The outgoing president leaves behind some solid accomplishments in the world of science, tech and medicine. But the biggest departure from his predecessors might have been in his approach.
When President Barack Obama gave his inaugural address in 2009, he promised to “restore science to its rightful place and wield technology’s wonders to raise health care’s quality and lower its cost.” For the previous eight years, scientists had protested that the Bush administration ignored their expertise and restricted research freedoms. So they were heartened when the new president removed barriers to federal funding for human embryonic stem cell research and took serious steps to mitigate climate change.
But President Obama should be remembered – and praised – for much more than his renewed support for science. As a scholar of science and technology policy, it is clear to me that this president and his advisers recognized that policy could be carefully crafted to maximize the social and economic benefits of research and innovation.
They designed intellectual property policies, for example, that enhance scientific collaboration and in turn accelerate research progress, and also improve the availability of important technologies. And by including average citizens in developing research projects and priorities, they increased the usefulness and public legitimacy of science and technology.
For decades, the United States government had largely accepted the idea that patents were a necessary incentive for innovation. With the promise of a temporary monopoly if they were successful, inventors would work hard to develop new, transformative technologies. The potential benefits were significant: access to technologies that could transform societies for the better. Ultimately new industries, new jobs and economic growth would result.
Over time, though, it became clear that patents can stifle research and make important new technologies prohibitively expensive. The Patent and Trademark Office (PTO) and its traditional stakeholders, such as patent lawyers, dismissed such problems as minor and temporary, suggesting that only those who misunderstood how the system worked were concerned.
But in 2010, the Obama administration took the unprecedented step of breaking with its own PTO to side with physicians and scientists, as well as civil liberties and patient advocacy groups, who raised these issues in the context of patents covering human genes. A case brought in federal courts focused on whether genes were products of nature, but the plaintiffs were clearly motivated by concerns that patents on human genes were stifling important research and limiting access to potentially lifesaving genetic testing.
The Obama administration argued alongside these plaintiffs publicly when the Supreme Court heard the case in 2013. And in a unanimous decision, the Supreme Court agreed with the plaintiffs and the administration. Today, isolated human genes are not patentable.
As a result, there is greater competition in the genetic testing market; more tests are available for common diseases including breast cancer, and at lower costs.
The Obama administration’s concern that intellectual property could be hurting biomedicine and ultimately patients is also clear in the research programs it established.
Both the Brain Initiative, designed to develop a more dynamic understanding of brain function, and the Precision Medicine Initiative, focused on designing individually tailored treatment and prevention strategies, emphasize data sharing and collaboration. While previous efforts viewed competition among individuals and proprietary interests as central to the development of biomedicine, the Obama administration has come to see these as potential obstacles.
Decades of significant government expenditures for cancer research – from President Nixon’s War on Cancer to an over 2,000 percent increase in yearly breast cancer research funding since the 1980s – have improved scientists’ understanding of the disease and reduced cancer deaths. But cancer incidence remains high, and there are still significant disparities in diagnosis and treatment.
The Cancer Moonshot aims to address these problems through increased data sharing.
For example, it includes a first-of-its-kind, open access, public data platform, the Genomic Data Commons. This allows researchers not just to store and analyze the genomes of cancer tumors, linking that information to data about how the disease appears and spreads in the body, but also to share all of this information with colleagues. The platform also provides privacy and security protections for patients and researchers.
Before 2008, policymakers seemed to assume that the competitive ethos and monopoly incentives provoked by patent policies were the most likely to stimulate important scientific research. But the Obama administration’s nuanced approach to patents and investment in data-sharing initiatives have created a legacy that emphasizes openness and collaboration as the best avenue for producing scientific progress.
The Obama administration also took important steps toward including citizen perspectives in science and technology development.
The Precision Medicine Initiative – which aims to gather data (genomic, medical, metabolic, microbial, environmental and lifestyle) from at least one million Americans to produce better medical diagnostics and therapies – emphasizes transparency, citizen representation and patient autonomy in its core principles. It is dedicated to keeping participants informed throughout the research process, and emphasizes the importance of culturally appropriate interactions.
It has created a new model of research that treats informed consent as ongoing and interactive, and gives research subjects the option to withdraw at any time.
Customarily, participants in similar research projects provide consent only once, at the beginning. This traditional approach has become controversial in recent years because blood and tissue samples are often used for a variety of projects, and citizens want more control over how their samples are used.
The PMI also includes “substantial participant representation” in all aspects of the process, including program design and implementation. This means research subjects will serve on the policy committees that develop data-sharing, privacy and recruitment guidelines, among others, and also help to determine research priorities. Previous scientific research initiatives have included citizen perspectives occasionally in the research process, either in funding decisions or identifying overarching goals. But the PMI approach is more ambitious and systematic.
The Obama administration’s enthusiasm for considering citizen perspectives is not limited to scientific research. We’ve seen this approach in its energy policy as well, including in decisions on the Keystone XL and Dakota Access pipeline.
After massive protests and millions of citizens submitting public comments, President Obama rejected the Keystone XL. Similarly, months of protests in Standing Rock, North Dakota, led the Army Corps of Engineers to halt development of the Dakota Access pipeline and request an environmental impact statement that would assess the environmental and social implications of the project and provide extensive additional opportunity for public input.
At this moment, when there is great concern that the priorities of scientists and engineers do not align with those of the public, and there is growing desire among citizens to be treated as “partners” rather than “subjects” in research, these kinds of initiatives are particularly important. They can lead to the development of science and technology that is more directly beneficial to the population – and also enhance the legitimacy of scientific and technological establishment.
There is a great deal of uncertainty about President-elect Trump’s approach to science and technology policy, and so far his cabinet appointments do not provide much reassurance to the scientific community. Some of these appointments have even explicitly denied the scientific consensus on climate change.
But there is a path forward that could allow Trump to remain true to those who voted him into office while building upon President Obama’s approach. Pundits tell us Trump’s victory is largely the result of a populist wave and deep frustration toward elites; many Americans feel that policymakers do not adequately consider the realities of their everyday lives.
President-elect Trump could address these concerns by bringing the needs and perspectives of rural and working-class Americans explicitly into the development of science and technology policies. His administration could consider new kinds of policy frameworks, including intellectual property regimes, that could help to lower drug prices. It could bring these “forgotten” Americans directly into policy discussions about how to tackle the unemployment triggered by increasing automation. And it could include them in discussions about biomedical research priorities, perhaps leading to increased funding for practical solutions to the opioid epidemic.
Such efforts could ultimately strengthen the legitimacy of the new administration among both the scientific community and the public, while continuing the work towards a socially engaged science and technology policy.