8. Stem cells. Stem cell research advocates say it may successfully lead to treatments for many chronic diseases and injuries, saving lives, but opponents argue that using embryos as a source for stem cells destroys human life. What is your position on government regulation and funding of stem cell research?
Stem cell research holds the promise of improving our lives in at least three ways—by substituting normal cells for damaged cells to treat diabetes, Parkinson’s disease, spinal cord injury, heart failure and other disorders; by providing scientists with safe and convenient models of disease for drug development; and by helping to understand fundamental aspects of normal development and cell dysfunction.
For these reasons, I strongly support expanding research on stem cells. I believe that the restrictions that President Bush has placed on funding of human embryonic stem cell research have handcuffed our scientists and hindered our ability to compete with other nations. As president, I will lift the current administration’s ban on federal funding of research on embryonic stem cell lines created after August 9, 2001 through executive order, and I will ensure that all research on stem cells is conducted ethically and with rigorous oversight.
I recognize that some people object to government support of research that requires cells to be harvested from human embryos. However, hundreds of thousands of embryos stored in the U.S. in in-vitro fertilization clinics will not be used for reproductive purposes, and will eventually be destroyed. I believe that it is ethical to use these extra embryos for research that could save lives when they are freely donated for that express purpose.
I am also aware that there have been suggestions that human stem cells of various types, derived from sources other than embryos, make the use of embryonic stem cells unnecessary. I don’t agree. While adult stem cells, such as those harvested from blood or bone marrow, are already used for treatment of some diseases, they do not have the versatility of embryonic stem cells and cannot replace them. Recent discoveries indicate that adult skin cells can be reprogrammed to behave like stem cells; these are exciting findings that might in the future lead to an alternate source of highly versatile stem cells. However, embryonic stem cells remain the “gold standard,” and studies of all types of stem cells should continue in parallel for the foreseeable future.
Rather than restrict the funding of such research, I favor responsible oversight of it, in accord with recent reports from the National Research Council. Recommendations from the NRC reports are already being followed by institutions that conduct human embryonic stem cell research with funds from a variety of sources. An expanded, federally-supported stem cell research program will encourage talented U.S. scientists to engage in this important new field, will allow more effective oversight, and will signal to other countries our commitment to compete in this exciting area of medical research.
9. Ocean Health. Scientists estimate that some 75 percent of the world’s fisheries are in serious decline and habitats around the world like coral reefs are seriously threatened. What steps, if any, should the United States take during your presidency to protect ocean health?
Oceans are crucial to the earth's ecosystem and to all Americans because they drive global weather patterns, feed our people and are a major source of employment for fisheries and recreation. As president, I will commit my administration to develop the kind of strong, integrated, well-managed program of ocean stewardship that is essential to sustain a healthy marine environment.
Global climate change could have catastrophic effects on ocean ecologies. Protection of the oceans is one of the many reasons I have developed an ambitious plan to reduce U.S. emissions of greenhouse gases 80 percent below 1990 by 2050. We need to enhance our understanding of the effect of climate change on oceans and the effect of acidification on marine life through expanded research programs at NASA, the National Oceanic and Atmospheric Administration (NOAA), the National Science Foundation (NSF), and the U.S. Geological Survey (USGS). I will propel the U.S. into a leadership position in marine stewardship and climate change research. Stronger collaboration across U.S. scientific agencies and internationally is needed in basic research and for designing mitigation strategies to reverse or offset the damage being done to oceans and coastal areas.
The oceans are a global resource and a global responsibility for which the U.S. can and should take a more active role. I will work actively to ensure that the U.S. ratifies the Law of the Sea Convention – an agreement supported by more than 150 countries that will protect our economic and security interests while providing an important international collaboration to protect the oceans and its resources. My administration will also strengthen regional and bilateral research and oceans preservation efforts with other Gulf Coast nations.
Our coastal areas and beaches are American treasures and are among our favorite places to live and visit. I will work to reauthorize the Coastal Zone Management Act in ways that strengthen the collaboration between federal agencies and state and local organizations. The National Marine Sanctuaries and the Oceans and Human Health Acts provide essential protection for ocean resources and support the research needed to implement a comprehensive ocean policy. These programs will be strengthened and reauthorized.
10. Water. Thirty-nine states expect some level of water shortage over the next decade, and scientific studies suggest that a majority of our water resources are at risk. What policies would you support to meet demand for water resources?
Solutions to this critical problem will require close collaboration between federal, state, and local governments and the people and businesses affected. First, prices and policies must be set in a ways that give everyone a clear incentive to use water efficiently and avoid waste. Regulations affecting water use in appliances and incentives to shift from irrigated lawns to "water smart" landscapes are examples. Second, information, training, and, in some cases, economic assistance should be provided to farms and businesses that will need to shift to more efficient water practices. Many communities are offering kits to help businesses and homeowners audit their water use and find ways to reduce use. These should be evaluated, with the most successful programs expanded to other states and regions. I will establish a national plan to help high-growth regions with the challenges of managing their water supplies.
In addition, it is also critical that we undertake a concerted program of research, development, and testing of new technologies that can reduce water use.
11. Space. The study of Earth from space can yield important information about climate change; focus on the cosmos can advance our understanding of the universe; and manned space travel can help us inspire new generations of youth to go into science. Can we afford all of them? How would you prioritize space in your administration?
As president, I will establish a robust and balanced civilian space program. Under my administration, NASA not only will inspire the world with both human and robotic space exploration, but also will again lead in confronting the challenges we face here on Earth, including global climate change, energy independence, and aeronautics research. In achieving this vision, I will reach out to include international partners and to engage the private sector to amplify NASA’s reach. I believe that a revitalized NASA can help America maintain its innovation edge and contribute to American economic growth.
There is currently no organizational authority in the federal government with a sufficiently broad mandate to oversee a comprehensive and integrated strategy and policy dealing with all aspects of the government’s space-related programs, including those being managed by NASA, the Department of Defense, the National Reconnaissance Office, the Department of Commerce, the Department of Transportation, and other federal agencies. This wasn’t always the case. Between 1958 and 1973, the National Aeronautics and Space Council oversaw the entire space arena for four presidents; the Council was briefly revived from 1989 to 1992. I will re-establish this Council reporting to the president. It will oversee and coordinate civilian, military, commercial, and national security space activities. It will solicit public participation, engage the international community, and work toward a 21st century vision of space that constantly pushes the envelope on new technologies as it pursues a balanced national portfolio that expands our reach into the heavens and improves life here on Earth.
12. Scientific Integrity. Many government scientists report political interference in their job. Is it acceptable for elected officials to hold back or alter scientific reports if they conflict with their own views, and how will you balance scientific information with politics and personal beliefs in your decision-making?
Scientific and technological information is of growing importance to a range of issues. I believe such information must be expert and uncolored by ideology.
I will restore the basic principle that government decisions should be based on the best- available, scientifically-valid evidence and not on the ideological predispositions of agency officials or political appointees. More broadly, I am committed to creating a transparent and connected democracy, using cutting-edge technologies to provide a new level of transparency, accountability, and participation for America’s citizens. Policies must be determined using a process that builds on the long tradition of open debate that has characterized progress in science, including review by individuals who might bring new information or contrasting views. I have already established an impressive team of science advisors, including several Nobel Laureates, who are helping me to shape a robust science agenda for my administration.
In addition I will:
• Appoint individuals with strong science and technology backgrounds and unquestioned reputations for integrity and objectivity to the growing number of senior management positions where decisions must incorporate science and technology advice. These positions will be filled promptly with ethical, highly qualified individuals on a non-partisan basis;
• Establish the nation’s first Chief Technology Officer (CTO) to ensure that our government and all its agencies have the right infrastructure, policies and services for the 21st century. The CTO will lead an interagency effort on best-in-class technologies, sharing of best practices, and safeguarding of our networks;
• Strengthen the role of the President’s Council of Advisors on Science and Technology (PCAST) by appointing experts who are charged to provide independent advice on critical issues of science and technology. The PCAST will once again be advisory to the president; and
• Restore the science integrity of government and restore transparency of decision- making by issuing an Executive Order establishing clear guidelines for the review and release of government publications, guaranteeing that results are released in a timely manner and not distorted by the ideological biases of political appointees. I will strengthen protection for “whistle blowers” who report abuses of these processes.
13. Research. For many years, Congress has recognized the importance of science and engineering research to realizing our national goals. Given that the next Congress will likely face spending constraints, what priority would you give to investment in basic research in upcoming budgets?
Federally supported basic research, aimed at understanding many features of nature— from the size of the universe to subatomic particles, from the chemical reactions that support a living cell to interactions that sustain ecosystems—has been an essential feature of American life for over fifty years. While the outcomes of specific projects are never predictable, basic research has been a reliable source of new knowledge that has fueled important developments in fields ranging from telecommunications to medicine, yielding remarkable rates of economic return and ensuring American leadership in industry, military power, and higher education. I believe that continued investment in fundamental research is essential for ensuring healthier lives, better sources of energy, superior military capacity, and high-wage jobs for our nation’s future.
Yet, today, we are clearly under-investing in research across the spectrum of scientific and engineering disciplines. Federal support for the physical sciences and engineering has been declining as a fraction of GDP for decades, and, after a period of growth of the life sciences, the NIH budget has been steadily losing buying power for the past six years. As a result, our science agencies are often able to support no more than one in ten proposals that they receive, arresting the careers of our young scientists and blocking our ability to pursue many remarkable recent advances. Furthermore, in this environment, scientists are less likely to pursue the risky research that may lead to the most important breakthroughs. Finally, we are reducing support for science at a time when many other nations are increasing it, a situation that already threatens our leadership in many critical areas of science.
This situation is unacceptable. As president, I will increase funding for basic research in physical and life sciences, mathematics, and engineering at a rate that would double basic research budgets over the next decade.
Sustained and predictable increases in research funding will allow the United States to accomplish a great deal. First, we can expand the frontiers of human knowledge. Second, we can provide greater support for high-risk, high-return research and for young scientists at the beginning of their careers. Third, we can harness science and technology to address the “grand challenges” of the 21st century: energy, health, food and water, national security, information technology, and manufacturing capacity.
14. Health. Americans are increasingly concerned with the cost, quality and availability of health care. How do you see science, research and technology contributing to improved health and quality of life?
Americans have good reasons to be proud of the extraordinary role that medical science has had in combating disease, here and throughout the world, over the past century. Work sponsored by the National Institutes of Health (NIH), other government agencies, and our pharmaceutical and biotechnology industries has produced many vaccines, drugs, and hormones that have improved the quality of life, extended life expectancy, and reduced the dire consequences of many serious illnesses and disabilities. These advances include methods for preventing and treating coronary artery disease and stroke, which have reduced mortality rates by two-thirds; new drugs and antibodies that allow us to effectively treat certain cancers; anti-viral agents that allow most patients with AIDS to control their disease; drugs that often help make severe psychiatric illnesses manageable; and new vaccines that are reducing the incidence of virus-related cancers; and minimally invasive surgery techniques that reduce hospitalizations, complications, and costs. We can expect much more from the exciting biomedical research now underway. For example, we can foresee medical care that will allow physicians to tailor care to individual patients, matching therapies to those most likely to benefit.
However, today our citizens have understandable concerns about their ability to afford the care they need, especially when our underlying system of paying for health care is broken. We spend more on health care per capita than people of other countries, yet lower income groups continue to suffer significant disparities in both access to care and health outcomes. Without major changes, costs will continue to increase. Our population is aging, many cancers and chronic disorders remain difficult to treat, and there are continuing threats of new and re-emerging infectious diseases.
It's wrong that America's health care system works better for insurance and drug companies than it does for average Americans, who face skyrocketing health care costs. My plan makes health care more secure and affordable by strengthening employer-based coverage, protecting patients' ability to choose their own doctors, and saving families $2,500 dollars by requiring insurance companies to cover prevention and limiting excessive insurance company charges. My plan covers everybody by requiring insurance companies to cover pre-existing conditions, providing tax credits to small businesses and working families, and covering all uninsured children.
These are difficult problems, and science and technology can solve only some of them. The effectiveness of medical care can be improved, and its costs can be reduced, by greater emphasis on best practices, electronic medical records, hospital safety, preventive strategies, and improved public health surveillance. The increased investments I support for medical research at the NIH may yield discoveries that reduce the cost of drug development, and we may produce new methods to prevent diseases that are costly to treat. But efforts to control costs also should make greater use of the tools for prevention and clinical management that already exist; enlist more effective participation of the Centers for Disease Control (CDC) and the Food and Drug Administration (FDA), as well as the NIH; and encourage investments in healthcare and health research by the private and not-for-profit sectors.
Overall, I am committed to three major tasks that will be necessary to confront widespread concerns about the nation’s health: provision of healthcare plans to all of our citizens; comprehensive efforts to make our health care system more cost-efficient; and continued biomedical research to understand diseases more thoroughly and find better ways to prevent and treat them.