'Consensus Statement' Fails To Capture Attention In Washington, D.C.

A "consensus statement" advocating increased United States government funding for biomedical research--endorsed by more than 230 institutions, associations, and companies and distributed widely last May--has generally been accepted in polite silence by lawmakers in Washington, D.C. The chairman of the forum at which the document was drafted says he is disappointed by the lack of attention given it by legislators and the media. At the same time, he and other framers of the statement say they are gratified that so many diverse and prestigious organizations have put their support behind the effort. "I guess I had hoped that more congressional offices and more parts of the [Clinton] administration would have taken note of the breadth of the constituents that had thought it important to prepare a statement," says Leon Rosenberg, president of the Bristol-Myers Squibb Pharmaceutical Research Institute in Princeton, N.J. Rosenberg chaired the March 9 meeting sponsored by Research!America, an Alexandria, Va.-based research-advocacy organization, at which the declaration was conceived. The document begins with the assertion that "too many Americans are suffering and dying needlessly because, as a nation, we don't invest enough in medical research." It concludes with recommendations, including calls to "incorporate the promotion of medical research as an integral element of health-care reform" and "encourage, do not obstruct, the discovery and development of innovative and effective pharmaceuticals . . . by private industry." (For the full text, see The Scientist, May 30, 1994, page 12.) Research!America president Mary Woolley estimates that the consensus statement was distributed to 2,000 individuals; it was hand-delivered to every member of Congress. The lawmakers, however, have not been quoting from the text in major speeches or using it in other publicity-generating ways. Moreover, despite the influential science and business constituencies represented among its signatories, the document has not inspired any new legislation. Dave Kohn, an aide to Rep. John Porter (R-Ill.), says that his boss is in accord with the document's tenets: "John Porter agrees with Research!America that biomedical research is an important aspect [of health care] and deserves to have very strong support." But Porter has planned no action on the statement, according to Kohn. "He received it, he generally agreed with its emphasis, but he hasn't responded in any particular way or used it in any particular way." The statement also has not made a splash in journalistic circles. While articles about it have appeared in The Scientist (B. Spector, May 30, 1994, page 1) and Wash-ington Fax--Life Science (June 13, 1994), most news organizations have ignored it. (A search of the Lexis-Nexis database for reports on the declaration turned up blank.) William T. Golden, former cochairman of the Carnegie Commission on Science, Technology, and Government who served as special consultant on scientific activities to President Harry Truman, speculates that many do not view the statement as revolutionary because it was issued by parties that stand to gain from implementation of its recommendations. "All these organizations will benefit from greater funding for scientific research. If the Association of Methodist Ministers sent such a document, they'd get attention for it," he says, citing a hypothetical, fictional nonscientific organization. "Congressmen are used to lobbyists and institutions looking for funding. It's hardly news--it's~ `dog bites man.' " Bruce L.R. Smith, a science-policy analyst at the Washington, D.C.-based Brookings Institution, says decision- makers may be ignoring the document because of deficiencies in its approach. "It doesn't deserve any attention," he says. Compared with the physical sciences, "the life sciences have been just booming in research support. [The signatories] assume they've been singled out for problems when theyUre the ones that have been spared." The authors of the text, Smith says, are "trying to make a case for continued support at a time when there's going to have to be some downsizing." But Rosenberg doubts that policymakers are disregarding the statement because they object to it. "I would find it hard to believe that anyone would take umbrage with the way the statement was framed," he maintains. "Great effort was made to be statesmanlike, to be positive, to be brief, to be constructive." Observers also speculate that the lack of response may just boil down to bad timing. "Congress is so totally enveloped with health-care reform that anything not related is pushed [down on the list of priorities]," says Susanne A. Stoiber, director of the Public Health ServiceUs Office of Health Care Reform. "Research is just not something that is at the center of attention. [Legislators] are focused on big regulatory issues [and on reform details like an] employer mandate. Research has been sort of tagging along in all this, in what I think is a fairly successful way." In addition to congressional representatives, the statement was given to key figures at the National Institutes of Health, the National Science Foundation, and other agencies. Several responded with letters to Research!America president Woolley. William R. Harlan, associate director for disease prevention at NIH, wrote that the statement "is an important manifesto that responds to the changing health care scene and the challenges faced by health research." Harlan says he intends to use the statement to respond to "people [who] call me from time to time and want background information [on] who supports a particular viewpoint. I would pull it out and quote from it [but] I wouldn't send people copies; it's not my part to do that. I wouldn't be circulating it widely or saying, `This is the direction we want to go.' " Ira C. Magaziner, senior adviser for policy development to the president, in a letter to Woolley, wrote: "You expressed concern about health research under the President's health care reform proposal. This is an issue that the Administration considered carefully while formulating the President's proposal." Magaziner's letter does not refer to the document. "It was disappointing that the only response from the White House failed to even mention the statement," says Rosenberg. "As a passionate advocate of biomedical research, I wanted the president of the United States to personally notice that effort." But Woolley notes that "Science in the National Interest," a White House report on U.S. science policy issued in August (B. Reppert, The Scientist, Aug. 22, 1994, page 1), parallels key issues in the statement. Specifically, she points to the three "strategic goals" in "Science in the National Interest," which she finds reflected in the Re- search!America document: economic growth and job creation; government that is responsive to citizens' needs; and world leadership in science, math, and engineering. "The biomedical research community is tracking very closely to the administration," she says. Some of the points made in the statement are likewise reflected in the Harkin-Hatfield Fund for Medical Research amendment to the health-care reform bill (No. S2357) introduced by Sen. George Mitchell (D-Maine). The amendment, originally proposed last spring by Sens. Tom Harkin (D-Iowa) and Mark O. Hatfield (R-Ore.), would set aside 1 percent of all monthly health insurance premiums for medical research above the NIH appropriation. The statement--which "emphasizes the need to encourage investment [in biomedical research] in the public and private sector'--notes Samuel C. Silverstein, president of the Federation of American Societies for Experimental Biology and a member of the group that drafted the document, is "absolutely congruent with Harkin-Hatfield." Silverstein, John C. Dalton Professor and chairman of the department of physiology and cellular biophysics at Columbia University, acknowledges that "Harkin and Hatfield proposed that idea long before" the Research!America text was written, and had received broad support in Congress prior to distribution of the statement. Yet he believes that the consensus document nonetheless should have received more attention from legislators. "It's the broadest consensus on anything to do with biomedical research ever achieved in this country," he says. "I don't know why it didn't do better." On the other hand, Carl Feldbaum, president of the Washington, D.C.-based Biotech-nology Industry Organization (BIO), which endorsed the document, says, "I don't have regrets; I didn't anticipate that it would be widely noted much outside our community. It's a pure policy statement; I don't believe it was ever intended as a press release." A signficant cause for optimism, say framers of the statement, is the growing list of organizations that have endorsed it. Names continue to be added, even though Research!America says it has stopped soliciting sign-ons. "In some sense, that means [the statement] has taken on a life of its own: by word of mouth, hand to hand, organization to organization, institution to institution," Rosenberg says. "It's become the thing to do now for organizations--when 200-plus organizations have signed, who wants to be off the list?" Research!America has circulated to signatories and potential en-dorsers a "Consensus Statement Action Packet," including a list of "ideas on how to maximize the impact." The group suggests that associations mention it in their newsletters, write to legislators about it, and contribute op-ed pieces on the subject to local newspapers, among other activities. As a result, the statement has been publicized in several organizationsU internal publications and at conferences. "We created this statement to give our members and those who are our partners lucid, clear messages to use as they make the case for research in health-care reform," explains Woolley. "I get good feedback; people are glad it's out there." "It's got legs to it," BIO's Feldbaum says of the statement. "It's got a long half-life. We can point to it again as wide and deep support [for biomedical research] in next year's budget." He adds that he would like to see "a new consensus to implement the statement in the form of real appropriations." Research!America president Woolley says no further action is planned at the moment: "I think we have done closest to the maximum we're going to with the consensus statement." But, she adds, "We're certainly open to new ideas." For example, "as [`Science in the National Interest'] moves more to an action phase, if there's a way for the consensus statement to tie in to that process, we'll certainly do so, but these things are going to have to evolve." Rodney W. Nichols, chief executive officer of the New York Academy of Sciences and a member of the steering committee for Research!America's Fall Outreach Campaign for New York, New Jersey, and Connecticut, says the act of signing the statement in itself constitutes a role in the health-care reform process. "It doesn't matter that there aren't any pyrotechnics; those signers will be more engaged in the debate about what the country wants [and thus] confronted with all the other forces in the debate. These participants, even in the act of signing on, are involved."

'Consensus Statement' Fails To Capture Attention In Washington, D.C.

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