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2006 National Health Research Forum — Transcript

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National Press Club

MAY 21, 2006

MS. MARY WOOLLEY, RESEARCH!AMERICA: Good afternoon. Good afternoon,ladies and gentlemen. Good afternoon and welcome. My name is Mary Woolley. I’mthe president of Research!America.Research!America,as you know, is an alliance of over 500 organizations of all kinds who are committedto research, to putting research to work, in order that we have a healthiercitizenry, a healthier world, and a healthy economy. Our over 500 membersrepresent well over 125 million Americans who join us in a commitment to research.At this time every year as part of our commitment to research, we organize anational forum to provide our members with the opportunity to hear from some ofthe nation’s most distinguished leaders what they see as the current challengesfacing research in our nation. Right now in these early years of the 21stcentury, we are at a time where there are considerable tensions between scienceand society. And I believe that were going to be hearing today some verythoughtful and provocative observations about what to expect and about whateach of us can do to address and overcome those tensions, so that we truly canput research to work. Now, I want to thank … before we begin, I want to thankthe people that have made this forum possible. You can see on the screen behindme almost all of our sponsors of this year’s national forum. The AAASunfortunately is not listed there, the American Association for the Advancementof Science. But it should be. And we thank the AAAS as well as otherlong-standing sponsors, Pfizer, Abbott, United Health Foundation and Infocast. Andthis year a special thanks to two new sponsors, to organizations we’re workingwith in new ways this year and going forward, NEMA, the National ElectricalManufacturers Association, and The Hill, the Washington-based publication availablein print and on the web. Thank you all. And my thanks to the Research!America boardmembers, an absolutely outstanding group of people who give freely of theirtime and a lot of it in the interest of serving our mission. And finally to ourwonderful staff, all of my colleagues at Research!America. Thank you all. [applause] Nowit is my pleasure this afternoon to introduce our keynote speaker, thepresident of the National Academy of Sciences, Dr.Ralph Cicerone. Dr. Cicerone is an atmospheric scientist who has helped shapescience policy at the highest levels. His research and policy leadership havebeen recognized on the citation for the 1955 Nobel Prize … ’95, excuse me,Ralph … 1995 Nobel Prize in Chemistry. With the Franklin Institute 1999 BowerAward and Prize for Achievement in Science, the American Geophysical Union 2002Roger Revelle Medal, and the World Cultural Council 2004 Albert Einstein WorldAward in Science. Before Dr. Cicerone was elected this past year as Academy President,he was a Chancellor of the University of Californiain Irvine. Weare delighted to welcome him today. Ralph. [applause] DR. RALPH CICERONE,NATIONAL ACADEMY OF SCIENCES: Thank you, Mary. I will speak about a report thatwe issued a few months ago that Mary and John Porter requested. But before doingthat, thinking about the theme of the annual meeting this year for Research!America, “Scienceand Health in the 21st Century-Leadership Requirements and Public Expectations,”it caused me to think back to the 20th century when most of us grew up. And onefact that stands out that most of you are very well aware of is that in the UnitedStates, life expectancy increased from something like 46 years at the beginningof the century to about 77 years at the end of the century. That is obviouslyvery dramatic. It’s as if every year that a person lived in that century, he orshe could count on an extra four months of life expectancy than what was expectedat the beginning of that year. That is incredibly dramatic. How did it happen?Well, we probably all have our favorite explanations. But I think certainly thecauses include antibiotics, immunizations, water treatment and water quality,the segregation and handling of waste, advancements in nutrition,refrigeration. In a word, nearly all of the explanations stem from science andtechnology, medicine and education in general. So as we look into the 21stcentury and ask what kind of leadership requirements we have and what thepublic will expect, I’m not sure how to match those two. But I think theleadership requirements are fairly clear. So the subject that I’m going to talkabout now is … I’m going to start a couple of slides. I have seven or eightslides which I hope will be visible. This is the cover page of a recent report[Rising Above the Gathering Storm] that the National Academy of Sciences, the NationalAcademy of Engineering and the Institute of Medicine worked on jointly. Thereport was requested in May or June of 2005 by Senator Lamar Alexander andSenator Jeff Bingaman together with endorsements from Congressman Boehlert andBart Gordon. They asked a series of questions. But the dominant question waswhat actions can and should the federal program undertake to assure prosperity,to enhance the scientific and technological basis of prosperity and security inthe 21st century? So the emphasis was on federal actions. And like we always do,we put together a committee last summer. And, of course, this speaks right tothe issue of leadership. The committee consisted of twenty people. You’llrecognize some of the names being leaders of universities, several corporateCEOs, Craig Barrett, the current chair of Intel, Gail Cassell from Eli Lillyand so forth, up and down the list, three Nobel Prize winners, one in medicine,two in physics, some educators and other very experienced people. People whohad already participated in similar studies of how the United Statescan improve its science and technology base for the future and what the countryneeds. And led very ably by Norman Augustine who’s had an amazing career inprivate industry as well as government. The committee decided to organize itsresponse to that set of questions along the lines of two key challenges. One wasprosperity means opportunities for employment to maintain a standard of living.So what does it require to create high quality jobs for Americans? And thensecondly, somehow to respond to the nation’s need for energy, clean, affordableand reliable energy supplies. So they tried to put this all together. Theyworked over the latter part of the summer and early fall by listening to otherexperts, by looking at as much data as they could find and by trying to discernwhat trends there were. And I think it’s fair to say that there was no singlepiece of data that was compelling, but probably 30 or 40 different trends that attractedtheir attention and led them to the recommendations which came in four majorcategories. Senator Alexander and Senator Bingaman asked for ten actions. Thecommittee produced twenty. They were in four different categories. And thefirst one . . . I’m just going to give you a sample of each of the four. Thefirst one and the highest priority identified by this group of Americans wasK-12 science and math education above all else. This is a recommendation invarious forms that many individuals and groups have made over the years. Infact, I think there’s very little new in this report. Almost everything thatwas suggested has been suggested before. Nearly every action that was suggestedhas been in fact implemented somewhere before. And there is a working model.The particular focus on K-12 education was to try to create, nurture andenhance teachers who are expert in subject matter that they teach. Now, I justmoved here from Californiaand the last time I looked, two-thirds of the high school teachers of biologyin Californiaare not biologists. They’re phys ed teachers who are being asked to teachbiology. In the physical sciences and mathematics, grades five through nine inthe United States,over 90 percent of the teachers have no certification or degree in the math or sciencesthat they’re teaching, in the physical sciences. Well, the assumption of thisgroup and the experience in the programs they had worked with, Roy Vagelosthrough Merck and Norman Augustine through Lockheed and other people, GailCassell through Lilly, some of the educational programs they’ve supported overthe years have been based on teachers who not only are enthusiastic about theirsubjects, but who have a firm grounding in them. So the particular set ofrecommendations was to create and help more teachers who have a subject mattergrounding in their fields. The second general category was federal support forresearch. The first one is something that Research!America took on, on behalf ofBiomedical Research many years ago. And through all of you working together overmany years, you were able eventually to essentially double the NIH budget. Mr.Porter and Mr. Rogers sitting here had a great deal to do with that. The topbullet here is to somehow increase federal investment and long-term basicresearch with special focus on physical sciences, engineering, mathematics,information sciences. And the way this is playing out, it’s primarily at theNational Science Foundation, the Department of Energy and the NationalInstitutes for Standards and Technology, NIST. There are a few otherrecommendations of the same kind. The third category was to greatly increasethe flow through educational opportunities for undergraduates and graduate studentsin the sciences and mathematics. And to try to maintain the attractiveness ofthe United Statesfor foreign students in the same subjects with a lot of important details herethat I won’t go into. And then finally, to try to reinvigorate the national commitmenttowards creativity and innovation in the entire climate for entrepreneurship,through research opportunities for students at universities all the way throughintellectual property protection and modernizing and standardizing our patentsystem to providing broad band access and so forth. So this is the flavor ofthe recommendations. There were, as I say, twenty all together. And what’s beenunusual is that I think all of us agree for various reasons in the last severalmonths, there has been a remarkable groundswell of positive reaction to thisreport and to the reports of several other groups and to a number of proposals.For example, there are a number of pieces of legislation now pending to take onsome of these actions recommended for the federal government. The first onethat I list here in the Senate sponsored by two Republicans and two Democratswhose names you see, Alexander, Domenici, Bingaman and Mikulski, plus about 65other co-sponsors now equally split amongst Republicans and Democrats entitled “ProtectingAmerica’sCompetitive Edge.” This legislation tries to implement each of the 20 recommendationsin the report that I just summarized, each and every one of them, through aseries of bills that are integrated. And along with this, Senator Baucus has focusedon one of the particular recommendations to create this new innovative agencyinside the Department of Energy focused on energy, research and technology. Anational innovation initiative which is closely related, coming from verydifferent recommendations, of course. And then, of course, the President’sState of the Union message and activity in the Senate to implement those particularrecommendations which are all along the same lines. In the House, there’s avery long list. I just show a few here in particular to implement the American competitivenessinitiative that the President announced sponsored by Congressmen Wolf andBoehlert. The bottom line there is (the) Mathematics and Science Teaching Core Actof 2006 which is sponsored by Congressman Saxton and Senator Schumer, largelyat the behest of some people who have been supporting mathematics education inthe State of New Yorkfor some years. A mathematician who’s also a very successful investor with recommendationsthat strongly overlap those of this Gathering Storm report to create andmaintain and reward a new generation of teachers who will be highly educated inthe mathematics that they’re teaching and so forth. So there is some hope. Andyet, the task is enormous. The annual price tag of the 20 recommendations thatour group concluded were the right mix of actions, the annual price tag wasabout $10 billion a year. Not for one year, not for two years, but for a lot ofyears. In fact, as the physical sciences and engineering side of the federalbudget would increase by ten percent per year, obviously, the annual incrementwould even have to grow a little bit. But the good news there has been a verystrong bipartisan response with I must say an inspiring commitment to get thedetails right, to try to find out what model is the recommendation based on.What has happened in the city of Dallaswhere some of these things have been tried or in the New York area or wherever, the Philadelphiaarea? What is the record of each of these recommendations? Who has opposed therecommendations? Why are they opposed? There’s been a great behind the sceneseffort to understand the assumptions and the recommendations and what would be requirednot only to implement them the first time, but to keep them going. So I’moptimistic. And yet, judging from the experience that many of you had indoubling the NIH budget and all the good that’s come from that, I think we haveto dig in for the long term. Because the country really has to be reminded ofthe opportunities that science and technology and medical research have tooffer. We somehow take things much too much for granted. And as all of youknow, we have to continually remind people of the opportunities and of thealternatives facing a world where there is no competition where we’ve beenvery, very successful in dominating many, many fields of research and inventionand commercialization. So a lot of people have become complacent. And the worldwe’re facing now has much, much more competition. We hope it will be healthy toeveryone’s benefit. But our first job is to be able to compete. And that Ithink is the bottom line of this particular report. So I’ll stop there, Mary.And I look forward to the discussions of the remainder of the afternoon. Andthank you for the opportunity. This is a group I feel very comfortable with. Thinkingabout the increase in life expectancy of the 20th century, all of you knewthat. And all of you know the basic reasons there are so many groups in theUnited States who take it all for granted, didn’t know it, didn’t know thereasons, don’t know how much commitment it takes, the role of leaders and therole of leaders shaping public opinion and showing them options the way youpeople do. So I’m very comfortable being here. And I hope that we can do a lotof good things together in the short time that I’ll be here. Six years. Thankyou, Mary. [applause] MS. MARY WOOLLEY: Okay. We’re going to take just a shortbreak in order that the panelists of the next piece of the forum will have achance to come up and get situated and get our electronics ready. So if you’dlike to get a cup of coffee or just stand up for a minute or two, we’ll callyou back in order in a few minutes. Thank you. [BREAK] MR. BILL LEINWEBER,RESEARCH!AMERICA:It’s my pleasure and honor this afternoon to introduce to you the chairman of Research!America, thechair of our board of directors, someone that is familiar to most of us in thisroom because of his long distinguished career as one of the nation’s mostoutstanding advocates for medical and health research during his 21 years inthe U.S. House of Representatives as chair of a subcommittee that wasparticularly important and remains particularly important to all of us, thatbeing the Appropriations Subcommittee for Labor, Health, Human Services andEducation. And really a leader and champion during those years in making thedoubling of the budget of the National Institutes of Health a reality. Butbeyond that, a champion for all research. John Porter, as chair of Research!America,currently a partner in the law firm here in Washington of Hogan & Hartson.It’s my pleasure and please join me in welcoming John. Thank you. [applause] MR.JOHN EDWARD PORTER, CHAIR, RESEARCH!AMERICA: Okay, Bill. I’m going totake you everywhere I go. Thank you for that very, very kind introduction. Iwant to join Mary and Bill in thanking you for joining us in our nationalforum. We also want to thank Ralph Cicerone for his very excellent keynoteremarks. At our annual meeting this morning, I noted that in these verychallenging and promising times for our nation’s research enterprise, it iscritical that as a community of advocates we work together and commit to takingaction and conveying messages to the public, to opinion leaders, to decisionmakers in the media that demonstrate the life saving and economic value ofresearch in our country. We have this afternoon convened an exceptionally distinguishedpanel of leaders to share their thoughts and insights with us. And I’mconfident the panel conversation will further provide motivation for all of ourcollective efforts. It is my pleasure to introduce our moderator for thisafternoon’s panel discussion. It is only fitting that a panel of the caliber ofthose with us today would be guided in conversation by one of the nation’sforemost commentators, David Gergen. For 30 years, David Gergen has been anactive participant in American national life. He served as Director of Communicationsfor President Reagan and held positions in the administrations of PresidentsFord and Nixon. In 1993, he put our country before politics when he agreed tofirst serve as counselor to President Clinton on foreign policy and domesticaffairs and then as special international adviser to the President and toSecretary of State Warren Christopher. David currently serves asEditor-at-Large at U.S.News & World Report. He is Professor of Public Service and the Director ofthe Center for Public Leadership at the John F. KennedySchool of Government at Harvard University. He is a frequent lectureraround the world and frequently serves as an analyst on various news programs.In the fall of 2000, he published a book titled, Eyewitness to Power: the Essenceof Leadership Nixon to Clinton.David is active on many nonprofit boards and is Chairman of the National SelectionCommittee for the Ford Foundation’s program on innovations in Americangovernment. A native of Durham, North Carolina, David is anhonors graduate of Yale University and of the Harvard Law School. He served forthree and a half years in the United States Navy. And David and his wife Annhave been married since 1967 and are the parents of two adult children,Christopher and Catherine. If you want someone who is thoughtful, if you wantsomeone who is caring about this country and its directions, if you wantsomeone who is careful to get it right and if you want someone who is engagedand right at the forefront of all the policy that’s made in America, you wantDavid Gergen. And very frankly, I wish he were in the White House right now.David. [applause] MR. DAVID GERGEN, U.S. NEWS & WORLD REPORT: Goodafternoon. I’m privileged to be here. And thank you for this opportunity. It’sa stellar panel. I’m looking forward to this conversation as I know many of youare. I know we are in the National Press Club here in Washington. And so perhaps it is fittingthat you ask someone with a background in journalism to be your moderator, butI want you to be on notice. You know, journalists, those of us are quick to seepatterns in things. We’re always looking. We look for two or three bits ofevidence. And we immediately spot a pattern and reach fairly large conclusions.I’m reminded of a journalist who woke up one day on the fifth day of May …May being the fifth month of the year … caught bus number 55 to work, noticedthat he arrived five minutes late to work, went up to his office on the fifthfloor and said, ah-hah. There’s a pattern here. And off he zoomed to theracetrack and put down his entire life savings on the fifth horse in the fifthrace. And sure enough, his horse came in fifth. So it’s good to be in thecompany of scientists who think, you know, who are much more careful with theirwork and speak from a more profound place. And I think all of us are lookingforward to their comments. Whether you’re a journalist or a citizen or aconcerned parent, it is perfectly obvious, I think, or increasingly obvious tomost of the American people, that we have a number of storms gathering off ourcoast. That in the environment there is increasingly the question amongscientists not whether we have global warning, but indeed when it may become irreversible.We all look at the latest information from Greenland.We look at the question of the nation’s finances and the imbalances. Andeconomists tell us you cannot continue indefinitely with these imbalances.There will be a slide at some point. The question is whether there will be a softor a hard landing. We look at the question of obesity in the country and peoplewho’ve looked at this have wondered whether in fact given the obesity rates andwhat’s happening with children who are being born today, whether the nextgeneration conceivably could have shorter lifespans than the currentgeneration. The kind of storms that are out there, one can see and worry aboutwhether we’re preparing ourselves adequately, whether a category four orcategory five hits us, whether we’re going to be washed under. But of all thestorms … and I think the one that is now front and center on the minds of theAmerican people is what they sense maybe happening to us with the rising tideof competition that’s coming from a number of countries especially in Asia. And whether we in fact are going to be able tomaintain our lead in science and technology, engineering and math in ways thatprepare us adequately for the future and protect American jobs and the standardof living in this country. Increasingly as I go around the country and talk topeople who are the CEOs of major corporations like Intel or Microsoft or talkto the presidents of universities like MIT and Harvard and Duke and others,what I hear is the same pattern of reflection and a growing concern about our capacityto deal with these issues. I don’t want to put too bleak a face on this. ButAndy Grove, who is an iconic figure in Silicon Valleywho co-founded Intel, a wonderful CEO there, did write a book saying … withthe title Only the Paranoid Survive. And I think it accounts for some of thesuccess of Intel under his leadership. But he’s teaching a course at Stanfordthese days. And he’s told me he thinks that the report by the National Academiesis too optimistic. What you’ve heard from Ralph Cicerone today is even moreoptimistic than he believes the future holds. And he’s been working on thiswith his graduate students at Stanford. And they have made calculations thatunless we change course in a serious significant way with regard to science,technology, engineering and math … and science is spoken of here in a broadlyframed, including the biological sciences . . . that unless we become moreserious about these challenges, that he believes we will see an erosion, anerosion in the living standards of our children, if not our children certainlyour grandchildren, in the range of 40 percent. An erosion in living standardsin the range of 40 percent. Now, those are very bleak numbers. I’ve never seenany other numbers which come anywhere close. But if we’re just 30 percent,we’re in trouble in a variety of social ways. And the coherence and thestability of our society will be challenged. And there will be an enormousnumber of people, especially at the lower end, who get hurt in that environment.So this is the issue that we’re all grappling with. And everyone from thechancellor of the schools of New York,Joel Klein, to the people who are running large corporations, like CraigBarrett, are really worried about this issue. And so this is a particularlytimely panel. The science community has begun to speak up. The people up on theHill began to speak up. The President then embraced this in his State of theUnion address. And yet, we find ourselves today with a feeling maybe this isn’tgaining the traction that it deserves. Maybe we’re not paying it serious enoughattention to this yet. Is the Congress really listening? Is the nation reallycoming together? It feels nothing like the post Sputnik era when there was agreat sense of rallying in the country. It doesn’t feel that way yet. Thequestion is what’s the nature of the problem? And how do we build momentum forsuccess? Those are the big issues that hang over this panel today and that Ithink we have with us people who are authorities on this issue, have thought a lotabout it. And I think there could be no better panel. And I congratulateResearch!Americafor bringing together this kind of talent. I think it’s really a tribute to thequality of Research!Americathat it could assemble this panel and that we could have this experience todayto listen to these good folks. I’m going to get out of the way. I’m going topose a question and we’ll just start. If I might, we’ll start on my far left,your right. And just ask the panel first of all to frame the issue as they seeit. And then I’d like to come back to the question of how do we achievesuccess? But I think we need a little more framing. Dr. Cicerone has helped usset this up. And he will speak. Because he’s on the other end, he can have achance to reflect on some of the remarks that are made. But if each of you couldreflect briefly on this. And let me start on the far left. And I want to makesure … it’s Elias, is it not? Yes, Elias Zerhouni, who is, as you know, heads… leads the nation’s medical research agency. He oversees the NIH- 27institutes and centers, more than 17,000 employees. A man who has said recentlythat he wants to start a campaign to educate the American people about what theinvestments of NIH have brought to the country already. So people understandwhy it’s vital that the funding continue to be robust. Dr. Zerhouni. DR. ELIASZERHOUNI, NATIONAL INSTITUTES OF HEALTH: Well, thank you. I think the questionyou’ve posed is probably the core question in terms of long-term strategicimperatives for us. And when you look at our field of interest and that isbiomedical research, and you look at the growth of health care expenditures inmodern economies. And you realize that in the next ten years our health care expenditureswill double to 20-22 percent of GDP. And you’re looking at a need for us tocompletely transform the way we practice medicine. Because if we practice itthe way we know it today 20 years from now, the game will be lost. We have totransform that. We can’t transform that without a scientific workforce that iscompletely able to interact across disciplines. There is no progress possibleright now without interdisciplinary collaboration between physical sciences andbiological sciences. There’s no such thing as basic science, fundamentalscience, biological science. There’s good science and there’s bad science. America has tobe the producer of good science. And you can’t do this unless you becomeparanoid as you mentioned by the next generation of scientists coming up. Andif they don’t have quantitative training and they don’t have a mastery as wedid in the Sputnik era of the complexity of biology today, we at NIH will lose.So I’m completely on board in the sense of making sure that the nation doesn’tlose its momentum and doesn’t lose the sense that an NIH investment is aninvestment. It’s not a cost. It is the fundamental investment. Because at the endof the day, how are you going to transform society or the city or our abilityto control the societal events without new discoveries? I don’t know how youwould do it. MR. DAVID GERGEN: Let me press you on an issue that arises periodicallynow in the press about this. And that is, well, NIH has had its big boom inspending. It doubled in spending in I don’t know how many years, a fairly shortperiod of time. We’ve been investing heavily. Now it’s a time for the physicalsciences. And some have interpreted the National Academy’sreport to be mostly about the physical sciences. If you look at it, if you readwhat it actually says, it talks about the importance of the biological sciencesas well and that they’re inter-dependent. Could you address that particularissue of why the biological sciences need this? DR. ELIAS ZERHOUNI: That’s avery good point. I was talking to Norm Augustine at the time of the generationof the report and the committee that generated the report clearly stated intheir front page that what you need is a balanced policy where you have wholefields of investigations balanced together. Because the synergy that you havebetween a physicist working with a computational biologist and working with atumor biologist, a cancer biologist, is greater than the sum of the parts. Soit’s clear that you can’t rob Peter to pay Paul. What you have to do is maintainthe momentum across a wide front. And that’s what I think if the message thatI’ve heard from Norm . . . I mean, Dr. Augustine . . . in the report that Iheard. MR. DAVID GERGEN: I want to come back at some point and talk aboutwhether the Congress has heard that message as well. Myrl Weinberg, ISPresident of the National Health Council- that’s an umbrella organization whosemembers are national organizations committed to quality health care. Its core constituencyis about 50 of the leading voluntary health agencies representing approximately100 million people with chronic diseases and/or disabilities. Your viewsplease. MS. MYRL WEINBERG, NATIONAL HEALTH COUNCIL: Well, I think that what weall know is that the power of the people could be greater. And so what werepresent are about 100 million people with chronic disease disabilities andtheir families. I think that one of the pieces that we are missing are theright messages for the right audiences. And I know that Research!America, theNational Health Council, Dr. Zerhouni, we are all attempting to come up withmessages that will help people in the United States understand the complexitiesof these issues, the interrelationships and why we need to have a patient consumermovement in the United States to make sure that many of these recommendationsin fact occur. So I think having the right messages, taking into account … wetalk a lot about health literacy, targeting your messages to the rightaudiences at the right reading level with the right culture and language, wehave a big challenge in the United States to get these messages out, so thatpeople understand them and therefore can take appropriate action. MR. DAVIDGERGEN: Let me come back to this. I want to help, if you can, focus in on whythe question of disabilities and the issues that you’re concerned with fit intothis issue of we’ve got to do something about science. We’ve got to takescience more seriously. Can you focus that or sharpen that a bit more? MS. MYRLWEINBERG: Absolutely. I think the most important thing to our constituencies isscience and medical research. That’s where the treatments, the improvements in thequality of their lives, the cures will come from. It will come from research atthe National Institutes of Health. It will come from programs that are run by theCenter for Disease Control and so on. So they look to the research and sciencecommunities for the answers to make their lives better, healthier and longer. MR.DAVID GERGEN: And what about our competitive position? Does that affect ourcompetitive position? The chronic disease issue. How does it relate tocompetitiveness? MS. MYRL WEINBERG: Well, I think that it relates in many ways.Clearly, if our population is less healthy over time, then we have fewer peopleto engage in the number of occupations that we need, the experts that Dr.Zerhouni spoke about. In the meantime, our whole population, which I thinkcould happen, with other things that are going on with our federal and stateprograms, then we will just have fewer and fewer people potentially that enterinto the professions that actually will make us competitive. MR. DAVID GERGEN:Okay. Thank you very much. John Leonard. Dr. Leonard is the Vice President forGlobal Medical and Scientific Affairs at Abbott. He joined Abbott in 1992 as headof the antiviral venture in the pharmaceutical products division. Dr. Leonard,your view from Abbott. DR. JOHN LEONARD, ABBOTT: I work in a corporation, asyou just said. And the life blood of our ability to carry out R&D comesfrom the scientists that work in our corporation. Our corporation is based inthe United States.But our scientists are based all around the world. And we look for scientistswherever we can find them. I think that it’s important to understand that inthe final analysis, corporations are ultimately stateless. And even though we havemuch of our R&D taking place here in the United States, it’s entirelypossible to imagine a future where the bulk of that work takes place offshore,carried out by foreign-born scientists. We can still call them an Americancorporation. But we can have much of that work being done elsewhere. MR. DAVIDGERGEN: Can you talk about the relative cost of science here versus …scientists here versus overseas these days, Say in Chinaor Mexico?DR. JOHN LEONARD: Well, from a purely labor point of view, there is vastdifferences. I mean, it’s no secret that people working in India or China can work for a fraction of whatsimilarly skilled people will do here in the United States. The way we approachthat … and I think the way that many people in our industry approach it is tohave the very, very technically advanced work done predominately here in the United States.And the more repetitive type things potentially considered for work being doneoffshore. MR. DAVID GERGEN: How much of your R&D operation have you moved offshore?DR. JOHN LEONARD: We haven’t moved it offshore. Most of our work is done herein the United Stateswe’re proud to say. I’ll just make the point that it is a global environment. Weare a global corporation. And as we go and look to the future and look forwhere we will build plants and where we will source our scientists, the rangeof choices that’s now available to us is vastly greater than it was a decade ortwo decades ago. MR. DAVID GERGEN: Would you also address … people tend to thinkof this mostly as, well, we’ve got to do far more training in K-12. And we’vegot to change the universities. But in fact, there is a corporate environmentthat can encourage companies to invest here versus overseas. Could you addressthat for us? The tax environment, the regulatory environment, the other issues whichgo to … the National Council’s report addressed that. DR. JOHN LEONARD: It’sa key point. And I thought some of the points that were brought up in thatreport were very insightful. It’s not enough just to have the scientists. Thescientists have to work somewhere. They work in an environment that is definedby their coworkers, by the universities that surround them, the resources theyhave, the investment environment, et cetera. I think that we can look elsewherein the world and look for success … examples such as Ireland, avirtual backwater from an R&D perspective 20 years ago who’s a leadinglight now. It’s no secret that Singapore’shad similar success. And we see it now happening in Chinaand India.I think we should learn from those success stories and make sure that not justthe scientists but all of the other elements that have contributed to thesuccess are things that we consider here. MR. DAVID GERGEN: It’s interesting.The Irish story in some ways shows how quickly things can change in acompetitive environment. I mean, to think where they’ve come from to be theleading … to have the highest standard of living in Europein just like that. And you can see how quickly Japan went down. I mean, that’s whypeople think this could be … you could be on a knife edge much more easily thanyou think and go down very quickly. Or somebody else could rise very quickly. Iwas looking for the numbers in the report that you brought out. There was onestatistic which I thought was quite interesting on the question of hiringoverseas. A company can hire nine factory workers in Mexico for the cost of one in America. Acompany can hire eight young professional engineers in India for thecost of one in America.That’s the relative challenge. All right. Let’s move on now if we could toCarolyn Clancy who is the Director of the Agency for Healthcare Research andQuality. It’s the lead federal agency charged with improving the quality,safety, efficiency and effectiveness of health care for all Americans. CarolynClancy. DR. CAROLYN CLANCY, AGENCY FOR HEALTHCARE RESEARCH AND QUALITY: Thankyou and good afternoon. So I come at the questions, the broad questions, thatyou are asking from the perspective of noting that too often our health caresystem fails to deliver the benefit of science to patients who can benefit.I’ve been incredibly excited by the discoveries and the potential foradditional discoveries that I hear about from Dr. Zerhouni and many others. Butdiscovery alone if we don’t also in tandem fix the delivery system is unlikelyto solve all of our problems. So the competitiveness issue that’s top of mindfor me is what health care is costing us today. Which means that it’s often farless expensive for employers to locate elsewhere. So it’s sort of downstreamimpact of our failure to reap the benefits from the science and the discoveriesthat we have made already. As I look into the future, it seems incredibly clearto me that we need much stronger bridges between discovery and the applicationof that discovery in a way that we can only begin to imagine now. I thinkadvances in informatics, just as they’re affecting physical and biologicalsciences, are also going to have a profound impact on the delivery of whatwe’ve learned from science to benefit patients. So the last point I would makeis it’s very hard to anticipate the shape of the future. And my guess is that wenot only need to be worried about the pipeline of scientists, but also that wehave the capacity to train them as science changes to keep up with thosechanges. I’m sure a lot of senior scientists now funded by NIH now find thatthey need new skills, or that they need to hire people with those new skills,because of the rapid changes that we’re seeing in science. MR. DAVID GERGEN:It’s useful to think about … health care, what is it now? Sixteen percent ofGDP? And rising. And some people believe that trends are not … if we don’t reformhealth care, it’s going to hit 25 percent. As a major CEO told me the otherday, they see that as a tax. That’s a tax that goes directly to their bottomline. And their issue is if you get those taxes too high, again, they face thequestion why shouldn’t we go overseas to avoid the taxation? So there is aparallel question of how we reform the health care system in conjunction withensuring we invest in R&D and ensuring we invest in science. DR. CAROLYNCLANCY: Absolutely. And, I mean, just to put a parallel number on it, over thepast forty years or so, the economist Uwe Reinhart has estimated that we havepretty much an annual eight percent increase. Some years, it’s a little higher.Some years, it’s a little lower. But eight percent pretty much does it everysingle year. And employers and their employees are feeling that in a big way rightnow. Last year, we reported in our annual on health care quality for the nationthat quality improved overall 2.8 percent. Now, I’ll celebrate any movementforward, but … MR. DAVID GERGEN: Quality improved 2.8 and prices went up? DR.CAROLYN CLANCY: About eight [percent]. Just as general benchmarks. MR. DAVIDGERGEN: Thank you. Declan Doogan. I want to make sure I’ve got that pronouncedright. I hope I do. Okay. Thank you. Dr. Doogan is the Senior Vice President,head of Worldwide Development at Pfizer. Another corporate representative here,but it’s critical players from the corporate world at this table to talk aboutthese issues. Dr. Doogan. DR. DECLAN DOOGAN, PFIZER: So I understand from Dr.Cicerone’s report and also from the introductory comments, sort of the size andnature of the problem about the competitive advantage or otherwise that America has inthe world today and the encroaching competition, particularly from Asia. I think at this point, we truly do have acompetitive advantage. And that is in the area of knowledge creation. I thinkthe knowledge creation is exquisite in this country and will continue to be so.But we have to look at collaborations between scientists, between otherproviders of health care, educators, et cetera, to create those alliances whichwill take us to a new place, a new place which frankly our competitors in lesserdeveloped countries do not enjoy at this point in time. And we should use thenotion of their gaining on us to galvanize us into doing some pretty importantthings. Dr. Zerhouni talked about this before. And I think it’s about despitehaving an appetite for more medicines, more technological advance, I’d like tothink that it’s the hunger to succeed and it’s the hunger that’s missing. It’sthe idea that we were great and we’re still great, but are we? What does ittake to be great again? And if there was some humility around what we do andthe recognition we could improve greatly, it would have a wonderful effect onthe society. Now, that sounds very philosophical. But to our own organization,we see ourselves as a global organization just like Dr. Leonard said. We areproviders of pharmaceutical solutions as part of the health care answer. Andit’s our job to go to the best places where knowledge is created. And we’ll go anywherefor that. We’re quite unashamed about that. But we want to bring all of thoseproviders together to create future health care solutions for America and forthe world. MR. DAVID GERGEN: The Scots have always been known as people who arevery careful with their pennies, right? DR. DECLAN DOOGAN: You could say that. MR.DAVID GERGEN: With good reason. I wanted to ask you, Dr. Doogan, if I might,about the issue of immigration and whether the technology companies are veryworried about the H1B visas, lifting the cap on H1B visas because they’re not getting… but that question is caught up in the immigration and border control issueup in Congress. Is it as much an issue for the pharmaceutical companies as itis for the technology companies? Whether you in fact can have the flow intoyour workforce here in this country? DR. DECLAN DOOGAN: Well, it’s difficult toask somebody who’s just recently acquired a green card. But what I will say isthat Pfizer corporately has enjoyed the fruits of other countries’ education.And we have a large number of foreign workers working within the shores of America. But thatdoesn’t matter as much as the fact that we have access globally to the talent.And technology has a huge impact on that. We are [a] knowledge-creatingbusiness. And so knowledge we can garner via the technology from all sectors ofthe planet now. But necessarily, we have to have the right people co-located.And it’s the co-location factor that preys on our mind a number of times. Whatis the critical mass of people you have to gather to create that creative sparkto make these new intuitive leaps? MR. DAVID GERGEN: How much of your R&Doperation was overseas say 20 years ago versus today? DR. DECLAN DOOGAN: If youthink about overseas, if you’re thinking outside of the U.S., we haveinvested substantially both in the U.S. and in other parts of the world.Their second largest research enterprise is in the U.K. It’s our Europeanheadquarters. And I would say that Pfizer has benefited mightily from theoutput of those laboratories over the past 10 to 15 years. But it has gone tothe greater corporate good. Yes, we have created employment. We have createdemployment in Europe. We’ve created employmentaround the world. But we’ve also succeeded in creating large numbers of jobopportunities within the U.S.as well. MR. DAVID GERGEN: And your market itself, are you finding that …where is the growth, the biggest growth areas? Where are the biggest growthareas for your company? DR. DECLAN DOOGAN: Well, recently from a very low base,we’re finding Asia is a substantial marketopportunity for us. It is a growing middle class within the Asian region that matters.We see and many other companies see that as a huge potential opportunity forthe future. MR. DAVID GERGEN: Thank you, sir. I’ve been honored in the lastcouple of years to work with Dr. Julie Gerberding who became in 2002 theDirector of the Centers for Disease Control. She has many, manyresponsibilities, including thinking through what threat that might present tothe country. I think many of you have seen her on television in recent weeks onthat subject. She joins us now from Atlanta.Dr. Gerberding, thank you very much for coming. DR. JULIE GERBERDING, CENTERSFOR DISEASE CONTROL AND PREVENTION: Thank you. You know, from where we sit atCDC in the public health system, we have a lot of different scientificdisciplines that we use to protect people’s health. But we do stand strong onone dimension and that really is the importance of prevention as the best investmentthat we can make. And as a society, we’ve made a very strong spiritualcommitment to health protection, to health promotion and prevention and, morerecently, preparedness. But I think we’ve really failed to shore up thatspiritual commitment with the true scientific and societal investments we needto really make a difference. And we’re paying a price for it. When I lookaround the globe today, I see the urgent threats that are in the news, theinfluenza and the SARS and the terrorism threats. But I also see the urgentrealities. And, you know, today in America, 4,100 people will bediagnosed with diabetes related to their obesity. More than 300 people willstart dialysis for end-stage renal disease today, 230 people will have a legamputated and 55 people will go blind. That’s an urgent reality. And we justsimply can’t sustain this lack of investment in effective prevention sciences. ButI also wanted to pick up on a point that came to my mind when you were speakingabout the importance of building the science of connectivity. Because thisisn’t something that one agency or one discipline or even one country can do.We really do have to learn how to connect. And the science of connectivity interms of communication or informatics or the other kinds of systems approachesto problems solving really are essential if we’re going to make that kind ofdifference. MR. DAVID GERGEN: All right. Dr. Gerberding, let me ask you thisquestion. There’s an urgency in the National Academy’s report about reallyinvesting more heavily at the federal level in the sciences, across the board.This may be awkward for you to address. But the fact is I believe the most recentbudget has a cut in funding for CDC. Is that correct? DR. JULIE GERBERDING:That is correct. MR. DAVID GERGEN: And how are you all going to grapple with that?How does that fit into this mosaic? DR. JULIE GERBERDING: Well, obviously itcreates a challenge. And we do what every family does when their budget is short.They have to really prioritize and make sure that the investments they’remaking are trying to accomplish the most that they can. But I think one of thesilver linings in this challenge for us is learning to look outside of our ownagency for opportunities to leverage. So we’re talking to Dr. Zerhouni abouthow CDC and NIH can do more together. And we have to talk to the NationalScience Foundation about where there are overlaps there. And, of course, we’rereaching more to the private sector. So we’re working hard to be more effectivewith less. But I’m not going to pretend it’s not a challenge. MR. DAVID GERGEN:Thank you. Dr. Arden Bement who came in 2004 to run the National ScienceFoundation. Now, in many ways you’ve suddenly become the favorite kid on theblock. Because everybody’s talking about with all of this new funding the NSFhas got to now really have a great deal. But I’m sure from where you’resitting, the outlook may not be quite that rosy. You may still have a lot ofconcern about where we’re headed. DR. ARDEN BEMENT, NATIONAL SCIENCEFOUNDATION: Well, taking a global view, it’s important that we have an educatedpublic and decision makers that understand what’s really driving our economy ina knowledge context. Most of the nations in the world get it. It’s theinvestment in education. It’s the investment in research and development. Andit’s the investment in research infrastructure. And in that regard, the United Statesis not quite an aging nation. But there are other nations that are aging. Andyet, there are developing nations that have a relatively young age. And theirmotherload or their goal for the future are the young people who can beeducated, that can play a role in the knowledge economy. The related point is,going back to Thomas Friedman’s book, The World is Flat, with regard toinformation and communication technologies, he makes very good points in hisgook. In many cases, the world has flattened. But there’s still some topologyleft. And the United States has a few spikes left. And our spikes arerepresented by our strong universities, our strong research infrastructure andalso our innovation system which has for many years had the ability to take newconcepts and bring them into the marketplace faster than anyone else, developkiller applications that could destabilize markets all around the world. Now,those tall spikes are being challenged by many nations around the world. Everycountry now wants to increase their research and development intensity as aratio of gross domestic product in order to get their spikes up to where ourspikes are. So we have to continue to protect our position. The other point isthat the National Science Foundation really focuses on frontier research. Wetried to dog the frontier. And when you get to the frontier, you discover thatall the sciences tend to converge. And as a result of that, in addition to thebiosciences, we had growing investments of biochemistry, biophysics, biomaterials,bioinformatics, biogeochemistry, on and on and on. And you were talking aboutthe disabled people a moment ago. In order to make them more productive in oursociety, we’re developing artificial retinas. We’re developing artificialcochleas. We’re developing a number of methods that will give them the abilityto use computers, to have greater mobility and to become very useful members ofour society as well as sighted engineers, very important. MR. DAVID GERGEN: Sofrom your point of view … the press may represent this as you’re sort of incompetition with NIH for federal funding. But from your point of view, these arecomplementary. DR. ARDEN BEMENT: Absolutely. Yes, I don’t think there’s any questionabout that. It’s been recognized by many in this room that the physicalsciences and the health sciences are very complementary and have had greatimpact on our economy and our development of medical products, medicalmaterials and have contributed greatly to our overall economy around the world.MR. DAVID GERGEN: Could you give us some sense of what we’re facing in terms ofinvestments? If you looked at … if the rest of the world … or let’s say China had anNSF. How much are they … how rapidly are they increasing their investmentversus what we’re doing on our side? You’ve looked at all of their combinedinvestments. DR. ARDEN BEMENT: The one thing that keeps me awake at night … MR.DAVID GERGEN: We’re getting down to the real point. DR. ARDEN BEMENT: China right nowis investing about one percent of their gross domestic product on research and development.But their economy is doubling about every eight to nine years. Their long-rangeplan is three percent of their gross domestic product by 2020. They want trade balancein R&D licensing. (Another goal they want) to achieve is they want to havea commanding position in developing technical standards for the industries andfor the markets that they expect they’ll be in a dominant position in arelatively short period of time. And they no longer want to be dependent on therest of the world to determine how China’s going to trade in the open marketplace.The third thing is they’re investing very heavily in education. They’rebuilding universities at a very rapid rate. And so, going back to my earliercomment, they understand that their value for the future is having a highlyliterate math and science workforce. And that’s what will drive their economyin the future. We need to worry about that. MR. DAVID GERGEN: Dr. Bement, yousaid that Chinais now investing one percent of GDP in science and technology. They want to getit up to three percent. What are the comparable numbers for the United States? DR.ARDEN BEMENT: We’re currently at 2.67 percent. And I have no projections,though, of where that’s likely to go over the next 15 years or so. But thereare only about three other countries, maybe four, in the world that have a researchintensity higher than us. I think Japan is clearly over threepercent. And the Scandinavian countries are over three percent. But most othercountries are less than 2.67 percent. And in absolute terms, the United Statesis investing more in research and development than the other G8 countriescombined. So we’re making very substantial investments. On the other hand, wealso have to worry about the rate of change. We just can’t be static. You justcan’t look at a snapshot and take a static point of view. MR. DAVID GERGEN: Soit’s the dynamic perspective that really comes into play in this nationaleconomy for the whole issue of the gathering storm. That’s the reason it’s gathering.DR. ARDEN BEMENT: That’s the reason it’s gathering. Industry has taken thelead. I think members of Congress understand it quite well. So that’s thereason why there’s … I think that’s the reason why science and technologypolicy has come back up on the radar screen. MR. DAVID GERGEN: Thank you. HelenDarling is the President of the National Business Group on Health. It wasformerly the Washington Business Group on Health. It’s a nonprofit membershiporganization that really works with large employers on their health careproblems. And those, of course, are manifold. So this is an issue that’s frontand center for you these days. Please. MS. HELEN DARLING, NATIONAL BUSINESSGROUP ON HEALTH: Well, I think health care costs, interestingly, the study thatResearch!Americaput out, the public also agrees with large employers that their number oneconcern, their priority, is health care costs, broadly. And second,prescription drug costs. And third, problems with the delivery system. So interestingly,the public in this survey at least is identical with the concerns of bigbusiness and large employers, including a lot of public sector employers who probablywill suffer the most. Because among other things, they have very high costs anda totally unfunded liability. So the politicians in the room will probably knowthat your colleagues at state, local and federal government are in for a bigshock. Health care costs have doubled in the last less than ten years, they willdouble again as Dr. Zerhouni mentioned. Also, I think importantly, that’s toabout $4 trillion dollars. And in 2015, 60 percent of the $4 trillion will bepublic sector. And that’s sort of everybody thinking about these things. Whichmeans that by then the entire cost of the current health care system will bewhat the federal government and the state government’s responsible for. And ifpeople don’t think that’s going to change priorities, they haven’t been payingattention. But that’s a source of great concern. MR. DAVID GERGEN: Are wemoving towards a time when large corporations are going to try to dump out oftheir health care and pension commitments and put those over on the government?MS. HELEN DARLING: We don’t talk about dumping. MR. DAVID GERGEN: Slipping,sliding, whatever one might want to do. MS. HELEN DARLING: There certainly aremany corporations that are already gone. Because they were doing business in a way,including the fixed costs. But they simply went into bankruptcy. MR. DAVID GERGEN:Are we starting to look at blue chip companies that certainly are going to bedoing that increasingly? MS. HELEN DARLING: A lot of them are gone. And more ofthem will be gone. And certainly, we see in the recent Medicare extension orthe new prescription drug act, we saw for the first time the federal governmentactually putting money into private corporations to get them to continue tocover their retirees. So I think we certainly have some natural experimentsgoing on. I think the point that we’d very much like to make are really two.One, we need to broadly define the way we use science, very much like Dr.Clancy talked about. We have billions of dollars worth of excellent medical treatmentsthat have been recommended and came from science, but in fact are not beingdelivered at the bedside. And in fact in many instances, it could be up to 50percent of the time the average American is not getting the excellent care thatthey should be getting which has already been discovered from these billions ofdollars of investment. So reallocating some money, whatever pockets it comesfrom, to make sure that everybody gets the best medicine is essential. MR.DAVID GERGEN: Let me ask this question. I puzzle over this kind of question.One of the reasons we’re told health costs go up so much is we’re discoveringall these new drugs and we can extend life. And therefore, it costs more. Onthe other hand, there are obviously some discoveries that go on in health careor if you move to say digitalizing the system, you can bring costs down. The morewe invest in NIH, do we bring health care costs down? Or do they go up? MS.HELEN DARLING: They go up. MR. DAVID GERGEN: They go up. MS. HELEN DARLING: Butthe thing is the problem is in the United States, we have what’s calledlayering on of technology. In fact, a gentleman and I were just talking aboutit. You get a new test or you get a new something. And whether it’s a screeningtest or treatment, anything. And we have a tendency, for a whole bunch ofreasons which we could spend hours on, but we have a tendency to keep doing theother things and then do the new on top of that. It’s called layering on. Itbecomes incredibly expensive. MR. DAVID GERGEN: Did you want to respond tothat, Dr. Zerhouni? DR. ELIAS ZERHOUNI: Right. I think there’s a distortionthat we need to avoid. And that was that bad technology costs you more money asyou deploy it. And if you look at telephones, the prediction was that eightphones was all the world could afford when Alexander Graham Bell put it. And Ithink it depends on where you are on the curve of technology and discovery. Ithink if you look at the challenge right now is that the technology’s notdriving the cost. It’s the delivery component and the deployment of our assetsin terms of providing the care. So if you look at 1960, you had about threepeople delivering care for any one individual. Today it’s twenty. So I thinkwhat is very important here is to ask yourself the question are we at the peakof medical technology? Are we where medical technology should end? And my viewis no. I think we need to identify those among the people who are going todevelop heart attacks would now … all the people receive therapy, we need tofind the markers to tell us who is going to get it. So that you can bepredictive. And then personalize the approach years before the disease leavesthe patient to hospital care. So I think to give up on knowledge and discoverybecause intermediate technologies like the computer in 1950 you couldn’t affordbut one for the country, it’s the same thing as saying we want to stoptechnology because we can’t believe that the system will adapt to it. MR. DAVIDGERGEN: Thank you. As we transition to Dr. Cicerone, I wanted to go back to onemore fact that came out of the Gathering Storm report. The amount investedannually by the U.S.federal government in research in the physical sciences, mathematics andengineering combined equals the annual increase in U.S. health care costs incurredevery twenty days. Think about that. Dr. Cicerone. DR. RALPH CICERONE: That isan astounding figure. There were some Senate hearings last summer where I heardone Senator discuss a possible way of paying for the $10 billion worth a yearrecommendations out of this Gathering Storm report. And he pointed out thatlooking some years ahead, health care costs in the United States were … to thefederal government, the cost to the federal government, were to increase 41percent in his projection. And by cutting that increase to 40 percent, that extraone percent saving could pay for all of these recommendations. I went home and checkedhis numbers because I did not believe he was right. He was correct. MR. DAVIDGERGEN: So the total cost of this whole package of recommendations is $10billion? DR. RALPH CICERONE: If you count all the R&D tax credits as a costto the federal government, yes. MR. DAVID GERGEN: And our monthly cost in Iraq is about? Monthly?How much are we spending there a year? DR. RALPH CICERONE: Maybe eight, seven,I don’t know. MR. DAVID GERGEN: So two months in Iraq is what we’re talking abouthere for the competitiveness of the country. That’s what we’re dealing with.Let me ask you this question about we were just hearing from Dr. Bement about China and itsinvestment and moving up from one to three percent. And I’m curious about thefuture of university research in China versus here. What is youroutlook on that question? DR. RALPH CICERONE: It’s pretty stunning. I’ve spentmost of the last 20 years at a research university. And like my colleagues atresearch universities all around the country, we had so many visits fromChinese delegations, but also from all over the world, basically trying tofigure out why American graduate schools are so successful. They are very muchtrying to imitate the American graduate school. And as Dr. Bement said, they’rebuilding universities left and right. Things which we haven’t done for the last40 years or so. MR. DAVID GERGEN: Let me relay the conversation I had with LarrySummers, the president of Harvard a few months ago. If you had to name the top10 universities, research universities in the world, how many would beAmerican? What would you … would you venture a guess on that? DR. RALPHCICERONE: Eight or nine. MR. DAVID GERGEN: Eight or nine. And have you thought20 to 25 years from now how many are likely to be American? DR. RALPH CICERONE:It will be less. MR. DAVID GERGEN: He thought as many as five would be Chinese.DR. RALPH CICERONE: I don’t think so. MR. DAVID GERGEN: But it will be less. DR.RALPH CICERONE: When you look at the top ten universities and say which one ofthem is going to be pushed out of the way, you realize how tough a job it is.We’ve got some tremendous universities. But one of the things I would like tospeak about, Mr. Gergen, is the emphasis on getting more American studentsinterested in science and mathematics again. This country has benefitedenormously from wave after wave of immigrants, usually people running away fromsomething and running towards opportunity. An unfortunate case of Jews beforeand during the second World War and afterwards, Eastern Europeans and others duringthe Cold War, many other nations sending people since then. But now thosepeople are finding opportunities at home. They have many more attractions tostay home. And, inadvertently, we have made it much more difficult for them tocome here since September 11th. So we’re sending them a message we don’t wantyou anymore. And they’re hearing that there are great opportunities at home. Soto the extent that we have built our competitive success, our dominance, partlyon immigrant talent, we’re throwing it away right now. We absolutely have toreverse that trend to make people feel more welcome here again. The entrepreneurialcreative people who want to take risks and who can build our country, but alsoeducate our own American students. It takes a lot more educated people to run ademocracy than it does a dictatorship. And we need them. MR. DAVID GERGEN: I’mglad you raise that. It goes back to the question of the H1B visa numbers. Iwill tell you the politics … John Porter would know this, about anybody elsein this room … but for some members of Congress who have been standing up forincreasing visas, they get killed back home right now. Because it gets wrappedinto the immigration issue and you’re soft on immigration. And it’s like it’s avery difficult proposition. Please. MS. HELEN DARLING: I’m glad you broughtthat up again. Because this is a big issue in corporate America. It hasbeen one for a while. We used to actually get all the way to March before wecapped the number you could have in any given year. So you had the whole restof the year which you couldn’t bring anybody in. And there are a lot of pretty ridiculouspolitical issues around the H1B visas. But it’s another piece of the puzzlethat all together, if you put all the pieces together, we are working againstbringing people in who, among other benefits to the American people, is beingsurrounded by other smart, trained people, whether they’re here for a littlewhile or not is itself very stimulating and exciting and everybody wins. Andyet, we’re really messing up on that one as well. MR. DAVID GERGEN: Let me askyou, Dr. Cicerone, you have to come back to the training, the education of moreAmericans in science and math. The impression one has is that we’re goingbackwards, not forwards on that question, that the trend lines are the otherway. And how do we change the culture? You’ve recommended increasing the numberof teachers. Would that be sufficient to change the culture? DR. RALPHCICERONE: There’s a powerful feeling from the people out in the trenches thatour children are getting turned off at an early age on math and science, partlybecause some of their teachers are afraid of the subjects themselves and arenot well equipped to do the teaching and, therefore, to convey the excitementthat goes with creativity and innovation. So the idea is to leverage all of ourefforts with teachers. The teachers are just so important. The teachers needsome help too. MR. DAVID GERGEN: Should the focus be on the lower schools or shouldit just be in high school? We just had a national summit conference here amongthe governors about American high schools. Bill Gates came in and said highschools in this country are obsolete. Where would your focus be on the K-12spectrum? DR. RALPH CICERONE: Well, I have to admit I’m not an expert. But Ithink many of us would be able to walk into a school room and with a decentamount of preparation teach almost any subject up to about grade four.Seriously. There’s some research that shows this. But to teach let’s say a goodcourse in biology in the eighth or ninth grade takes some special educationthat most of us don’t have. We’re in physics. So I think you’d have to focusthe subject matter content expertise at the older grades. MR. DAVID GERGEN: Atthe older grades. And do you have any sense of the scoring when we do prettywell internationally in the fourth grade. Internationally, we stack up reasonablywell in the fourth grade scores. By the eighth grade, we’re starting to showsome slippage. And by the twelfth grade, it’s gone. That’s when we really get slammed.So is it somewhere between the fourth and twelfth or somewhere between theeighth and twelfth? DR. CICERONE: Effort is needed everywhere. We know thatearly childhood development is part of it, nutrition early on. Just everythingis involved. But to be strictly focused on your point, yes. I think focus onthe higher grades. I’d like to make one more comment. You mentioned Sputnik afew minutes ago about whether we’re rallying the way we did in 1957 and theanswer’s no. The United States graduated more physicists in 1956,the year before Sputnik, than we did last year. Twice as many in fact. So ourresolve has really slipped. MR. DAVID GERGEN: You mean in absolute numbers? DR.RALPH CICERONE: Twice as many in 1956 as in 2004. MR. DAVID GERGEN: With apopulation that was about 60 percent the size? DR. RALPH CICERONE: Fifty orsixty percent, right. MR. DAVID GERGEN: So the question becomes … and thankyou for teeing it up really well … that’s the landscape. How do we change it?How do we generate the momentum? How do we achieve success? Let’s go backthrough the panel one more time. Then we’re going to open this up to your conversation.Dr. Zerhouni, from your perspective, NIH, you looked at the politicallandscape. You have to pay attention to the political landscape, Even as youpay attention to science. How do we change this? DR. ELIAS ZERHOUNI: It’s ournumber one worry, the generation of new scientists, new investigators. And whenwe look at it and we ask the young scientists or hopeful scientists, what wehear is that there is a disconnect actually between K-12 and undergraduate andpost-graduate education. So I guess to go back to what Julie [Gerberding] wastalking about, sometimes the value is making sure there are no disconnects andconnectivities there. And what we find is that society in some ways hasdevalued the professions in science. I mean, when you were a scientist at 25,you have a choice. You can go to a certain investment bank or law. Or you go toscience. And you won’t get your first grant at NIH until you’re age 39. So therisk/benefit analysis of our young scientists … MR. DAVID GERGEN: Say thatagain now? DR. RALPH CICERONE: If you looked at NIH 30 years ago, 35 percent ofour new scientists were 35 years or younger. I have an example that I alwaysgive. This is the example: Marshall Nirenberg was a Nobel Prize at NIH. Hestarted his research, independent research, at 27. He discovered the geneticcode at 31, received his Nobel Prize at 35 or 36. Today, he wouldn’t get hisfirst NIH grant until after he got his Nobel Prize. MR. DAVID GERGEN: You’rekidding? Why is that? I don’t understand. DR. RALPH CICERONE: Because we haverigidified our system. As you grow, and as any organization grows, it becomesrigid. We’ve built barriers between different categories of disciplines and theway you get there. And the prospects are not what they are for a Chinesescientist. I went to China.Being a scientist in Chinais the top of the social standing. Being a scientist here now is more like you dependon the goodness anD willingness of Congress to support you. And then it’s touchand go. It’s increased one year and flat the next and decreased the next. Youknow, scientists are not … I mean, young bright Americans are not stupid. Andthey look at it and they say is this a career that I really want to go to? IfI’m told that in ’56 I could go to the moon and get paid and be at NASA? Andall of these scientists are now retiring. And the new ones are saying, you knowwhat? I’d rather go into marketing or investment banking and so on. So I’mmaking a … I’m overstating the case obviously. But I think integration acrossthe life cycle of a scientist and the career path of the scientist is importantfrom K to 39 years to get your first grant. MR. DAVID GERGEN: Well, that’s anextremely interesting point. Dr. Bement, in the life cycle, when do peopleoften make their best discoveries? If we look back over the last … well, overhistory, what do we learn about … DR. ARDEN BEMENT: It depends on the field.Mathematicians and physicists usually make their best discoveries at a relativelyyoung age. It’s pretty hard to generalize, but in many cases in other fields,it takes longer. But the response I’d like to make is it’s critically importantwe give young people research experiences throughout their educational career,even starting in high school. We’re putting much more focus on freshman,sophomore, junior and senior research experience as an undergraduate incolleges. And also providing a greater continuity between undergraduate andgraduate research. And furthermore, we’re focusing our career grants, which is avery generous grant, on young pre-tenured faculty So that they can get theresearch teams up relatively early. MR. DAVID GERGEN: That’s interesting. Ifpeople started on the research side in the eleventh and twelfth grade, do they gethooked. They just get excited about what they’re doing? DR. ARDEN BEMENT: Youbet your life they do. And even in the fifth grade. You don’t have to wait tohigh school. We can teach them very important research principles even in elementaryschools. DR. RALPH CICERONE: That’s very interesting. I want to come back, Dr.Zerhouni, to the politics of getting this done. This is a very political city.How does one generate the political support to get something serious done aboutthis? When you’ve got a sense not quite of lethargy, but a real sense ofdysfunctionality right now that’s quite pervasive? You know, on Capitol Hill,one talks to leading senators and they say, you know, the system is brokendown. We’re not going to get much more done in the next three years. Andgetting the appropriation bills out of here. Don’t expect large ambitiousprojects. How do you generate … after all, the time is ticking here. Or toput it another way, the storm gathers more force over time. So time is notnecessarily on our side. DR. ELIAS ZERHOUNI: David, I still have a few morethings to do with my agency before I get fired. [laughter] MR. DAVID GERGEN:That’s a fine point. DR. ELIAS ZERHOUNI: But I think the number one thing iswhat you’re doing. And I think that if you educate and you present facts in themost objective way and you make your point, I think one of the problems we havewe haven’t really made the point in educating our political leaders about thevalue of science in society. If we don’t revalue the scientific professions asa strategic investment with the country, everything we do at the educationlevel, you won’t get the best teachers. If you do it at undergraduate educationyou won’t really have the focus of universities on that issue. So there is asocietal need from the top down and from the bottom up to revalue what it isthat science and technology has done for our country. I’m looking at Dr.Wheeler there, Cass from the AHA [American Heart Association]. You know howmuch we spent for each one of us in America over the past thirty yearson cardiovascular research? $110. This is what all of you here, all of us, havespent in total over the past thirty years. $4 a year is what we spent. Forthat, we’ve spared a million lives a year by reduction, 60 percent reduction inmortality from heart disease and 70 percent in stroke. So the question is isscience and technology an investment for the future? And I think that is thedebate that we need to have. Relative to other priorities obviously. MR. DAVIDGERGEN: I think we spent more than that on the cookies over here today. Do youhave scientists come out to NIH … I mean, members of Congress who come out toNIH? Do you have delegations that in effect come and visit and get a sense ofthe excitement that you all have about the future of biological research? DR.RALPH CICERONE: We do. And not enough. Not enough. Washington is, as you know, a very difficulttown, busy and you don’t have a lot of time to really educate yourself. But wehad lately a Congressman who came. His grandfather dropped dead of a heartattack. His father had a heart attack, went to surgery and died fromcomplications. He had a heart attack. He went to the hospital, was treated byan NIH doctor. And within an hour was saved because of stent and newtechnologies which [are] maybe transitional technologies for curing. Andeventually we will have preventive technologies rather than curativetechnologies. Survived. Was back to work in four hours. Came to NIH, visited usand said, you know, this is the story. My granddad died. My father was operatedon, didn’t make it. I had this very minimally invasive surgery. I’m here. And whatI want you to do is . . . I just had a baby. And I want my baby not even tohave to feel heart pain, a heart attack or have that issue. That’s the trend.If we can’t do this with our legislators, nothing I think will convince therest of us to put that re-evaluation of science in society. MR. DAVID GERGEN:If I could be permitted a personal comment to those of you who are in science.One of the things that I’ve discovered is that a lot of us who arenon-scientists don’t understand, that it’s very hard for us to share in theexcitement that you have about what’s over the horizon, what the possibilitiesare, that your sense of what human possibilities are, that those of us who arein the humanities . . . you know, it’s a barrier for us to get over and see andget into it . . . is the excitement of science, not just the competition thatreally I think can get people turned on and say, yeah. We ought to do that. Ifyou can come close to that, yeah. DR. DECLAN DOOGAN: I think you make a greatpoint. And what I would say is I think we’ve done a very bad job of communicatingthe potential that exists within science and medicine and allied sciences.Because I believe that, as Dr. Bement said, when people come and get in contactwith the scientific experience, it is energizing. We can see it from folks thatwork in our place who are engaged in some sort of scientific endeavor. They’reexcited a lot of the time. What kills them is bureaucracy. You mentioned big institutions.If you take the bureaucracy and mitigate the effects of bureaucracy and allowthe space for creativity and an entrepreneurial spirit within the scientificendeavor, I think you can see some good things happening. But my worry is thatthe society doesn’t yet value the scientific endeavor in the way that it did 50years ago. And I think we have to capture the hearts and minds of the public.And we all have a part to play in that. MR. DAVID GERGEN: Ms. Weinberg, I wantto come back to you about generating momentum for success in these areas. MS.MYRL WEINBERG: I think of all of these areas, to me one of the biggest problemswe have in the country is the national debt. And when you look at the debt andthe way it’s growing and there’s no end in sight and you trace that back tocomments that have been made across the board where we have program afterprogram after program that because I think of the pressure that is on our nationand policymakers looking to the time they’re in office and then what happenslater, feeling intense pressure to cut vital programs, whether it’s CDC,Medicaid, across the board, it starts to undermine. And so in all of the areaswe’ve discussed, to me there is no sense of urgency in the nation. There is no understandingof the interrelationships of all of these issues, whether it’s education, NIH.And I think that it’s not going to be only the scientists and researchers that conveythe excitement which they should and they do. And hopefully, we’ll all dobetter together. But it is going to be the people. I’ll go back to my firstpoint. If we don’t find a way when you have such barriers to having any ofthese recommendations be implemented because of the situation our nation’s in,if we don’t find a way to have the people that can benefit if we are morecompetitive in science and health care, then they’re the ones that need to understandwhy they should be demanding these kinds of changes, the support that agenciesneed, et cetera. And I just want to give one example. If we had a real commitmentas a nation to doing something that would make us more competitive, improvesomething health care and save a heck of a lot of money, it would be toimmediately put money into having electronic medical and personal health records.People would get engaged in their care. Mistakes would be avoided. We’d save aton of money. And yet, we’re unable to do that because of the overall situationwe’re in. And we have such a “siloed” system in every way that if there ismoney saved, we can’t redirect it in a way that it goes to the areas where it’sneeded most. So I think instead of talking about this technology or this medicineis too expensive, that’s not what we should be talking about. We should betalking about there’s enough money in the system now to pay for all of thesethings and improve health and have lower health costs. We can’t even modernizethe technology in the very system where we’re not competitive. MR. DAVID GERGEN:I’m glad you raise that. My understanding that one of the institutions in America, one ofthe few institutions, where you really can see the benefit of moving towards anelectronic system is one of the most surprising and that’s the VeteransAdministration. That they really invested a lot. You know, we used to think of Veteranshospitals as being sort of second rate and they were downstream. But they’veinvested in it and it’s now paying off. And their costs, their annual costincreases, are pretty flat compared to the rest of society. Is that right? MS.MYRL WEINBERG: That’s exactly right. In fact, one of the things we’ve beendoing is bringing the Undersecretary for Health, Dr. Perlin, to meetings of theleaders of all of the groups like American Heart and Cancer and Diabetes, so thatwe really get the information, not only in significantly improved healthoutcomes, which they’ve documented, but the cost savings to the system. AndI’ll just give you one example. It’s the kind of thing that they’re able totrack because they are a closed system. They’re able to track that when someonecomes to the office when they were at a paper based system, they tracked every personthat had to pull that paper and get it through and get it to the doctor andhave it read. That cost $5.00. It cost one cent to hit the button on thecomputer and bring up the record. MR. DAVID GERGEN: And the VeteransAdministration it might be noted is also a single payer system. MS. MYRLWEINBERG: That’s right. MR. DAVID GERGEN: That’s not to say a single payersystem for everybody would be right. But it is to say that is a single payersystem. Helen Darling, do you have a view on that by the way? MS. HELENDARLING: Single payer system? MR. DAVID GERGEN: Well, where savings can befound. So that you don’t have these continuing pressures and you do have enoughmoney to invest in R&D. MS. HELEN DARLING: Yes, there are lots. And I wouldagree with what Myrl said. But also, if you could take something like healthcare-acquired infections, which are rampant, cost billions of dollars, hurtpeople. There’s a lot of money there that in fact could be available for otherthings. We also know in the political process there’s a lot of money in anyfederal budget that’s passed that is well known to everybody to not be neededover many years. Some bases, military bases, when I worked for a senator from Minnesota, there werelabs that everybody agreed we didn’t need. But it had 30 jobs and nobody wantedto lose it. So you have to find ways to allow people to exhibit some politicalcourage on the things where everybody agrees it’s a total waste. But give themsomething. Like maybe that would be the community in which you would give 40extra . . . or summer workshops for kids in math or science. So you do some veryspecific almost dollar for dollar tradeoffs. So that you move the math andscience agenda forward by getting some money out of things that need to go. MR.DAVID GERGEN: Thank you. Let me come back to Dr. Leonard. You do not stand, assomeone down to your left does, in some peril if you talk about the politics oftrying to get things changed. DR. JOHN LEONARD: Oh, I didn’t say that. MR.DAVID GERGEN: Perhaps you do. Perhaps we all do. I still want to come back tothis. How do you generate momentum politically in the political system to getsome urgency to this and get real change? Or are we just going to pick away atthis and not be successful as we pick away at so many other things? DR. JOHNLEONARD: You know, I think it’s multi-factorial. It’s multi-factorial. I thinkthat there has to be a broad based … MR. DAVID GERGEN: I think you’re safefrom being fired on that basis, yeah. Multi-factorial. Nobody ever … DR. JOHNLEONARD: No, I’m being serious. We talk about this in our own corporation. Weare engaged, as we speak, thinking about these very issues and what voice ourcorporation should have locally and nationally. Abbott Laboratories will be oneof the hosts of something called BIO which is the biotechnology industryorganizations’ annual event. Our CEO will be the keynote speaker. And one ofthe things that he will emphasize to that gathering of 20,000 scientists fromour industries are individual responsibilities to carry this message forward. Iknow that at the level of our government affairs office, we engage our localrepresentatives in these issues. I think, you know, it’s bigger than just that.Ultimately, I believe it is a cultural issue here and it is who we are. Youmentioned the humanities before. That struck me. I can’t think of doing anythingmore human than science. It is what separates us from all else. Some of thebest humanists were scientists. And I think that one of the things, you know,we can talk about the economic valuation. It is the valuation of being human.And I think that within our families, within our schools, within our communities,it is something that we must absolutely demand of each other. We need potentadvocates, all of us, the people we know. We need sustained attention frommultiple quarters. We need national recognition of accomplishments, et cetera,et cetera. And it’s something that we can’t wait for a Sputnik to happen andthen 50 years later, oh, the next crisis. This is something that happens every singleday. MR. DAVID GERGEN: Let me ask you this. The Democrats have a bill that theyintroduced early on which was almost straight out of the Gathering Stormreport. And then the President came forward with a parallel proposal in the Stateof the Union. Is there a corporate coalitionthat’s forming behind and giving support in Congress to getting majorlegislation through that would provide for these teachers and provide for theincreased funding? Is there a corporate coalition that’s coming together onthat? DR. JOHN LEONARD: I’m probably not the best person to speak to that. Ithink there is to some extent how well organized it is, how unified it is andhow much of a consensus there is behind it would probably be debatable. But Ithink that that’s a step that should be taken. I think there are some veryprominent business leaders, Bill Gates for example, who speaks on this all ofthe time. But whether or not we can say 80 percent of the Fortune 500, forexample, as part of something, I don’t know. MR. DAVID GERGEN: Because whencorporate Americadoes get behind tax bills, things often happen. And there have been other areasthat they’ve gotten quite concerned about and legislation changes. It does makea difference. Carolyn Clancy, your perspective on how we get the legislative momentum,the political momentum to make the kind of reforms that are necessary. DR.CAROLYN CLANCY: Well, it strikes me that Julie Gerberding started to lay thisout a little bit. I think that we have not always connected the dots for peopleas much as we can. I mean, right now what’s keeping every governor awake at nightin Americais the Medicaid budget. And it’s only going to get worse. I think there aresuch huge opportunities there for moving disease prevention and treatment wayupstream from where we are right now. I mean, to put it concretely in ourquality report, the good news is we are improving the care of people in thedialysis program. And that is actually a good thing. The really bad news is weare not doing a good job at all from accelerating the path to getting into thedialysis program. And that’s where we ought to be focusing our energies. Theother point I wanted to pick up that Myrl Weinberg made is I think there’s away to package this in a vision that people would understand. I think whathappens when times get very tough is people get torn between thinking about abig vision and where we’re going as a country and for [the] future versussomething that’s doable right now and feasible even if it’s only a small pieceof the puzzle. The point that Myrl Weinberg made about personal health recordsoffering people an incredibly important new tool to get engaged in their healthis quite important. On the other hand, most of the patients in this country arenot prepared for it and simply handing them an electronic health record, it’sgoing to make some things more transparent to them. It’s not going to give themthe skills they need, the skills to ask questions to say what’s the evidence?Is this the right treatment for me and so forth? So I think the same paths thatwill make people better patients and perhaps wiser consumers of care will alsohelp us to fill the scientific pipeline and presumably have better teachers andso forth. But I think it’s that kind of sort of framing these pieces togetherthat might have some real salability. MR. DAVID GERGEN: IBM is one company …I believe there are others maybe coming on … who are encouraging people as theyretire to go teach in the public schools and go teach science and math inpublic schools. I think they have 100 coming out this year that they’re helpingalong the way. Is that something that would also help if other corporations gotengaged in that? DR. CAROLYN CLANCY: It’s hard to imagine that it wouldn’t. My brotheris sort of a self volunteered. Left corporate America to go teach high schoolscience and math. I think inspired both by the need for science and math, butalso a need for a lot of the students to have male role models. MR. DAVIDGERGEN: The IBM Foundation told me they were trying to sign up 100 corporationsthat might be willing to commit 100 apiece. And that gives you a fair number ifyou did that on an annual basis. Dr. Doogan, let me come back to you, sir, onyour perspective again on the politics of getting this done. How does onegenerate … are you all engaged in efforts on the Hill and working with theWhite House and working with the Democrats to get something accomplished here? DR.DECLAN DOOGAN: Well, I think our Chairman, Dr. McKinley, is very active on theHill and advocating for improved investments and health care and betterconditions in America.I think that a number of things that strike me are alongside the technologicaladvancements that we have in this country is this sort of strange parallelworld where we see a decreasing health care situation with the epidemic ofobesity and diabetes. And I think that most of the public can relate to theproblem of obesity. Because if you see the advertising that’s on for remedies onthe television and so on. And I think to galvanize around that, for example, assomething that the public can relate to, scientists want to engage in andrecognizing the downstream benefits of attacking the problem I think could beone area where we could look at wonderful partnerships being created betweenpharmaceutical companies, the front line health care providers, politicians andvarious other groups like food companies, et cetera. Something like that wherewe could all bring our might together to solve a problem, we’d have substantialeffect, both in the short and the long term. So I would really see that someaction around that would be a wonderful initiative and would continue to drivethe wealth of the country by better use of our dollars. MR. DAVID GERGEN: Dr.Gerberding, within the federal government itself, is there … this issue hasarisen, often put on the White House doorstep. Where are you guys on your domesticpolicy? Why aren’t you … you know, do you have a domestic policy? Why aren’tyou pushing anything? But, you know, the responsibility here rests well beyondthe White House in terms of the federal government, gathering its own forces totry to help educate the public and educate the Congress to get something donebehind this competitiveness agenda. Are there efforts going on within thefederal … at the upper levels of the federal government beyond the WhiteHouse to try to come together? Or is this sort of every agency for itself? DR.JULIE GERBERDING: No, I think there’s very definitely collaboration. And theissue in my mind isn’t that people don’t know this is important. I thinkCongress knows that science saves lives. I think Congress knows that good sciencewill save money and build a stronger economy. I don’t think the issue is theneed for more information or more evidence. I also think that Congress gets electedby people who decide that those things are important in their decisions aboutvoting. And until Congress really feels the connection between a desire to havea strong scientifically based economy or a prevention agenda at the local levelthat it isn’t a factor that influences their decisions at the grassroots level.And what we need to do is better communicate to the public about why theyshould make their voting decisions on these criteria. One of the challengesthat I have … and there are many exceptions to this. But I actually am often troubledby scientists communicating to the public. I’m not sure that we’re always thebest communicators. And we are learning how to translate. And one of the …actually the great gifts that Congress has given CDC is a new global communicationcenter with state of the art television studios. And when we start using thosestudios to deliver messages about the importance of science and the importance ofprevention to children in this country and make it exciting for them and funand interesting, I think we’ll begin to lay a groundwork for a differentdialogue in the future. So I guess I’m saying this is a grassroots solution. MR.DAVID GERGEN: Do you find a receptivity on the part of the media to talk aboutscience? I don’t. DR. JULIE GERBERDING: I think it’s difficult. And I’m sittingin the National Press Club. So I’d like to come back here again too. But I dothink that it’s a tough job. Where we’ve had the most success is with thescientific media who have come to the boot camp that CDC supports for thepress, teaches them about our business and helps them be informed. So that whenthey write, they’re writing stories from a frame … a knowledge base thatallows them to be effective translators. MR. DAVID GERGEN: Right. It’s aninteresting question. Many of the gatekeepers in the media as far as I’mconcerned assume that science is tough. It’s not going to sell. Let’s go doanother crime story. But, in fact, as of a few years ago, The New York Times,you know, its Tuesday science section, after it was established, the Tuesday newspapersold more out on the streets than any other newspaper during the weekday. Itspiked on Tuesdays which was a … and they interpreted it as … their scienceteam interpreted as it had a lot to do with that special section and trying tomake it accessible to people. Dr. Bement, your views on this. Where do westand? What’s the likelihood of getting serious legislation that in effect providesmost of what the President and indeed the Democrats are seeking on thiscompetitive area? DR. ARDEN BEMENT: Yes, thank you, David. I’d like to go back andindicate that the momentum that has built was largely started by industry,especially through the report of the Council on Competitiveness. And there area number of corporations that are not just committed, they’re engaged. Andthey’re engaged not only in trying to sell this package, but they’re engaged inpublic education. You mentioned IBM. But there’s Dow Corning. There’s Intel. There’sDupont. There’s Microsoft. There are many other companies, Merck, that aredirectly engaged in public education. And that’s the point I want to make.There are many school districts where the business sector is directly engaged, theydo much better in math and science education. That’s a demonstrated fact. Andso it’s not just the expectation that the teacher sets. It’s not just theexpectations that the school sets or even the school district. It’s the expectationsthat the community sets. So community action, keeping score, keeping track,continually improving, I think is really the key to success. Now, we get to thequestion of advocacy. Unfortunately, the general belief is that all advocacyoccurs in Washington.And I think many of you who have been part of this recognize the closer thatyou get to saturation, the quicker the signal to noise ratio approaches zero.So that local advocacy, grassroots advocacy, community advocacy, reallyaccounts for quite a bit. And as you know, all politics are local. So havinglocal advocates, I think, in trying to educate the public and engage the publicin some of the issues we’ve been talking about I think is critically important,which gets me to the last point. We oftentimes … and this is your mediaquestion … we oftentimes inform the public about science and the wonders ofscience, but we have not yet gotten to engagement. And with modern informationtechnology, we could actually engage the public in science. And we could bringscience into the public classrooms. NASA started that movement, actually underDan Golden. He wanted to engage the public in science on the space station. Well,that’s yet to develop. But if the science agencies had their own channel, wecould put children on research vessels vicariously. We could put them inobservatories. We could have them be involved in cosmological studies. We couldhave them involved in ecological studies. And that’s here and now. That can bedone. MR. DAVID GERGEN: Say that again. You said if the science agencies hadtheir own channel. Do you mean television channel? DR. ARDEN BEMENT: Yes. MR.DAVID GERGEN: That’s a novel idea. I have not heard that before. Could youexpand on that a little bit? How would you do that? You’d start your … you’dget funding for it. DR. ARDEN BEMENT: Well, NASA has a channel. There’s noreason why you couldn’t have a multi-agency channel. DR. JULIE GERBERDING: CDCis getting a channel. MR. DAVID GERGEN: CDC is getting a channel. You guys areall going to be anchors pretty soon. Great. You’ll be household names. DR.ARDEN BEMENT: Your job is secure. MR. DAVID GERGEN: The more the merrier. Butwhat would you do with it? If you had a channel, what would you … that’s a reallyinteresting idea. Could you have it interactive with schools and that sort ofthing? DR. ARDEN BEMENT: Well, let me just give you an example. We’redeveloping an undersea research vessel which will be the successor to Alvin, Except this vesselwill actually explore 95 percent of the ocean bottom. And it would be quitepossible to have children involved in actually selecting samples to take. Andthen following the examination of those samples to see what they represent. Thatcould be possible. MR. DAVID GERGEN: Wow. That’s really interesting. DR. ARDENBEMENT: And that’s just a small example. MR. DAVID GERGEN: And not veryexpensive. DR. ARDEN BEMENT: Not very expensive. We could … MR. DAVID GERGEN:One-day increase in health care costs. DR. ARDEN BEMENT: We could actuallyinvolve children in Arctic exploration or Antarctic exploration and actually goout and vicariously by television work with the penguins. That could be done. MR.DAVID GERGEN: Now, that could put a documentary maker out of business, if youstarted messing around with penguins. DR. ARDEN BEMENT: No, but our ability todo real time research coverage by television is here now. It’s not futuristicat all. MR. DAVID GERGEN: That’s fascinating. Ms. Darling, your views on,again, about this generating public and political support. MS. HELEN DARLING:Well, based on what’s been said, one thing to do would be to break down thenegative facts, the things that have gotten everybody appropriately frighteneddown to the local and state level. So if you take a state … let’s say thecurrent head of the National Governor’s Association from Arkansas, how many scientists and mathematicianswould you want Arkansasto produce? And you could take it at every level, at the local level. And then talkabout what we need to do if Arkansas… if each of those locations is going to have a standard of living that isn’tsignificantly lower than where it is. So taking it back to the local and statelevel, with hard numbers, let them see the consequences. If you look at the kindsof jobs. Again, not to pick on Arkansas,but if you look at job growth in Arkansaswith a few exceptions, probably around the university, all the job growth is inthings like low pay, retail, fast food and mostly low level hospital employees,low level in terms of wages, significantly lower than where it is. So you couldjust take each of those … I mean, this is something somebody could do andmodel it. You could see if you could change state by state … and maybe you’dstart with the most successful ones and see how you can do it. And even think aboutthings like maybe they don’t have the capacity at the state university. Butwould the state be willing to spend some money to send them off to a nearbyuniversity that has the capacity? And essentially get them thinking this is a warthat we have to fight if we’re going to save the quality of life in the UnitedStates. And that’s even recognizing that there’s a lot that’s really good aboutglobal competitiveness. MR. DAVID GERGEN: Good. We come back to you, sir, forthe last question from here. And then we’ll open this up. You’ve been reallythinking about this probably longer than anybody else on the panel in terms oftheir report. Because this is a report after all that was requested by Congress.You responded to the Congress. They then began introducing legislation. The administrationthen introduced legislation. Are you optimistic, sir, that we in fact are goingto have comprehensive legislation to carry out the main recommendations of thereport? DR. RALPH CICERONE: I am. MR. DAVID GERGEN: You are. DR. RALPHCICERONE: I am. MR. DAVID GERGEN: Do you think we’ll have it this year? DR.RALPH CICERONE: Yes. I think there has been an amazing example set in abipartisan way, especially in the Senate, but with some leading proponents inthe South, people who behind closed doors are doing the right things. And they wantto work together and get something done. I think though the problem is largerthan legislation. And getting back to the theme of this meeting, leadership ofall kinds and what the public desires and needs and expects. I think we need avery broad communications effort. And I think everybody on the panel has justsaid that in different ways. I came over to visit with Mary Woolley and JohnPorter a couple of times in my first few months here to ask about this great recordthat Research!America has achieved over the years of finding out what’s on theminds of the public, how much they know, what they’d like to know and wherethey don’t know enough. And I’d like to submit one of the roles … I’m goingto look at Mr. Gergen now because he’s a master of this … storytelling. Ithink President Reagan was as good as anybody at that. And another great leaderwas Lewis Thomas who, of course, led Sloan Kettering. His books, which told ina very dramatic way the excitement of science and the enormous financial valueof prevention as opposed to treatment. Lewis Thomas’ books have many stories inthem. We have to get out there and tell the stories and do it in the homedistricts as Dr. Bement said to reinvigorate the entire sense of excitement andwhat can be done, stories about people’s opportunities and careers. Of course,to be practical, maybe some scary stories too. But we have to get the story outthere. I think Congress will follow. MR. DAVID GERGEN: That’s a striking point.And Howard Gardner has written a book called Leading Minds. And it’s all aboutleadership, and the central argument of that book is that the best leaders areones who create narratives in the minds of their followers about what the groupor the organization is trying to accomplish. And if you have a convincingnarrative, people will then buy into and want to be part of the larger … andthen that narrative is made up of many strands of individual stories thatpersuade people or inspire or scare or whatever. And by the way, I also thinkthat nuggets, factual nuggets, are very helpful as I thought with yourcompetitive or your Gathering Storm report. I was quite impressed that you hadthose last two or three pages of those nuggets. Those are something like forsomebody like me, you can see that those are wonderful things to be able tograb hold of. I thought you were on the way towards communicating, and indeedyour executive … DR. RALPH CICERONE: Those are Norm Augustine’s babies. Andit drove our staff crazy making sure they were all accurate. MR. DAVID GERGEN:But, you know, Norm Augustine is a fellow who’s written a book aboutShakespearean leadership and understands the importance of stories toleadership. And the Shakespearean stories really go right to the heart of whathe does. So we’re in a court here. The floor is now open for about a half anhour. And we wanted to go through a couple of rounds. Yes, sir. Please, if youwould identify yourself when you stand up. There are microphones. We do have aC-SPAN audience that has joined us. We’re very grateful for that. And if youwould, please, sir, identify yourself. DR. DENNIS AUSIELLO, MASSACHUSETTS GENERAL HOSPITAL,HARVARD MEDICAL SCHOOL: Yes, my name is Denny Ausiello.I’m chairman of medicine at Mass General Hospital,Harvard Medical School and a member of the board of Research!America. I’dlike to take the point of the partnership that has been a thread of all of thespeakers today to another level and perhaps then challenge the panel to addresshow we could use it in an effective way. In the most fundamental sense, biologyis not a science. But it is the most elegant expression of chemistry, physicsand mathematics. And I think in that light, we as scientists, and I as abiological scientist, have not done a great job to tell the stories of theseamlessness between those enterprises. And particularly the elegance of themost fundamental science and biological outcomes and biological achievements. Andcoming back to the point that Dr. Zerhouni and Dr. Gerberding made earlier, thefuture of biological health care and science really lies in pre-symptomaticdisease prevention and management. And most of the tool kits and the activitiesand the language that is being spoken to achieve that really are coming fromthe most fundamental science in physics, mathematics and chemistry. And so if we’regoing to provide an educational framework that the population in our countrycan understand, it seems to me it can’t be segregated. It has to be acontinuum. And I would like to ask Dr. Zerhouni and perhaps Dr. Cicerone tocomment on what are the goals of the educational process? Because I think if wego back to the era when we’re going to emphasize mathematics and we’re going toemphasize physics and emphasize chemistry, all of which happened in mygeneration and I’m very pleased for, I think that might be a mistake. And thequery I would have is can we look to a more integrated scientific educational processthat would bring the magic of the most fundamental science into the biologicalarena and link that to biological outcome which may make scientific achievementa much more palatable and exciting opportunity for our next generation? MR.DAVID GERGEN: Dr. Zerhouni. DR. ELIAS ZERHOUNI: I think Dr. Cicerone … Ithink Ralph should answer that first. Is he there? MR. DAVID GERGEN: We’ve gotan (inaudible) here. Do you want to tackle that? DR. ELIAS ZERHOUNI: I thought Arden was first. MR.DAVID GERGEN: Okay. Ardenwill take that. Okay. DR. ARDEN BEMENT: Your point is very well taken. Thething that we’re looking to is development of better visualization models usinginformation technology which is one way you cannot only integrate graphicallythe complexity of some biological structures at a fairly complex level toinclude membranes and macrophages and so forth. But you can actually get insidethe model and begin to think about it. And part of that is really taking a plethoraof data and synthesizing it and trying to understand how you take data andconvert it to new knowledge and new understanding. And that synthesis processin the past was not given very much credence or not very much credibility bythe science community. It was more discovery rather than synthesis. But that’schanging dramatically, and I think over time by getting to a systemic level andbeing able to deal with higher levels of complexity than we had before, bygetting out of our narrow channels and bringing in more interdisciplinary involvement,we’ll be able to do much of what you’re talking about, have a much moreintegrated approach. DR. RALPH CICERONE: I would like to make a comment. Ithought that was a great question. We have so much work to do. I’ll give youjust two examples of things that give some specific focus to what you weresaying. One is the way we layer the sciences in junior high, middle school andhigh school, where it’s generally biology or earth sciences first and thenchemistry and finally physics. It should be upside down. It should be the otherway around. I don’t know why physics is taught last. Maybe at some point it wasthought to be more regal and more difficult and required more mathematics. Butbiology’s changing so fast that I think we should reverse it, physics first,then chemistry, and then biology if we have to have the layer cake approach.And then even in universities, what we as university professors call an introductorycourse in the sciences for 90 percent of the students, it turns out to be aterminal course. And we teach them as if all of these students are just startingon the path towards a Ph.D. in physics. It’s the last course that they’rerequired to take in the sciences. We’re teaching them all upside down andwrong. So we have an enormous amount of work to do that maybe won’t cost somuch money as it will rethinking the whole exercise. MR. DAVID GERGEN: Howwould you rethink the introductory course at the university level? DR. RALPHCICERONE: I think it would be very much what Dr. Ausiello, chair of Medicine atMass General, I think what you had in mind was not so much specific facts butin the way people ask questions, what is the value of science. DR. ELIASZERHOUNI: I would just say that, the key here to understand, the disciplineshave been created as a means to science, not an end in themselves. And I think whatDenny’s talking about is the need for us to break the silos between disciplinesand teaching science again rather than the disciplines of science. Inchemistry, for example, it’s well known … a Nobel Prize in chemistry one timetold me, he said, the way we teach chemistry today is designed not to ignitethe young mind, but to cremate the young mind. MR. DAVID GERGEN: Well, hecertainly knew how to tell a story. Please. DR. FRANCESCA GRIFO, UNION OFCONCERNED SCIENTISTS: Thank you. I’m Francesca Grifo. I’m the Director of theScientific Integrity Program at the Union ofConcerned Scientists and, I might add, ex-science teacher, former high schoolscience teacher, former university professor. And I go back to Dr. Zerhouni’scomments. Because I think one of the things that he talked about was what is itthat squashes the excitement of a 25-year-old scientist about to go into the system?And I think one of the things that we haven’t mentioned here is the idea thatif we choose a federal career, a federal scientific career, that in factthere’s a very high likelihood that our research results will be politicized,if we can even get them out of the agency into the mainstream. And it’s one ofthe things I think is missing from the Gathering Storm report is really how dowe address the politicization of science. And I’d just be thrilled to hear fromany of you on that point. Thank you. MR. DAVID GERGEN: Does someone want torespond to that? Dr. Zerhouni. DR. ELIAS ZERHOUNI: Well, our position is veryclear. I think that science should be above politics. Because when you look atthe objective science, whether it be disease, it doesn’t really check yourpolitical affiliation. And I think it would be great disservice to the countryif we end up at the point where federal agencies no longer provide independentunimpeachable advice to inform policy, whatever that policy ends up being. So Ithink it’s very important. I say it and state it again. We make sure thatscience does not become a political punching ball, That it really remains whatit has always been. And that is the activity of looking for facts and not …be factual and not factional if you will. And I think government scientists orany other scientists, I think we should be very clear that there’s got to be aseparation between the policies and the politics of decisions made on the basisof science and other factors and science itself. MR. DAVID GERGEN: Sensitiveissues, especially these days. Please. MR. AL MILIKIN, WASHINGTON INDEPENDENT WRITERS: Al Milikin, Washington IndependentWriters. Do any of you object to destroying a human embryo for embryonic stemcell research? MR. DAVID GERGEN: That’s not quite the subject matter of the day.But if one individual wants to respond to that, the floor is open and thequestion’s posed. Someone want to respond to that? Arden, are you responding there? DR. ARDENBEMENT: Well, embryonic research is not within the scope of the NationalScience Foundation. So we haven’t taken a position on it. Now, that’s not tosay that we don’t support stem cell research. We do a lot of work in somaticstem cells and other types of research. And we have supported stem celldevelopment from yeast. But we haven’t gotten into human stem cells. MR. DAVIDGERGEN [to Dr. Zerhouni]: But you must support a good deal of stem cellresearch. DR. ELIAS ZERHOUNI: We do. And I think this is one of the most polarizedissues right now in society. And I think science is somewhat hostage to that inthe sense that society has not come to a consensus. And typically, when youdeal with ethical issues, we’ve reviewed the history of ethical issues. If youlook at blood transfusions, they were considered also at one time questionable.In some religious denominations still today do not accept blood transfusions.And I think at the end of the day, society will come to a measure of goodversus bad. And every advance in medicine would be surgery or blood transfusions,always been either rejected or accepted on the basis of eventually that firstpatient that gets to benefit from an advance versus the first person who gets harmedby it. And I think people eventually make that balance. So from our standpoint,the science is advancing to a point where it’s coming so close to fundamental questionsof society like origin of life and so on that no one can glibly answer thatquestion without thinking about the balance of risk and benefit relative to thestate of the science as we know it. MR. DAVID GERGEN: Dr. Cicerone, I wouldtake it that your argument would be that the issue of the gathering storm oughtto be on a separate track from the question of stem cells or global warming orevolution versus intelligent design and these other issues that have come intothe national dialogue. DR. RALPH CICERONE: Yes, I think so. I think Dr.Zerhouni just stated it very well. There’s no glib answer to a question likethat last one. The National Academy of Sciences has released a couple ofreports now on proposed guidelines, ethical guidelines, for stem cell research.And the answers that we came up with guided by ethicists and scientists andmedical practitioners and people who work against various diseases have gonealong the lines that Dr. Zerhouni said. It’s not glib. There are certainlyembryos being created in fertilization clinics which would otherwise bediscarded. That’s perhaps a different … an easier answer. If an embryo isgoing to be discarded anyhow, perhaps it could be used for research. Earlier stageembryos, certain guidelines against not purchasing embryos and putting a womanor a couple in an ethical bind over making money out of the transaction. Andthen being aware of international differences that are developing on the answerto that question. But I hope that we will all treat these issues separately.And I think, yes, they would be on a separate track from the rest of the discussiontoday. MR. DAVID GERGEN: Why don’t we cover the questions … we will addressthose who are standing now. And then we will call it a day. We’ve got aboutfour people. Yes. Identify yourself if you would please. DR. SAM SILVERSTEIN, COLUMBIA UNIVERSITY: My name is Sam Silverstein.I’m a professor of physiology and medicine at Columbia. I’m a member of the Research!Americaleadership. I’d like to make a comment and then address a question to the panelwhich I think, Mr. Gergen, you addressed to them repeatedly, but got no answer.MR. DAVID GERGEN: I appreciate your support. DR. SAM SILVERSTEIN: The commentis that C.P. Snow pointed out to us a long time ago that there are twocultures. And in fact when one asks people what is culture, they will tell youit’s poetry. It’s music. It’s writing. But it’s not science. In fact, whatdistinguishes contemporary civilization from the past is in fact that scienceis the very root of contemporary culture. When one looks at (the) public agendaand what it says American parents are worried about, they are not worried aboutthe education of their children and science. They’re worried about lots ofother things, but not that. I think what we’re looking at here is just afailure of leadership. And we ought to say it like it is. We have not seenleadership at the national level. And we have not seen leadership at the locallevel. In fact what we’re beginning to see in many areas is that grassroots leadershipat the local level is having to take over because in fact the politicalleadership seems to be astray. The question I’d like to put to the panel, andthat you raised repeatedly, is how do we get some kind of synthesis? MyrlWeinberg wants us to have electronic medical records. And she’s right. EliasZerhouni wants us to invest more heavily in the NIH and he’s right. JudyGerberding wants more money for the CDC and she’s right. And all of you wantmore money for education. And, in fact, the amount of money all of you want andall of us want is a pittance compared to the benefits that those dollars willbring. So I’d like to ask the panel the question I think that you have beenleaning on them to answer. How do we get together even in this room to supportone another, because Myrl Weinberg doesn’t disagree with Dr. Zerhouni. And there’sno disagreement between Julie Gerberding and the members of the panel on herside. Or between the business community for that matter in the main. What is itthat we’re missing that we could do? That’s (the) synthetic kind of questionthat was being asked by Dennis Ausiello in education. What is missing in thesynthesis of our politics that doesn’t allow us to do what we all know is theright thing? MR. DAVID GERGEN: Dr. Cicerone, do you wish to respond? DR. RALPHCICERONE: I’m just a scientist. MS. HELEN DARLING: The short answer is what youstarted with which is leadership. It will take leadership, political leadership,to make it happen. MR. DAVID GERGEN: Well, let me ask you another aspect. Letme just come back. Would it be worthwhile to form a coalition, as we have seenon other issues in the past, that brought together the presence of the majorresearch universities in the country? With the CEOs of the major companies whoare deeply concerned about this. With people from the scientific community whoare on the forefront that would include Nobel Prize winners and others. Andother leading citizens in a coalition that would continue pushing for change onan ongoing basis. There was an advertisement, for example, a full page advertisementin the Times, I believe, and a couple of other newspapers here recently thathad the names of a number of people. But I haven’t sensed that there was a coalitionthat it was actively working. There was the competitiveness council in itsearlier form when Chuck Vest was there from MIT. That really did have an impactsome years ago. And I’ve seen other such groups work before. Is it worthwhileto consider formulating something like that, raising the money privately, inthe private sector. I can just tell you I can name ten university presidents I knowwould join like that if they thought there was a way they could make a reallybig difference here in this city. And be heard. DR. JOHN LEONARD: In a shortanswer, I think yes. And I am reminded what can happen within companies whenthere are things, laws or legislation that’s being proposed that is either verymuch in our interest or against our interest. We have an amazing ability toorchestrate massive letter campaigns. I mean, Mr. Porter I’m sure can tell usabout being on the receiving end of many of those letters as constituentsexpress their interests. I’m thinking about my own corporation. We have 60,000to 70,000 employees worldwide. And the county where I live, 15,000, all of whomare readily reachable by our leadership in a day. And it is … if the will isthere, I don’t think it’s going to come from any one person. But this coalitionyou’re describing could potentially start the ball rolling where a few veryprominent leaders from different walks of life, private industry, universities,et cetera, we might surprise ourselves. We might surprise ourselves with what wecan do. MR. DAVID GERGEN: Do you have a response to that? DR. SAM SILVERSTEIN:Well, I agree. John [Porter] and Mary [Woolley] will tell you that I’vebelieved for some time that Research!America should create a council ofbusiness leaders. As President of FASEB, that’s what I did when we wanted tochange the Republican policy on science in 1995, and we succeeded by bringingbusiness leaders to Speaker Gingrich. I believe that this is not just a tactic.It is an accurate reflection of how America works. And I think BillGates’ comments about how American high schools are indeed antediluvian arecorrect. But we’re not going to fix them in this room. That requires one byone, teacher by teacher, et cetera. But we can bring together major groups toinsist that we start doing the right thing. I think your suggestion is a verygood one. And we ought to try and extract some kind of synthetic activity outof this hugely intelligent and thoughtful panel. Because the recommendationsthat you’ve heard across the board, as I said, are a pittance compared to the$2 trillion that are saved every year just by the decrease in deaths from cardiovasculardisease or the amount of money that we could save in other ways by using ourheads instead of fighting about it. So, Mr. Gergen, if you would like to leadus, we’d be glad to have you. MR. DAVID GERGEN: I can assure you there arebetter people. But I can help you sell the story. Please. MR. JONATHAN PECK,INSTITUTE FOR ALTERNATIVE FUTURES: Jonathan Peck, Institute for AlternativeFutures. I was thinking back to one of the great leadership moves in reactionto Sputnik. And our President said in ten years, we’re going to put a man onthe moon. And I’d asked the panel if you could set a goal that would galvanizescience in the public mind as a great success story, what would it be? Would itbe predict and prevent these medicines we can see, these diseases we can see,of obesity? Or what goal would you put that could galvanize all these sciences?MR. DAVID GERGEN: Someone want to take a crack? Yes, Dr. Doogan. DR. DOOGAN: Iwould like us to cure cancer and Alzheimer’s disease, because these are two ofthe greatest opportunities rather than issues. And I think that people couldrelate to that. I’m not ignoring other diseases. There’s a huge amount of workto do in mental illness, for example. But I think those two are tantalizing inthe opportunity. MR. DAVID GERGEN: Other thoughts about what goals might be realistic,in sight, 10 years away? DR. JOHN LEONARD: I’ll offer one up. And it’s nothealth care based. But it would be energy independence and the use of renewableenergies. I think that that’s something that would touch absolutely everysingle American every single day of his or her life. MR. DAVID GERGEN: Good.Thank you. You want to jump in briefly on that point? MALE SPEAKER: Yeah, I’m areporter. And I saw much of this happen. And I saw Richard Nixon start the waron cancer to get rid of it. Johnson’s President. Johnson starts to have the waron heart disease, cancer and stroke. They were so determined at that time toabolish diseases. But those research efforts didn’t quite make it. And I (inaudible).MR. DAVID GERGEN: That’s helpful. We have two more. And we’ll go to you. MS.MARCELA GAITAN, NATIONAL ALLIANCEFOR HISPANIC HEALTH: Marcela Gaitan with the National Alliance for Hispanic Health. My question hasto do … it’s following up on the comments by Dr. Zerhouni and Dr. Cicerone onthe need to invest in the next generation of scientists. In thinking about thediversity of our schools nowadays, how can we address the issue of increasingthe number of minority (inaudible) groups in the professions of engineering andmathematics, health sciences? MR. DAVID GERGEN: I’m really glad you broughtthat into the conversation. Dr. Gerberding. DR. JULIE GERBERDING: I don’t havean easy answer. But I think the principles are the same no matter what groupyou’re specifically interested in exciting about science. We’ll have to usedifferent tools different messages, different opinion leaders and perhapsdifferent channels. But I think the fundamental principle here is that if youexcite children about science and you create a world of possibilities for themand somebody to take them by the hand and help them believe they can get there,they’ll come. They will be excited and they will join in. MR. DAVID GERGEN: Doyou think we also need to change the cultural, the norms, the expectations foryoung scientists, young doctors so that this isn’t … our daughter is now goingthrough her residency and she has a young child. I find it stunning that thesystem is so … does what it does … puts the pressure on these young mothersthat it does in health care. And I can see why it would be discouraging toothers. I don’t understand why we can’t fix these systems so that young womencan move into science and these other fields without the conflicts that they face.DR. JULIE GERBERDING: I agree with you completely. I have to have a caveat herebecause I was extremely fortunate as a little girl to know at age four I wasgoing to be a scientist and a doctor. And no one stood in my way until I wasapproaching tenure. And so I was very, very fortunate. But I’ve made it apersonal mission. And that is another challenge to the people in this room.Every one of us could reach to a little girl or a child that you’re interestedin and take that child by the hand and help remove some of those barriers. DR.CAROLYN CLANCY: I had the privilege to speak at a biomedical sciences careerprogram last week at Harvard which specifically focuses on recruiting minoritystudents interested in sciences. And it was quite instructive what they do.They actually engage a lot of the Harvard faculty to spend a couple of dayswith these students working in small groups and they recruit from high schoolon up. And some of them come back every year. But in essence, they’re givingthem a sense of possibilities, what it would look like. And I will say pickingup on Elias’ earlier point, they’re fairly cautious. I mean, they’reencouraging them. But they’re also letting them know that the road ahead isgoing to be pretty tough. But they’re also creating a built-in network forthese students. They all leave with cards that say, you know, BSCP and theirname on it. So they have the sense that they’re part of a larger entity. Thisis funded entirely privately, not from governments or foundations. So it struckme as sort of one step or one piece of a potential strategy here. Because we’reway, way behind. DR. ARDEN BEMENT: The down side is the reason why it mayappear that we’re not making broad progress in public school or even privateschool education is that the fastest growing segment of our population areunderrepresented minorities. And yet, the highest dropout rate is in thatsegment. So it sort of balances out. On the other hand, there’s great hope.There are school systems that are predominately Hispanic, as much as 87 percentHispanic, that have now achieved 95 percent efficiency in both math and scienceat elementary, middle school and high school ranks. Incredible. A week ago, Imet 200 students in our Lewis Stokes Alliance for Minority Participation fromaround the country, 200 that are in graduate work. Maybe 25 years ago, thatwould have been the whole national cohort. This is just one program. Thesestudents are hopeful. They’re energetic. They’re bright. They have a greatfuture ahead of them. Many of them want to go into university teaching. Some wantto go into industry. And they represent a broad spectrum of fields, many ofwhich are represented here. So many will go into medicine. Many will go intothe biosciences. Some will go into engineering. Some will go into computerscience as well. We need to build on these successes. We need to exchange bestpractices. And we have a long way to go. But on the other hand, this is not thetime to get discouraged. MR. DAVID GERGEN: Dr. Bement, could you tell us abouta couple of the Hispanic schools that have made this part of … are theypublic schools? DR. ARDEN BEMENT: Yes, the school district that I’m familiar withI believe is District 9 which is El Paso, Texas. The other school district isthe one the President visited. I believe it was … I want to say Dallas. But Icould be wrong. I think it was Dallas, Texas. But I visited a similar school inGreenville, South Carolina just about three weeks ago. I’m not sure their proficiencyis quite that high. But I only visited the fifth grade and that was dynamite.You talk about doing an experiment in the fifth grade. They were building carswith propulsion systems made with renewable materials. They did test data. Theychanged … they optimized their propulsion system. They understood friction.They understood alignment. And they were taking data in the metric system. Thatwas in fifth grade. MR. DAVID GERGEN: That’s very helpful. Thank you. Yes, Dr. Cicerone.DR. RALPH CICERONE: The National Science Foundation has been great here.Sixteen years ago, I helped to start a program, the California Alliance forMinority Participation at U.C. Irvine focused on the Hispanic population in thearea. And one of the early failures we had is that we traced difficulties infreshman and sophomore year chemistry and biology to calculus. And then thatfailure was traced back to the middle schools. And I’m proud to say that thepeople out there with NSF support have dug in. I’ve been working with middleschools in algebra in seventh and eighth grade. And the success rate now inthose programs is stunning. On a typical Saturday session, which goes on allyear that involves the families of the children and middle schools, we now havereturning M.D.’s and Ph.D.’s of kids who went through the program, Hispanics inthe area. And this never would have happened without not only NSF support, butpeople who feel optimistic and positive and who are making good thingshappening. And tremendous family support. MR. DAVID GERGEN: Good. That’s good.Thank you, very much. Now. DR. JAY GERSHEN, UNIVERISTY OF COLORADO AT DENVERAND HEALTH SCIENCES CENTER: I’m Jay Gershen, Executive Vice Chancellor at theUniversity of Colorado at Denver and Health Sciences Center. And I have theprivilege of being on the board of Research!America and chair the Membership Committee.And I would like to drill down a little bit on the business side of this andbusiness advocacy and getting the bio and non-bio business community involvedin advocating for medical research. And I’d like to start with a very shortanecdote story. Since storytelling is a good thing you said. Then ask aquestion. And the story is a local story. There’s a military base in Coloradothat was closed. The University of Colorado Health Sciences Center is movingout there. It will be done in two years. And one of the main reasons for thatis the cooperation of the business community. And sitting behind me is WendyMitchell, who is president of the Aurora Economic Development Council, who has100 businesses that pay $10,000 a year to be an investor in that council. And theUniversity was stalled at about 14 votes in the state senate. You need 18. AndWendy and her coalition delivered 23 votes for $200 million in constructionmoney to complete the campus. And my question is, if you look at Research!Americaand its main advocacy message, which is better health for Americans and alsoimproving the economic health of America if you will, how do we get thebusiness community more involved in what Research!America is doing and thiscoalition you were talking about? Going beyond that we need leadership. How dowe get more bio and non-bio businesses to participate in Research!America and tocarry this message? So that we move from 125 million people in this country whosupport this to 200 million? MR. DAVID GERGEN: Good question. Let’s see, Helen,do you want to respond to that? MS. HELEN DARLING: Well, I would say they’re alot like politicians. If it’s something they can understand and if they havethe facts. For example, if you’re a business that requires math and scienceexperts for your business, then you can argue with them that if they help inthe following ways, they’re going to be better off. Most large corporations,who are mainly my members, in fact are usually very active in theircommunities. And they usually are active in two situations. They care abouteducation. So it’s partly a function of maybe redirecting how much of theirinterest in education also focuses on math and science. And second, where theyhave people in the company who are active. So, for example, most corporate foundationshave a requirement that they put money in activities that they have employeesor sometimes retirees who are working in them. Because they see it. They know they’regoing to get more for their money. And they also know that there’s going to beadded value there for everybody. So it would be again like politicians at the localand state level where they’re headquartered. MR. DAVID GERGEN: All right. Well,this has been a long, sometimes complex, but always vital conversation. Mary Woolleyand John Porter, do you have any final words? MS. MARY WOOLLEY: John. MR. DAVIDGERGEN: All right. Fine. Good. MR. JOHN EDWARD PORTER: Well, I don’t know aboutanyone else … yes, I do. For this non-scientist, I have learned more andgotten more insights in the last two hours than any other time perhaps in mylife about the subjects that we’ve discussed today. And I think all of us aregreatly in debt to our nine very distinguished panel members and to our wonderfulmoderator, David Gergen, for making all this possible. [applause] Now, beforeyou jump up, one of the things that I leave with … and by the way, I thinkit’s also been helpful for the panelists to hear each other, by the way aswell. Maybe you don’t have as many opportunities as there should be to interactwith one another for such a long timeframe and talk about the things that wetalked about today? But the message I get for everyone is that we have to goout and be the leaders that carry the message. Every one of us in this room hasto go out there and lead and carry the message of the importance of working toput the priority of science and technology and research at the forefront of thethinking of the American people, our policymakers and our administration. AndDavid, we’re going to take you up on helping us tell that story. Because youare good at it. And I think that we add the right way to tell it. We can capturethat imagination and bring our passion to the table to make it happen. Marytells me we all need to do “friend-raising” before fundraising. And I thinkthat’s exactly right as well. Obviously, we need to do both. They work witheach other. We need to go out though and provide the leadership and take themessage home and make this happen. And David, we’re going to pass thatlegislation in this Congress. But that isn’t the end of the story. We have alot more to do after that. Thank you all for being here. [applause]