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Strategic Planning Document - Health, Safety and Food R&D
Executive Summary
PURPOSE
Improved health, safety and food security depends on scientific progress. CHSF will coordinate research and development,
disseminate new knowledge, and support the development of sound and cost-effective national health, safety and food policies. CHSF plans an
interactive mix of research and development investments that will improve our nation's health, safety and food, expand technological capabilities and stimulate
growth. Fundamental scientific discovery will support technological development. Active surveillance will monitor current and emerging health, safety and
food security issues. Knowledge- based evaluation will maximize program results and improvement. Multiple educational tools will inform
the public about issues regarding their health, safety and food. CHSF scientists--fueled by accurate integrated information--will act on this plan in
partnership with other dedicated professionals domestically and internationally.
THE CHALLENGE
CHSF is committed to developing the science base needed to
meet complex challenges to health, safety and food security in a cost-
effective manner. The U.S. science enterprise is at a juncture where rapid
growth in science and technology can improve the health, safety and food of
U.S. citizens, and national productivity, competitiveness, and
economic security. The CHSF strategy supports "Science in the National Interest" by
identifying research and development investments to help address national priorities such as health care quality and cost, welfare reform,
food safety, violence and injury prevention, and improved health through proper nutrition and new medical treatments and technologies. The
challenges we face include the following:
- Every day disease claims lives, causes suffering and costs
money. For example, Alzheimer's disease currently affects 4 million
Americans and costs about $90 billion annually. The cumulative costs of
treating HIV-infected persons are forecast to increase 48% over the next three years.
- Health care spending has risen to 14% of the U.S. Gross
Domestic Product, but by many indicators Americans are receiving less for
their health care dollars than citizens of several other countries.
- Approximately 2/3 of premature deaths in the United States are the result of behavioral and environmental factors--many of which can
be modified or prevented. Effective prevention can greatly reduce suffering and treatment costs. Injuries alone cost about $215 billion
annually.
- The world population is expected to double by the year 2050. Growing demands for food and water need to be met. Abundant and safe food
supplied through sustainable agricultural systems have many health, social, environmental and economic benefits.
- In the United States, dietary factors and sedentary activity patterns have been identified as the second leading underlying cause of
death, accounting for 14% of total deaths in 1990. Obesity is increasing--over one third of adults, or 50 million people, are obese.
MEETING THE CHALLENGE: HEALTH, SAFETY AND FOOD FOR AMERICA
On November 21-22, 1994 the CHSF and OSTP sponsored a national forum: "Meeting the Challenge: Health, Safety and Food for
America". The purpose of this Forum was to convene 450 scientific experts from a mix of
disciplines, organizations and areas to review and improve CHSF plans, share ideas, and help develop and support our country's health,
safety and food R&D objectives. The Forum endorsed the following priority areas: Biomedical, Socio-Cultural and Behavioral R&;D; Health
Systems and Services R&D; Health Promotion and Disease and Injury Prevention R&D; Food Safety, Security and Production R&D;
and Human Nutrition R&D. In each area, planned R&D investments will yield positive returns, expand public and
private capabilities, improve the nation's health, safety and food, and reduce the incidence and cost of disease and injury. CHSF plans in all areas
were developed to optimize the focus, balance and inter-disciplinary interaction of basic and applied research, technological applications,
surveillance, evaluation, intervention and communication. Health, safety and food research and development also play an integral role in building
strong industrial partnerships. These partnerships will transfer research into new biomedical and agricultural technologies, support economic growth
and job training and development in areas like health systems and services; continue basic research and graduate education in all areas of health,
safety and food research, and support global competitiveness and economic security in areas like agricultural and biomedical production.
The biomedical and socio-cultural and behavioral research strategy reflects recent assessments of Federal efforts to develop safe
and effective HIV and cancer therapies, which have indicated that much basic research remains to be done. To improve health, research is needed on the
biomedical, social, cultural, psychological and behavioral factors which influence individuals' exposure, susceptibility, treatment and recovery from
disease. Variations in ability to comply with treatment regimens need to be better understood. The influences of social context, peer, family
and community pressure in such situations also need to be better understood. Gender, socioeconomic, as well as racial/ethnic differences in
disease incidence and prevalence must be examined.
The health systems and services research strategy supports research on how to deliver more cost-effective mix of preventive, treatment
and population-based health services to all population groups, and on research that enables citizens and other public and private
decision-makers to make more informed decisions. For example, two recent clinical practice guidelines, addressing problems of low back pain and fluid in the
inner ear of children, could reduce health care expenditures by more than $15 billion. It is clear that research and development investments on the effectiveness of
the entire health care system--from clinical, preventive, and public health interventions to managerial, organizational, and financial strategies--coupled with research on the effective dissemination of these
findings--can improve the value we receive for our health care dollars. It is also important to link existing public health and personal care data bases in
the public and private sectors. This will call for an unprecedented level of federal-state and public-private sector cooperation.
The health promotion and disease and injury prevention R&D strategy is to develop the knowledge base to manage and reduce
the human and financial burden of preventable injury, disease and disability. This strategy will also provide individuals, communities and the
government with the information they need to promote healthier lives, and to reduce disease, injury and disability. This strategy includes monitoring
health problems, surveying health measures, developing and testing effective strategies, and strengthening individual and community
involvement and responsibility for sustainable prevention.
The food safety, security and production research strategy is to meet the growing food needs of the nation and the world with a technology
base for a sustainable system to efficiently produce and deliver abundant, safe, and healthful food to the public while strengthening the economy and
contributing to ecosystem harmony. The strategy will focus on research to improve food safety and quality and to preserve, maintain,
characterize and utilize the genetic resources of life forms important to food production.
The human nutrition research strategy is to enhance our knowledge of the critical role of diet and physical activity in human health
and disease, and to support Americans in achieving healthier and more productive lives. The strategy will facilitate research and development
coordination across agencies, help disseminate new knowledge to the public, and support the development of sound national food and nutrition policies.
To be successful, strong partnerships among researchers and disciplines, across organizations, and with the public, industry,
academia and government at all levels are required for a successful scientific enterprise that will support and cost- effectively expand
national technological capabilities, economic growth and competitiveness. CHSF and forum participants have identified both CHSF-specific
research and development initiatives and cross-cutting research and development issues that are important not only to CHSF but also to other NSTC
committees. These areas are outlined below, and information on current and future CHSF agency activities is provided in this strategic planning
document. CHSF will continue to refine these plans in the future.
RECOMMENDED CHSF-SPECIFIC R&D INITIATIVES
HUMAN NUTRITION INITIATIVE--This initiative includes
research and development needed to achieve a healthier and more
productive society through enhanced knowledge of the critical
role of diet and physical activity in human health and disease. Diet is one of
the leading risk factors for chronic diseases such as heart disease, cancer,
stroke and diabetes. Over the past decade, obesity in the U.S. has increased
dramatically. Now over one third of adults, or 50 million people, are obese.
Research is needed to identify the causes of obesity, who is at risk, and how
to reduce the incidence of obesity. The initiative will facilitate coordination
across agencies, translation of new knowledge to the public, and development of sound national food and nutrition policies.
HEALTH SYSTEMS AND SERVICES INITIATIVE--This initiative includes research and development needed to deliver a
more cost-effective mix of preventive, treatment and population-based health services to all population groups. It would also provide information to
enable citizens and other decision-makers to make more informed health service decisions. This initiative includes research to increase the
understanding of public and private decision-makers on how to integrate population-based public health and personal care services, and on how to improve
the balance between prevention and treatment. This initiative supports public and private innovation and reforms now underway in U.S. and
international health care marketplaces by providing the information needed to improve private and public sector operations. This initiative also
improves how research results are disseminated and used by consumers and policy-makers.
GENETIC RESOURCES FOR FOOD INITIATIVE--This initiative is a comprehensive program to preserve, maintain,
characterize, and utilize the genetic resources of life forms important to food production. This research and development is needed to meet the growing food
needs of the nation and the world with a technology base for a sustainable system to efficiently produce and deliver abundant and healthful food to
the public while strengthening the economy and contributing to ecosystem harmony.
FOOD SAFETY AND QUALITY INITIATIVE--This initiative includes research and development needed to assure the
safety and quality of food for consumers. This initiative would include research and development to identify and reduce significant food-borne risks
for human health, including surveillance and quality assurance. Research is needed to improve food processing technologies, sterilization and
irradiation techniques, and waste management. This initiative supports research and development on compositionally enhanced foods and better
understanding of how food components improve health.
HEALTH PROMOTION AND DISEASE AND INJURY PREVENTION INITIATIVE--Promoting health through preventing
disease, injury and disability is a necessary companion to health care. Research and development in this area can reduce the human and
financial costs of health care and long-term disability, and support increased individual and community responsibility and involvement. Expanded
research and development is necessary in areas such as the following: vaccine development, emerging health threats, aggressive and violence-
related behaviors, drug abuse and smoking, mental disorders, reproductive and child health, environmental and occupational health risks,
chronic disease control, injury control and prevention.
CROSS-CUTTING R&D INITIATIVES INVOLVING
OTHER NSTC COMMITTEES
The following cross-cutting initiatives are important not only to CHSF, but also to other NSTC committees.
INFORMATION SYSTEMS FOR RESEARCH AND DECISION-MAKING--This includes the design, development and
implementation of data systems for current and future R&D and surveillance needed to improve the nation's health, safety and food. This includes
national health, safety and food data systems needed to maintain active surveillance, collect national health statistics, monitor risks, fuel vital research,
evaluate results and inform the public. This includes coordinating and integrating ongoing public and private data and information collection, and improving
use of existing information and surveillance systems by expanding them to include factors such as environmental, behavioral, occupational and
socioeconomic factors. The need to maintain, update, build, integrate and better use information systems necessary to conduct research, maintain
surveillance, and evaluate performance is the single greatest obstacle to CHSF agency efforts. The systems need to be automated, linkable and
accessible, as well as timely and complete.
INVESTING IN THE RESEARCH CONTINUUM--The nation needs a multidisciplinary scientific agenda with a core of
long term, high risk fundamental research that is interactively linked to applied research, clinical and field trials, technology applications, and
marketed products. Private sector incentives to conduct fundamental research should be improved. Federally- supported research should be peer
reviewed. This scientific agenda will enable the nation to use research results to support knowledge-based, cost-effective health, safety and food policies;
and sustainable economic growth and competitiveness. Greater attention is needed to improve the interface between fundamental research,
evaluation, information dissemination, and technology transfer.
PARTNERSHIP FOR A NEW GENERATION OF 21ST CENTURY SCIENTISTS--This includes training and supporting
creative investigators, especially beginning investigators, to conduct fundamental, applied and cross-disciplinary research on health,
safety and food. This research drives the scientific enterprise. Maintaining the leadership position of the United States in the life sciences
depends on producing outstanding beginning investigators and supporting an array of professional opportunities for them. This includes assessing the
effectiveness of programs supporting beginning investigators.
INFORMATION DISSEMINATION AND PUBLIC EDUCATION (SCIENCE LITERACY)--A continuous effort to effectively communicate the results of research to the public is needed. This
includes basic K-12 science education in all areas of health, safety and food; science writing and reporting; a variety of electronic media, information
resources, extension services, product labeling, and other targeted communications. Widely disseminating the results of research will increase the
public's capability to make more informed personal choices, improve their health and make a difference in their daily lives.
PARTNERSHIP FOR HUMAN PRODUCTIVITY--People are the world's most important resource. This research will clarify the
processes that shape the intellectual, physical and emotional capacities of people. This includes multidisciplinary research to understand
the biomedical, socio-cultural and behavioral factors that contribute to mental and physical health, as well as research that examines the
interrelationships among individual action, family behavior, schools and other institutions. This partnership includes research on violence, and the Human
Capital Agenda, which is intended to increase our understanding and ability to maximize human capacities, as well as violence-related
research.
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