Questions also remain about the role of Russian cosmonauts in the conduct of biomedical research, especially during the early phases of ISS utilization. Issues that must be clarified include the nature and extent of the training these crew members will receive for the conduct of ISS-based research protocols, their commitment to participate as subjects in human studies, and the nature and adequacy of postflight longitudinal follow-up to such human research studies.

In conclusion, the adequacy of the life sciences research facilities that will actually be in place on the ISS at its final build-out remains an issue of serious concern. Possible design changes, the mounting delays in utilization timetables, and the perceived potential for downgrading of research facilities and budgets have continued to erode the confidence of the user scientific community. Important questions also remain about the role of Russian cosmonauts in the conduct of biomedical research, especially in the early phases of ISS utilization.

The availability of effective countermeasures against the deleterious effects of spaceflight on astronaut health and performance will be an increasingly critical issue as longer-duration flights become the norm on the ISS and beyond.

Development of effective, mechanism-based countermeasures requires three well-integrated phases: (a) basic research, ground-based and in flight, to identify and characterize mechanisms of spaceflight effects; (b) testing and evaluation of proposed countermeasures, to determine their efficacy in ground-based models of the flight environment; and (c) validation of promising countermeasures by well-designed clinical studies in flight as well as pre- and postflight. Maintenance of a longitudinal database documenting relevant physiological and performance parameters in the presence and absence of the given countermeasure will be crucial to validating efficacy.

Basic research whose ultimate goal is the development of improved countermeasures is a primary mission of the National Space Biomedical Research Institute (NSBRI) and a major component of the life sciences NASA Research Announcement (NRA) program overall, while Johnson Space Center (JSC) has primary responsibility for ground-based testing and evaluation of proposed countermeasures. There has been no well-established, standard procedure whereby newly proposed countermeasures can gain access to the evaluation pipeline, and well-defined, published criteria for accepting candidate countermeasures for testing appear to be lacking. A defined process for carrying out such testing and evaluation is currently under development at JSC but has not yet been implemented. It is essential that