The Government is The Bridge Between Science and the Public

Sri Pinnamareddy

During my sophomore spring break, I had the opportunity to travel to a small town on the eastern side of the Dominican Republic, Hato Mayor. I only stayed a week there, but I stayed long enough to officially declare that peacocks were indeed the most annoying birds in existence. (Here is video evidence) No one told me that what was considered to be the world's most beautiful bird was the most dangerous and dreadful. There was also an ostrich right next to our room, but he was pretty chill. We fondly named him "Estaban."

While I suffered temporary insomnia with 20 peacocks screaming at 2 AM, I lie on the top bunk of a metal bunk-bed that could collapse at any time and had a lot of time to reflect on that day's experience. My thoughts ranged from ranking the birds based on their irritability to reflecting on the stories I heard. Now I usually leave the majority of anecdotes and stories to Michelle, but witnessing the conditions and speaking in my sub-par Spanish with the people of the DR, made me realize that there is a fundamental disconnect between the public and science.

Every day we would travel to a different part of town, the women's center, downtown, a few different schools, and some people's homes in rural villages. A part of our service trip was installing 14 water filters in various homes and schools. Before we installed the filter, we would ask the family members about their income, where they retrieve their water and the history of illness within their family. Almost every family responded that disease was common because the water from the nearest creek was often polluted, and bottled water costs 60% of the family's income. Then we would ask about how they would get their illness treated. The short answer is, "You can't." The nearest clinic is often miles away, and treatment is sometimes unaffordable. So the question is, "Are you willing to drink poisoned water when it is the only thing you can drink to survive?" This goes past water accessibility, however. When we spoke to Doctor Rainier Martinez from the Dominican Republic Health Administration, he told our group that the DR spends less than 1% of their government revenue on healthcare. One of the most prevalent diseases in the Dominican Republic is called helminthiasis (parasitic worm disease). Before, my team traveled to the Dominican Republic and began researching this disease. I have never heard of it before, and most likely, you haven't either. However, this isn't some estranged or niche disease; it affects around 1/6th of the world's population or 1.5 billion people. For a condition so prevalent, why haven't you or I ever heard of it? The more troubling fact is that treatments exist, they are effective, and not that costly. So why aren't they delivered to people who need them?

This is the paradox of science. As we advance in knowledge and research, we lag in implementation and application. Even in "modern" America, we often sacrifice accessibility and affordability of drugs for Big Pharma's pleas of "Innovation and R&D." Too often, we ignore the voices of the public and place our money in the mouths of the wealthy businessmen of these industries. Now, this isn't necessarily a bad thing; humanity thrives on curiosity and innovation. But throughout history, science has not been appropriately used to inform policy and business decisions that can save thousands or millions of lives. However, this is not just the role of the government, but also scientists, the public, and you. Science is complex. That is why scientific literacy and communication is low. In addition to all the social and political issues, governments should consider the scientific and ethical implications of their policies. Scientists need to consider the impact of their research on society actively, so scenarios like the CRISPR baby scandal are not repeated. The public must inform itself on how scientific research and policies affect them. Ultimately, communication is the bridge between science and the public.

My argument here is that when research exists, it is often left in the textbooks and academic papers because it is not "profitable" for the industry. That is when the government should step in. Perhaps, I do take a very "humanitarian" outlook on the applications of science. However, empirically, the public center intervention has worked. Take a look at the pharmaceutical industry for context. Currently, 30% of all pharmaceutical prescriptions in the US are "never filled," leading the government to lose $300 billion in avoidable Medicare healthcare costs (Viswanathan et al.). If this lost money is recovered through lower drug prices, the government could invest in publicly funded research institutions such as the National Institute of Health (NIH). The most innovative drugs come from public and academic institutions due to a lack of monetary incentives. Roughly 75% of so-called new molecular entities with priority rating (the most innovative drugs) trace their existence to NIH funding, while companies spend more on "me too" drugs (Mazzucato). However, public sector innovation leads to private sector innovation because of the "spillover effect." That is why the National Institutes of Health (NIH) concludes A $1.00 increase in public basic research stimulates an additional $8.38 of industry R&D investment after eight years. The warranting for this evidence relies on investors' willingness to support innovation only after the initial and more uncertain stage of drug development is overcome. When public sector basic research has been conducted, private companies are more confident in their drug development timeline than if a drug had to be developed from its basic molecules. Ultimately, government intervention in scientific research kills two birds with one stone: accessibility and innovation.

However, I would be wary of basing all national policies on scientific studies and discovery. As much as government intervention can fund scientific initiatives, make research more applicable to the public, and sustain the healthcare and pharma industries, basing policies on science is like basing policy on "the subjective happiness of civilians." This is because scientific justification is a "theory." Nothing in science is a hard-core fact, but instead has an immense amount of evidence supporting the hypothesis. This leads to variability in scientific "facts." At the same time, it would be foolish to trust cherry-picked or faulty studies. For example, the vaccines cause Autism movement originated when Andrew Wakefield and 12 co-authors claimed in their 1998 Fraudulent study to have investigated "a consecutive series" of 12 children with chronic enterocolitis and regressive developmental disorders. This one study sparked the mass controversy on vaccine regulations and caused select parents to refuse to vaccinate their children. This goes to show the moral role scientists have in the contribution to public knowledge. Publishing and publicizing faulty science can lead to dangerous precedents within society. Therefore, it is essential to place resources in encouraging peer-reviewed and sound scientific investigations. By acknowledging the variability of experimental results, we can promote more productive scientific discussion and its role in informing policy.

The government also has a vital role in enforcing laws about ethics and morality of scientific studies. With advancements in genetic engineering innovation, there is a thin tight-rope in which studies are net-beneficial of society at the cost of certain sacrifice. However, there is no universal doctrine or regulations on what experimental designs are permitted and ethical. Of course, there are Institutional Review Boards and Ethics Boards, but these vary based on institution and the specific policies. Having a more interdisciplinary government committee over-seeing such research as well as the way to plan and apply the research to the public in need can improve considerations of ethics and human impact.

Ultimately, I would argue that fostering this symbiotic relationship is important now more than ever. There has been evidence that if the government listened to epidemiologists earlier and implemented quarantine just a week ahead, thousands of lives could have been saved. We must use science to supplement policy decisions in sectors such as healthcare, environmentalism, pharmaceuticals because the current situation is very similar to the facade of peacocks. Our healthcare system may seem sustainable, beneficial, and pretty on the surface, but like the peacock, we wait until a pandemic screams in our faces to take action finally.