require new studies and research with better integration and the creation of a national research agenda to ensure that there is no duplication of effort and that researchers are properly linked and cohesively working together to leverage limited resources. Perhaps a new portfolio of research and a fresh focus of inquiry may advance the scientific process. A few observations from the presentations can be highlighted:

  • The philosopher Nietzsche once stated that “the most common form of ignorance is forgetting what it is that we are trying to do.” For Lyme disease and other tick-borne diseases, as noted by Pamela Weintraub, the goals are the reduction in the morbidity and the mortality of this group of diseases, the reduction of the burden of disease, and the creation of better strategies for prevention, control, and amelioration.

  • Weintraub noted that perhaps the number one problem that limits progress toward these goals is the polarity that exists between patients and some of the medical community. This can be extended further to the polarization that exists between the medical community and the advocacy groups.

  • A number of individuals suggested the need for less hubris and more sensitivity to others’ points of view. People are suffering, and there is a need to reframe and refocus the research to generate new ways to reduce disease burden. As one researcher noted, it is about creating a better path forward and not maintaining the status quo.

I believe that science could emerge as the mediator to define a new common ground to reduce the polarity between groups and focus on areas where there is agreement. Scientific research is the key to new knowledge, and the application of this knowledge is the key to reducing the burden of illness. It seems unlikely that any gains in reducing TBD illnesses and impact can occur without filling our gaps in knowledge and better understanding the dynamics and complexities of these diseases through research. A critical review of the state of the science, such as that found in this summary, is an essential first step.

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