The future will come sooner than you think: A manifesto for science communication in biomedical research

Note: This is the first of two parts. The second, which I will publish next week, discusses strategic and practical measures which will be necessary to address the issues it raises. I hope that the two pieces will trigger a very wide debate in the science research, communication, and teaching communities, and I will use this site to integrate comments and feedback along the way.

I.

For biomedical researchers, learning to communicate with the public is more than a way to acquire useful skills – it’s a social responsibility. Today’s scientific work will have profound effects on society that may come sooner than we think. Researchers need to help prepare for change, and they need to start now.

 

For years, biomedical scientists have spoken of a revolution in which findings from basic research will lead to new forms of diagnosis, treatment and prevention for major diseases that affect mankind. The pace of discovery and development has surpassed the most optimistic predictions of researchers from even just a few years ago. The public may have a different impression: Research operates on a different timescale than daily life. Scientists know that it may take decades for “potential drug targets” or “new therapeutic approaches” to affect a broad group of patients. The road from the laboratory to the clinic has more stages than the Tour de France, and it takes a lot longer to reach the finish line. Yet records are continually being broken all along the route – in terms of time, costs, automation and efficiency. There is no speed limit on biomedical progress; it is zooming down the fast lane at a pace that threatens to leave political, economic and social structures lagging far behind. It’s impossible to predict when and where the next leap forward in biomedicine will occur – breakthroughs often appear in the places you would least expect. Take the case of the biotech company that was using genetic engineering to try to create tulips with a more vivid purple color. In the process they discovered small interfering RNAs – which have become immensely important tools for research and the basis of numerous experimental therapies.

Cumulatively, progress arising from across the spectrum of research is starting to have significant effects on society. This impact will surely increase, and it will happen even if progress comes in small steps rather than some single, magnificent cure for a major disease. My children can surely expect to live a decade or two longer than I – and this is probably a conservative estimate. They will have to support an elderly population that lives longer and longer, will likely have to deal with the political fallout of an increasing health gap between industrialized countries and the rest of the world, and will face other serious consequences. Something similar happened over the course of the 20th century: vaccines, antibiotics, modern sanitation, and the development of modern surgical techniques added decades onto people’s life expectancy, but this happened at a time of rising birthrates in the developed world.  Today’s situation is different, and unless we plan for these situations well in advance, society will face dramatic and difficult adjustments. Coping with the biomedical revolution will require intensive interactions between scientists, physicians, politicians, economists, lawmakers, insurance companies, sociologists, and many others. Currently these groups receive almost no training in talking to each other and have little experience working together.

I think this has two important implications for scientists. First, they should accept a greater degree of social responsibility for the consequences of their work. This means doing everything they can to ensure that society is prepared to integrate their discoveries in the healthiest way possible; it also requires high standards of ethical behavior. This suggests the second point: Researchers must become much more engaged in public education and communication and will require new kinds of training to become involved. Scientists and clinicians will be the first to have a sense of the pace of change, and should serve a central role as both multipliers and a kind of early-warning system for the public. Professional science communicators will have an important role in this process – for example, by helping researchers develop their communication and teaching skills – but the task is too important to leave entirely to them.

We urgently need to start a very wide, public debate that engages all future stakeholders (i.e., everyone). It should draw on creative new modes of reaching school children, who are the scientists, decision-makers, patients, and workers of tomorrow and will directly experience the effects of the biomedical revolution. Society is already feeling the first symptoms; we can’t wait any longer. People need to learn to communicate across disciplinary boundaries at an early age and keep talking to each other as they advance along different educational paths and careers. This will require that they develop new skills, but that should happen anyway: The ability to communicate clearly and effectively pays off at every stage of a career in science and nearly every other field. Sadly, most European schools and universities lack a system to accomplish this – a point addressed in part 2.

Adequately addressing these issues will require the cooperation of partners at many levels: individuals, schools, institutes, and state and federal governments. The next section of this paper presents some specific ideas for short- and long-term actions that would be helpful and need to be undertaken soon. The most urgent point is to help teachers, scientists, and other groups of potential “multipliers” develop new skills and new, creative ways of engaging their pupils and the public. These groups will need to work closely together to prepare society to cope with the effects of biomedical research – which may be quite dramatic, and may come much sooner than we think. That can only happen if they first learn to talk to each other, are motivated, and are given many opportunities to do so.

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3 thoughts on “The future will come sooner than you think: A manifesto for science communication in biomedical research

  1. Greetings Russ, Nice paper. My comment is related to the conclusion:
    … “the effects of biomedical research – which may be quite dramatic, and may come much sooner than we think.”

    I get your sense of urgency but it doesn’t impact me instantly as I read this -due to my unfamiliarity with current biomedical research. I heard of the looming “aging population” effect, of course, but can you provide several more examples in addition to this one for me as an outsider to understand why this communication bridge is so urgent; i.e., how are things going to become that different from today? Thanks, and keep up the good work. Enrique

    1. Hi Enrique – very nice to hear from you, my friend. To reply: Some might think that basic biological research – which has changed a great deal due to the advent of new technologies like rapid, inexpensive DNA sequencing methods – will have a major impact on society through the development of some sort of “magic bullet” to cure cancer, Alzheimer Disease, etc. Over the long run, significant demographic change can be achieved through an accumulation of steps that seem smaller.
      Here are some examples: 1) major improvements in diagnosis; various tumors that seem similar on a superficial level are actually quite different and need to be treated differently; molecular markers have now been found to identify the types and determine whether a treatment will be effective or actually worsen a patient’s condition; 2) new molecular methods of diagnosis are being developed to identify cancer or other diseases at an earlier stage, allowing much earlier interventions – in most cases, extending a patient’s lifespan is best achieved when the disease is detected very early on; 3) new approaches to treating cancer are being developed that involve activating a patient’s own immune system, which may be able to distinguish cancerous from healthy tissues and “target” the cancers in ways similar to attacks on infectious disease; another approach is to give a person a viral infection – the viruses target cancer cells and deliver molecules that kill tumor cells; 4) a range of stem cell therapies are being developed which use cells derived from a patient to replace damaged cells or organs; etc., etc. While currently all of these methods are being used in small-scale clinical trials, they promise – within a few years, certainly in the next couple of decades – to become more widely used on much larger groups of patients. Additionally, scientists are learning to identify subtle risk factors that predispose individuals toward a range of diseases – cardiovascular disease, Alzheimer Disease, etc. This will permit a much wider identification of people at risk and the development of individualized prevention programs. And we now know that obesity, for example, is accompanied by a much higher risk of many types of disease – all kinds of cardiovascular conditions, for example, as well as neurodegenerative diseases and possibly many types of cancer. We still haven’t identified the molecular mechanisms that link these things, but people are working on them quite hard.
      So if you look at what is likely to happen over the next few years, we should see rapid inroads on the development of a very wide range of measures in disease diagnosis, treatment, and prevention that will eventually cause demographic change. At a time when birthrates are low in industrialized countries, I think this means that society needs to prepare far in advance so that our children are prepared to cope with the economic and social fallout of an ever-aging population that they will have to support.

      1. I’ll follow the news over the next couple of days and provide links to the kinds of things mentioned here. Just a sample from the news over the past couple of days:

        http://edition.cnn.com/2013/08/17/health/alzheimers-test-eye/
        http://www.bloomberg.com/news/2013-08-12/dementia-risk-factors-may-begin-as-early-as-adolescence.html?cmpid=otbrn.sustain.story
        http://www.business-standard.com/article/pti-stories/ageing-gene-may-be-behind-blood-cancer-113081900362_1.html
        http://www.npr.org/2011/05/13/136280452/can-viruses-be-used-to-fight-cancer
        And the NIH’s “Clinical trials” page, listed below, provides an amazing list of ongoing trials at various stages of progress. See, for example:
        http://clinicaltrials.gov/ct2/results?term=reovirus

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