In March, David Satcher, the 16th Surgeon General, former Assistant Secretary for Health and former Director of the Center for Disease Control (CDC), came to Rockefeller as part of the new Rockefeller Insight lecture series. A Surgeon General’s job is to take the lead in evaluating national health problems scientifically and thereby make recommendations based on the best available science. If there was one message to take from Dr. Satcher’s talk, it would be that science, even of the clear-cut variety, does not always translate into changes of public policy.

Sometimes the reasons for this failure are general misconceptions and societal stigmas that make change difficult. In a report on mental health in the U.S., the Surgeon General’s office found that more than 1 in 5 people suffer from a mental health illness. Yet, although 80–90% of these problems are treatable, less than 50% seek treatment because of stigma and fear of discrimination. Public policy reflects these opinions in the high cost of Medicare co-payments required for treatment.

Rather than general misconceptions or ignorance being the culprits, sometimes scientific evidence may not impact policy for more political and ideological reasons. Take for example one of the major reports of Dr. Satcher’s career as Surgeon General: The 2001 Report on Sexual Health. In this report, the best available evidence showed that abstinence-only sex education programs were less effective at reducing sexually transmitted diseases and teen pregnancy than more comprehensive sexual health education that included topics on contraceptives. Yet, when asked about the report’s findings, the President’s spokesman Ari Fleischer admitted the President had not even read the report. He then refused to address questions about its findings (in favor of broader sex education) by repeatedly stating “…that the only method that is fail-proof for averting unwanted pregnancies is abstinence.” Abstinence-only programs continue to receive significant funding: in fact, President Bush has recently proposed doubling the budget for these programs.

Perhaps more disturbing than failure to translate scientific findings into policy changes, is the willful manipulation and misrepresentation of the scientific process itself. Several reports and accusations have thus far been made, most notably summarized in an August 2003 report by the staff of Rep. Henry Waxman (D-California and member of the Committee on Government Reform) and a February 2004 report by the Union of Concerned Scientists that was signed by over 60 well respected scientists including 20 Nobel laureates. Local scientists that signed the report included Sloan-Kettering’s Harold Varmus and Rockefeller’s own Joel Cohen. These reports detail numerous examples of how the Bush administration has suppressed and distorted research findings at federal agencies, manipulated the appointment process of scientific advisory panels to support the administration’s policies, and interfered with ongoing research and analyses. The examples below paint a grim picture for the future of science in America as an objective process that can advise and guide public policy.