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Remarks as Prepared for Delivery by Dr. Elizabeth G. Nabel for the 229th Induction Ceremony of the American Academy of Arts and Sciences on October 10, 2009
Dr. Nabel - October 20, 2009
“Scientific and Medical Discovery - in Service of Human Health”
Good afternoon and welcome. I am honored to speak to you today on behalf of Class II, the Biological Sciences. Congratulations to all of you on a very well deserved honor.
While we come from different backgrounds and have different research interests, for those of us in Class II, we share a passion for science and a responsibility to put intellectual contributions to humanitarian use.
Our nation’s citizens and leaders are in the midst of a vitally important discussion on health care. This debate has provided insights into who we are as Americans and what we value.
All people deserve to be healthy. Yet unfortunately, even now for many middle-class Americans, good health has become increasingly unaffordable due to lost jobs, a lack of insurance and/or insufficient income. It is my belief, shared and articulated by many in the audience, that health is a basic human right, and my comments today will focus on two dimensions of this discussion from the perspective of a physician-scientist.
While issues of access, quality, and affordability are complex and difficult to solve, they do not negate the underlying principle that Americans should have the ability to enjoy good health. The intensity of our national health care debate offers the scientific and medical community an important opportunity. Many of us have worked in impoverished areas in this country and abroad. We understand that there is a close association between poverty, a lack of decent housing and education, and poor health. How should we respond? What is our duty to our fellow citizens? A recent survey confirms that the vast majority of physicians consider it a professional obligation to address societal and health policy issues. Health care professionals, for the most part, are eager to serve. And so these efforts, begun by many in this Class of new fellows, must continue – our voices must be heard as we, as scientists and physicians, advocate for health as a human right. We must continue to reach out to those in need, and to those whose voice may be muffled to society’s ears, to those who are the most vulnerable.
This past summer, I had an opportunity to witness such advocacy in rural Rwanda, when I visited the Partners In Health program at the Rwinkwavu District Hospital. Rwanda is a war-torn land that is now rebuilding itself after decades of politically motivated atrocities. Here is a place where divisive acts in 1994 shredded the fabric of a country where Tutsi, Hutu and Twa residents once peacefully coexisted. During the 1994 genocide, neighbor turned against neighbor, and the country was literally destroyed. The country’s infrastructure is being rebuilt due to the vision and leadership of Rwanda’s President, Mr. Paul Kigame. Access to quality health care in Rwanda, as in many impoverished or politically unstable regions, is far from guaranteed. But, the advocacy is making a difference, and there is a lot of room for hope and optimism.
I visited with government and health leaders in Rwanda, and I was impressed by what is being done and by the potential for what can be done. For example, Partners In Health is currently making great progress in caring for sick Rwandans, rebuilding the medical care infrastructure, and training local people to do vital work. I acknowledge in particular the vision and on-the-ground efforts of my colleague and our fellow inductee Dr. Paul Farmer, the medical anthropologist and physician who is Partners In Health’s founding director. He has accomplished similar gains in Haiti.
One of the most profound and lasting ways we can serve our fellow citizens in places where poverty and political oppression vanquishes the right to good health is through biomedical research. That is because research results are multiplicative – extending benefit that is not possible through individual contact. Basic discoveries, translation to clinical medicine and implementation into urban and rural communities have been the story line of medical advances for decades, sparing millions from infections, cancer and heart disease. Much of this work is supported by tax payer investments in biomedical research in this country through the National Institutes of Health (NIH), the National Science Foundation, and other government agencies.
President Franklin Delano Roosevelt foresaw the power that basic research could bestow on human health when on October 31, 1940, he dedicated the newly established NIH on the Bethesda campus where I am now privileged to work:
“We cannot be a strong nation unless we are a healthy nation. And so we must recruit not only men and materials but also knowledge and science in the service of national strength. … The ramparts we watch must be civilian in addition to military.”
And so we should remember that the NIH came to be during a time in which this country was suffering, in the wake of the Great Depression. President Roosevelt appreciated the necessity of this research investment and we can attest today that he was correct in his vision. I am continually inspired by the many outstanding minds that have followed suit and devoted their talents to public service in the worlds of science and medicine. A perfect embodiment of this ideal is fellow Academy member and my colleague at the NIH, Dr. Tony Fauci, with whom I work closely and often on a range of policy issues that make a mark on national and global health.
This is a very special and challenging time for our biomedical community. We are in another time of economic hardship, and the NIH was fortunate to be the recipient of a multi-billion dollar investment from the American Recovery and Reinvestment Act of 2009 to create jobs and accelerate the pace of medical discovery. We can and should use the urgency of the current health care discussion as an opportunity to focus on the role of biomedical research and medical discovery in laying the foundation for better human health. It is also a time for physicians to renew their commitment to advocating for health as a human right.
We are optimistic that knowledge from important fields of NIH-funded research will contribute significantly to our progress in achieving affordable and high quality health care for all Americans. Research gives us the mechanism to improve health outcomes by developing and disseminating evidence-based information to patients, clinicians and other decision makers about which interventions are most effective for which patients under specific circumstances. Research in the areas of health economics, health systems research, health disparities, and personalized medicine will also undoubtedly inform the health care discussion in unique and important ways.
As physicians and scientists, we carry deep within us a belief that health is a human right and an understanding that when our health system does not serve many of our fellow Americans adequately, we must change it. Biomedical research offers hope to improve vaccines, therapeutics, devices and health system approaches that will bring health and security to the nation. This health care discussion is not solely about our nation’s health. Rather, it is a testament to our commitment to civility and to the protection of core human values. Thank you.
To watch Dr. Nabel’s speech, please visit The American Academies of Arts and Sciences .
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| NHLBI Director, Elizabeth G. Nabel, M.D., spoke before colleagues at the induction ceremony for the American Academy of Arts and Sciences 229th class of new members. Dr. Nabel was elected as a Fellow of the Academy’s section on medical sciences and was chosen to represent her section as a speaker at the ceremony held at Sanders Theatre in Cambridge, Massachusetts. (American Academy of Arts and Sciences Photo/Martha Stewart) |
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