A Handbook For Activist Scientists

Here is a book that belongs on the desk of every biomedical researcher in the United States: Building a Healthy America Conquering Disease and Disability Facts, Figures and Funding, edited by Terry L. Lierman. Lierman is president of Capitol Associates, Inc., a Washington, D.C.-based government relations firm specializing in health-related issues and funding. The volume, published last November, is the successor to a series of handbooks initiated by Mary Lasker, all entitled Killers and Cripplers, which were issued from 1968 to 1976. Like its predecessors, Building a Healthy America aims to equip the public with current statistics and plain facts about many of the major diseases and disabilities we face in this nation, such as AIDS, Alzheimer’s disease, cancer, coronary heart disease, diabetes. stroke and 20 others. Lierman gives a brief description of each, as well as up-to-date figures on the number of people afflicted, the costs in terms of medical care and lost productivity, and the amount spent on research in fiscal year 1987. Lierman also provides a summary of recent research advances, a list of organizations focusing on the disease, and a glossary of key terms. He has included numerous diagrams and charts to supplement the text. Moreover, in an introductory section called “How the Body Works,” he describes the basics of the cardiovascular, endocrine, immune and nervous systems, thereby giving context to the discussion of each disease. Scientists will want to read this part of the book carefully, not so much for the basic health information it provides (although it is a model of clear, concise exposition) but for the numbers that Lierman has marshaled together. These data are especially useful to those of us who are occasionally asked to comment on the level of federal funding for biomedical research and why it should be increased. For example, Lierman tells us that U.S. citizens are currently spending some $440 billion on health care annually, but only $8 billion on research to find solutions to our health problems. He also tells us that Americans spend $25.4 bil lion a year on cigarettes—over three times the NIH’s research budget. This is the type of comparison that Mary Lasker has used so successfully in making the need for government support for biomedical research plain to the public. But my chief reason for recommending this book to working scientists is for the section it contains on the federal government and how it works to support science. If you do not understand how the federal government is organized to deal with health matters or how Congress decides upon and enacts funding for biomedical research—and many scientists remain blissfully ignorant of this mind-numbing process—this is the primer for you. Lierman lists the various Congressional committees on health and describes the multiple actions, including authorization and appropriation in both the House and Senate, that are required before the funding process becomes funding reality. Furthermore, this section contains two chapters that are, in my opinion, essential reading for activist scientists. Previously I have exhorted scientists to get involved in science-related public issues and to learn to lobby. In a chapter entitled “Lobbying for Medical Research,” Lierman describes how to do so. He outlines what makes for an effective presentation, whether by letter or in person. As Lierman writes, "we have not naa a President in 20 years who has made medical research a high priority.... The nation’s major political parties totally ignore medical research in their national platforms, and there are no national candidates who work for and strongly support such programs.” “Fortunately,” he continues, “many members of Congress have gained sufficient understanding of the importance of aggressive medical research to maintain viable, if not fully funded, research programs. Most senatore and representatives will listen to knowledgeable and enthusiastic constituents who can help them .to understand the advances that could be made in the next 5 years—with adequate funding” (p. 34). Who better than research scientists can provide our representatives with this information? The second chapter deserving special note is ‘The Role of Animals in Research.” This issue is of increasing concern to the public, owing to the tireless efforts of animal-rights groups. Lierman states clearly why animals are used in research and why other models are inadequate in many instances. He enumerates the many ways humans—as well as animals—have benefited from research using animals. I was particularly interested to read that 77 percent of the American public supports the use of animals in research (p. 58). Scientists should realize the degree to which the public supports their work, but they should not squander that support by allowing their opponents to dominate the public debate. I’m afraid too many have done just that. Biomedical researchers ought to answer the anti-vivisectionists’ arguments directly and often. They ought to be able to tell their neighbors about the benefits of research using animals and the safeguards the scientific community has instituted to protect laboratory animals. Lierman provides the relevant facts. For giving scientists a very usable book on how to help shape national support for biomedical research and for continuing the work of Mary Lasker, Lierman deserves genuine thanks. I strongly recommend Lierman's Study it closely, and then, as the author says, “when you put down this book, pick up your pen.” [Building a Healthy America (ISBN 0-913-113-12-3) is available for $19.00 from the publisher, Mary Ann Liebert, Inc., 1651 ThIrd Ave., New York, NY 10128; telephone (212) 289-2300. Bulk sales available upon request.] Eugene Garfield is Publisher and Editor- in Chief of THE SCIENTIST, and President of the Institute for Scientific Information, Philadelphia, PA 19104.

A Handbook For Activist Scientists

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