• September 23, 2014

On Climate Controversies and AIDS Research, Scientists Reach Out to the Public

Outside the waterfront convention center here on Friday, a small group of protesters warned against secret scientific plots to modify the weather. "Are we the experiment?" asked some of the posters carried by about 20 people.

A smaller group, also with signs, was more worried about the University of California. "President Yudof, stop cutting education and research," read their placards, referring to Mark G. Yudof's austerity plans for the state system.

Such was the immediate outside face of public engagement at the 2010 annual meeting of the American Association for the Advancement of Science, which started last week at the convention center. The official theme: "Bridging Science and Society."

Inside the building, the attempts at bridge building and dealing with public concerns were more expansive. Climate change and geoengineering were on the agenda, as were optimism about advances in AIDS research, public doubts about scientific integrity, and the tentative future of university-to-clinic medicine. (The University of California system was not an agenda item, though many California professors, in the hallways, said that every meeting with a dean these days brought more bad news.)

Halfway through the meeting, 3,700 attendees had registered, 300 fewer than in 2009, said Alan I. Leshner, chief executive of the association. "I don't worry about that small a drop in a tight economy," he said, adding that the meeting was intended for public interaction, not to make money from attendance. "One thing that has changed is that more and more young people are coming," he said. "Forty-two percent of our registrants are under age 45; a decade ago, they were older. I can't explain it. My perception is that more people are interested in science-and-society issues, and maybe those are younger people."

Testing Climate-Change Solutions

Climate change, and what scientists should or shouldn't do about it, was clearly of interest to all ages. The protesters outside were matched inside by some scientific skeptics of ideas to cool the planet by blocking sunlight before it warms the atmosphere. That notion, part of the concept of geoengineering, seems straightforward: Inject tiny reflective particles called sulfate aerosols into the stratosphere, and they will bounce some sunlight back into space, reducing the greenhouse effect on Earth.

But it isn't simple at all, warned Martin Bunzl, director of the Rutgers Initiative on Climate and Social Policy and a professor of philosophy at Rutgers University, at a symposium on the topic. He, and others, worried about unintended consequences.

"The planet is too big a laboratory," Mr. Bunzl said. Models and small-scale simulations don't capture effects that would only appear after a planetwide intervention. Inserting particles in the stratosphere could, in theory, disrupt a monsoon cycle and harm the food supply for two billion people in Asia, but scientists would not know that until they had already tried the intervention. "Our models get worse as you get more local, more fine-grained," he said. If you get an immediate, inadvertent result, it would take a while to ramp it down.

That concern was echoed by Philip J. Rasch, chief scientist in the atmospheric-sciences and global-change division at Pacific Northwest National Laboratory, who is investigating ways to make clouds more reflective by seeding them with sea salt. "We don't believe this is the time for deployment."

More of a proponent was Ken Caldeira, senior scientist in the department of global ecology at the Carnegie Institution for Science and an associate professor at Stanford University. "What these other speakers said is wrong," he said, provoking gentle laughter from the podium. (Mr. Caldeira had studied under Mr. Bunzl.) "The premise that we have to test at full scale is incorrect." It is possible, he said, to validate some features of those plans by doing small-scale tests. "And we wouldn't just turn on the switch and leave it there."

Mr. Caldeira added there was a severe risk of doing nothing. "You mentioned disruption of the monsoon cycle and food supply," he said. But "there could be two billion people at risk for famine from existing climate-change trends. So we need to do the research now."

He and other panelists did discount the notion of long-term secret weather-modification programs, when asked about it by an audience member. "During eight years of the Bush administration," Mr. Caldeira said, "they were not interested enough in climate change to try and mitigate it."

But concerns like those and, more important, basic doubts about the integrity of climate science have been exacerbated during the last several months by the actions of scientists, speakers said in another symposium devoted to scientific integrity. The discussion was dominated by "Climategate," the release of e-mail exchanges among climate researchers that seemed dismissive of questions about global-warming data, and errors in reports on that warming by the Intergovernmental Panel on Climate Change.

"The IPCC should have released all the peer reviews of their work and the responses right away," said James J. McCarthy, professor of biological oceanography at Harvard University. "At the root of all this controversy is access to data."

At the same time, he acknowledged, access to all data isn't easy to grant. "Scientists are getting requests for samples of ocean sediment cores, computer algorithms that they didn't create, as well as their own analyses." Such things may not even be in a scientist's possession, he said. Clearly, both scientists and the public need to reach an understanding about what is the norm for openness, and what is a reasonable request, he said. Otherwise trust will be hard to come by.

A New AIDS Strategy

In contrast to the disputes miring climate science, a cautiously optimistic view of progress emerged from a panel of AIDS researchers. It was somewhat surprising, given the dismal history of HIV vaccine trials. But a different strategy for controlling, and perhaps eliminating, the epidemic was outlined by epidemiologist Brian Williams, a research fellow at the South African Centre for Epidemiological Modelling and Analysis.

By adopting universal screening in heavily infected areas, followed immediately by treatment with antiretroviral drugs, Mr. Williams said, HIV transmission and mortality could be reduced by 95 percent by 2015. That is because the drugs are very effective at reducing the amount of virus in an infected person.

The strategy has gathered some support. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Disease, plans to start a trial of this approach in New York City and Washington, D.C., this year, and another trial is being considered by researchers at the University of British Columbia.

This is not a cure-all, Mr. Williams emphasized. "We can stop transmission in five years. But this doesn't solve the problem, because we will then have 30 million people living on retroviral drugs." He said it would cost a lot of money—up to $4-billion a year in South Africa, one of the world's most heavily infected regions. "But it will be cost effective," he said, "because otherwise these people are hospitalized with AIDS-associated diseases like tuberculosis, which costs even more money to treat. And half a million of the AIDS patients die each year. So the only thing more expensive than doing this is not doing this."

Money for 'Bench to Bedside' Research

Testing novel anti-HIV strategies calls for major involvement from academic medicine and physician scientists, and concern emerged in another symposium that such scientists were disappearing. Translational medicine, going from "lab bench to bedside," is key to health-care innovations, speakers said in another symposium. And while there are many forces pushing this model, there is also some concern that medical schools are not training enough workers to carry it out.

In the last decade, the National Institutes of Health, under pressure from Congress, began a greater push for translational medicine, said Eric J. Topol, director of the Scripps Translational Science Institute. New awards programs became available. Those were enhanced by various public-private partnerships, added Ellen V. Sigal, founder of the Friends of Cancer Research, a think tank in Arlington, Va.

One major source for financing and training is the Clinical and Translational Science Awards program of the NIH. There are now 46 sites that get support this way, and most are universities and academic medical centers. In part with that support, Scripps has begun a program offering a master's degree in clinical science for research Ph.D.'s, said Dr. Topol, who is also chief academic officer for the Scripps Health system, a network of community health centers.

Yet in his talk, Dr. Topol flashed a slide of a 2009 book, The Vanishing Physician-Scientist?, edited by Andrew I. Schafer, chair of the department of medicine at Weill Cornell Medical College. Despite all the federal, private, and academic initiatives, Dr. Topol said the concern was a real one. "It's not just vanishing M.D.-Ph.D.'s," Dr. Topol said. "It's a generally shrinking pool of M.D.'s." If we have fewer medical doctors, he said, it stands to reason that there will be fewer combination degrees, particularly specializing in translational medicine.

Ms. Sigal added to the caution, saying "You know, money may be drying up very quickly." Academic medicine got a boost last year from federal stimulus money, she said, "but this year we are likely to get just what we got, and maybe less." Translational medicine will need new financing models, she said, and may need to look toward growing initiatives financed by disease advocacy groups such as the American Association for Cancer Research.

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