. or death, epidemic of the acquired immunodeficiency eliminated tro the Americas The current syndrome (AIDS) and the related increase in drive towards global eradication is one 011 tuberculosis (TB) cases in the United States. the great challenges OF generation In fact, there has been a general resurgence of Once the global eradican program is infectious diseases throughout the world, completed target date: 2000) the United including significant outbreaks of cholera, State will save millions of dollars years malaria, yellow fever, dengue, and diphtheria, on vaccin alone. since there will as well as illnesses caused by antibiotic- no abe alneed.to immunize news resistant bacteria. There has also been a boms. FB ased on the rate resurgence of fungal infections for which there Aprogress towards eradica tion WHO are very few treatments. Furthermore, the predicista globals of $500 million incidence of AIDS is increasing in many by the increasing to: savings eli countries. $3 Ilion annually by the year 2015 New diseases have also appeared within Other Infectious& iseas the United States, including Lyme disease, Childhood. Health economists estimate Legionnaires' disease, and most recently, that for every dollar-spent on the imeastes/ hantavirus pulmonary syndrome (HPS). HPS Amumps/rubella $219 are saved 70 was first recognized in the southwestern the diphtheria/tetanus/pertussis vaccine United States in 1993 and has since been $29 are saved; and for the polio Vaccine detected in more than 20 states and in several $6 are saved other countries in the Americas. Other new or 9 and CDC. Reliable lines of communication Interdisciplinary Research to must be established to ensure that surveillance support Control and Prevention. information is received promptly enough to Form linkages between control outbreaks before they spread. A list of Experimental biologists and epidemi- clinical circumstances that require high- ologists both here and abroad. priority surveillance efforts is shown on page The global infectious disease network 23. and environmental and climatic Diagnostic Tests. Work with WHO, research programs. national public health authorities, universities, Encourage collaborative research to and research centers to implement WHO's determine the causes of epidemics, devise country-level objectives. This entails deter- strategies for control and prevention, and mining which "common" diseases should be identify environmental and climatic conditions diagnosed within a country and which "un- that favor the emergence of pathogenic common" ones should be referred to reference microbes. laboratories. It also requires that diagnostic tests be made available through a regional laboratory referral and distribution system. vention, noug TEA Develop simpler, more cost-effective the Sex ren ein procedures to determine the causes of disease. Effective Preumonic Vaccine Ideally, these procedures should be simple the arrest Klier infant-and enough for use in the field when laboratory syoting Offiction ti developing countries facilities are not available. are Toute respiratory mainly Support basic and applied research on pneumonia which claim.ine lives of an infectious microbes, especially on pathogens estimate 3187 million children-unders for which there are no reliable diagnostic tests. Fevery We While The new tools of biotechnology should be mana using ommon antibiotes, exploited to speed these efforts. hasbeen very, uccessful in treating,these Response. Enhance the capabilities of diseases the gence of antimicrobile, U.S. Government agencies and existing resistant strains that this success disease-specific networks (see page 50) to may be relati aly Onerwayste respond to recognized outbreaks identified lavoid istanceris to through improved surveillance. Also, rebuild prevent the on fromic and coordinate the relevant technical resources using safe and effective vaccines of U.S. Government agencies such as CDC, Through bildren Vaccine DoD, USAID, and FDA. Project, initiating Emajo new Diseases that are transmitted by different program to altuate eloped) routes will necessarily require different control Vaccines-that may hildrensin strategies. Types of response may include "underdevelop Educountries): These vas sanitation and hygiene measures, controlling Joines are aimed against/major bacterial populations of disease vectors (for example, and viral.causes of pneumonia including malaria-carrying mosquitoes or rabid rac- Streptococ pneumoniae and coons), drug treatment, vaccination or post- Haemophilus influenzae by Studies in the exposure prophylaxis, or education to decrease industrializ world and eliminary human behaviors that cause spread. studies m developing countries suggest that these illy new "conjugated" versions hold great promise 24 efforts must be coordinated to prevent global of new, emerging, and re-emerging infectious pandemics, disease surveillance must be the diseases are identified." Soon after the responsibility of each sovereign nation. resolution was drafted, WHO issued a report However, individual governments may not urging the strengthening of global disease easily share national disease surveillance surveillance and control, and encouraging information, fearing losses in trade, tourism, greater use of WHO Collaborating Centers in and national prestige. Nevertheless, because this endeavor. U.S. experts are often consulted on problems of infectious disease recognition and control, Are infectious disease surveillance the U.S. Government is usually informed and control cost-effective? about major disease outbreaks in other The direct and indirect costs of infectious countries, although not always in an official or disease are staggering (see Table 1). Clearly, timely fashion. To ensure that we continue to public health measures that prevent infectious be notified when an unusual outbreak occurs, diseases can be extremely cost-effective. we must encourage and support other coun- In 1994 and 1995 two major U.S. health- tries' efforts in national disease surveillance care expenses have been for the treatment of and respond when asked for assistance. We tuberculosis and AIDS. The Public Health must strive to develop a sense of shared Service budget for fiscal year 1996 includes responsibility and mutual confidence in the $343 million to combat TB and nearly $3 international effort to combat infectious billion to combat AIDS. TB is a very old, diseases. well-known disease that has re-emerged There is much room for optimism. If the sometimes in a drug-resistant or multidrug- United States takes the lead, we can expect resistant form. AIDS, on the other hand, is a that other nations will contribute resources to a new disease, unrecognized before the 1980s. global surveillance system. Both Canada and When the first cases of AIDS and drug- the European Union have recently decided - resistant TB were detected in the United in spite of tight budgets - to provide substan- States, control measures were delayed, partly tial funds ($7 and $10 million per year, because of a lack of surveillance information respectively) to strengthen infectious disease and incomplete understanding of the epidemi- surveillance and control. It is also absolutely ology of these diseases. critical that developing nations be engaged in Tuberculosis an international effort that is in their own interests. In May 1995, WHO passed a For many years, the United States had in resolution urging member states "to strengthen place a surveillance system to monitor cases of national and local programmes of surveillance TB. However, during the 1980s, federal and for infectious diseases, ensuring that outbreaks local spending on infectious disease control Table 1 Estimated costs of common infectious diseases in the United States, per year Disease Financial Cost Intestinal infections $23 billion in direct medical costs and lost productivity Food-borne diseases $ 5-6 billion in medical and productivity costs Sexually-transmitted diseases (excluding AIDS) $ 5 billion in treatment costs Influenza $ 5 billion (direct medical costs) and $12 billion (lost productivity costs) Antibiotic-resistant bacterial infections $ 4 billion in treatment costs and increasing Hepatitis B virus infection $720+ million in combined direct and indirect costs These costs, combined with dollars spent on AIDS and TB, exceed $120 billion per year. 12 NEW MEDICINES IN DEVELOPMENT FOR HEART DISEASE & STROKE Presented by the Pharmaceutical Research and Manufacturers of America 1997 Survey New Medicines in Development Include 96 for Heart Disease and Stroke pending billions of dollars every year, pharmaceutical company 1997 MEDICINES IN DEVELOPMENT research is' tackling two of the FOR HEART DISEASE AND STROKE nation's most vexing health problems: heart Angina 12 attack, the number one killer of both men and women, and high blood pressure, which Arrhythmia 5 afflicts about 50 million Americans. Atherosclerosis 3 Eighteen medicines are in development Congestive Heart Failure 17 for heart attacks, which kill nearly 500,000 Coronary Artery Disease 5 Americans every year, and 10 new drugs are being developed for high blood pressure, Heart Attack 18 which plays a role in the more than 150,000 Hyperlipidemia 7 aths a year from stroke. Beyond the Hypertension 10 Uman suffering, the illnesses brought on by uncontrolled high blood pressure cost Peripheral Vascular Disease 9 billions of dollars annually, Stroke 22 Though There is clearly needed, Other 27 great strides have been made. Heart attack deaths decreased more than 30 percent from 1981 to 1991, due in large part to bet- In the past 30 years, the stroke death rate death in the brain when a stroke occurs; ter prevention, diagnosis and advancements has declined by about 60 percent. Prevention helping to salvage damaged brain cells; and in medicines. Treatment of heart attacks and medicines have both played a major role improving recovery efforts. with clot-dissolving drugs, for example, has in the reduction. With continued introduc- The commitment to battle heart disease helped reduce deaths dramatically. tion of new stroke medicines and continued and stroke is now shared by 63 companies High blood pressure, meanwhile, is attention to reducing risk factors, scientists as researchers strive to develop more effec- being controlled today by increasingly effec- predict that Americans will be able to pre- tive medicines. When heart disease became tive new medicines and more knowledge- vent 80 percent of all strokes by the end of the leading killer of Americans in 1921, few able use of existing drugs. treatments were available to fight it. And New Medicines in Development for Heart In an important step for better treat- development of no drugs Disease and Stroke, a new report released by ment, the FDA last June approved Activase, was a slow process When President P/RMA, shows that 96 new drugs are in Genentech's genetically engineered clot- Franklin Delano Roosevelt was diagnosed development for heart disease and stroke. dissolving agent, as a new stroke medicine. with high blood pressure in the early 1940s, In addition to the new drugs for heart Stroke patients, if treated with Activase doctors could only advise him to eat a low- attacks and high blood pressure, other heart within three hours, are 33 percent more salt diet and take sedatives. medicines in clinical testing or at the Food likely to end up with little if any disability. Poday, patie from wide and Drug Administration (FDA) for final The finding is based on a study conducted range of medicines for heart-related ail- review include 12 medicines for angina, 9 for of ments, including high blood pressure. And peripheral vascular disease, 5 for arrhythmia Disorders and Stroke, published in the the 96 medicines now in development will and 5 for coronary artery disease. December 14, 1995 issue of the New lead to further progress against heart dis- Preliminary estimates indicate that the England Journal of Medicine. case and stroke. pharmaceutical industry will spend $3.1 Pharmaceutical company researchers billion on cardiovascular research in 1997. have learned more in recent years about the Alan &. Holmen The 22 medicines in development for complex mechanisms at work before, during Alan F. Holmer ke show researchers are trying to con- and after a stroke. This knowledge is lead- President .uc progress against that feared disorder. ing to new and better ways to limit cell PARMA Facts About Heart Disease and Stroke in the United States¹ Heart disease is the leading cause of death in the United States; stroke is the third. These diseases together will cost Americans an estimated $259.1 billion this year (in direct and indirect costs). Disease Annual Incidence Prevalence Deaths Hospitalizations and Discharges² Angina 350,000 7.1 million 152,000 discharges Arrhythmias 4.5 million 43,431 398,000 hospitalizations 679,000 discharges Atherosclerosis and 2.3 million 17,980 97,000 hospitalizations Peripheral Vascular Disease 265,000 discharges Congestive Heart Failure 400,000 4.8 million 41,819 874,000 discharges 220,000* Coronary Artery Disease 13.7 million Heart Attack 1.5 million 487,490 2.1 million discharges Hyperlipidemia 97.2 million (cholesterol levels above 200) Hypertension 50 million 38,130 372,000 discharges (High Blood Pressure) (age 6+) 180,000* Stroke 500,000 3.9 million 154,350 885,000 discharges Deaths from angina are included in total deaths from heart attacks. Number of deaths where disease was listed as a contributing cause of death. Key Facts: An estimated 57.5 million Americans-more than one in five males and females-suffer from at least one form of cardiovascular disease. More than 954,000 Americans die from cardiovascular disease each year, representing nearly 42 percent of all deaths in the United States. More than 2,600 Americans die each day of these diseases-an average of one death every 33 seconds. One in two women (50 percent) will eventually die from heart disease or stroke. On average, someone suffers a stroke in the United States every minute; every 3.4 minutes someone dies from a stroke. An estimated 7.9 million Americans age 15 and older have disabilities resulting from cardiovascular conditions, representing 19 percent of all disabilities in the United States. Cardiovascular disease is the leading diagnosis in all hospital discharges-more than 5.8 million, almost equally divided between males and females. Notes: 1. 1997 Heart and Stroke Statistical Update, American Heart Association. 2. "Hospitalizations" refers to the number of patients admitted to the hospital for a specific cause; "discharges" refers to the number of inpatients-whether alive or dead-discharged from short-stay hospitals where some type of disease was the first listed diagnosis. 14 Improved Drugs Have Played a Key Role In Reducing Coronary Heart Disease Deaths By John F. Beary, III, M.D. Senior Vice President, Regulatory and Scientific Affairs, PhRMA D eaths from coronary congestive heart failure (CHF) vessels and are taken daily by many heart disease (CHD) in The annual cost of CHD in the heart patients. 1990 were 34 percent United States is close to $80 billion ACE inhibitors help regulate the lower than in 1980, according to an and consumes about 15 percent of heart's pumping action by prevent- article in the February 1997 issue of the U.S. health care budget. Left ing production of a substance that the Journal of the American Medical untreated, CHD can lead to constricts blood vessels. These Association (JAMA). The article myocardial infarction, or heart medicines dilate blood vessels, attributes nearly half of the mortal- attack, the leading cause of death which helps to lower blood pressure ity decline to improved medicines for both men and women in the in a phenomenon known as after- and surgery techniques. United States. About a third of the load reduction. ACE inhibitors are For many patients, heart disease 1.5 million Americans who suffer a useful for both hypertension and risk factors are controlled by drugs heart attack each year die. CHF. that manage blood pressure, choles- Nevertheless, the number of Biomedical researchers are now terol and diabetes. Many other fatalities has decreased: treatment striving to move beyond today's heart medicines are also available, of heart attacks with clot-dissolving arsenal of drugs for coronary heart including beta blockers, diuretics, drugs, for example, has helped disease and its complications. antiplatelet drugs, thrombolytics reduce heart attack deaths. The Pharmaceutical researchers are and ACE inhibitors. number of drugs for treating CHD, trying to develop new medicines The JAMA article was written by heart attacks and CHF has increased based on gene therapy. Industry a team of health policy and medical dramatically over the years. scientists are trying to find the specialists from the Harvard School Beta blockers block structures in genes responsible for myocardial of Public Health, Harvard Medical the body called beta receptors. cell growth in the heart so they can School, the University of Groningen These drugs, by blocking the recep- stimulate normal production of in the Netherlands and several tors, reduce heart muscle oxygen heart muscle and a return to normal other medical centers. demands during physical activity or functioning after heart attacks. CHD is a result of atherosclerosis, excitement. Beta blockers also help Research is also leading to a which occurs when arteries become to reduce blood pressure. Addition- better understanding of the basic narrowed or clogged by deposits of ally, the role of beta blockers in causes of atherosclerosis and vascular hardened fat, cholesterol and preventing second heart attacks is disease. This will lead to still more plaque. The arteries are unable to now well established. new treatments, such as targeted supply enough blood for the heart's Antiplatelet drugs, such as low- antibody therapies directed at needs. This can lead to chest pain dose aspirin, help prevent clots reducing artery-clogging plaque. known as angina, heart attacks and from forming in coronary blood 13 SUDDEN INFANT DEATH SYNDROME Sudden Infant Death Syndrome (SIDS) is the leading cause of death among infants from one month to one year of age. Though the causes of SIDS remain unknown, research efforts have facilitated scientific breakthroughs and enabled the development of public health strategies to combat it. Research sponsored by the NIH over the last two decades has identified risk factors associated with SIDS, the effects of sleep position on infant health, and other related issues. This information led the American Academy of Pediatrics to recommend, in 1992, that babies be placed on their backs or sides to sleep. In addition, research conducted by the CPSC provided the first epidemiologic evidence that infants who sleep on their stomachs on top of soft bedding (e.g., pillows, comforters) are likely to rebreathe carbon dioxide. The research showed that rebreathing carbon dioxide trapped in bedding may have contributed to the deaths of as many as 30 percent of the infants initially diagnosed as experiencing SIDS. CPSC warned the public about the hazards of soft bedding through Safety Alerts, a national press conference, and by joining in the "Back to Sleep" public health campaign. The "Back to Sleep" campaign was launched in 1994 and sponsored by a coalition of Federal agencies, the American Academy of Pediatrics, the SIDS Alliance, and the Association of SIDS Program Professionals. These events have been credited with lowering the percentage of babies placed on their stomachs to sleep from over 70 percent to less than 30 percent, and helping to reduce the death rate from SIDS by 30 percent in the two-year period from October 1993 to October 1995. This is a prime example of how research can be linked to practice and program development to achieve a national objective. 52 REDUCING CHILDHOOD LEAD POISONING: SIGNS OF PROGRESS¹⁴ Efforts to understand the extent of lead poisoning in America's children began to flourish in the 1950s, as people became more aware of the harmful effects of lead exposure and its sources. Lead poisoning adversely affects three major organ systems in the human body: the central nervous system (specifically, the brain), the kidneys, and the blood- forming organs. Children can experience lead exposure not only from lead-based house paint, but also from leaded gasoline, drinking water, and household products. Numerous Federal agencies - the EPA, the NIH, the CDC, ASTDR, HUD, and the CPSC - have cooperated to generate the data needed to understand the consequences of lead exposure to infants and children as well as how to prevent and treat it. One of the greatest steps in protecting children's health occurred 20 years ago, when the EPA phased out lead in gasoline and the CPSC also banned lead in residential paint, coatings, and certain other consumer products. In the 1980s, studies tracking children from birth showed that levels of lead in children's blood previously thought to be safe were, in fact, associated with serious neurological and behavioral problems such as impaired coordination, increased aggressiveness and hyperactivity, and lower IQ scores. CDC revised their screening guidelines for acceptable blood lead levels in children, from 60 g/dL in the 1960s to 10 g/dL today. In 1991, CDC recommended that virtually all children be screened for lead exposure and poisoning. CDC, HUD, EPA and CPSC issued strategies for elimination of lead poisoning. Together, these efforts have led to a 98 percent reduction in lead levels in the air and protected millions of children against serious, permanent learning disabilities. From 1976 to 1993, the percentage of children ages one to five with blood lead levels higher than acceptable levels decreased from 88 to about 4 percent. Though lead levels in children have significantly declined, this environmental health hazard currently affects as many as 0.9 million children age five and under. The fact remains that lead exposure is an entirely preventable childhood health problem. There is still much to be done to protect children particularly those living in lower income areas or in older homes threatened by chipping or peeling paint and excessive amounts of lead- contaminated dust. What is more, there is a host of other environmental hazards, the effects of which on child and adolescent development are still not fully understood; even less is known about their cumulative effects and the risks they pose to children. 31 THE UNITED STATES EXPERIENCES DRAMATIC DECLINES IN CHILDHOOD IRON DEFICIENCY ANEMIA 11 Iron deficiency, a widely prevalent condition in America that causes anemia, has serious effects on the health and development of infants and children. Infants with iron deficiency anemia have been shown to score lower on tests of mental and motor development than their healthy counterparts. Evidence also points to long-term effects of iron deficiency at young ages including impairment in general intelligence, language capability, fine and gross motor skills, and visual integration. Public policy efforts to reduce iron deficiency date back to the 1940s, when the NAS endorsed the addition of iron to white flour and the Food and Drug Administration (FDA) established Standards of Identity for enriched flour. By 1990, 95 percent of grain products in the food supply were enriched, contributing to a 50 percent increase in per capita consumption of iron. Food assistance programs directed toward specific populations have also succeeded in improving the iron status of these groups. The USDA's WIC program, established in the early 1970s, is especially noteworthy. WIC provides highly nutritious, iron-fortified food to low-income women who are pregnant or breast-feeding and to their children up to the age of five. The program also provides nutrition education and increased access to other health care and social services, including prenatal care. One of the goals of the WIC program is to reduce the incidence of iron deficiency among this high-risk population. Research shows that the overall prevalence of anemia in children from low-income families who participated in WIC declined from 8 percent in 1975 to about 3 percent in 1985. Among inner-city infants who were given an iron-fortified formula during the first year of life, only 1 percent suffered from iron deficiency anemia as compared to about 9 percent of infants who did not receive an iron-fortified formula. Despite these improvements, iron deficiency anemia in infants and children remains a public health concern. To assure the health and well-being of America's children and infants, continued monitoring of iron levels as well as dietary interventions are needed. 16 Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a tabbed divider. Given our digitization capabilities, we are sometimes unable to adequately scan such dividers. The title from the original document is indicated below. Progress in Agriculture Divider Title: NABC REPORT 8 Agricultural Biotechnology: Novel Products and New Partnerships SHARPS moser) Genetic Engineering of Flavor and Shelf Life in Fruits and Vegetables DAVID A. EVANS DNA Plant Technology Corp. Oakland, Calif. Twenty years ago, consumers only ate fruit that was "in season." Fruit was not shipped long distances and supply was dependent on local production areas. Demand for year-round, inexpensive produce has led to consolidation of pro- duction where temperatures are warm, sunshine is plentiful, and labor is cheap. In most cases, produce is now shipped long distances before being consumed. Tomatoes grown in Mexico are trucked 3,500 miles, bananas grown in Ecuador travel 6,000 miles on a boat, bell peppers from Holland greenhouses are flown 5,000 miles to market. Unfortunately, fruit was not designed to be shipped long distances. In order to make it to market, fruit is picked before it is ripe (and before it has any taste). Despite harvesting immature fruits, post-harvest losses of fruits and vegetables still exceed 25 percent of crop production and the fruit that makes it to market has often been described as tasteless. STRATEGIES FOR FLAVOR AND SHELF-LIFE IMPROVEMENT Flavor can be addressed by increasing intensity (concentration) of an impor- tant chemical component of flavor. This can be accomplished by increasing production of a specific compound (e.g., sucrose), by shifting the balance of compounds (glucose versus sucrose), or by blocking production of undesirable compounds (such as starch). Genes have been isolated to explore increased sweetness. These include sucrose phosphate synthase (increased sucrose), invertase (interconversion of sugars), and ADPG-pyrophosphorylase (sugar to starch conversion). 68 Agricultural Bíotechnology: Novel Products and New Partnerships 69 Alternatively, flavor can be improved by delaying harvest until the fruit is for 90 days. At DNA Plant Technology Corp., we completed commercial tests ripe. Greater firmness or reduction in ethylene production can permit fruit to on a hybrid tomato variety that was blocked for ACC-S using Transwitch™ be retained on the vine until ripe, when it has achieved full flavor potential. ,,technology. In commercial tests, these ethylene-regulated tomatoes have a 40 Increased firmness through regulation to decrease fruit softening enzymes has day shelf-life. This includes harvest, five to seven days ethylene treatment to met with limited success to date. Control of ethylene content appears to be complete color development, five to seven days to ship to market, five to seven more promising. Ethylene controls ripening and rotting in many fruits and days storage in the local market at a repacker, seven days in the supermarket, vegetables. By reducing ethylene concentration in fruit, it is possible to arrest and 10 days with the consumer prior to consumption. This contrasts with the development of the fruit and permit the fruit to remain on the vine until ripe. maximum of 20 days for current commercial tomato varieties. CASE STUDY: ETHYLENE REGULATED TOMATOES The current commercial system works as follows (How, 1991): 1. Growers harvest a tomato field two or three times during a season. Technology All tomatoes (unless red ripe) are harvested. Tomato fruits produce ethylene in high concentrations during ripening. There 2. Tomatoes are brought from the field to a packing shed where they are is a burst of ethylene production, called the climacteric, that occurs when the sorted by size and color. Tomatoes with some red color are usually sold tomato fruit begins to turn from green to red (Grierson and Covey, 1988). The at a discount price in the local market because they are already beginning increased concentration of ethylene in tomato fruit is associated with color to soften and will not survive trucking over long distances. The 90+ per- development, fruit softening, increased respiration, and sugar accumulation. cent green tomatoes are placed in 25 pound boxes and treated for one to Ethylene is a simple chemical. Its biosynthesis is understood well and the genes three days with 100-150 ppm ethylene, then trucked to a repacker at a that are required for biosynthesis have been identified. In addition, genes have local market. been identified that degrade intermediates in ethylene biosynthesis. 3. Upon receipt, the repacker sorts tomatoes for color. Tomatoes that Ethylene formation is the result of a three-step biosynthetic pathway developed color in transit are shipped to supermarkets (or food service (Imaseki, 1991): Methionine is converted to S-adenosyl-L-methionine (SAM) outlets) immediately. The remaining tomatoes receive an additional two by the enzyme methionine adenosyltransferase. SAM is converted to 1-amino- to seven days of ethylene treatment and then are shipped to market. cyclopropane-1-carboxylic acid (ACC) by the enzyme ACC synthase (ACC-S). Extended shelf life provides a distinct advantage throughout the chain of ACC is converted to ethylene by the enzyme ACC oxidase. Genes encoding commercialization. the enzymes involved in biosynthesis (ACC synthase and ACC oxidase) have Grower: The ACC-S regulated tomato reaches full size and flavor potential, been identified, isolated, and cloned. It is possible to use techniques to block begins to degrade chlorophyll, but does not turn red in the field. At this stage, expression of those genes, thereby blocking or reducing biosynthesis of ethy- the tomato can remain in the field for several weeks without rotting or soften- lene. Alternatively, enzymes have been identified in microorganisms or viruses ing. This attribute affords the grower two benefits. First, all the tomatoes are that metabolize the intermediates in ethylene biosynthesis. These include ACC harvested, i.e., no over ripe tomatoes are left in the field. This increases field deaminase, an enzyme capable of degrading ACC, and SAM hydrolase, an yield per acre. Second, harvest costs per pound are lower because fewer total enzyme capable of degrading SAM. harvests are required. The process for developing genetically engineered plants with reduced Packer: Over-ripe tomatoes are sold at a discount in local markets (Florida, concentrations of ethylene in the fruit is complicated and requires several California, and Mexico). Because all the ACC-S regulated tomatoes that are technologies that have been developed over the past twenty years. These harvested can be shipped to remote markets, revenue per pound is increased. technologies include gene introduction into plants, selection of transformed In addition, tomatoes left on the vine generally increase in size. Large tomatoes expression. cells, regeneration of plants from genetically transformed cells, and gene command an average premium price of four to six cents per pound. Repacker: When tomatoes arrive at a repacker they are sorted based on stage Commercial Opportunity of ripeness. Losses at the repacker range from six to ten percent of tomatoes The principle commercial benefit of ethylene-regulated tomatoes is long shelf- shipped from production areas. These are discarded tomatoes that have rotted life. Tomatoes blocked for ACC-synthase can survive in laboratory conditions in route or are showing signs of impending deterioration. Ethylene-regulated tomatoes are superior, with decreased losses. Retailer: B- e current tomatoes rot in two to three days at retail; orders `ene Introduction: There are two methods available for gene introd and shipmer made daily by most large supermarkets. Loss due to rotting omatoes. Agrobacterium tumefaciens-mediated gene transfer is the P can reach 20 percent of product at the retail store level. Both issues are ad- method. Agrobacterium plasmids are modified to incorporate desired pro CTS dressed by a long shelf-life tomato. Moreover, better tasting tomatoes can be and genes and the natural infection behavior of the bacterium is used to deliver sold at a premium price, resulting in increased revenue and profit per square the DNA into plant cells. Broad claims have not been issued on this technology. foot in the produce section of the supermarket. However, several components of this technology, such as the use of binary Consumers: Because ethylene-regulated tomatoes are left on the vine until vectors, are the subject of patents. A secondary gene introduction method is they reach full maturity, the consumer purchases a better tasting tomato. ballistics. Ballistics uses some method to shoot DNA into plant cells. Variations Moreover, there should be a significant reduction in the number of rotten on the type of microprojectile and the acceleration device have been optimized tomatoes in consumer homes. during experimentation for different crop plants and likely would need to be The commercial potential of a better tasting, longer shelf-life tomato that is optimized for tomatoes. DuPont Corp. has claims in a U.S. patent that are sold at a premium price can be quantified as follows: directed to the ballistics technology. Other patents are issued or pending on various modifications of the ballistics approach for specific plant species. per 100 lbs. harvested standard ethylene controlled Plant regeneration: Regeneration using standard tissue culture methods is Revenue routine in tomato. The method using leaf pieces of tomatoes as explant material $20.00 $60.00 has been used in several laboratories since the early 1980's. No broad patents Costs $16.00 $38.00 cover the commonly used techniques for tomato regeneration. Margin $ 4.00 $22.00 Promoters: A wide range of promoters have been identified that will express DNA in plants. Some of these, including 35S, derived from cauliflower mosaic Margin % 20% 37% virus, are the subject of issued or pending patents (Fraley, et al., 1994). Much effort has been directed to isolation of tissue-specific promoters. Fruit-specific INTELLECTUAL PROPERTY promoters in tomato would be ideal to ensure that ethylene regulation is The technology that is required to make an ethylene-regulated tomato is the directed to the tomato fruit and to ensure that ethylene production (involved subject of several patents and represents a mine field that must be successfully in disease resistance) is not blocked in leaf and other tissue. navigated prior to introducing a product to market. The present intellectual Selectable markers: Markers are foreign gents that are inserted into target property situation is as follows: plant cells at the same time as a segment of DNA that can modify ethylene. Germplasm: Nearly all commercial acreage of fresh market tomatoes is Because ethylene regulation cannot be selected in a test tube, the selectable grown using proprietary seed developed by a seed company. The open polli- marker permits transformed cells to proliferate while non-transformed cells die. nated, publicly available varieties (e.g., Rutgers, Floradade) cannot compete Resistance to kanamycin (conferred by the nptll gene) is a preferred selectable with current hybrid varieties in yield and disease resistance, hence genetically marker that has received both EPA and FDA approval for use in tomatoes and engineered open pollinated varieties are not commercially viable. As proprietary other crop plants. Kanamycin resistance is the subject of an issued patent in the seed is controlled by seed companies, relationships must be negotiated with United States and a pending patent in Europe (Rogers and Fraley, 1991). seed companies to obtain access to parental seed for genetic engineering. The Genes: Segments of DNA can be patented in the United States. For ethylene, largest tomato seed companies are Seminis, Ferry Morse, and Sun Seeds. Other patents are issued or pending on each gene that has been identified in ethylene companies with breeding capability have developed proprietary tomato germ- biosynthesis or degradation. For example, the USDA has a pending patent on plasm using breeding or cellular genetics (Morrison and Evans, 1996). In the ACC-S gene that we have used. The gene isolation work was completed at addition to hybrids and the protection inherent in segregation of hybrid seeds, the USDA in Albany, California (Oeller, et al., 1991). The USDA has licensed most companies also seek Plant Variety Protection Certificates on one or both the gene to multiple companies within different fields to ensure broad com- of the hybrid's parents. Those layers of protection, along with seed production mercialization of the government funded technology. Other genes have been capability, assure seed company involvement in commercialization of geneti- isolated including ACC-oxidase (Hamilton, et al. 1990), ACC-deaminase cally engineered tomatoes. (Klee, 1994), and SAM hydrolase (Good, et al., 1993). D. Evans 73 72 Agricultural Biotechnology: Novel Products and New Partnerships Gene expression: In order to block ethylene biosynthesis using ACC- 4. In a complex business system a novel trait may have multiple benefits. synthase or ACC-oxidase, the endogenous genes must be regulated to decrease The ethylene-regulated tomato provides benefits to growers, packers, their expression. Two methods have been used in tomatoes: Transwitch repackers, retailers, and consumers while originally targeted to increase and antisense. Transwitch is a unique phenomenon in which some plants shelf-life. resulting from transformation with a homologous gene are suppressed for the target gene (Jorgensen, 1995). Antisense achieves a similar result, i.e., gene SUMMARY suppression, by inserting a gene sequence that is complementary to the target The initial hurdles for commercialization of products of plant genetic engineer- gene (Shewmaker, et al., 1992). Each technique is the subject of issued patents ing included technical, regulatory, and consumer acceptance. As the first prod- in the United States and Europe. ucts are now ready for market introduction, it is obvious that an additional COMMERCIALIZATION IMPLICATIONS major hurdle exists: intellectual property. Patents have been granted that cover a number of basic biotechnology methods and the use of specific genes for Despite the demonstrated value of ethylene-regulated tomatoes, no one is genetic engineering. For some technologies and genes, patents already have presently in the market with such a product. This product has extremely high been issued and represent barriers to commercialization. For other technol- barriers to entry due to the intellectual property situation. The companies ogies, the patents are still pending and represent an uncertainty. Indications closest to market are DNA Plant Technology, Monsanto/Calgene, and Zeneca from the first products being commercialized in cotton, corn, and soybean Plant Sciences. It is likely that each party will need licenses to intellectual suggest that patents are being aggressively enforced and are being used to property from other companies in order to successfully commercialize an establish competitive advantage in the marketplace. Clearly, if broad patents ethylene-regulated tomato. While the current patent situation presents an are upheld by the patent office and the courts, alliances and cross licenses will additional commercialization hurdle to the three companies, it also tends be necessary for commercialization. to eliminate the prospect of future new entrants developing and marketing The modification of consumer-preferences traits could have implications an ethylene-regulated tomato. for several, perhaps unintended, steps in the chain of commercialization. For RESEARCH AND PLANNING IMPLICATIONS example, ethylene regulation in tomato will primarily result in a tomato with longer shelf-life. However, the tomato will not be red when it reaches full Several general lessons have been learned from attempts to commercialize maturity, can stay in the field for a longer period of time prior to harvest, ethylene-regulated tomatoes that apply to all commercial projects using plant requires post-harvest ethylene treatment, and results in delivery of a better genetic engineering. tasting tomato to consumers. These features of the ethylene-regulated tomato 1. Many patents are still pending. Work initiated today using technology require modification of harvest practices and modification of handling and developed by others may never be commercialized in the absence of packing procedures. Moreover, production trials and operation tests may licenses. Many of the basic agricultural biotechnology patents have suggest modification of pesticide practices, staking, and handling in the field; not been resolved, with broad patents still possible or likely for gene sorting, ethylene treatment, and shipping from the field; as well as packaging introduction and gene regulation technology. and pricing for the retailer. Ultimately, successful commercialization of new 2. In commercial or academic genetic engineering research, genes need to consumer-preference traits in fruits and vegetables requires more than simple be inserted into the best existing germplasm. This affords an appropriate insertion of a gene into a plant. benchmark to value the technology and eases adoption of new varieties. Seed company and technology-provider alliances involving universities and research laboratories are more likely in the future. 3. The earliest product developed is not always the first to be commercial- ized. The complex business system of fresh market tomatoes and the complex patent situation have delayed commercialization. If a new genetically engineered variety requires modification of growing or handling practices, adoption is slow. Imut. 1996. Sheep Nature. 380, 64-66 1, D. B. Recves, and Phytoremediation feactors: stable [ sheep. Bio/Technology BURT ENSLEY 1 testing of therapeutic Phytotech, Inc. Monmouth Junction, N.J. nals. Docket no. 95D S in the manufacture.ol y, 1995 A. Iglesias. 1995. munological approach K.M. Walker, and : dibasic cleavage site imalian cells: Effects of mistry. 29, 347-354 g the glycosylation Phytoremediation is a new application of biotechnology - an exploitation of ture Biotechnology. 14 specific plants to clean up the environment. Plants are used to treat or remove environmental contaminants from soil and other solids like dredge spoils, y. 14, 698-700 water, other liquids, and air. Iman A. R. Scott and Plants may be viewed as the original polluters. Our earth was hospitable to 2' hits isolation methanogenic bacteria before the evolution of photosynthesis by plants, pro- t. n-permissive ducing oxygen that now is 20 percent of our atmosphere. Oxygen forced the methanogens into anaerobic regions of the world. Now we plan to use plants nbauer, M. G. to help us clean up toxic soils. Scientists at the Ag Biotech Center at Rutgers h of mice that develop University, such as Ilya Raskin, have explored methods of using plants to treat hormone fusion genes organic and inorganic contaminants in soils, and have discovered that plants provide very effective biological processes for cleaning up and removing rymple, G. Lasser, contaminants from the environment. of recombinant human I will focus on the use of plants to remove and concentrate heavy metals. echnology. 14, 867-871 Heavy metal contaminants in the soil and water in all developed countries are nsgenic animals. In: a large and important worldwide problem caused by manufacturing processes hnology's role in the and other activities of commerce dating back to the 1700s. One may view a V.G. Pursel and plant as a solar driven concentrator of chemicals like metals that took 360 1 Science million years to build, test, and optimize. The scientists at the Ag Biotech Center enhanced that process so it is more rapid and useful for clean up at contaminated sites. What is the appeal of phytoremediation? First, it is an elegant method of treating contaminated sites relative to conventional treatment methods in which contaminated soil is transferred to a landfill (which means simply moving it artnerships 145 somewher ), presumably for permanent storage, and then transferring Prassica juncea (Indian Mustard) has the special property of metal acr uncontan on that was discovered at the AgBiotech Center by screening plants r 4 soil to the original site. Plants leave the soil in place while removing the contamination. Phytoremediation is cost effective, while transfer metal uptake abilities. This metal uptake property is being expanded a. Al- of contaminated soils to a licensed hazardous waste site is expensive. hanced by research including genetic engineering, mutagenesis, and selection at Even after 25 years of cleanup efforts and growing awareness of the dangers the Ag Biotech Center and at Phytotech. Most plants do not accumulate heavy posed to the environment by contaminated sites, America still has a huge metals in the stems or leaves and are not useful for phytoextraction. For most number of contaminated sites. The main reason for the slowness of the cleanup plants, some metal is taken up by the roots, but not much is transfered to is the large expense of using conventional technology to clean up these sites. the shoots and stems. Indian Mustard and Amaranthis accumulate cadmium, We must find more cost effective methods. The use of plants helps address hickel, zinc, copper, lead, and chrome6, a widespread pollutant in New Jersey the economic issue. This use offers owners a new method of remediating con- and a carcinogen. taminated property at less cost, which presumably will accelerate the pace of To increase availability of lead, a biodegradable, short-lived chemical is added remediation. to the soil to cause the plants to take up the lead. An example is the metal che- Phytoremediation is compatible with public concerns about technology. lator EDTA added to contaminated soil. There is a direct correlation between People have been concerned about biotechnology. They are frightened particu- the amount of EDTA added and the metal uptake. We are also doing environ- larly about genetically engineered bacteria. They always will be. It is easy to mental impact rates and effect studies to evaluate the environmental impact, frighten people about bacteria. For example, when you tell people how many good and bad, of removing metal from the soil by growing the plants on site bacteria there are in yogurt, it doesn't make them think better of the bacteria, and adding chemicals to induce uptake and clean the site. it makes them quit eating yogurt. Plants are something that everyone can see; We are in the process of modeling, analyzing, and monitoring the impact they are familiar and therefore comfortable with plants. Using plants to clean of this approach to remediating contaminated sites. What do you do with the up a contaminated site is more acceptable to community members than the use harvested plants following phytoextraction? We dry the plants, may incinerate of bacteria. them, may compost them, or may compact them by pressing followed by acid At the time of the Exxon Valdez oil spill, the state of Alaska decreed that no leaching and disposal, or recycling, of the heavy metal. The volume or mass of non-Alaskan micro-organisms could be used. This was the first microbial- the plants that contain the extracted heavy metals is only about two percent of immigration policy and it was useless. Bacteria travel on the wind, and in many the volume or mass of contaminated soil. This is a 50-fold concentration. other ways, and they didn't seek Alaskan regulators' permission before they Indian Mustard has many attractive characteristics for cleaning up toxic entered Alaskan waters to eat the oil on the beach. metal sites. It is inexpensive to grow and grows very rapidly to about five feet Phytoremediation is sophisticated scientifically. Technology must be devel- in about two months, producing 2-10 tons/hectare of dry weight with fairly oped so it can be safe, effective, and reliable. rapid clean up of the site. We believe there are a significant number of con- Over the next five years the United States will spend $43 million to treat only taminated heavy metal sites in the U.S. that could be remediated in about three sites contaminated with heavy metals and heavy metals mixed with organics. years or less so that the Environmental Protection Agency or the state environ- That's not what would be needed to clean up all the sites. We need low-cost mental agency would conclude that that site was safe for use. We have great approaches so that we can accelerate the pace of remediation. hope that we will be able to use phytoremediation as an effective technology. Phytoextraction is the subset of phytoremediation in which plants remove We have treated a site in the middle of an urban environment, Magic Marker, contaminating toxic or radioactive metals from a site by root uptake and in Trenton, N.J. It was originally contaminated by a battery manufacturing and accumulation in the plant shoots. recycling facility located there since about 1950. I will describe the use of a plant - Indian Mustard - to remove lead from a Other sites that we have examined in Trenton and other New Jersey towns toxic site. The plants are watered with agricultural chemicals that make the lead were contaminated in the 1700s and 1800s by practices such as pottery making. water soluble. The water containing lead is taken up by the roots and moved Trenton was a big pottery making center at one time. Pottery glazes contained into the stems and leaves where it evaporates, leaving the concentrated lead in lead or cadmium and there is a large number of lead and cadmium contami- the plant. The harvested plants may be sent to a smelter where the metal is nated sites in the city of Trenton. recycled - a hazardous waste is removed from the environment and recycled to The Magic Market site was blocked out, samples were taken to establish lead commerce. This technology, developed by the Ag Biotech Center, is the subject content, the site was plowed, and fertilizer was added. The soil on the site is of a technology transfer agreement between Rutgers University and Phytotech. dark, not because of humus, but due to the asphalt in the soil. The site was 146 Agricultural Biotechnology: Novel Products and New Partnerships Ensley 147 onc rking lot. An irrigation system was installed and Indian Mustard wa. hydroseeded to evenly distribute the seeds without disturbing the soil. We collaborated with the local residents. There was a Phytoremediation Day in Trenton. Through an organization called Isles Inc., we attended community meetings, told everybody that lived in the area (there are houses all around this Agricultural Biotechnology: site) what we were doing, and invited everyone to attend the first planting. The A Farmer's Perspective costs of those trials were paid by Phytotech, which had raised $6 million of venture capital and has 16 employees. MARY Lou GARR As indicated in my presentation, we are enthusiastic about the role of phytoremediation in the cleanup of toxic sites. Ontario Federation of Agriculture Beamsville, Ontario, Canada I am particularly pleased and somewhat surprised to be a speaker today, given that I am neither a scientist nor an expert in biotechnology. Frankly, I have only a limited understanding of biotechnology. I'm just a plain ordinary family farmer from a long line of plain ordinary family farmers. However, this humble status has never prevented me from striving to make as much money as pos- sible and I see exciting opportunities ahead to do just that: rapid improvements in the quality of crops, livestock, and livestock products; huge reductions in input usage and costs of production; and the creation of new consumer prod- ucts. In fact, I expect that my family farming operation will be fundamentally changed over the next few years because of the things most of you are doing. However, in the push to advance the field of agricultural biotechnology, farmers are often the last to be considered or consulted. Does the research always meet our production needs? Does the regulatory system provide for timely approvals of new technologies? Are farmers sought out to participate in forums like this? At NABC 7, held in May, 1995, I met very few farmers, though I found our input in workshops much appreciated. This year, I doubt I'd see many hands raised if I asked how many people rely on farming for their income. Yet farmers are your critical link in the biotechnology path to market. We utilize the re- search and produce the product which then must be marketed and find public acceptance. And all this in a world where the anti-technology crowd is way out in front in shaping public opinion. Most farmers are cautiously optimistic about agricultural biotechnology, but they need someone to take leadership in managing this controversial issue on their behalf. 148 Agricultural Biotechnology: Novel Products and New Partnerships 149 Plant Beotech Plant-Microbe Interactions: An Overview 1667 of molecular genetic manipulations that have been so infor- gineer crop plants that express novel or altered specificities mative in other symbioses. It will be most interesting to and therefore exhibit broad spectrum resistance to disease. determine whether any of the plant genes with a critical role Disease control strategies based on a more detailed under- in legume nodule initiation are also involved in the establish- standing of the intricate relationships among roots, pathogens, ment of actinorhizal symbioses. and beneficial microbes in the rhizosphere are also forthcom- One significant difference between legume and actinorhizal ing. Strategies hinging on the deployment of decoy molecules nodules is the site at which root cells become reactivated to that contribute to shifts in the expression of pathogen virulence form nodule primordia. In rhizobial symbioses, cortical cells genes or that affect the ability of rhizosphere pathogens to are activated to reenter the cell cycle, whereas in actinorhizal compete with benign soil organisms could well be realized. symbioses, pericycle cells are activated. The early phases of It has been enormously satisfying to participate in the for- quite similar to lateral mulation and editing of this Special Issue of THE PLANT CELL. eling hypotheisize that Collectively, the reviews in this issue offer an outstanding anal- ag- this developmental pro- ysis of our current knowledge of plant-microbe interactions and the plant and microbial processes upon which they de- progress lutionary origin of sym- pend. The insight gained from these analyses are already in this review. Although impacting studies of plant development and responses to the #2 wlowski and Bisseling environment. We fully anticipate that you will enjoy reading volve from pathogenic these reviews as much as we have enjoyed editing them! ct? Why are nitrogen- S of two plant families, whereas mycorrnizar association widespread? Answers REFERENCES to these questions are of considerable practical value and may provide fundamental insight into the evolution and operation Agrios, G.N. (1988). Plant Pathology (San Diego: Academic Press). of many plant-microbe interactions. Carefoot, G.L., and Sprott, E.R. (1967). Famine on the Wind (Chicago: Rand McNally and Co.). Cotter, P.A., and Miller, J.F. (1996). Triggering bacterial virulence. CONCLUDING REMARKS Science 273, 1183-1184. Dropkin, V.H. (1989). Nematology (London: John Wiley and Sons). The rapid progress that continues to be made in our elucida- Flor, H.H. (1971). The current status of the gene-for-gene concept. Annu. Rev. Phytopathol. 9, 275-296. tion of plant-microbe interactions is contributing to major advances in our understanding of plant and microbe cell biol- Fullner, K.J., Lara, J.C., and Nester, E.W. (1996). Pilus assembly by Agrobacterium T-DNA transfer genes. Science 273, 1107-1109. ogy and biochemistry. On the pathogen side, studies reported in this issue provide illuminating information concerning the Fulton, R.W. (1986). Practices and precautions in the use of cross- protection for virus disease control. Annu. Rev. Phytopathol. 24, evolution of virulence, the signaling processes involved in sym- 67-81. biotic relationships, pathogenesis, and resistance responses, Harrison, M.J. (1996). A sugar transporter from Medicago truncatula: and the nature of protective mechanisms relevant to the ecol- Altered expression patterns in roots during vesicular-arbuscular (VA) ogy and survival of nonpathogenic microbes. mycorrhizal associations. Plant J. 9, 491-503. On the plant side, studies of plant-microbe interactions have Janda, M., and Ahiquist, P. (1993). RNA-dependent replication tran- led to the development of a wide range of model systems that scription and persistence of brome mosaic virus RNA replicons in can be used to probe normal cell biological processes. For Saccharomyces cerevisiae. Cell 72, 961-970. example, the recent suggestion that plant pathogenic bacte- Jones, J.B., Jones, J.P., Stall, R.E., and Zitter, T.A. (1991). Com- ria export virulence factors directly into plant cells is an exciting pendium of Tomato Diseases (St. Paul, MN: APS Press). concept that impacts investigations of both plant and animal Large, C.E. (1940). Advance of the Fungi (New York: Dover diseases. Similarly, identifying the host components that are Publications). involved in plant virus replication and movement should prove Lomonossoff, G.P. (1995). Pathogen-derived resistance to plant helpful for understanding the intricacies of plant nucleic acid viruses. Annu. Rev. Phytopathol. 33, 323-343. metabolism. The same systems are also providing informa- Lucas, W.J., Bouche-Pillon, S., Jackson, D.P., Nguyen, L., Baker, tion about the role of the cytoskeleton in macromolecular L., Ding, B., and Hake, S. (1995). Selective trafficking of Knotted1 targeting and the potential developmental impact of diffusion homeodomain protein and its mRNA through plasmodesmata. gradients that may be created by cell-to-cell transport of these Science 270, 1980-1983. macromolecules. Moré, M.I., Finger, L.D., Stryker, J.L., Fuqua, C., Eberhard, A., and The practical utility of understanding plant-microbe inter- Winans, S.C. (1996). Enzymatic synthesis of a quorum-sensing au- actions is obvious. For example, as the bases for the astounding toinducer through use of defined substrates. Science 272, 1655-1658. specificity that is typical of most host resistance responses Murphy, F.A., Fauquet, C.M., Bishop, D.H.L., Gabriel, S.A., Jarvis, are unravelled, it should become possible to genetically en- A.W., Martelli, G.P., Mayo, M.A., and Summers, M.D. (1995). Virus 05/09/97 08:52 301 734 5205 LPA-MEDIA SVCS 002/003 Ride published in FR 5-2-97 United States APHIS Department of Brotech Agriculture Ref. streamly Animal and Jim Rogers (301) 734-3256 News Plant Health [email protected] Inspection Jerry Redding (202) 720-6959 Service [email protected] Beg USDA AMENDS REGULATIONS FOR GENETICALLY ENGINEERED ORGANISMS WASHINGTON, May 1, 1997--The U.S. Department of Agriculture is amending its regulations pertaining to genetically engineered plants introduced under USDA's notification and petition regulatory processes. "The amendment will simplify procedures for the introduction of certain genetically engineered organisms, expedite review for certain determinations of nonregulated status, and adjust procedures for the reporting of field tests Speed process conducted under notification to the biology of the test organisms," said John Payne, director for biotechnology and scientific services with the Animal and Plant Health Inspection Service, a part of USDA's marketing and regulatory programs mission area. Developing and commercializing new genetically engineered plant varieties most often involves field testing under APHIS oversight, followed by San Protect environment submission of a petition for determination of nonregulated status by the agency. APHIS grants nonregulated status to a new plant variety when it determines that the new variety has no potential to pose a plant pest risk and Bosed is as safe to grow as any other variety of the same plant. The amended regulations will allow a broader application of existing simplified procedures for requests for movement or field testing of genetically engineered plants. They will also streamline the determination of nonregulated status for plant varieties that closely resemble other varieties that have already been through the determination process. This will enable APHIS, when appropriate, to extend the existing determination of nonregulated status for new products that do not raise new risk issues. For plants that are being evaluated in field tests, reporting requirements have been made more consistent. For example, for trees and other long lived plants field data reports will only need to be provided upon the conclusion of the trial. However, applicants must apply to APHIS for yearly renewal to ensure appropriate measures are taken when plants become reproductively mature. APHIS will also use appropriate guidelines to provide additional information to developers of regulated articles and other interested persons regarding procedures, methods, scientific principles, and other factors that could be considered for various aspects of its regulations. The first guidelines will provide information to help applicants on requests for extension of a determination of nonregulated status. Payne added that USDA has the responsibility to ensure that, in releasing any bioengineered plant, no plant pest risk is presented. APHIS - more - 8/7 it 1818 20-770-3034 VO-SIHEV INVESTM 46616 May. 05/09/97 08:52 301 734 5205 LPA-MEDIA SVCS 003/003 - 2 - reviewers focus on the biology, propagation, and cultivation of the plant. The reviewers also consider the source of the engineered genes, the vector used to transfer them, and the stability of the insertion. The original final rule which was printed in the April 24, Federal Register was retracted April 25, a month before it would have gone into effect. This final rule supersedes the previous one issued. For further information on the regulatory changes, contact John Payne, director, biotechnology and scientific services, 4700 River Road, Unit 98, Riverdale, Md. 20737-1237; (301) 734-7602. For technical information, contact Michael schechtman, biotechnology and scientific services, plant protection and quarantine, Unit 146, Riverdale, Md. 20737-1237, (301) 734-7601. Notice of this action is scheduled for publication in the May 2 Federal Register and becomes effective June 2. NOTE: USDA news releases, program announcements, and media advisories are available on the Internet. Access the APHIS Home Page by pointing your Web browser to http://www.aphis.usda.gov and clicking on "APHIS Press Releases." Also, anyone with an e-mail address can sign up to receive APHIS prese releases automatically. Send an e-mail message to [email protected] and leave the subject blank. In the message, type subscribe press_releases 8/8 'd 8184 No. VO-SIHPV May. 9. 1997 11:23AM Activities of the Animal and Plant Health Inspection Service Blotechnology and Scientific Services (BSS) April 1997 301-734-7602 VOICE 301-734-3643 FAX Field Testing of New Petitions: Determination of Nonregulated Status Agricultural Products approved and pending: as of 3/31/97 Continues and Expands Field testing of new agricultural products 92 continues its rapid pace of expansion by approximately doubling each year. Since 93 1987 the Animal and Plant Health 24 Inspection Service (APHIS) has approved Year or acknowledged 2,745 field trials at 11.291 90 field sites. The notification option, which 96 simplifies regulatory requirements for certain field trials involving particular types $7 of modified crops, has been in effect since 1993 and now accounts for approximately 0 5 10 15 20 a 30 85% of all current field testing Since the Number Approved/Panding beginning of 1994. 2.086 field trials (at Applicable 9.746 test sites) were approved or REPending acknowledged, of which 1,781 were AITRIT conducted under notification and 305 under permit. Derivatives of 48 different plant species have been field tested to date. with a Field Releases* : Most Frequent Categories wide variety of modifications (see right). 1987 to 1997 (3/31/97) Com continues as the major crop being field tested under our regulations. In the past 2 years we have seen the first field trials Viral Resistant involving Arabidopsis thaliana, barley. Herbicide Tolerant 317 (10.6%) broccoli. carrot, chicory, cranberry, 127 (27.5%) creeping bentgrass, eggplant, gladiolus, Insect Resistant 722 (24.2%) grape, pea, pepper. raspberry, strawberry, sugarcane, sweetgum. sweet potato, Fungal Resistant watermelon. and wheat. 124 (4,2%) In an effort to expand public access and Product Quality Other 789 (26.2%) awareness of the progress in the 209 (7.0%) development of work with transgenic plants, APHIS has made available on the Internet Permits Issued and Agrenome Properties Marker Gener. Selective Markers, information on both field testing and Notifications Acknowledged Resistant and Nerratode Resistent commercialization of new varieties. 4/7/97 This information. which is updated daily and provides direct public access to information formerly available only upon 1. Insect-resistant com, Ciba Seeds, written request, is proving useful both to 11. Male-sterile com, Plant Genetic May 1995. companies and to individual researchers Systems (America). Inc., who wish to track the progress of 2. Herbicide-tolerant com. AgrEvo. February 1996. June 1995. agricultural biotechnology. The World 12. Altered-ripening tomato, Agritope. 3. Insect-resistant cotton, Monsanto Wide Web site can be accessed at Inc., March 1996. Agricultural Co., June 1995. htp://www.aphis.usda.govtbbepibpi. 13. Colorado potato-beetle- resistant 4. Delayed-softening tomato, Zeneca potato, Monsanto Agricultural Co., Plant Science/Petoseed Co., Inc., Some New Products No May 1996. June 1995. 14. Virus-resistant squash, Asgrow Seeds, Longer Regulated 5. Herbicide-tolerant cotton, Monsanto June 1996. Over the past year, there has been a con- Agricultural Co., July 1995. 15. Herbicide-tolerant soybean, AgrEvo. tinuous flow of requests for determinations 6. Insect-resistant com, Monsanto July 1996. by APHIS that particular field-tested organ- Agricultural Co., August 1995. 16. Virus-resistant papaya, Cornell isms have no potential for plant pest risk 7. Altered-ripening tomato, Monsanto University and The University of and should no longer be regulated (see Agricultural Co., September 1995. Hawaii. September 1996. right). These requests, from developers of 8. Herbicide-tolerant com, DeKalb 17. Insect-resistant com, DeKalb new products produced through biotech- Genetics Corp., December 1995. Genetics Corp., March 1997. nology, facilitate the entry of the products 9. Insect-resistant corn, Northrup King into the marketplace. Seventeen new prod- Co., January 1996. 10. Herbicide-tolerant cotton, DuPost ucts in six crop plants were the subject of such determinations in the past 23 months- Agricultural Products, January 1996. No. 8184 P. 4/8 VO-SIHOA May. 9. 1997 11:23AM Four types of products that have been the field trial. and these documents have have established a Permanent Tech- approved merit particular mention here- also been made available electronically. nical Working Group on Biotechnology and In April 1996 APHIS made available to the Environment. There are also other 1. Virus-resistant squash. the first of the public a regulatory assessment and informal meetings with representatives of which was approved in 1994. was the granted a courtesy permit for the conrolled the Commission of the European Union and first crop considered for which there field testing of a transgenic nematode in key trading partners to discuss policy de- are populations of intertreeding wild Salem County, NJ after going through a velopments on the commercialization of, relatives in the major areas of squash similar process. The nematode, and trade in. new agricultural commodities. cultivation in the United States. and Heterorhabditis bacteriophora. is a native Under the joint auspices of the OECD with a trait that has the potential in nonpathogenic organism widely distributed Environment and Agriculture theory to alter the fitness of the crop across the United States. It was modified Directorates, the United States has plant or its wild relatives. The with the addition of a gene encoding a taken the lead in a project on the analysis demonstrated that there was fluorescent marker protein and another Commercialization of Agricultural no potential for increased weediness encoding a heat-shock response protein. Products Derived Through Modem of either the crop or its relatives as a Biotechnology. The aims of this proj- result of cultivation in agriculture of Regulatory and Policy ecl, which was initiated in 1994, are to the new squash variety. Developments In Progress assist member countries in their oversight of these organisms, 2. Insect-resistant crops, of which a We continually reexamine our regulations specifically in their efforts to ensure potato developed by Monsanto to keep abreast of the latest scientific safety. to make oversight policies more Agricultural Company was the first developments to remain responsive to the transparent. and to facilitate trade. A approved in March 1995. may have demands of rapidly expanding technology key area of work has been the the potential to offer an alternative to and to the public. In the interest of such development of scientific consensus the use of chemical insecticides. flexibility and responsiveness, new documents 00 specific topics relevant regulations were proposed in the Federal to the environmental biosafety of 3. The insect-resistant com developed by Register 00 August 22, 1995, which, if transgenic plants, such as the biology of Ciba Seeds was the first new com finalized, would particular cTop plants and issues variety that has been determined not to Enable APHIS to extend an existing associated with the introduction of pose a potential plant pest risk. The determination of nonregulated status to particular traits into plants. One that modification in the corn line may offer additional organisms that resemble the has been completed concerns the use of the potential for control of European organism for which the determination coat protein genes from plant viruses to com borer, which has not heretofore was initially made confer virus resistance on host plants. been effectively managed. Com is the Extend the notification system to enable Regular meetings continue with Canada leading crop in terms of economic field testing under performance and Mexico to address safety issues importance in the United States. standards of most crop plant species. relevant to biotechnology-derived 4. Virus-resistant papaya, which was The proposed rule also announces commodities that are under regulatory APHIS' intent to develop guidelines on review or already approved in one of approved in 1996. was the first new product developed by academic various topics relevant to our regulations to our three nations, and to facilitate trade researchers in collaboration with developers of new varieties and to other in these products. USDA scientists. interested persons. In addition. the pro- APHIS continues to be an active posed rule would lessen certain paperwork participant in discussions by the requirements for the research community Conference of Parties (COP) to the Transgenic Arthropods and and for State agricultural officials. The Convention on Biological Diversity. Nematodes-First Field comment period on the proposed rule closed The COP, of which the United States is Trials Approved on October 23, 1995. not a member. decided to negotiate a In February 1996 APHIS granted 2 permit binding protocol that may affect inter- for the first limited field trial release of a International Harmonization national transfer of certain bio- transgenic arthroped. Metaselulus of Regulatory Approaches technology products, and set up an ad occidentalis (Acari: Phytoseiidae), in hoc working group to develop it The For the first time several new agricultural United States is participating in those Ajachua County, Florida. This organism. a biotechnology products developed in the negotiations, which commenced in July transgenic predatory mite, may be United States are entering the international 1996 in Aarhus, Denmark. The next potentially useful for the control of spider mite in strawberries and other crops. The marketplace as produce and as bulk meeting is to be held in May 1997 in commodities. Montreal. Canada. APHIS is working particular transgenic organism was modified only by the addition of marker DNA A key effort we have undertaken is to along with other Federal agencies to ensure that these products can enter existing ensure that appropriate policies are sequences, which are not expressed and do export markets without the imposition of agreed upon to guarantee the safe not alter any of its phenotypic undue regulatory burdens. We are working international use and development of characteristics. Upon receipt of the on several fronts to being about international new products derived through application. APHIS made it available to the harmonization of regulatory approaches for biotechnology. public clectronically and established an these products- expert team for its review. An Environmental Assessment and Finding of Ongoing bilateral environmental No Significant Impact was prepared in consultations with the Commission of support of the agency decision to authorize the European Union continue and we 8/9 di 8184 VO-SIH¿V 11:24AM Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a tabbed divider. Given our digitization capabilities, we are sometimes unable to adequately scan such dividers. The title from the original document is indicated below. NBAC Divider Title: EXECUTIVE OFFICE OF THE PRESIDENT OFFICE OF SCIENCE AND TECHNOLOGY POLICY WASHINGTON, D.C. 20502 March 19, 1997 NBAC MEMORANDUM FOR FRANKLIN D. RAINES DIRECTOR OFFICE OF MANAGEMENT AND BUDGET FROM: JOHN H. GIBBONS SH DIRECTOR SUBJECT: AMENDMENT TO EXECUTIVE ORDER 12975 - Extending the Charter of the National Bioethics Advisory Commission (NBAC) The purpose of this memorandum is to seek a two-year extension of the charter for the National Bioethics Advisory Commission (NBAC). NBAC was established on October 3, 1995 by Executive Order 12975. As with other Federal advisory committees, the original charter provides for a two-year term, expiring on October 3, 1997, unless extended. Due to the length of time required for member selection and background reviews, the Commission did not meet until October 4, 1996, a full year after its establishment. (E.O. 12975, draft amendment and NBAC charter are attached.) The President issued an initial charge to the Commission to consider protection of the rights and welfare of human research subjects, and issues in the management and use of genetic information. Then, on February 24, 1997, the President asked NBAC to take on an additional charge: thorough review of the ethical and legal issues associated with possible use of cloning technology to clone human embryos. The Commission's report on cloning is due at the end of May. I understand that Federal advisory committee charters are customarily reviewed and extensions filed with the General Services Administration each September. However, in view of the special circumstances in this case, it seems reasonable and appropriate to take action on NBAC's charter immediately, thus facilitating the Commission's planning process for meeting the President's requests. You should be aware of a potential complication regarding NBAC's financial support. The President delegated administrative responsibilities for NBAC under the Federal Advisory Committee Act to the Secretary of the Department of Health and Human Services (HHS). For the current fiscal year, HHS has explicit Congressional authority to seek funding for NBAC from other Executive branch agencies and has done so, resulting in an arrangement that spreads the estimated $1.6 million budget over seven agencies, with HHS paying one-half of the total. (A list of the other agencies and their level of support is attached.) At a meeting on January 22, all the agencies supported a two-year extension of the NBAC term, as proposed by HHS, and agreed in principle to continue the current funding arrangement, subject to Congressional approval. The Memo to Franklin D. Raines March 19, 1997 Page two President's FY 98 budget requests broad permission for multi-agency funding of Federal advisory committees or alternatively, permission limited to NBAC. NBAC's charter is not dependent on resolution of this issue since it leaves the matter of funding to HHS alone, subject to the availability of appropriations. Extending NBAC's charter will enable the Commission to respond to the President's immediate request for advice and recommendations on the cloning of human beings, without unduly constraining resources to address the President's two original concerns: protection of human research subjects and proper use and management of genetic information, both important issues in their own right. The issue of delays in naming the NBAC members and obtaining support has been reported in the media as indicative of lack of attention from the Administration. While this is not the case, prompt action on extending the Commission's term might be one way to convey a more positive attitude and would support the Commission's efforts to provide thoughtful, astute responses to the President's requests. Please contact me or Rachel Levinson of my staff if you require further information. Attachments SENT BY: 10-27-95 : 3:36PM SCI & TECH POLICY- 3014022071: 21 4 52063 Federal Register Presidential Documents Vol. 60. No. 193 Thursday. October S. 1995 Title 3- Executive Order 12975 of October 3, 1995 The President Protection of Human Research Subjects and Creation of National Bioethics Advisory Commission By the authority vested in me as President by the Constitution and the laws of the United States of America. it is heroby ordered as follows: Section 1. Review of Policies and Procedures. (a) Each executive branch department and agency that conducts, supports, or regulates research involv- ing human subjects shall promptly review the protections of the rights and welfare of human research subjects that are afforded by the department's or agency's existing policies and procedures. In conducting this review, departments and agencies shall take account of the recommendations con tained in the report of the Advisory. Committee on Human Radiation Experi- ments. (b) Within 120 days of the date of this order. each department and agency that conducts, supports, or regulates research involving human subjects shall report the results of the review required by paragraph (a) of this section to the National Bioethics Advisory Commission, created pursuant to this order. The report shall include an identification of measures that the depart- ment or agency plans or proposes to implement to enhance human subject protections. As set forth in section 5 of this order, the National Bioothics Advisory Commission shall pursue. as its first priority. protection of the rights and welfare of human research subjects. (c) For purposes of this order. the terms "research" and "human subject" shall have the meaning set forth in the 1991 Federal Policy for the Protection of Human Subjects. Sec. 2. Research Ethics. Each executive branch department and agency that conducts. supports, or regulates research involving human subjects shall. to the extent practicable and appropriate. develop professional and public educational programs to enhance activities related to human subjects protec- tion, provide forums for addressing ongoing and emerging issues in human subjects research. and familiarize professionals engaged in nonfederally-fund ed research with the ethical considerations associated with conducting re- search involving human subjects. Where appropriate, such professional and educational programs should be organized and conducted with the participa- tion of medical schools. universities, scientific societies, voluntary health organizations, or other interested parties. Sec. 3. Establishment of. National Bioethics Advisory Commission. (a) There is hereby established a National Bloethics Advisory Commission ("NBAC"). NBAC shall be composed of not more than 15 members to be appointed by the President. NBAC shall be subject. to the Federal Advisory Committee Act. as amended (5 U.S.C. App.). (b) The President shall designate a Chairperson from among the members of NBAC. Soc. 4. Functions. (a) NBAC shall provide advice and make recommendations to the National Science and Technology Council and to other appropriate government ontities regarding the following matters: (1) the appropriateness of departmental. agency. or other governmental programs, policies. assignments, missione. guidolinos, and regulations as they relate to bioethical issuos arising from research on human biology and behavior: and 2064 Federal Rogister i Vol. GO, No. 193 / Thursday, October 5. 1995 / Presidential Documents (2) applications, including the clinical applications, of that research. (b) NBAC shall identify broad principles to govern the effical conduct of research. citing specific projects only as illustrations for such principles. (c) NBAC shall not be responsible for the review and approval of specific - projects. (d) In addition to responding to requests for advice and recommendations from the National Science and Technology Council, NBAC also may accept suggestions of issues for consideration from both the Congress and the public. NBAC also may identify other bioethical issues for the purpose of providing advice and recommendations, subject to the approval of the National Science and Technology Council. Sec. 5. Priorities. (a) As a first priority, NBAC shall direct its attention to consideration of: protection of the rights and welfare of human research subjects; and issues in the management and use of genetic information, including but not limited to, human gene patenting. (b) NBAC shall consider four criteria in establishing the other priorities for its activities: (1) the public health or public policy urgency of the bioethical issue: (2) the relation of the bioethical issue to the goals for Federal investment in science and technology: (3) the absence of another entity able to deliberate appropriately on the bioethical issue: and (4) the extent of interest in the issue within the Federal Government. Sec. 6. Administration. (a) The heads of executive departments and agencies shall, to the extent permitted by law, provide NBAC with such information as it may require for purposes of carrying out its functions. (b) NBAC may conduct inquiries, hold hearings. and establish subcommittees, as necessary. The Assistant to the President for Science and Technology and the Secretary of Health and Human Services shall be notified upon establishment of each subcommittee, and shall be provided information on the name, membership (including chair). function, estimated duration, and estimated frequency of meetings of the subcommittee, (c) NBAC is authorized to conduct analyses and develop reports or other materials. In order to augment the exportise present on NBAC. the Secretary of Health and Human Services may contract för the services of nongovern- mental consultants who may conduct analyses. prepare reports and back- ground papers, or prepare other materials for consideration by NBAC, as appropriate. (d) Members of NBAC shall be compensated in accordance with Federal law. Members of NBAC may be allowed travel expenses, including per diem in lieu of subsistence. to the extent permitted by law for persons serving intermittently in the government service (5 U.S.C. 5701-5707). (e) To the extent permitted by law. and subject to the availability of appropria- tions. the Department of Health and Human Services shall provide NBAC with such funds as may be necessary for the performance of its functions. The Secretary of Health and Human Services shall provide management and support services to-NBAC. Sec: 7. General Provisions. (a) Notwithstanding the provisions of any other Executive order. the functions of the President under the Federal Advisory Committee Act that are applicable to NBAC. except that of reporting annually to the Congress. shall be performed by the Secretary of Health and Human Servicus. in accordance with the guidelines and procedures established by the Administrator of General Services. (b) NBAC shall terminate two years from the date of this order unloss extended prior to that date. DCNS or 10 Federal Register / Vol. GO. No. 193 / Thursday, October 5, 1995 / Presidential Documents 52085 (c) This order is intended only to improve the internal management of the executive branch and it is not intended to create any right, benefit. trust, or responsibility. substantive or procedural, enforceable at law or equity by a. party against the United States, its agencies, its officers, or any person. areriam Tennten THE WHITE HOUSE, [FR Doc. 05-24821 October 3, 1995. Filed 10-3-95: 2:11 prul Billing code 3185-01-1' EXECUTIVE ORDER AMENDING EXECUTIVE ORDER'NO. 12975 By the authority vested in me as President by the Constitution and the laws of the United States of America, and in order to extend the term of the National Bioethics Advisory Commission, it is hereby ordered that Section 7(b) of Executive Order No. 12975 is amended to date." read, "NBAC shall terminate on October 3, 1999, unless extended by the President prior to that WILLIAM J. CLINTON NATIONAL BIOETHICS ADVISORY COMMISSION CHARTER Purpose The National Bioethics Advisory Commission will provide advice and make recommendations to the National Science and Technology Council, other appropriate entities and the public, on bioethical issues arising from research on human biology and behavior, and the applications, including the clinical applications, of that research. Authority Executive Order 12975. This Commission is governed by the provisions of the Federal Advisory Committee Act (FACA), Public Law 92-463, as amended (5 U.S.C. Appendix 2), which sets forth standards for the formation of advisory committees, and implementing regulations (41 C.F.R. § 101-6.10). Functions The National Bioethics Advisory Commission shall advise, consult with, and make recommendations to the National Science and Technology Council, Federal agencies, and other appropriate entities, and also make available to the public the Commission's advice and recommendations. The Commission's purview includes the appropriateness of departmental, agency, or other governmental programs, policies, assignments, missions, guidelines, and regulations as they relate to bioethical issues arising from research on human biology and behavior, and applications, including the clinical applications, of that research. The Commission shall identify broad, overarching principles to govern the ethical conduct of research, citing individual projects only as illustrations for such principles. The Commission shall not be responsible for the review and approval of individual projects. As a first priority, the Commission will direct its attention to consideration of: A. Protection of the rights and welfare of human research subjects; and B. Issues in the management and use of genetic information including but not limited to human gene patenting. In addition to responding to requests for advice and recommendations from the National Science and Technology Council, the Commission also may accept suggestions for issues for consideration from both the Congress and the public. The Commission also may identify other bioethical issues for the purpose of providing advice and recommendations, subject to the approval of the National Science and Technology Council. The Commission shall consider four criteria in establishing priority for its activities: A. The public health or public policy urgency of the bioethical issue. B. The relation of the bioethical issue to the goals for Federal investment in science and technology. C. The absence of another body able to deliberate fruitfully on the bioethical issue. D. The extent of interest in the issue across the government. (The Commission ordinarily will not deliberate on a bioethical issue of interest to just one department or agency.) Structure The National Bioethics Advisory Commission shall consist of not more than 18 members including the Chairperson. Appointments shall be made by the President, who shall select from knowledgeable non-Government experts and community representatives with special qualifications and competence to deal effectively with bioethical issues. At least one member shall be selected from each of the following catégories of primary expertise: (i) philosophy/theology; (ii) social/behavioral science; (iii) law; (iv) medicine/allied health professions; and (v) biological research. At least three members shall be selected from the general public, bringing to the Commission expertise other than that listed. The membership shall be approximately evenly balanced between scientists and non-scientists. Close attention will be given to equitable geographic distribution and to ethnic and gender representation. Members shall be appointed for overlapping four-year terms. Initially, members will be appointed for two-, three- or four-year terms. Terms of more than two years are contingent upon renewal of the National Bioethics Advisory Commission by appropriate action prior to its termination. The Chairperson shall be appointed by the President. The term of office for the Chairperson shall be two years, renewable by appropriate action of the President. If a vacancy occurs on the Commission, the President shall make an appointment to fulfill the term. Any member appointed to fill a vacancy occurring prior to expiration of the term for which his or her predecessor was appointed shall serve for the remainder of such term. Members may serve after the expiration of their terms until their successors have taken office. The heads of executive departments and agencies shall, to the extent permitted by law, provide the Commission with such information as it may require for purposes of carrying out its functions. The Commission may conduct inquiries, hold hearings and establish subcommittees, as necessary. The Commission is authorized to solicit information from relevant human research subject groups. The Commission is authorized to conduct analyses and develop reports or other materials. In order to augment the expertise present on the Commission, the Secretary of Health and Human Services is also authorized to contract for the services of non-governmental consultants who may conduct analyses, prepare reports and background papers or prepare other materials for consideration by the Commission, as appropriate. 2 In order to avoid duplication of effort, the Commission is encouraged to review the deliberations of other entities. The Commission may incorporate or otherwise use the results of the deliberations of other entities as it deems appropriate. The Assistant to the President for Science and Technology and the Secretary of Health and Human Services shall be notified upon establishment of each subcommittee, and shall, be provided information on the name; membership (including chair), function; estimated duration of the subcommittee, and estimated frequency of meetings. To the extent permitted by law, and subject to the availability of appropriations, the Department of Health and Human Services (DHHS) shall provide NBAC with such funds as may be necessary for the performance of its functions. Management and support services shall be provided by the DHHS. Meetings Meetings of the Commission shall be held up to 10 times a year at the call of the Chairperson. Meetings of the subcommittee(s) shall be convened as necessary. A Federal Government official shall be present at all meetings. Meetings shall be open to the public except as determined otherwise by the Assistant to the President for Science and Technology and the Secretary of Health and Human Services. Advance notice of all meetings shall be given to the public. Meetings shall be conducted, and records of proceedings kept, as required by applicable laws and Federal regulations. Compensation Members may be compensated at a rate not to exceed the maximum pay authorized by 5 U.S.C. 3109, plus per diem and travel expenses as in accordance with standard government travel regulations. Annual Cost Estimate The estimated annual cost for operating the National Bioethics Advisory Commission is $500,000. Reports Reports by the National Bioethics Advisory Commission on specific issues shall be submitted to the National Science and Technology Council, the appropriate committees of Congress, and other appropriate entities. The Commission may specifically identify the Federal department, agency or other entity to which particular recommendations are directed and request a response from the Federal department, agency or other entity within 180 days of publication of such recommendation. 3 Executive summaries of each report of the Commission shall be promulgated in the Federal Register. Such summaries shall specifically list the department, agency, or other entity to which any recommendations are directed and the date by which such responses are expected. An annual report shall be submitted to the National Science and Technology Council and the appropriate committees of Congress. It shall contain, at a minimum, (i) the Commission's function; (ii) a list of members and their business addresses; (iii) the dates and places-of meetings; (iv) a summary of the Commission's activities during the year; (v) a summary of the Commission's recommendations made during the year; and (vi) a summary of responses made by departments, agencies, or other entities to the Commission's recommendations during the year. General Provisions Notwithstanding the provisions of any other Executive Order, the functions of the President under the Federal Advisory Committee Act that are applicable to the Commission, except that of reporting annually to the Congress, shall be performed by the Secretary of Health and Human Services, in accordance with the guidelines and procedures established by the Administrator of General Services. Termination Date Unless extended by appropriate action prior to its expiration, this National Bioethics Advisory Commission will terminate October 3, 1997. Approved: John John H. Gibbons Hilbaurn Date 26 July 1996 Assistant to the President for Science and Technology NBAC Funding Request - FY 97 Agency Amount ($$ in 000's) DHHS 800 DOD 200 DOE 150 VA 150 USDA 125 NASA 100 NSF 75 ROSTER OF NBAC MEMBERS Chair R. Alta Charo, J.D. Harold T. Shapiro, Ph.D. Professor of Law President University of Wisconsin Princeton University 6108 Law Bldg., 975 Bascom Mall One Nassau Hall Madison, WI 53706 Princeton, NJ 08544-0015 (July 19, 1996 - July 18, 2000) (July 19, 1996 - July 18, 2000) James Childress, Ph.D. Patricia Backlar Department of Religious Studies Senior Scholar University of Virginia Center for Ethics in Health Care Cocke Hall, Rm. 101 Oregon Health Sciences University Charlottesville, VA 22903 Portland, OR 97207 (July 19, 1996 - July 18, 1999) (July 19, 1996 - July 18, 1998) David R. Cox, M.D., Ph.D. Arturo Brito, M.D. Professor of Genetics and Pediatrics L Assistant Professor of Clinical Pediatrics Stanford University School of Medicine University of Miami School of Medicine Department of Genetics, M-336 1601 NW 12th Avenue Stanford, CA 94305 Miami, FL 33136 (July 19, 1996 - July 18, 1999) (July 19, 1996 - July 18, 1999) Rhetaugh Graves Dumas, Ph.D., R.N. Alexander M. Capron, LL.B. Vice Provost for Health Affairs A.A Co-Director The University of Michigan Pacific Center for Health Policy and Ethics 3088 Fleming Administration Building Univ of Southern California Law Center Ann Arbor, MI 48109-1340 699 Exposition (September 16, 1996 - September 15, 1999) Los Angeles, CA 90089-0071 (July 19, 1996 - July 18, 2000) Ezekiel J. Emanuel, M.D., Ph.D. Associate Professor of Medicine Eric J. Cassell, M.D. and Social Medicine Professor of Public Health Dana-Farber Cancer Institute Cornell Medical College 44 Binney Street 1550 York Avenue Boston, MA 02115 New York, NY 10028 (July 19, 1996 - July 18, 1998) (July 19, 1996-July 18, 1998) Laurie M. Flynn Bernard Lo, M.D. ASIAN- Executive Director Director AMERICAN National Alliance for the Program in Medical Ethics Mentally III University of California, San Francisco 200 N. Glebe Road, Suite 1015 521 Parnassus Avenue, Rm. C126 Arlington, VA 22203 San Francisco, CA 94143-0903 (July 19, 1996 - July 18, 2000) (July 19, 1996 - July 18, 2000) Carol W. Greider, Ph.D. Lawrence H. Miike, M.D., J.D. HAWAII AN Senior Staff Scientist Director Cold Spring Harbor Laboratory State Department of Health 1 Bungtown Road 1250 Punchbowl Street Cold Spring Harbor, NY 11724 Honolulu, HI 96813 (October 29, 1996 - October 28, 1998) (July 19, 1996 - July 18, 1998) Steven H. Holtzman Thomas H. Murray, Ph.D. Chief Business Officer Director, Center for Biomedical Ethics Millenium Pharmaceuticals Inc. School of Medicine 640 Memorial Drive Case Western Reserve University Cambridge, MA 02139 10900 Euclid Avenue (July 19, 1996 - July 18, 1999) Cleveland, OH 44106-4976 (July 19, 1996 - July 18, 1999) Bette O. Kramer President Diane Scott-Jones, Ph.D. A-A Richmond Bioethics Consortium Professor 1803 Hanover Avenue Department of Psychology Richmond, VA 23220 Temple University (September 16, 1996 - September 15, 1998) 564 Weiss Hall 1701 North 13th Street Philadelphia, Pa 19122-6085 (July 19, 1996 - July 18, 2000) 12/17/96 Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a tabbed divider. Given our digitization capabilities, we are sometimes unable to adequately scan such dividers. The title from the original document is indicated below. Building Public Trust Divider Title: CANADA RYN CALINO OF ATES OF ACTIONS TO RESPOND TO THE REPORT OF THE ADVISORY COMMITTEE ON HUMAN RADIATION EXPERIMENTS HEALTH INTERNATION FREE) STATE STATES OF United States Government Human Radiation Interagency Working-Group THE WHITE HOUSE WASHINGTON In January 1994, after accounts of Cold War-era experiments involving the effects of radiation on humans came to light, I established an independent Advisory Committee on Human Radiation Experiments to investigate these reports. I asked the Committee to determine the truth about this dark chapter in our nation's history. After taking extensive testimony and conducting numerous public hearings, the Advisory Committee issued its report in October, 1995. The Committee's report included recommendations to make the record of these experiments open to the public, improve ethics in human research today, and right the wrongs of the past inflicted on unknowing citizens. In my remarks when I accepted the report, I promised that it would not be left on the shelf to gather dust. I made a commitment that we would learn from the lessons that the Committee's report offered and use it as a road map to lead us to better choices in the future. This document -- my Administration's response to the Advisory Committee's report -- is a milestone in meeting that commitment. We have actively worked to respond to the important recommendations made by he Advisory Committee through a special interagency working group. This oup includes representatives from the Executive Office of the President, the Departments of Energy, Defense, Health and Human Services, Justice, Veterans Affairs, the National Aeronautics and Space Administration, and the Central Intelligence Agency. The Environmental Protection Agency has also joined the effort. This report reflects the joint progress of these agencies to address the Advisory Committee's recommendations. My Administration has made significant achievements in opening government and making information more easily available to the citizens to whom it belongs. Agencies have also improved the protections in place for subjects of future human research. Finally, the Federal government is providing redress to those who have suffered from radiation experiments, as recommended by the Advisory Committee. I emphasize that this document is by no means the end of the journey. Much work remains to be done. I am confident that all of us -- the eminent committee that produced the original report, the Federal officials who worked SO hard to support the Committee's efforts and now are implementing its recommendations, and most importantly, the citizens of this great country from whose experiences we have learned SO much can together help ensure a better world for our children. My thanks to all of you for a job well done, I pledge my strong support for your continued efforts. Rin Chinton Executive Summary "Our greatness is measured not only in how we do right but also [in] how we act when we know we've done the wrong thing; how we confront our mistakes, make our apologies, and take action." -President Clinton October 3, 1995 In January 1994, President Clinton established the Advisory Committee on Human Radiation Experiments (ACHRE) to examine reports that the government had funded and conducted unethical human radiation experiments and releases of radiation during the Cold War. The President directed ACHRE to uncover the truth, recommend steps to right past wrongs, and propose ways to prevent unethical human subjects research from occurring in the future. The Committee published its findings and recommendations in The Administration October 1995. has adopted most of ACHRE's recommen- This report presents the Administration's actions to respond to dations and has ACHRE's findings and recommendations. The Committee found that acted throughout the government had conducted several thousand human radiation the government to experiments from 1944 to 1975. Although the majority of the implement them. experiments advanced biomedical science and were unlikely to have caused harm, some were conducted unethically. ACHRE made 18 recommendations to improve openness in government, protect human subjects in the future, and redress past wrongs. The Admin- istration has adopted most of ACHRE's recommendations and has acted throughout the government to implement them. Opening the Record ACHRE recommended that the government take a number of steps to organize the historical records of human radiation experiments and to give the public access to these records. ACHRE identified the National Archives as the appropriate repository for documents. The Committee also recommended an independent review of the CIA's recordkeeping system and all of its documents related to human radiation experiments. V Building Public Trust: Actions to Respond to the Advisory Committee on Human Radiation Experiments Key Actions The Administration has invested heavily in making documents accessible. ACHRE transferred more than 1 million pages of documents to the National Archives. The Administration has made 300,000 fully searchable pages of documents available on the Internet, and will add an additional 200,000 pages shortly. The Departments of Energy and Defense have published document search guides. The Administration has invested heavily The President signed Executive Order 12958 directing Federal in making documents agencies to review and declassify thousands of documents, accessible. including documents on radiation experiments. The National Archives and Records Administration is conducting an independent review of the Central Intelligence Agency's (CIA's) recordkeeping system and the CIA's Inspector General reviewed and reported on the CIA's human experiments. Protecting Human Subjects in the Future The Advisory Committee recommended steps to strengthen protec- tions for human subjects and ensure the government does not repeat past mistakes. Key Actions President Clinton is issuing a directive to strengthen protections for subjects of classified (secret) research. Agencies will propose A subcommittee of new rules to eliminate waiver of informed consent; disclose the National Bioethics identity of the sponsoring agency; ensure a more independent Advisory Committee review process; and require permanent records. Agencies will will address certain also report annually on the number of classified human research projects and the number of human subjects involved in each broad questions raised project. by ACHRE, including how to strengthen President Clinton established the National Bioethics Advisory Institutional Review Committee (NBAC) to examine bioethical issues, including Boards-the local human research issues. A subcommittee of NBAC will address ethics panels for certain broad questions raised by ACHRE, including how to federally sponsored strengthen Institutional Review Boards (IRBs)-the local ethics research. panels for federally sponsored research. President Clinton directed agencies to develop plans to improve oversight of ethics rules. NBAC will review these plans in the coming months. vi Executive Summary Agencies have undertaken nationwide education efforts to raise the profile of ethical considerations, and are funding research to improve our understanding of ethical issues. Righting Past Wrongs The Advisory Committee recommended, among other things, that the government apologize to all subjects, compensate certain sub- jects, and consider modifying the Radiation Exposure Compensation Act, and its regulations, to compensate additional uranium miners. Key Actions The President apologized to all subjects on behalf of the govern- ment; former Energy Secretary Hazel O'Leary made apologies in certain individual cases. ACHRE recommended that the government compensate the families of the 18 subjects of the plutonium injection experi- The Federal govern- ments. The government has settled compensation claims with ment has settled the the 16 families who have come forward. ACHRE and the govern- compensation claims ment have not been able to identify participants in additional experiments that ACHRE included in its recommendation for of the 16 families of compensation. plutonium injection subjects who have The Administration will propose legislative and regulatory come forward. changes to the Radiation Exposure Compensation Act to incorporate the latest science and better compensate affected uranium miners. The Administration will propose legislation to make veterans treated with nasopharyngeal radiation eligible for health screen- ing under the Department of Veterans Affairs' Ionizing Radiation Program. The actions and policies described in this report will help bring justice to those harmed by the mistakes of the Cold War, and pre- vent the recurrence of past wrongs. The report presents those actions that are completed or underway. The Administration will continue to take steps to open the government's records, raise ethical standards, and right the wrongs of the past. vii Building Public Trust: Actions to Respond to the Advisory Committee on Human Radiation Experiments ACHRE Findings and Recommendations on Protecting Human Subjects in the Future Based on its review of current human subject protections, the Advisory Committee found, among other things, that [H]uman research involving radioisotopes is currently subjected to more safeguards and levels of review than most other areas of research involving human subjects. The Advisory Committee further finds that there are no apparent differences between the Responsibility for treatment of human subjects of radiation research ethical conduct of and human subjects of other biomedical research. research begins with (Finding 20) researchers and extends to their [T]oday [T] research involving human subjects sponsored institutions, and the by the government may be classified and conducted Institutional Review in secret, but it must comply with the provisions of Boards (IRBs). the Common Rule. (Finding 21) [I]n comparison with the practices and policies of the 1940s and 1950s, there have been significant advances in the protection of the rights and interests of human subjects of biomedical research. However, we also find that there is evidence of serious defi- ciencies in some parts of the current system for the protection of the rights and interests of human subjects. (Finding 22) ACHRE Recommendation on the Centrality of Ethics ACHRE recommended that active efforts on a national scale be made to ensure that human subjects researchers fully understand the ethical implications and responsibilities of their work, and the cen- trality of ethical decisions. (Recommendation 9) Response Responsibility for the ethical conduct of research begins with researchers and extends to their institutions and the Institutional Review Boards (IRBs). The Administration has multiple efforts underway to reach, educate, oversee, and hold accountable each layer of the research system. The Administration is also taking steps to promote understanding of, and consensus about, ethical issues. 10 Part 2: Protecting Future Human Subjects National Bioethics Advisory Commission The National Bioethics Advisory Commission (NBAC), a national deliberative body of private citizens, was established by the President to provide guidance to all Federal agencies on the ethical conduct of human behavioral and clinical research, and the applica- tions of that research. NBAC was established, in part, to respond to The Executive Order ACHRE, and the Administration expects NBAC will choose to ad- establishing NBAC, dress the key issues identified in ACHRE's recommendations. NBAC required each agency will not be able to review all issues raised by ACHRE. The Adminis- to review its current tration has been careful to ensure that issues not taken up by NBAC human subjects re- will be addressed elsewhere. search in light of the Advisory Committee As a first priority, NBAC will seek to improve protection of the recommendations and rights and welfare of human research subjects. The Executive Order report the results to establishing NBAC, required each agency to review its current NBAC. human subjects research in light of the Advisory Committee recom- mendations and report the results to NBAC. NBAC is currently reviewing these documents. Appendix C details specific activities currently being carried out by the agencies as a result of their reviews. NBAC's meetings are public and provide a forum for dialogue on ethics issues. NBAC has heard presentations on issues related to genetic research, including cloning, as well as the broader area of human subjects research. Members of Congress, Congressional staff, and representatives from diverse organizations including the Task Force on Radiation and Human Rights, the College of American Pathologists, the Biotechnology Industry Organization, and Citizens for Responsible Care in Psychiatry and Research testified on ethics issues and on NBAC's mission. Further information can be obtained ACHRE's report made from the NBAC Web Site (www.nih.gov/nbac/nbac.htm) clear that a key to preventing the Education repetition of past ACHRE's report made clear that a key to preventing the repetition of mistakes is thorough past mistakes is thorough and continuing education about ethics and continuing and how they apply to current human subjects research. The Ad- education about ministration is responding to ACHRE's specific recommendations by ethics and how they co-sponsoring educational programs with external groups such as apply to current medical schools, universities, and scientific societies. The goals of human subjects these educational efforts are to strengthen human subjects protec- research. tion, to provide a forum for addressing ongoing as well as emerging issues in human subjects research, and to familiarize professionals engaged in non-federally funded human subjects research with relevant ethical considerations. Part of the ongoing educational process is a reinforcement of the importance of Institutional Review Boards (IRBs) at institutions conducting federally funded research. These IRBs are local groups 11 Building Public Trust: Actions to Respond to the Advisory Committee on Human Radiation Experiments whose membership and responsibilities are regulated by the Federal government. They are responsible for reviewing and approving the ethical content of all proposed human subjects research projects. IRBs are a linchpin in the protection of human subjects, and their credibility and effectiveness depend on adequate awareness of basic ethical topics. Similarly, educational programs are also being targeted at govern- ment-regulated research that is not government-funded (e.g., FDA- regulated research sponsored by the pharmaceutical industry). In September of 1996, the FDA sponsored its first nationwide confer- ence on human subjects protection. Government employees who have responsibility for supporting or overseeing human subjects research are also targeted for educa- tional programs. Thus, Federal agencies are implementing training programs to educate senior level officials on regulations and policies governing this research. For example, NASA is working with inter- national research partners to develop common ethical principles that ensure the protection of human subjects. DOE educational efforts target laboratory staff, field office personnel, and program officials. Despite the vigor with which all parties Information Gathering embrace the informed consent process, it is ACHRE's report highlighted the limited state of knowledge regard- not well understood. ing some key issues in human subjects research. Most importantly, NBAC will be reviewing and evaluating the IRB process. In addition, Departments have pooled resources to sponsor research on the informed consent process. The informed consent process is intended to help each potential research subject decide whether to participate in research by providing advance information about the research. Information includes a description of the nature of the research, the subject's role and potential risks, and the subject's rights and responsibilities. Despite the vigor with which all parties embrace the informed consent process, it is not well understood. Much of the Advisory Committee's commentary on current human subjects research was centered on informed consent. The National Institutes of Health (NIH), VA, and DOE are committed to support- ing research that will more fully illuminate the informed consent process. A Request for Applications (RFA) to conduct research on this issue was published in the fall of 1996, and Fiscal Year 1997 monies are earmarked to support this RFA. 12 Part 2: Protecting Future Human Subjects ACHRE Recommendation on Institutional Review Boards ACHRE recommended specific changes to IRBs in five critical areas (Recommendation 10): (1) mechanisms to ensure a stronger focus on studies that pose more than minimal risk to subjects; (2) better means of explaining to potential subjects the distinction between research and treatment, the realistic likelihood of medical benefit to the subject from participation, and the potential for discomfort and pain; (3) ensuring that potential subjects fully understand the sponsors and purposes of the research; The Administration (4) ensuring that potential subjects fully understand the financial anticipates specific implications of participation; and recommendations (5) recognition that the IRBs must decide if the quality of the science from NBAC regarding justifies the risk to the subjects. reform of IRBs, includ- ing recommendations Response that address ACHRE's concerns. The Administration agrees that there are indications that the IRB system is not always adequate to ensure protection of human subjects. NBAC has undertaken to review the current IRB system and intends to finish that project within a year. The Administration anticipates specific recommendations from NBAC regarding reform of IRBs, including recommendations that address ACHRE's con- cerns. In the interim, agencies are informing IRBs of ACHRE's recommen- dations and are working to improve IRBs. The Office for Protection from Research Risks (OPRR), part of NIH, is undertaking a national effort to educate the research community about ACHRE's recommendations. OPRR and FDA support an annual public meeting for individuals interested in the governance of human subjects research. In addition, OPRR, in cooperation with FDA and local academic institutions, has held discussions of the recommendations at national workshops in Atlanta, Oklahoma City, Honolulu, Peoria, Houston, and San Diego. OPRR and the FDA make extensive use of public meetings, forums, hearings, and electronic media to address evolving issues on human subject protection. OPRR and FDA also regularly mail information directly to IRBs and other interested parties. FDA seeks public input through the Federal Register and by mailing proposals to the IRB and clinical investigator communities. In October 1995, FDA issued 13 To See opposite poge It might be a good time to develop an Administration on the Glenn bill (S. 193) with the thought of announcing support, if that is our conclusion. The major element of the bill is to extend protection to human subjects of research conducted outside PHS or FDA regs. Criminal penalties are authorized for violation of the Act. A relatively minor element of the bill is to elevate the status of the Office for Protection from Research Risks out of NIH and place it in the Office of the Secretary, DHHS. As part of its deliberations on the adequacy of current protections for human subjects, NBAC is considering adopting a resolution that would have the same effect as the Glenn bill. Building Public Trust: Actions to Respond to the Advisory Committee on Human Radiation Experiments Response The Administration agrees that extraordinary steps are needed to protect military personnel, and DOD is implementing ACHRE's recommendations. Among other steps, DOD is revising directives and Military Department regulations, and incorporating needed training into courses for commanders, senior leadership, and those involved in human subjects research. In the summer of 1997, DOD will publish a revised human subjects protection directive that includes policy changes recommended by the Advisory Committee. For example, to avoid undue command influence, the new policy will preclude officers and noncommissioned officers from playing a role in selecting volunteers for military tests. (See Appendix C for more details). In the summer of 1997, DOD will ACHRE Findings and Recommendation on the Federal publish a revised Oversight of Research human subjects protection directive ACHRE found that oversight of human subjects research is limited and that includes policy is constrained by practical considerations. ACHRE found that the changes recommended "current mechanisms for oversight do not provide a sufficient by the Advisory basis for ensuring that the current system is working properly." Committee. ACHRE found that sanctions may be inadequate for violations of human subjects research protections. For example failure to obtain consent from subjects (who are not physically injured) is generally punishable only by the withdrawal of research funding. ACHRE also found that "there is a need to assess the level of research performed outside [the Common Rule] and to consider action to ensure that all subjects are afforded the protections it offers." ACHRE recommended the improvement of three parts of the current Federal system for human research subject protection: oversight of the research process; sanctions for violations of human subjects protec- tions; and protections for subjects of non-federally funded research. (Recommendation 13) Response The Administration agrees that there are important gaps in the current system of human subjects protection, and has identified, in testimony before Congress, examples of research that does not fall within the ambit of Federal protection. Congress has proposed the Human Research Subject Protection Act of 1997 (S. 193) to ensure that all human subjects are adequately protected The Administra- 7 16 Part 2: Protecting Future Human Subjects tion believes that Congress is also the appropriate place to consider whether additional civil or criminal sanctions for the violation of human subject protections are necessary and desirable. (Sanctions, including criminal liability, apply to investigators conducting FDA- regulated research who violate FDA regulations protecting human The Administration subjects.) Any legislation would need to protect research subjects and avoid deterring needed research. expects that NBAC will recommend additional In addition to exploring legislation, Federal agencies are undertak- actions to improve ing specific activities to strengthen oversight, some of which are oversight of Federal described in Appendix C. The Administration expects that NBAC research, and will will recommend additional actions to improve oversight of Federal identify the highest research, and will identify the highest priority steps. priority steps. ACHRE Findings and Recommendation on the Compensation of Subjects in the Future ACHRE found that the Federal government lacks a "policy or guide for a fair system of compensation of research subjects." ACHRE recommended that the government resolve the longstanding issue of whether and how all persons injured in the future from federally funded human subjects research should be compensated. ACHRE recommended that the Federal government consider a system of compensation for research subjects who suffer physical injury or dignitary harm as a result of federally funded research. (Recommendation 14) Response In the absence of a finding that a significant number of modern research subjects are unfairly denied compensation, the Administra- tion is not prepared to propose a system outside the existing net- work of Federal and state liability and insurance systems. The Administration does, however, view the debate over the extent and effectiveness of our current human subject protections to encompass this issue. The Administration would be open to consid- ering any recommendations from NBAC or legislation from Congress that seek to address this issue. The desire to spread the cost of research injury is a reason to consider a compensation scheme. The current tort system, though imperfect, provides one mechanism to seek compensation for injuries that arise from research. In addition, the tort system 17 APPENDIX A REMARKS BY PRESIDENT WILLIAM J. CLINTON IN ACCEPTANCE OF HUMAN RADIATION FINAL REPORT October 3, 1995 Old Executive Office Building Let me begin with a simple thank you to everyone who participated in this extraordinary project and to everyone who supported them. I want to thank Secretary O'Leary for her extraordinary devotion to this cause. And you heard in her remarks basically the way that she views this. It's a part of her ongoing commitment to finish the end of the Cold War. And perhaps no Energy Secretary has ever done as much as she has to be an advocate, whether it is for continued reforms within the Energy Department or her outspoken endorse- ment of the strongest possible commitment on the part of the United States to a Comprehensive Test Ban Treaty, which I believe we will achieve next year in no small measure thanks to the sup- port of the Secretary of Energy. And, of course, I want to thank Dr. Ruth Faden for her extraordinary commitment of about a year and a half of her life to this unusual but important task. And all of you who served on the committee-I remember the first time we put this committee together. I do thank you so much for the work you have done. I saw this committee as an indispensable part of our effort to restore the confidence of the American people in the integrity of their government. All of these political reform issues to me are inte- grated. When I became the President, I realized we had great new economic challenges, we had profound social problems, that a lot of these things had to be done by an energized American citizenry, but that our national government had a role to play in moving our country through this period of transition. And in order to do it, we needed to increase the capacity of the government to do it through political reform, but we also needed, as much as anything else, to increase the confidence of the American people that, at the very least, they could trust the United States Government to tell the truth and to do the right things. A-1 Building Public Trust: Actions to Respond to the Advisory Committee on Human Radiation Experiments So you have to understand that, for me, one reason this is so impor- tant is that I see it as part of our ongoing effort to give this govern- ment back to the American people-Senator Glenn's long effort to get Congress to apply to itself the same laws it imposes on the private sector-the restrictions that I imposed on members of my administration in high positions for lobbying for foreign govern- ments; and when the lobby bill failed in the Congress, I just im- posed it by executive order on members of the Executive Branch. All these efforts at political reform, it seems to me, are important. But none of these efforts can succeed unless people believe that they can rely on their government to tell them the truth and to do the right thing. We have declassified thousands of government docu- ments, files from second world war, the Cold War, President Kennedy's assassination. These actions are not only consistent with our national security, they are essential to advance our values. So, to me, that's what this is all about. And to all those who repre- sent the families who have been involved in these incidents, let me say to you, I hope you feel that your government has kept its com- mitment to the American people to tell the truth and to do the right thing. We discovered soon after I entered office that with the specter of an atomic war looming like Armageddon far nearer than it does today, the United States government actually did carry out on our citizens experiments involving radiation. That's when I ordered the creation of this committee. Dr. Faden and the others did a superb job. They enlisted many of our nation's most significant and important medi- cal and scientific ethicists. They had to determine first whether experiments conducted or sponsored by our government between 1944 and 1974 met the ethical and scientific standards of that time and of our time. And then they had to see to it that our research today lives up to nothing less than our highest values and our most deeply-held beliefs. From the beginning, it was obvious to me that this energetic com- mittee was prepared to do its part. We declassified thousands of pages of documents. We gave committee members the keys to the government's doors, file cabinets and safes. For the last year and a half, the only thing that stood between them and the truth were all the late nights and hard work they had to put in. This report I received today is a monumental document-in more ways than one. But it is a very, very important piece of America's history, and it will shape America's future in ways that will make us a more honorable, more successful and more ethical country. A-2 Appendix A What this committee learned I would like to review today with a little more detail than Dr. Faden said, because I think it must be engraved on our national memory. Thousands of government- sponsored experiments did take place at hospitals, universities, and military bases around our nation. The goal was to understand the effects of radiation exposure on the human body. While most of the tests were ethical by any standards, some were unethical, not only by today's standards, but by the standards of the time in which they were conducted. They failed both the test of our national values and the test of humanity. In one experiment, scientists injected plutonium into 18 patients without their knowledge. In another, doctors exposed indigent cancer patients to excessive doses of radiation, a treatment from which it is virtually impossible that they could ever benefit. The report also demonstrates that these and other experiments were carried out on precisely those citizens who count most on the government for its help-the destitute and the gravely ill. But the dispossessed were not alone. Members of the military-precisely those on whom we and our government count most-they were also test subjects. Informed consent means your doctor tells you the risk of the treat- ment you are about to undergo. In too many cases, informed con- sent was withheld. Americans were kept in the dark about the effects of what was being done to them. The deception extended beyond the test subjects themselves to encompass their families and the American people as a whole, for these experiments were kept secret. And they were shrouded not for a compelling reason of national security, but for the simple fear of embarrassment, and that was wrong. Those who led the government when these decisions were made are no longer here to take responsibility for what they did. They are not here to apologize to the survivors, the family members or the communities who's lives were darkened by the shadow of the atom and these choices. So today, on behalf of another generation of American leaders and another generation of American citizens, the United States of America offers a sincere apology to those of our citizens who were subjected to these experiments, to their families, and to their com- munities. A-3 Building Public Trust: Actions to Respond to the Advisory Committee on Human Radiation Experiments When the government does wrong, we have a moral responsibility to admit it. The duty we owe to one another to tell the truth and to protect our fellow citizens from excesses like these is one we can never walk away from. Our government failed in that duty, and it offers an apology to the survivors and their families and to all the American people who must-who must be able to rely upon the Untied States to keep its word, to tell the truth, and to do the right thing. We know there are moments when words alone are not enough. That's why I am instructing my Cabinet to use and build on these recommendations, to devise promptly a system of relief, including compensation, that meets the standards of justice and conscience. When called for, we will work with Congress to serve the best needs of those who were harmed. Make no mistake, as the commit- tee report says, there are circumstances where compensation is appropriate as a matter of ethics and principle. I am committed to seeing to it that the United States of America lives up to its responsi- bility. Our greatness is measured not only in how we so frequently do right, but also how we act when we know we've done the wrong thing; how we confront our mistakes, make our apologies, and take action. That's why this morning, I signed an executive order instructing every arm and agency of our government that conducts, supports, or regulates research involving human beings to review immedi- ately their procedures, in light of the recommendations of this report, and the best knowledge and standards available today, and to report back to me by Christmas. I have also created a Bioethics Advisory Commission to supervise the process, to watch over all such research, and to see to it that never again do we stray from the basic values of protecting our people and being straight with them. The report I received today will not be left on a shelf to gather dust. Every one of its pages offers a lesson, and every lesson will be learned from these good people who put a year and a half of their lives into the effort to set America straight. Medical and scientific progress depends upon learning about people's responses to new medicines, to new cutting-edge treat- ments. Without this kind of research, our children would still be A-4 Appendix A dying from polio and other killers. Without responsible radiation research, we wouldn't be making the progress we are in the war on cancer. We have to continue to research, but there is a right way and a wrong way to do it. There are local citizens' review boards, there are regulations that establish proper informed consent and ensure that experiments are conducted ethically. But in overseeing this necessary research, we must never relax our vigilance. The breathtaking advances in science and technology demand that we always keep our ethical watchlight burning. No matter how rapid the pace of change, it can never outrun our core convictions that have stood us so well as a nation for more than 200 years now, through many different scientific revolutions. I believe we will meet the test of our times-that as science and technology evolve, our ethical conscience will grow, not shrink. Informed consent, community right-to-know, our entire battery of essential human protections-all these grew up in response to the health and humanitarian crises of this 20th century. They are proof that we are equal to our challenges. Science is not ever simply objective. It emerges from the crucible of historical circumstances and personal experience. Times of crisis and fear can call forth bad science, even science we know in retro- spect to be unethical. Let us remember the difficult years chronicled in this report, and think about how good people could have done things that we know were wrong. Let these pages serve as an internal reminder to hold humility and moral accountability in higher esteem than we do the latest devel- opment in technology. Let us remember, too, that cynicism about government has roots in historical circumstances. Because of stonewallings and evasions in the past, times when a family mem- ber or a neighbor suffered an injustice and had nowhere to turn and couldn't even get the facts, some Americans lost faith in the prom- ise of our democracy. Government was very powerful, but very far away and not trusted to be ethical. So today, by making ourselves accountable for the sins of the past, I hope more than anything else, we are laying the foundation stone for a new era. Good people, like these members of Congress who have labored on this issue for a long time, and have devoted their careers to trying to do the right thing, and having people justifiably feel confidence in the work of their representatives. They will continue to work to see that we implement these recommendations. A-5 Building Public Trust: Actions to Respond to the Advisory Committee on Human Radiation Experiments And under our watch, we will no longer hide the truth from our citizens. We will act as if all that we do will see the light of day. Nothing that happens in Washington will ever be more important in anyone's life affected by these experiments, perhaps, than these reports we issue today. But all of us as Americans will be better off because of the larger lesson we learned in this exercise and because of our continuing effort to demonstrate to our people that we can be faithful to their values. Thank you very much. A-6 The Administration Announces Actions Responding to President Clinton's Advisory Committee on Human Radiation Experiments March 28, 1997 Background In January, 1994 President Clinton established the Advisory Committee on Human Radiation Experiments (ACHRE) to examine reports that the government had supported unethical human radiation experiments and releases of radiation during the Cold War. He asked ACHRE to uncover the truth, recommend ways to right past wrongs, and suggest ways to make sure the government will not repeat past mistakes. October, 1995 ACHRE issued its report. ACHRE found that the government had conducted several thousand human radiation experiments from 1945 to 1975 and that the majority advanced biomedical research. The Committee found, however, that some were conducted unethically. For example, scientists injected plutonium into 18 patients without their knowledge, and researchers conducted experiments on indigent patients and children. ACHRE made 18 recommendations to open the public record, protect human subjects of future research, and compensate those wronged by the government's actions. In October, 1995 the President received the Advisory Committee's report and made it clear that the report would "not be left on a shelf to gather dust" He directed his Cabinet to "use and build on these recommendations." Over the past year and a half, the Administration has acted to implement ACHRE's recommendations to improve openness in government, strengthen ethics in human subjects research, and compensate individuals for the government's mistakes. Today's Announcement The Administration released Building Public Trust, outlining its comprehensive response to the President's Advisory Committee on Human Radiation Experiments (ACHRE). The report summarizes actions to address ACHRE's 18 recommendations. The Departments of Energy and Justice announced that the government has settled compensation claims with families of all of the known individuals ACHRE recommended for compensation. ACHRE recommended the government compensate the families of 18 subjects of plutonium injection experiments. The government has settled with all 16 families that came forward. President Clinton signed a memorandum to strengthen the rights and protections of people participating in secret, government-supported research. ACHRE recommended that subjects of secret experiments have special protections and information. Acting on that recommendation, the President directed agencies today to propose new rules for secret research that would require scientists to: obtain informed consent from all potential subjects of all secret experiments (current rules allow researchers to waive informed consent in certain cases); disclose the identity of the sponsoring agency to potential subjects; and tell potential subjects that an experiment is classified. The new rules would also establish a more independent review process; require the head of the agency conducting secret human research to approve each project; and require permanent records of secret experiments. The President also directed federal agencies to report annually on the number of classified human research projects and the number of subjects in each project. A preliminary review by the Administration's human radiation Interagency Working Group indicates that the government is not supporting any classified human research at this time; today's directive initiates a formal, routine accounting of secret human studies. The Administration announced proposed amendments to the Radiation Exposure Compensation Act of 1990 to compensate hundreds of uranium miners who would not be compensated under current law. ACHRE found that some deserving miners do not qualify for compensation under the Act. The amendments would establish fairer, science- based criteria for compensation. The Administration will also propose regulatory changes to RECA to facilitate claims processing. Previous and On-going Actions Described in Building Public Trust Include: Actions to Improve Openness in Government. ACHRE transferred more than 4,000 cubic feet of documents to the National Archives. The Administration has made 300,000 fully searchable pages of documents available on the Internet, and will add an additional 200,000 pages shortly. The Departments of Energy and Defense have published document search guides. The President signed Executive Order 12958 directing Federal agencies to review and declassify thousands of documents, including documents on radiation experiments. Actions to Protect human subjects in the future. President Clinton established the National Bioethics Advisory Commission (NBAC) to examine bioethical issues, including human research issues. A subcommittee of NBAC will address certain broad questions raised by ACHRE, including how to strengthen Institutional Review Boards -- the local ethics panels for Federally-sponsored research. In October, 1995 President Clinton directed agencies to develop plans to improve their oversight of ethics rules. The agencies have completed their review and upgraded protections, and NBAC will review agency procedures in the coming months. Agencies have undertaken nationwide education efforts to raise the profile of ethical considerations, and are funding research to improve our understanding of informed consent. Actions to Right Past Wrongs. In October, 1995 President Clinton apologized to subjects of radiation experiments and their families on behalf of an earlier generation of American leaders and citizens; former Energy Secretary O'Leary made apologies in certain individual cases. The Administration will propose legislation to make veterans treated with nasopharyngeal radiation eligible for health care services under the Veteran's Administration's Ionizing Radiation Program. Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a tabbed divider. Given our digitization capabilities, we are sometimes unable to adequately scan such dividers. The title from the original document is indicated below. Glenn Bill (S. 193) Divider Title: 01/22/97 11:39 202 228 3792 US SEN GAC MIN 029 Senator John Glenn News Release For Immediate Release: Contact: Bryan McCleary (202) 224-9799 January 22, 1997 Jack Sparks (202) 224-7784 New Law Proposed to Prevent Researchers from Conducting Experiments on Unsuspecting Americans Glenn Calls on Administration to Put Human Research Issue on Front Burner Tough new safeguards are needed to protect the rights of Americans who participate in medical research, Senator John Glenn (D-Ohio) said today. Glenn made his comments as he introduced comprehensive legislation aimed at ensuring that "informed consent" is obtained from potential research subjects, closing gaps which have allowed unethical human experiments, and creating first-ever criminal penalties for violators. "I find it astounding that after horror stories like experiments described at Nuremberg, the thalidomide babies, and recent revelations about Cold War radiation experiments in Ohio and elsewhere, we still don't have a law on the books saying it is illegal to experiment on Americans without their permission. Glenn said a large body of federal regulations has evolved to protect human research subjects, but he believes it ie spotty, contains major gaps that invite abuse, often fails to give subjects an honest picture of risks, and lacks the force of law. "There is more protection in existing statutes for animals than for humans, Glenn said, citing the Animal Welfare Act. "Think about your own family, your son or daughter or parent or grandchild. The next time they go to the doctor or hospital, they could be the subject of some medical experiment or research they know nothing about. There can't be anything more un-American than that. " Glenn is also calling on the Clinton Administration to make this issue a higher priority. The Senator complained that a Presidential advisory commission charged with suggesting better protections for human research subjects is being hobbled by a lack of funding. In a letter last week to Dr. John Gibbons, President Clinton's science advisor and chief of the Office of Science and Technology Policy, Glenn called the issues to be addressed by the commission "among the most important, complex, and controversial of our time. Glenn says President Clinton exhibited strong leadership in creating the National Bioethics Advisory Commission following revelations about radiation experiments on unsuspecting subjects during the Cold War. Now, he said, the Administration needs to 01/22/97 11:40 202 228 3792 US SEN GAC MIN 030 follow through on its commitments. The Senator said that more than 15 months after its establishment, the commission is having difficulty conducting its business because federal agencies have not fulfilled their pledges to support it. Glenn wrote to Gibbons that "past abuses have affected my constituents directly" and asked him to see that the commission is fully funded. Dr. Gibbons is meeting today with representatives from agencies who agreed to support the commission with resources and staff. Glenn, the senior Democrat on the Senate Governmental Affairs Committee, has long pushed the Government to disclose evidence about Cold-War era excesses. He was among the first to identify the environmental and health risks posed by U.S. nuclear production plants. More recently, he released information about how the U.S. government deliberately released radiation into the atmosphere during the 1940's and 50's. Finally, he has worked on the Governmental Affairs Committee to examine how it could happen that Americans became unwitting guinea pigs in experiments involving radiation and plutonium injections and exposure. In the course of conducting hearings and spearheading Congressional probes into radiation experiments -- one of the most infamous sets having occurred at the University of Cincinnati -- Clenn continued to ask two questions. First: what protections are in place to prevent such abuses from happening again? Second: what law prohibits experimenting on people without their consent? Today's legislation is an outgrowth of these two questions. A number of problems with the way in which research is conducted have been identified by Congressional investigators, the media, Glenn and government commissions. Some examples: * The "common rule" -- a guideline requiring that researchers fully inform tests subjects about experiments and submit them to a local ethics review board -- is not applied to all U.S. medical research. Some of private industry is exempted and not all government research is covered. What's more, the common rule is not law and no criminal penalties are on the books if it is violated. * The Cleveland Plain Dealer has identified cases where deaths have resulted from treatments patients were not told were experimental. In a comprehensive investigation, the paper also reported that since 1977, more than half of the 4,154 investigations the FDA has made of drug research have shown that researchers failed to clearly disclose the experimental nature of their work. They also showed cases where the federal government sponsored research where informed consent was not obtained. * Local ethics committees called Institutional Review Boards (IRB's) are supposed to approve experiments while ensuring that 01/22/97 11:41 202 228 3792 US SEN GAC MIN 031 researchers minimize risks, clearly inform subjects of the nature of proposed treatment or experimentation, and let patients know about alternative treatments. However, reports show IRB's often face an overwhelming workload, do not check up on experiments after they are approved, and do not receive sufficient guidance or oversight from the federal government Glenn noted that no one even knows how many review boards are operating nationally or what kind of job many of them are doing. * Consent forms approved by IRB's for distribution to potential subjects often gloss over the experimental nature of proposed treatment, blurring the distinction between therapy and research. The Advisory Committee on Human Research Experiments found such consent forms "flawed in morally significant respects" and concluded that over half the studies they reviewed raised "serious or moderate concerns." Glenn's legislation, among other things, would: apply Common rule protections Lo all human subject research and put criminal sanctions on the books for violators; create new protections for classified federal experiments; provide additional protections to vulnerable populations such as children and pregnant women; and elevate the Office for Protection from Research Risks to newer, more independent watchdog status. Glenn said his bill will be referred to the Senate Labor and Human Resources Committee. Later this week, he will introduce a narrower bill which will deal solely with public research and will be sent to the Governmental Affairs Committee on which Glenn serves as ranking Member. The Senator said he expects that both committees will hold hearings on the issue in the near future. He said he would be working to gather support for the legislation from his colleagues and would also reach out to organizations representing patient rights, veterans, senior citizens, and others. Glenn stressed that human research is absolutely critical to America and its development of new medicines and treatments to fight and cure diseases. "I don't think people mind being test subjecte if they know the pros and cons." Still, he said, "people need to have all the facts. They need to make their decision based on good information -- not information that is selective or slanted or misleading." For additional background on the issue, including a 1996 General Accounting Office report to Clenn, call 202-224-9799. 105th CONGRESS 1st Session S. 193 To provide protections to individuals who are the human subject of research. IN THE SENATE OF THE UNITED STATES January 22, 1997 Mr. Glenn introduced the following bill; which was read twice and referred to the Committee on Labor and Human Resources A BILL To provide protections to individuals who are the human subject of research. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the "Human Research Subject Protections Act of 1997". SEC. 2. FINDINGS AND PURPOSES. (a) Findings.--Congress makes the following findings: (1) The Constitution guarantees the right of the people to be secure in their persons, and the Declaration of Independence asserts as self- evident that all men have certain unalienable rights among these are life, liberty and the pursuit of happiness. (2) The first principle of the Nuremberg code states that with respect to human research, the voluntary consent of the human subject is absolutely essential. The Nuremberg code further asserts that such consent must be competent, informed and comprehending. (3) In 1974, the Department of Health, Education and Welfare published regulations (45 CFR 46) governing the protection of human subjects in research. These regulations applied only to research sponsored by the Department. In 1991 these regulations were adopted by 16 additional Federal agencies to apply to any research which these agencies may sponsor. (4) Between 1974 and 1983, Congress enacted 2 Public Laws that established ethical advisory bodies. Public Law 91-348 established the National Commission for the Protection of Human Subjects of Biomedical Research and Public Law 95-622 established the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Each of these advisory bodies made recommendations to the President and Congress to expand protections for human research subjects. Some of these recommendations have been incorporated into the Federal regulation (45 CFR 46). (5) In 1995, the President's Advisory Committee on Human Radiation Experiments found that there are significant deficiencies in some aspects of the current system for the protection of human subjects. In particular, the Committee found that some consent forms currently in use are flawed in morally significant aspects. (6) The President's Advisory Committee on Human Radiation Experiments recommended the adoption of a Federal policy requiring the informed consent of all human subjects of classified research and that this requirement not be subject to exemption or waiver. The Committee further recommended that in all cases, potential subjects should be informed of the identity of the sponsoring Federal agency and that the project involves classified information. (7) Some agencies of the Federal government sponsor research involving human subjects, but these agencies have not adopted the Common Rule as provided for in part 46 of title 45, Code of Federal Regulations. (8) Private individuals or institutions that do not receive any Federal funding or that are not seeking the approval of the Food and Drug Administration for a drug or device, and that sponsor research involving human subjects, do not need to abide by the requirements of part 46 of title 45, Code of Federal Regulations. (9) Many, but not all, research institutions that receive Federal sponsorship for research involving human subjects may voluntarily apply the protections of the Common Rule to all research conducted at the research institution. (10) Notwithstanding paragraphs (1) through (9), no provision of United States law explicitly requires that informed consent and independent review of research involving human subject be obtained. (11) The human research subject activities described in this section are either in interstate (or foreign) commerce or substantially affect such commerce or the free flow thereof, and the regulation of those activities as provided for in this Act is necessary to prevent and eliminate burdens upon such commerce and to effectively regulate such commerce, in order to insure that the rights and welfare of human research subjects are protected. (b) Purpose.--The purposes of this Act are-- (1) to apply common rule protections to all human subject research and provide for criminal sanctions for violations of this Act; (2) to prohibit the provision of Federal support for classified research that is not reviewed by an institutional review board and require disclosure to human research subjects of certain information regarding classified research; and (3) to address any potential regulatory conflict of interest within the Department of Health and Human Services and the National Institutes of Health, and establish an Office for Protection of Research Subjects within the Office of the Secretary of Health and Human Services. SEC. 3. DEFINITIONS. In this Act: (1) Assurance.-The term "assurance" means a written agreement between the Secretary and a research facility, or an institution supporting the research facility, that such research facility will comply with all Federal ethical standards regarding human subject research, including the common rule protections. Such term includes a "single project assurance", "multiple project assurance", and "cooperative project assurance". (2) Board.--The term "board" means an institutional review board established in accordance with and for the purposes expressed in this Act. (3) Classified research.--The term "classified research" means research involving human subjects that is specifically authorized under criteria established by an Executive Order to be kept secret in the interest of national defense of foreign policy. (4) Common rule protections.--The term "common rule protections" means the requirements and protections provided under part 46 of title 45, Code of Federal Regulations, as in effect on the date of enactment of this Act. (5) Human subject.--The term "human subject" means a living individual about whom an investigator (whether professional or student) conducting research obtains-- (A) data through intervention or interaction with the individual; or (B) individually identifiable private information. (6) Interstate commerce.--The term "interstate commerce" has the meaning given the term in section 201(b) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321(b)). (7) Office.--The term "Office" means the Office for Protection of Research Subjects established under section 102(a) or the Office designated under section 102(b). (8) Research.--The term "research" means a systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge, and those activities for which a Federal department or agency has specific responsibility for regulating as research activities. (9) Research facility.--The term "research facility" means any public or private entity, agency (including Federal, State, and other agencies) or person that-- (A) uses human subjects in research involving interstate commerce; or (B) receives support under a grant, loan, contract, or other award from a department, agency, or instrumentality of the United States for the purpose of carrying out research using human subjects. (10) Secretary.--The term "Secretary" means the Secretary of Health and Human Services. (11) State.--The term "State" means a State of the United States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, or any other territory or possession of the United States. TITLE I--GENERAL RESEARCH REQUIREMENTS SEC. 101. APPLICATION OF COMMON RULE REQUIREMENTS AND PROTECTIONS. (a) In General.--Except as provided in subsection (b), the requirements and protections provided under part 46 of title 45, Code of Federal Regulations, as in effect on the date of enactment of this Act, shall apply to research conducted by research facilities using human subjects. (b) Exception When in Conflict with Act.--The provisions of this Act shall supersede any provision of part 46 of title 45, Code of Federal Regulations, if such provisions are in conflict. SEC. 102. OFFICE FOR PROTECTION OF RESEARCH SUBJECTS. (a) Establishment.--Not later than 90 days after the date of enactment of this Act, the Secretary shall establish within the Office of the Secretary an office to be known as the "Office for Protection of Human Research Subjects" or make the designation described in subsection (b). (b) Designation.--Not later than 90 days after the date of enactment of this Act, the Secretary may reassign the Office for Protection from Research Risks to the Office of the Secretary and designate such Office to carry out the duties of the Office under this Act. (c) Funding.--The Secretary shall ensure the availability of such sums as may be necessary to enable the Office to conduct all activities under this Act, as well as to conduct appropriate oversight and implementation activities. SEC. 103. REGISTRATION OF FACILITIES. (a) In General.--To conduct research using human subjects, a research facility shall have in effect a valid registration with the Secretary in accordance with this section and with such regulations as the Secretary may promulgate. (b) Requirements.--An application for registration under subsection (a) shall include-- (1) a statement of the principles of the applicant research facility with respect to the protection of the rights and welfare of humans subjects of research conducted or supported by the research facility; (2) a designation of the official responsible for all human subject research conducted or supported by the applicant research facility; (3) a designation of, and membership roster or rosters for, each board that is responsible for reviewing human subject research conducted or supported by the applicant research facility; and (4) an assurance that the applicant research facility is complying and will continue to comply with the requirements for-- (A) board membership; (B) the functions and operations of the board; (C) the review of research by the board; (D) the approval of research by the board; (E) the suspension or termination of board approval of research; (F) the maintenance of records by the board; and (G) obtaining and documenting informed consent from human subjects, consent from children, and permission from parents or guardians as provided for in the common rule protections. (c) Period of Registration.-The registration of a research facility shall be valid for the 3-year period beginning on the date on which the Secretary approves the application for registration, except that such registration may be suspended, revoked or deemed to be incomplete or otherwise insufficient by the Secretary. (d) Affect of Assurances.--Upon the notification of the Secretary by the official designated under subsection (b)(2), a research facility shall be deemed to be in compliance with the registration provisions of this section, if that research facility has in effect a valid assurance negotiated with the Department of Health and Human Services. (e) Failure to Register.-- A research facility may not conduct an activity covered by this Act if the facility is not registered with the Secretary under this section or an assurance described in subsection (d) is not in effect. SEC. 104. INSPECTION AND INVESTIGATION. (a) In General.--The Secretary may carry out such inspections or investigations as may be necessary to enable the Secretary to determine whether any research facility has violated or is violating any provision of this Act. (b) Access to Facilities and Records.--To enable the Secretary to carry out subsection (a), the Secretary shall, after providing reasonable notice, be provided with access to a research facility and the records required to be kept by the facility pursuant to section 103(b)(4) and the common rule protections. (c) Penalties.--Title 18, United States Code, is amended by inserting after chapter 89 the following: "CHAPTER 90--PROTECTION OF HUMAN SUBJECTS BY RESEARCH FACILITIES "Sec. 1841. Protection of human subjects "(a) In General.--Whoever forcibly assaults, resists, opposes, impedes, intimidates, or interferes with any person while such person is engaged in the performance of his or her official duties under the Human Research Subject Protections Act of 1997, or because such person has carried out such duties, shall be fined not more than $10,000, or imprisoned not more than 3 years, or both. "(b) Use of Weapon.--Whoever in the commission of an act that is a violation of subsection (a), uses a deadly or dangerous weapon shall be fined not more than $25,000, or imprisoned not more than 10 years, or both. "(c) Homicide.--Whoever kills any human being while that human being is engaged in the performance of his or her official duties under the Human Research Subject Protections Act of 1997, or because such human being has carried out such duties, shall be fined or imprisoned as provided for under sections 1111 and 11 14.". SEC. 105. ENFORCEMENT. (a) Suspension of Registration.-If the Secretary has reason to believe that any research facility registered under section 103 has violated or is in violation of any provision of this Act, or of any of the rules or regulations or standards promulgated by the Secretary under this Act, the Secretary may suspend the registration of that research facility for a period of not to exceed 30 days, and after notice and opportunity for a hearing, may suspend such registration for any additional period as the Secretary may determine appropriate. Upon a determination by the Secretary that such a violation has occurred the Secretary may continue such suspension or revoke the registration. (b) Penalties.--Any employee of a research facility that knowingly violates any provision of this Act shall, on conviction thereof, shall be fined not more than $10,000, or imprisoned not more than 3 years, or both. Such violation shall be referred by the Secretary to the United States Department of Justice for prosecution. SEC. 106. REGULATIONS. The Secretary may promulgate such regulations as the Secretary determines to be necessary to carry out this Act. ) TITLE II-CLASSIFIED RESEARCH SEC. 201. PROHIBITION. Notwithstanding any other provision of law, no Federal funds shall be the performance of his or her official duties under the Human Research Subject Protections Act of 1997, or because such person has carried out such duties, shall be fined not more than $10,000, or imprisoned not more than 3 years, or both. "(b) Use of Weapon.--Whoever in the commission of an act that is a violation of subsection (a), uses a deadly or dangerous weapon shall be fined not more than $25,000, or imprisoned not more than 10 years, or both. "(c) Homicide.--Whoever kills any human being while that human being is engaged in the performance of his or her official duties under the Human Research Subject Protections Act of 1997, or because such human being has carried out such duties, shall be fined or imprisoned as provided for under sections 1111 and 11 14.". SEC. 105. ENFORCEMENT. (a) Suspension of Registration.- If the Secretary has reason to believe that any research facility registered under section 103 has violated or is in violation of any provision of this Act, or of any of the rules or regulations or standards promulgated by the Secretary under this Act, the Secretary may suspend the registration of that research facility for a period of not to exceed 30 days, and after notice and opportunity for a hearing, may suspend such registration for any additional period as the Secretary may determine appropriate. Upon a determination by the Secretary that such a violation has occurred the Secretary may continue such suspension or revoke the registration. Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a tabbed divider. Given our digitization capabilities, we are sometimes unable to adequately scan such dividers. The title from the original document is indicated below. Human Subject Abuse Divider Title: 97 05/08 16:08 3014022071 NIH OPRR 002 SERVICES DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service ( National Institutes of Health Hand delivery or express mail: Office for Protection from Research Risks 6100 Executive Boulevard, MSC 7507 6100 Executive Boulevard, Suite 3B01 Rockville, Maryland 20892-7507 Rockville, Maryland 20852 Phone: 301-496-7005 ext. 205 FAX: 301-402-2071 April 10, 1997 me & James F. Childress, Ph.D. Chairman Mean all Human Subjects Subcommittee National Bioethics Advisory Commission 6100 Executive Boulevard, Suite 3C01 Rockville, MD 20892 Dear Dr. Childress: I am writing to respond to questions raised by some members of your Subcommittee regarding the nature and extent of human-subjects research taking place beyond the boundaries of existing protections. Subcommittee members have made repeated reference to human subjects involved in such activities as the "most vulnerable" of all human subjects. In my October 4, 1996 remarks to the National Bioethics Advisory Commission, I noted that human subjects involved in research outside the perimeter of the existing protections are protected only by occasional state or local law or regulation, or at the discretion of the individuals or institutions undertaking the research. In other words, I am referring to human subjects research that is: 1) not conducted or supported by any of 17 Federal Departments or Agencies that adhere to the Federal Policy for the Protection of Human Subjects; 2) not regulated by the Food and Drug Administration (FDA); and 3) not voluntarily pledged to the Department of Health and Human Services' regulations at 45 CFR Part 46. The Office for Protection from Research Risks (OPRR) receives a number of inquiries involving human subjects research over which it has no jurisdiction. Most are informal inquires received over the telephone and are never pursued by OPRR. Each year, however, OPRR is presented with several formal, written complaints that can be reviewed in sufficient depth to confirm OPRR's lack of jurisdiction. For example, parents of a young child who underwent experimental bone marrow transplantation alleged that they were not adequately informed about the procedure's reasonably foreseeable risks, including the severe brain damage which their child suffered. In a second example, it was alleged that women who had experienced multiple miscarriages were misled about 97 05/08 16:08 3014022071 NIH OPRR 1 003 - 2 - the substantial financial cost of participating in research to enhance pregnancy. A third example involved a mid-level state university, where there was a considerable controversy about appropriate confidentiality protections for subjects involved in a study of adult literacy, as well as charges of conflict of interest among members of the university's Institutional Review Board (IRB). In a fourth example, a woman who had been treated for breast cancer alleged that identifiable private information from her medical record had been placed in a registry and made available to research investigators without her consent. In each of these examples, OPRR was unable to pursue the allegations, because it was formally determined that the research was neither supported by the Federal government nor voluntarily covered under an institutional Assurance of Compliance submitted to OPRR OPRR also receives many less-formal inquires and complaints involving individuals or institutions for which OPRR's lack of oversight authority is readily apparent. For example, it is frequently alleged that patients have been subjected to "experimental" treatment procedures without appropriate informed consent and without IRB review. OPRR has received specific inquiries about the use of "experimental" techniques in gall bladder surgery; "experimental" psychotherapy techniques; and surgery research that was not subjected to IRB oversight, allegedly because the investigator generated a great deal of revenue for the hospital involved. Other examples involve breach of confidentiality in research. In one instance, it was alleged that confidential, identifiable responses of nurses involved in research about lapses in patient care were made available to the nurses' employers. In another instance, it was alleged that an investigator utilized sensitive, identifiable drug abuse treatment information for research without informed consent OF IRB review. In a third instance, it was alleged that several physicians provided a research investigator with confidential patient identity and medical record information without patient permission or IRB review. The use of deception in research has also generated inquiries to OPRR. For example, one complainant described "team management" research in which unsuspecting individuals were subjected to a sham robbery, resulting in significant stress, fear, and anxiety. Another complainant described "fright response" research in which participants were subjected to unexpected and disturbing visual stimuli. OPRR was also unable to pursue complaints alleging 1) a coercive structure of payment for participation in weight loss research which made it extremely unlikely that subjects would discontinue participation prior to completion of the research; 2) failure to characterize adequately the severity of reasonably foreseeable risks associated with a research comparison of two FDA- approved drugs; and 3) lack of parental consent and IRB review for survey research in which children were asked sensitive questions about their own behavior and that of their parents and friends. 97 05/08 16:09 3014022071 NIH OPRR 004 - 3 - From time to time, OPRR is also made aware of media reports describing questionable involvement of human subjects in research. A November 9, 1995 University news release describes private-foundation funding of a dentist's study of removal and replacement of mercury amalgam from the dental fillings of approximately 30 patients. On October 10, 1994, the New York Times reported that a Manhattan gynecologist had successfully induced abortions in 121 of 126 patients with two FDA-approved drugs in an attempt "to show the medical community that there is a safe, simple, effective, legal technique of terminating pregnancies that is private and inexpensive." In another New York Times story (August 15, 1994), grade schools in North Carolina are described as permitting industry-sponsored survey of the height of children, 80 that short children could be identified for referral for potential treatment with genetically engineered human growth hormone. On June 13, 1996, the San Diego Tribune reported that "four African- American children were singled out for a race-related survey" by a local graduate student without the permission of their parents or of the school system. The information contained in these 19 examples drawn from OPRR files may seem fragmentary. That is by necessity. With current authority, it is neither proper nor possible for OPRR to pursue these incidents and many other like incidents, and to fully describe and understand what is happening to the participants that are involved. 1 hope that the details provided herein will put to rest any uncertainty among Subcommittee members as to the existence of a substantial problem: That is, the unwitting participation--with attendant possibility for physical or dignitary harm-of some of our fellow Americans in research. OPRR's experience indicates that there exists in 1997 a substantial reservoir of such research activity. The Nation needs the tools necessary to insure that human subjects are protected by 1) initial and continuing IRB review, and 2) legally effective informed consent. As the Subcommittee proceeds with its consideration of protecting the rights and welfare of human subjects, please do not advance beyond what I would call Square One without articulating a meaningful standard of protection for all individuals who may be research subjects. Sincerely, HamB.Ellis Gary B. Ellis, Ph.D. Director Office for Protection from Research Risks