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HHS in the 21st Century: Charting a New Course for a Healthier America
communicate and transfer research results into clinical, public health, and human service practice (HHS, 2007).
To the greatest extent feasible, HHS policies and programs should incorporate and be informed by current scientific knowledge and evidence-based practices. Using results of applied research on program effectiveness and valid evaluations, as discussed in Chapter 4, HHS also should promote best practices in health care, public health, and program management. For this to happen, the department needs to strengthen its science base across the board. A credible, transparent process should also be developed to resolve scientific disputes that arise when evidence does not provide definitive answers or when there are disagreements among experts in the interpretation of that evidence.
Especially when scientific findings are inconclusive, the door is opened for policy decisions that are based on nonscientific grounds and “political pressure” from various sources. But in all cases, policy should rely most heavily on best available scientific evidence. There are many examples, from the current and previous administrations, in which political interference has influenced policy and diverged from sound, available evidence. These include decisions relating to fundamental HHS responsibilities:
Biomedical research funding has been affected, such as the elimination of federal funding for embryonic stem cell research on cell lines established after 2001, despite the potential value of such research (IOM, 2005).
Federal funding for needle-exchange programs, a provenHIV/AIDS prevention strategy, has been withheld since 1988, although these programs are effective in reducing the spread of HIV without increasing illegal drug use or encouraging new users (IOM, 1995).
Effective family planning methods, such as contraceptives, have not been promoted, but instead, an “abstinence-only” approach has been embraced (Union of Concerned Scientists, 2004), despite its ineffectiveness in reducing sexually transmitted infections and unintended pregnancies (DiCenso et al., 2002; Underhill et al., 2007).
Findings contained in scientific reports have been compromised and scientists muzzled. Former Surgeon General Richard Carmona said that “top officials delayed for years and tried to ‘water