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A major investment in fighting tropical infections and chronic conditions like heart disease and diabetes in poor countries would transform international perceptions of the US, according to Harold Varmus, who co-chairs the President’s Council of Advisers on Science and Technology.
In an exclusive interview with The Times, Dr Varmus said that American diplomacy had undervalued the role of medicine and science in fostering friendly relations with developing nations.
He is asking President Obama to endorse a plan from the US Institute of Medicine that would almost double annual US support for global health to $15 billion by 2012.
Dr Varmus is also advocating a “Global Science Corps” of scientists willing to spend at least a year working in a poor country, and a network of science attachés for every US embassy.
“We know economic times are tough, but this is a small amount of money, and it is so important to our international reputation,” he said. “We build alliances here, that’s the essence of the argument. We’d be looked on as leaders who take a humanitarian interest.
“I believe doing good things in health and science is not just for pragmatic interest. But investment in global health is in the national interest too.”
Scientific exchange, he added, could repair some of the damage done to American’s reputation by the Iraq war. “One very healthy way to build relationships up when they have deteriorated is to get the scientists together,” he said. We’re used to internationalism, it’s part of the way we live.
“We’re all trying to understand the same forces of nature, which are pretty much the same in every country. We’re trying to understand the same problems, we use the same methodologies, the same rules of evidence. There’s no doubt that this is a very very fertile field which I think needs to be further incorporated into our foreign policy.”
He cited a recent meeting with Iranian scientists at the recent World Academy of Sciences meeting in Mexico City. “This is a country with which we do have political tensions. But these folks just wanted to talk to American scientists. We do share certain values.”
While Dr Varmus does not have an executive role in the Obama Administration, his position suggests the President is likely to sign up to an expanded global health and science programme.
Dr Varmus, who won the 1989 Nobel Prize for Medicine for his research into cancer genetics, is part of the “dream team” of senior scientists recruited by Mr Obama as policy advisers. The appointments, which also included another Nobel Laureate, Steven Chu, as Energy Secretary, signalled a new White House attitude to scientific advice, which was often ignored by President Bush on various issues from stem cells to climate change.
Dr Varmus was in London yesterday meeting British science ministers and officials from the Royal Society, the UK’s national academy of science. His memoirs, The Art and Politics of Science, have just been published in Britain.
He said Mr Obama should build on Mr Bush’s biggest achievement in science and health — the establishment of the President’s Emergency Plan For Aids Relief (Pepfar), which has transformed access to HIV drugs in 15 countries, mostly in sub-Saharan Africa.
“The new administation should seize and opportunity here to extend one of the few good things that the Bush Administration did, namely to take a greater interest in global health,” he said.
“The Pepfar programme was not perfect in my view, in that it didn’t give enough attention to prevention and spent too much time worrying about abstinence as opposed to condoms, but it showed clearly that you can do anti-HIV treatment with anti-retroviral drugs in poor countries. There are now 1.7m people who are under treatment. I give President Bush some credit here.”
Pepfar has already been expanded to include malaria and tuberculosis, but needs to go further. “Simply treating HIV is not enough. If you look at the general layout of health problems in poor countries, you have a large amount of persistent childhood respiratory illnesses and diarrhoea, there are many neglected tropical diseases like hookworm and and schistosomias [bilharzia].
“Increasingly, chronic diseases because the improvements we’ve made in health are allowing many more people to live into their 50s and 60s, and we’re not doing anything about diabetes, hypertension, cardiovascular disease and stroke. We could even with modest means do something about that.”
Further US investment should target science and health infrastructure in developing countries, so that fewer of their scientists are tempted to leave to pursue their careers in the West.
“We also think there’s a lot of potential for harnassing science for making relations between countries stronger,” Dr Varmus said. “Perhaps the simplest and most obvious way is to have people with scientific expertise in our embassies, helping to advise countries on the development of science and technology.
“It’s fair to say that most Americans believe that we are lucky people. Even though we’re in the middle of a terrible downturn at the moment, we lead much better lives than somebody who is struggling in an African village, and we have an ethical responsibility to do something about that. It doesn’t take a lot of our time and money to make a big difference.”
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