Proceedings of a Workshop

Science, Technology, and Health Capabilities Within the Department of State and USAID at an Inflection Point

Proceedings of a Workshop—in Brief

The need for U.S. foreign and development policy to be informed by science, technology, and health has perhaps never been more important. Amidst the COVID-19 pandemic, additional global challenges such as climate change, rapidly emerging technologies, and geopolitical competition underscore the importance of strong integration of science, technology, and health (STH) into diplomatic and development missions for American prosperity and security.

In September 2020, the National Academies of Sciences, Engineering, and Medicine (the National Academies), held a workshop to identify approaches to strengthen STH capabilities at the U.S. Department of State and the U.S. Agency for International Development (USAID) over the next 5 to 10 years. The 3-day workshop was organized by an ad hoc committee of the Roundtable on Global Science Diplomacy. It featured brief presentations by more than 30 leading American experts from government agencies, universities, research centers, non-governmental organizations, and the private sector, and several leaders from abroad who are actively integrating science and technology developments in the foreign policies of their countries. This Proceedings of a Workshop in−Brief is a summary of the presentations and the discussions during the workshop.

SESSION 1: PLACING TRANSNATIONAL CHALLENGES AT THE CENTER OF U.S. FOREIGN POLICY

To begin the workshop, Frances Colon, Jasperi Consulting, moderated a plenary discussion with former USAID Administrator Gayle Smith and former U.S. Ambassador and Under Secretary of State for Political Affairs, Ambassador Thomas Pickering.

Gayle Smith (One Campaign) noted that the United States, through efforts in global health at USAID, the Centers for Disease Control (CDC), and the President’s Emergency Plan For AIDS Relief (PEPFAR) program, has been a leader in sustaining gains in development through STH in recent years. She noted that a number of actions are needed to achieve progress. First, there is a need to deploy science and technology (S&T) for development goals at scale—including integrating S&T into programs and policy—in order to drive systemic change. Second, there needs to be more use of “full-spectrum data” that can be shared among decision makers, such as common baseline analyses [e.g., the process used by the Millennium Challenge Corporation (MCC)], data-based evaluation of projects and programs, and budget assessments that show demonstrable impact for funding decisions. Third, there is a need for more public understanding and support for S&T in development. Smith indicated that sharing stories of impact as well as increasing transparency of public data could inspire solutions.

Thomas Pickering (Hills & Company) stressed how diplomacy and science go hand-in-hand. He indicated that the need for the Secretary of State to understand the importance of science goes beyond relying on a handful of science advisors. COVID-19 has brought about a trifecta of issues in the U.S.: a global health crisis, a depressed economy, and a renewed focus on systemic racism. Ambassador Pickering remarked that science should support developing innovative responses that balance national and international priorities. He noted a 2015 National Academies report¹ that recommended re-examining the focal S&T issues in the Department of State 5 years after its release. He

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¹ National Research Council. 2015. Diplomacy for the 21st Century: Embedding a Culture of Science and Technology Throughout the Department of State. Washington, DC: The National Academies Press. https://doi.org/10.17226/21730.

also stressed that many of the recommendations, such as the need for greater interagency participation and a whole of society approach, incentivizing foreign service officers to spend time on S&T activities, and greater engagement by embassy staff in local communities, still apply today. The report’s recommendation to use the U.S.’s strength in S&T to promote leadership around the world through public diplomacy is even more important now. On the issue of training, Pickering said that structural impediments result in S&T falling far down the list of priorities for foreign service officers, yet it is increasingly important to have people trained to cover the wide gamut of science topics.

Both Smith and Ambassador Pickering addressed lessons from the pandemic on the role of international institutions. Smith cautioned against creating new institutions without diagnosing the challenges in the current ones—challenges that can stem from politics. She noted two global governance gaps that have been clarified during the pandemic: (1) lack of a global inventory or distribution channel for critical personal protective equipment, though she highlighted Africa’s successes in maintaining one, and (2) lack of a global plan for distributing global public goods, noting that vaccine development and distribution should not be dependent on a “coalition of the willing.” Ambassador Pickering noted that failures of the World Health Organization (WHO) in minimizing the impact of the current pandemic could be addressed through efforts such as enhanced leadership and strengthened requirements on member states with respect to data sharing, and better utilization of experts to review any shortcomings.

Following the plenary remarks and discussions, participants joined one of three breakout sessions with speaker presentations, followed by discussion.

BREAKOUT SESSION: STRENGTHENING U.S. AND GLOBAL HEALTH IN THE COVID-19 ERA

Loyce Pace (Global Health Council) noted that a 2017 National Academies study² examining global health approaches also made recommendations that still apply today, such as the need for strong national primary healthcare systems, smart financing of domestic and international resources for global health, and a focus on global public goods. Pace presented her proposed “Global Health 3.0 vision,” which addresses several current gaps, namely: a health systems approach based on synergy that moves away from health exceptionalism and focuses on the intersection of health with other priorities such as economics and climate change; the need to take on the idea of equity, elevate the global to local connection, be centered on humility and not on a protectionist mentality; and approaching solidarity as not just a ‘nice to have,’ but a way to democratize information and bring in more people, communities, and organizations in an equitable way.

Carolyn Reynolds (Pandemic Action Network) spoke on global health security, noting the importance of strengthening health systems. She also pointed to the role of strong leadership and accountability, including at the Department of State, and the need to leverage all government tools such as bilateral relationships, multilateral institutions, foreign assistance, the military, technical assistance, and science cooperation. She identified 7 elements of an agenda for action, including:

1. Increase investments in core capacity building to detect, prevent, and respond to outbreaks at the source;

2. Increase capacity of countries to build systems of change at scale and sustain them;

3. Strengthen outbreak monitoring and data systems;

4. Address domestic and global supply chains for personal protective equipment;

5. Accelerate and increase access to global health research and development (R&D);

6. Enhance public diplomacy around vaccine hesitancy and behavior change; and

7. Adopt better metrics and tools for accountability, including a potential new framework for emergency preparedness and response.

Jimmy Kolker (Georgetown University) spoke from a practitioner’s perspective about his experiences with PEPFAR as a U.S. Ambassador in Uganda. PEPFAR needed buy-in from all stakeholders including the public at large, and was ultimately successful because of presidential leadership and the scale of the U.S. investment. In PEPFAR’s early years, there were clear numeric targets but U.S. ambassadors had flexibility in distributing funds to achieve success on the ground in each country. Ambassador Kolker highlighted the importance of (1) acknowledging health as a first order diplomatic issue, (2) leveraging U.S. expertise to project power and build coalitions toward a new paradigm in global health beyond the donor/recipient model that brings people together to form communities of practice, and (3) using the comparative advantage of the U.S. government’s ability to act across its agencies.

During the discussion following the presentations, one participant noted a gap between the scientific consen-

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² National Academies of Sciences, Engineering, and Medicine. 2017. Global Health and the Future Role of the United States. Washington, DC: The National Academies Press. https://doi.org/10.17226/24737.

sus and policy action that exists in global health security. The participant suggested that bridging that gap may require building “triggers” into the national and international systems to help countries know what to do, and when, in a crisis. These triggers may also bridge the gap between institutions’ capacity to act and their propensity to act, a challenge highlighted by the pandemic. Other participants highlighted the various roles of non-governmental actors, such as the involvement of the private sector and foundations in the WHO’s COVAX initiative,³ or the ways that established relationships in the science community can be leveraged by governments in times of crisis. The discussion emphasized the need for the government to be at the core of global health engagement, including funding early research that drives private sector financing. Two different rationales were presented to make the case for stronger global health investments to stakeholders in Congress and with the American public: one based on a nationalistic, counter-terrorism model and the other based on a model of common ground of health and wellness between the U.S. and around the world.

BREAKOUT SESSION: ADDRESSING CLIMATE CHANGE AND PROTECTING THE ENVIRONMENT

Rosina Bierbaum (Global Environmental Facility) provided background on the state of the science of key environmental and climate-related challenges. She stressed the need to address many impacts of climate change simultaneously, such as crop productivity, food security, sea level rise, urban areas at risk, biodiversity loss, and demand for resources, especially as our planet approaches 9 tipping points.⁴ Bierbaum noted that a major scientific advance is the ability to attribute single extreme weather events to climate change. Climate change is a recognized national security threat, with the Pentagon and investors calling for risk management. COVID-19 has heightened the realization that pandemics result from the loss of ecosystems’ integrity given the interconnectedness of our natural environment.

Susan Biniaz (Yale Jackson Institute for International Affairs and former climate lawyer and negotiator at the Department of State) discussed international legal instruments for environmental agreements and the many ways she saw science being taken into account in the Department of State’s environmental diplomacy efforts, specifically: (1) when developing the U.S. position on whether to seek international cooperation or a new agreement on a particular topic, e.g., marine plastics, (2) in developing the content of new agreements and the commitments of the Parties under the agreement, (3) in evolving an existing environmental agreement, e.g., making changes to the Montreal Protocol or the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES), (4) preparing U.S. positions to a scientific body, e.g., the Intergovernmental Panel on Climate Change (IPCC), and (5) in reviews of collective progress under environmental agreements. She noted that the Department of State’s scientific expertise came from the Bureau of Oceans and International Environmental and Scientific Affairs (OES) and from other agencies. Biniaz commented that the U.S. coordinates well across the government compared with other countries, although more could be done. Moving forward, given that climate is now central to many priorities (such as the ocean and evaluating other countries’ 2030 emissions targets under the Paris accord), “climate consciousness” should be integrated more broadly into the Department, including the regional bureaus. In addition, Biniaz said, the Office of the Special Envoy for Climate Change should be reinstated and augmented, and the Secretary of State’s role in making environment and climate issues a priority within the Departments is critical.

Eric Postel (DAI and former Associate Administrator at USAID) noted that COVID-19 is doing much more damage than more conventional threats. USAID should be strengthened with a focus on climate and biodiversity as the priority issues. During his tenure, USAID lacked the necessary subject matter experts on climate adaptation, agriculture, and other topics, and fellowship programs were not sufficient to meet USAID’s programmatic needs. Hiring mechanisms should be reviewed to allow for longer-term technical hires with the proper training in development to effectively manage programs, he noted.

Much of the discussion focused on institutional mechanisms, including leveraging internal ([e.g., National Oceanic and Atmospheric Administration] scientists directly involved in negotiations about whaling) and external (e.g., scientific advisory bodies) expertise, to meet the challenges raised by the speakers. Postel pointed to successful innovation at USAID arising from prizes and challenges. To close the session, Jonathan Pershing (William and Flora Hewlett Foundation) noted two key themes from the discussion: (1) the complexity of the scientific issues and the foreign policy needs to understand and communicate them, and (2) the importance of the appropriate technical expertise and personnel to grapple with this complexity.

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³ See: https://www.who.int/initiatives/act-accelerator/covax.

⁴ See: https://www.weforum.org/agenda/2019/12/climate-change-tipping-points-earth.

BREAKOUT SESSION: OPPORTUNITIES AND CHALLENGES IN URBANIZATION AND THE FUTURE OF CITIES

Wolfgang Lutz (Wittgenstein Centre for Demography and Global Human Capital) focused on urban populations, noting that 55 percent of all people already live in urban areas. This is expected to grow to 68 percent in 2050, with variable regional differences. Across countries, there is a positive linear relationship between national income level and urbanization level. Lutz suggested that education was a key driver, pointing to examples such as China’s investment in human capital leading its growth over time and fertility rates being linked to a woman’s education level to demonstrate this.

Karen Seto (Yale University) stated that the physical expansion of the built environment accompanies urban population growth, citing data showing that urban areas are currently expanding at a rate equivalent to building a new New York City every 8 years. Such urban growth will result in loss of croplands at a rate that is regionally and country dependent and will impact rural livelihoods, regional food security, and political stability. The resource requirements needed to construct cities will disproportionately affect areas where human and financial capital is weak; growth will impact climate change, as building and upgrading infrastructure will lead to significant increases in greenhouse gas emissions. She said how the world builds and operates cities will affect sustainable development, the environment, and national security in the United States and across the world.

Seto noted that the vulnerability of one country or region is affected by global interconnections, as demonstrated by the local impact of global supply chain shortages due to COVID-19 or other disasters. She argued that there needs to be a recognition that urbanization does not always equate with development, and urban growth is happening in areas without infrastructure (e.g., water resources, electricity), which may drive instability. As the future of the planet depends on how cities are designed, built, and powered, now is a window of opportunity for the world, as more than 50 percent of urban areas in 2050 have yet to be built.

Soo-Jin Kim (Organisation for Economic Co-operation and Development, OECD) discussed the impact of COVID-19 on cities. The pandemic has had an asymmetric impact on populations, with urban areas often hosting the first clusters of confirmed cases. Data show that where a person lives, particularly whether in an area of existing inequalities or as part of a vulnerable group (e.g., the elderly, homeless, disabled, refugee and migrant populations, or youth), determines one’s chances of getting healthcare and weathering the economic crisis. She noted that there is no evidence that the “urban premium” is turning into an “urban penalty” that would have resulted in people moving out of cities, and that cities are learning to adapt to living with the virus. Priorities for cities across OECD member countries include leveraging remote work options, deprioritizing mobility and prioritizing accessibility, and pursuing more sustainable development. She highlighted surveys suggesting citizens usually trust their local leaders more than national leaders, further underlining the importance of cities in recovery and resilience.

Following the presentations, discussions focused on topics related to bilateral and multilateral funding mechanisms for urbanization, defining measures of impact, the importance of active involvement in regional and local communities, and the tension between investments in sustainability and people versus short-term profits for commercial benefits. Regarding smart cities, the participants noted that small-scale experiments have achieved success, but more work is needed in developing the correct indicators and in clarifying the difference between a smart city and a technology-connected city to ensure that the general public can equitably participate in these environments.

SESSION 2: ADVANCING AMERICAN INTERESTS IN A QUICKLY EVOLVING SCIENCE AND TECHNOLOGY LANDSCAPE

The second day of the workshop began with perspectives on the workshop topics from leaders outside of the United States. In her opening keynote address, Minister Grace Naledi Mandisa Pandor (Ministry of International Relations and Cooperation, South Africa) observed that paradoxically, the current public health emergency has resulted in the international “state of science” receiving greater attention. She noted that properly executed international science cooperation is critical to finding solutions to the pandemic, for global solidarity, and holds numerous benefits for partners. She emphasized that network science⁵ and shared resources can support more robust science systems and institutions in developing countries.

Minister Pandor stressed that multilateral partnerships among the U.S. and multiple African countries—as op-

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⁵ Defined as the “study of network representations of physical, biological, and social phenomena leading to predictive models of these phenomena.” National Research Council. 2005. Network Science. Washington, DC: The National Academies Press. https://doi.org/10.17226/11516.

posed to bilateral partnerships between the U.S. and South Africa—would better serve the African continent. A focus on S&T should be entrenched in offices within foreign affairs departments to provide a broad sense of global scientific activity and advise on potential national opportunities. She further observed that the WHO COVAX initiative demonstrates the link between foreign affairs, national interests, and science, and is a prospect for a new kind of global science cooperation. Minister Pandor highlighted the opportunity to expand the current U.S.—South Africa collaboration on COVID-19 vaccine development via Operation Warp Speed⁶ into other research realms, such as global climate change adaptation and mitigation in Africa, green economy sector opportunities, and digital technology access opportunities. She concluded by emphasizing the need for “diplomacy for science,” noting that the COVID-19 pandemic will require diplomacy to ensure distribution of global resources and the availability and affordability of treatments.

Jovan Kurbalija, (DiploFoundation and Geneva Internet Platform, Switzerland) discussed how the pandemic has forced diplomacy to evolve. He noted that diplomats have adapted quickly to use online tools and continue operations (e.g., the virtual 2020 United Nations General Assembly). There is now a stratification of countries’ capacity for digital diplomacy with respect to both addressing new policy issues (e.g., cybersecurity) and using new tools in diplomacy (e.g., online meetings). He predicted that post-pandemic, ‘hybrid diplomacy’ will emerge, combining in-situ and online meetings. This would inherently pose challenges to diplomacy dynamics and participation—as ‘corridor diplomacy’ and personal interactions are essential for complex and controversial negotiations. Kurbalija concluded that there will be a growing need for diplomacy to tackle the increasing interdependencies inherent in challenges such as climate change, the digital economy, and migration. He predicted that diplomacy would thrive in the age of digital interdependence by involving a wide range of actors (e.g., citizens, companies, religious communities).

Atsushi Sunami (National Graduate Institute for Policy Studies, Japan) discussed the importance of science diplomacy and the potential harm of economic competition when it leads to protectionism. He recalled the experience of the Japanese government in creating an Asian network of infectious disease research in response to bird flu, a network that is now being used for research collaboration in the current pandemic. Science cooperation was a foundational component for recent meetings between the Japan International Cooperation Agency and African countries. He noted that the blue economy⁷ is a possible focus for future international collaboration between Japan, the United States and other countries particularly via the United Nations Decade of Ocean Science for Sustainable Development (2021-2030).⁸

During the discussion, one participant noted the need for greater recognition of cyber diplomacy as a core issue of national security and foreign policy around the world. Sunami called for collaboration with the U.S. on research integrity issues. Kurbalija recommended that the U.S. mainstream digital issues into traditional policy topics, such as trade and humanitarian issues, and consider new, non-traditional players not yet integrated into policy processes (e.g., the gaming community). To conclude the session, Minister Pandor pointed to 4 of South Africa’s international scientific partnerships as excellent examples of science in the service of diplomacy: the U.S.—South Africa HIV partnership, the regional Center for Climate Change and Land Adaptation,⁹ the Square Kilometer Array,¹⁰ and human paleontology research.

Following the plenary remarks and discussions, participants joined one of three breakout sessions with speaker presentations, followed by discussion.

BREAKOUT SESSION: ENHANCING AMERICAN COMPETITIVENESS IN A CHANGING SCIENCE AND TECHNOLOGY AND GEOPOLITICAL CONTEXT

Rita Colwell (University of Maryland) framed broad challenges for dealing with complexities of the 21st century. She spoke about the need to expand the perspective of science, such as the relationship between the environment, biodiversity, and human health to develop robust models and predictive tools. Colwell indicated that scientists need to develop long-term relationships, through initiatives like bilateral science exchange programs, and devise international, interdisciplinary solutions.

Tobin Smith (Association of American Universities) discussed U.S. leadership in science in an era of enhanced

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⁶ See: https://www.hhs.gov/coronavirus/explaining-operation-warp-speed/index.html.

⁷ The blue economy is defined by the World Bank as “comprising the range of economic sectors and related policies that together determine whether the use of oceanic resources is sustainable.” See: World Bank and United Nations Department of Economic and Social Affairs. 2017. The Potential of the Blue Economy: Increasing Long-term Benefits of the Sustainable Use of Marine Resources for Small Island Developing States and Coastal Least Developed Countries. World Bank, Washington DC.

⁸ See: https://en.unesco.org/ocean-decade.

⁹ See: http://www.sasscal.org.

¹⁰ See: https://www.skatelescope.org.

competitiveness. He noted a recent report by the Task Force on American Innovation¹¹ that showed U.S. progress flattening in a number of key indicators (e.g., number of publications, R&D expenditures, quality of education), while China’s progress increased on all of these indicators. Smith said that the United States has been dependent on foreign talent, which has defined U.S. success in science.¹² Universities and industry rely on talent from around the world. For example, foreign students become faculty who teach the next generation of U.S. scientists and with immigrants are responsible for a greater number of U.S.-based startups.¹³ Additionally, the greatest number of co-authored scientific papers are between the U.S. and China.¹⁴ Other countries, like Canada, are taking advantage of the current U.S. policies, including those announced during the COVID-19 pandemic, to recruit foreign talent to their own countries.¹⁵ Smith emphasized the need to leverage the strengths of the U.S. science system. This includes the merit-based review system, and the university-based funding model to support basic science while training the next generation of scientists. He also pointed to the need to develop ways to address any vulnerabilities in the U.S. science ecosystem, including diversifying “STEM talent supply chains” beyond China and growing domestic STEM talent.

Rebecca Keiser (National Science Foundation, NSF) discussed global science leadership and the role of the United States. She noted that the key drivers of American leadership include establishing environments that enable researchers to take risks; supporting collaborations among government, academia and industry; and adhering to core principles of scientific research—objectivity, fairness, honesty, openness, and accountability. She emphasized that research should be openly available to encourage further innovation. Looking forward, she noted that competition is a positive driver for progress and should not preclude collaboration. Keiser said that China is NSF’s fifth largest partner (in terms of the number of projects funded by NSF and Chinese counterparts) and expressed a desire to maintain, if not grow, that level of collaboration. As one example of international collaboration, she pointed to the NSF’s Industry-University Cooperative Research Centers Program,¹⁶ which focuses on early-stage research collaborations between industry, university, and government, and includes several international universities and companies. She concluded that the U.S. needs international collaborative structures that emphasize the intellectual contribution of each partner, leverage resources, and reinforce the importance of transparency and openness.

Following the presentations was a discussion on the impact of COVID-19 on new research collaborations under virtual conditions and the need to build stronger research ties with new partners. One participant asked how to reimagine relationships with countries that may not honor intellectual property rights. Another participant noted that the U.S. funding ecosystem is risk averse compared to that of the Chinese system, e.g., in providing venture capital. Tobin Smith said there was a need to take a stronger stance on research integrity with China and to reconsider the balance of U.S. government funding for basic and applied research. Participants commented on the fact that the U.S. does not have a national strategy for elements linked to global competitiveness such as industrial policy or the recruitment of international students. In closing, Keiser highlighted the important role of the Department of State in establishing and ensuring the sustainability of international science collaborations.

BREAKOUT SESSION: CATALYZING MULTISECTORAL SCIENCE AND TECHNOLOGY ENGAGEMENT AT ALL LEVELS OF SOCIETY

Geraldine Richmond (University of Oregon) began the breakout session by giving insights from her experience addressing gender disparities across the sciences. She said entrenched gender roles are further exacerbated during the COVID-19 pandemic. It is important to ensure that women are in leadership roles. She identified USAID’s Partnerships for Enhanced Engagement in Research program¹⁷ and the Department of State’s International Visitors Leadership Program¹⁸ as successful models that help women in developing countries advance their careers and provide opportunities in tangible and scalable ways.

Skye Gilbert (PATH) provided three observations on how the COVID-19 pandemic has enhanced opportuni-

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¹¹ Task Force on American Innovation, Benchmarks 2019: Second Place America? Increasing Challenges to US Scientific Leadership. http://www.innovationtaskforce.org/benchmarks2019.

¹² National Center for Science and Engineering Statistics, Survey of Earned Doctorates, 2018, Data Table 17, Doctorate recipients, by broad field of study and citizenship status: Selected years, 1993–2018, , 2018. https://ncses.nsf.gov/pubs/nsf20301/data-tables.

¹³ See: https://www.kauffman.org/wp-content/uploads/2019/12/kauffman_compilation_immigration_entrepreneurship.pdf and and https://www.kauffman.org/wp-content/uploads/2019/12/the_economic_case_for_welcoming_immigrant_entrepreneurs_updated_september_2015.pdf.

¹⁴ See: https://ncses.nsf.gov/pubs/nsb20206/international-collaboration.

¹⁵ See: https://cset.georgetown.edu/wp-content/uploads/CSET-Canadas-Skilled-Immigration-System-Increasingly-Draws-Talent-from-theUnited-States.pdf.

¹⁶ See: https://iucrc.nsf.gov.

¹⁷ See: https://sites.nationalacademies.org/PGA/PEER/index.htm.

¹⁸ See: https://www.iie.org/Programs/IVLP.

ties and engagement of scientists. First, there have been shifts in membership in decision making bodies and governing boards without the limitations of visas or travel costs. Second, social science research methods requiring in-person focus groups have become virtual, allowing more efforts in more countries with the same budget and forcing an increase in the quality of data collection via a digital format. Third, the decline in travel has resulted in more responsibility shifting to partners on the ground for general program implementation, allowing managers in low resource environments to do more and get additional opportunities on the global stage. She cautioned that some of these gains in inclusion are not equitably distributed and are dependent on who has access to digital technologies.

Wole Sobeyojo (Worcester Polytechnic Institute) shared a number of case studies that demonstrate the capacity for impact in moving from concept, to lab, to the community. The first was a U.S.—Africa workshop in 2000 sponsored by NSF that led to the creation of the U.S.—Africa Materials Institute. Sobeyojo also spoke about the Pan-African Nelson Mandela Institutions that formed Centers of Excellence across the continent focused on specific topics (e.g., Center for Water and Environmental Engineering in Burkina Faso). Finally, he discussed the African University of Science and Technology¹⁹ that demonstrates how governments can invest in training Africans to be leaders in science. He identified several factors for success and impact, including collaborating, engaging women and girls, and connecting with industry to strengthen the links among research, education, and innovation.

The discussion largely focused on other good practices and models to develop sustainable programs that create system-level changes in science systems around the world. Several participants stressed the importance of human capital, and mentioned the Mandela Washington Fellowship and Engineers without Borders as being successful examples of cross-border exchanges that have lasting impact and inspire participants.

BREAKOUT SESSION: INTERNATIONAL SECURITY AND ADDRESSING THE PROMISE AND PERILS OF EMERGING TECHNOLOGY

Jason Matheny (Georgetown University, Center for Security and Emerging Technology) focused on artificial intelligence (AI) and biotechnology as technologies with the potential for broad impact. The Department of State will play a key role in AI and synthetic biology, he said, in amplifying the promise and limiting the peril of these technologies, and it should identify ways to maximize its role on technology policy issues. Priorities for the Department include the following: increasing staff; creating a Technology Council that supports diplomacy, development, and intelligence needs; increasing resources for cooperative threat reduction programs; strengthening support for the Biological Weapons Convention; and reinstating programs such as USAID’s PREDICT²⁰ that address emerging disease threats. He also mentioned the central role of semiconductors as an enabler for technological development, and the need to make global supply chains more robust including through multilateral institutions and sharing technology with allies. Finally, Matheny noted that it is important to watch how massive amounts of compute power will be leveraged for solving difficult problems in biology and chemistry with new applications in health, agriculture, and energy.

Catherine Novelli (Listening for America) observed that because most diplomats do not generally understand technology and the innovation ecosystem, they are not prioritized, including for promotion, in the Department of State. Without tech-savvy diplomats, the U.S. is at a disadvantage and there is a tendency to focus on the perils over the promises of technology. The Department must infuse this knowledge into the regional bureaus. There are, however, mechanisms that have been successful at getting expertise into the government. These include fellowships like the AAAS S&T Policy Fellowship, the Eagleberger Fellowship (focused on the private sector), and White House Fellowships. Such fellowships, Novelli indicated, need to be more broadly utilized especially by the regional bureaus, and the fellows’ projects need to be better coordinated and brought into policymaking. Training on technology issues for mid- to senior-level diplomats—even short-term opportunities—should be required to bring these issues into diplomats’ consciousness. Novelli highlighted the Global Connect Initiative²¹ to demonstrate the Department of State’s convening power across the government to work on ambitious strategic diplomatic or development goals.

David Kirkpatrick (Techonomy) stressed how technology is integrated into every part of the economy and society. This reality requires a shift in understanding that technology policy needs to be national policy. In contrast to countries like China, the U.S. has not put these issues at the core of policy and does not have enough government officials with technology skills, which threatens U.S. technology preeminence. Kirkpatrick noted that companies such as Facebook—and even individual Facebook data scientists—can sometimes be more powerful than states at influencing economic and political realities. Some countries are consequently adopting diplomatic strategies to account for the importance of technology to their governments, such as Denmark creating an Ambassador to Silicon Valley. Most coun-

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¹⁹ See: https://aust.edu.ng.

²⁰ See: https://www.usaid.gov/sites/default/files/documents/1864/predict-global-flyer-508.pdf.

²¹ See: https://2009-2017.state.gov/e/eb/rls/rpts/othr/266985.htm.

tries recognize technology as key to their national success, and Kirkpatrick suggested that the U.S. government should take advantage of the diplomatic opportunity to learn from how U.S. companies are engaging other countries.

The discussion following the presentations focused on how technology should be mainstreamed across the Department of State. This includes the types of resources that employees need to demystify technology and make decisions, the need for leadership at the top, and integration of technology into Department-wide strategy documents. One participant spoke of the need to better integrate thinking about technology, regulatory, and security topics as a package, and for USAID to get involved in issues like cybersecurity as an enabler for development and capacity building. Several participants stressed the importance of some level of training for all employees at the departments, with one participant using an analogy to note that diplomats “don’t need to understand how the building is made to understand the threats.” Standards-setting bodies were raised as a topic where diplomats need to better understand the nuances involved in the process of technology development.

SESSION 3: ACCELERATING SCIENCE, TECHNOLOGY, AND HEALTH INTO DIPLOMACY AND DEVELOPMENT

Glenn Schweitzer (the National Academies) highlighted recommendations from four recent National Academies reports focused on the Department of State and USAID.²² Some of these recommendations included forming the S&T Advisor’s Office at State, a need to create career incentives for STH positions in the United States and in missions; establishing an innovation center at USAID that reports directly to the USAID Administrator; merging disaster response programs with follow-on USAID activities; infusing a culture of S&T throughout the Department of State. Schweitzer also spoke about the importance of foresight activities, understanding digital technologies, broader risk taking, and scaling as core priorities for USAID.

Vaughan Turekian (the National Academies) then moderated a plenary discussion with Rose Gottemoeller (Stanford University and former Undersecretary for arms control and international security at the Department of State) and Andrew Natsios (Texas A&M University and former USAID Administrator), focused on framing large-scale S&T issues going forward.

Gottemoeller’s experiences directing nuclear policy issues in the U.S. government and North Atlantic Treaty Organization (NATO) reinforced to her the importance of interdisciplinary teams with the right expertise. She noted that the ‘T Family’ bureaus²³ at State have in-house expertise through civil servants, but there is a need for that expertise throughout all the bureaus. She recognized much talent has been lost in recent years at the Department of State, including younger staff, and rebuilding personnel should be a focus in the coming years.

Natsios pointed out the direct links between development and S&T, and highlighted three areas where USAID has made a large impact around the world: global health, including vaccines and family planning; agriculture through Green Revolution investments; and information and communications technologies through efforts to spread the internet and its necessary legal and institutional frameworks to the developing world. Effective development interventions are scalable, sustainable and transformational. He said that development efforts should focus on institutions to include organizations and the “rules of the game” as described by economist Douglas North.²⁴ He noted that top-down initiatives are not the answer in development since all development is local. In his time in government, Natsios observed that scientists do not understand the politics or culture of the Departments, which may be why they are ignored. He proposed that S&T fellows receive training in diplomacy and development theory and practice to understand why science is not the driver for decision making. He also suggested that fellows start tenures at the Department of State and USAID by working in an embassy or a mission.

In addressing how the landscape was changing around diplomacy, development, security, and foreign affairs and the need for talent at the Departments, Gottemoeller stressed that new areas need attention from in-house, national labs, and external expertise (e.g., understanding what technologies we need for monitoring and verifying new treaty agreements). With respect to the increasing role of China in development, Natsios noted the importance of foreign aid

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²² National Academies of Sciences, Engineering, and Medicine. 2017. The Role of Science, Technology, Innovation, and Partnerships in the Future of USAID. Washington, DC: The National Academies Press. https://doi.org/10.17226/24617; National Research Council. 2015. Diplomacy for the 21st Century: Embedding a Culture of Science and Technology Throughout the Department of State. Washington, DC: The National Academies Press. https://doi.org/10.17226/21730; National Research Council. 2006. The Fundamental Role of Science and Technology in International Development: An Imperative for the U.S. Agency for International Development. Washington, DC: The National Academies Press. https://doi.org/10.17226/11583; National Research Council. 1999. The Pervasive Role of Science, Technology, and Health in Foreign Policy: Imperatives for the Department of State. Washington, DC: The National Academies Press. https://doi.org/10.17226/9688.

²³ Includes the Bureau of International Security and Nonproliferation, the Bureau of Arms Control, Verification and Compliance, and the Political-Military Affairs Bureau.

²⁴ North, D. 1990. Institutions, institutional change and economic performance. Cambridge University Press, Cambridge.

during the last period of great power rivalry in the Cold War,²⁵ which has lessons for how U.S. national interests and those of our allies may be more important drivers than global frameworks like the Sustainable Development Goals.

On the issue of the need for an environment, science, technology, and health (ESTH) cone in the foreign service, Gottemoeller pointed out that career progression through the Department is not currently driven by S&T expertise, and there are only a few senior positions at the top. Other issues such as low salaries and a broken security clearance process hinders the ability to bring the right experts into the Department of State.

Fellowship programs can successfully get experts into the offices and departments, but Gottemoeller spoke of challenges in ensuring Jefferson Fellows’ expertise matched the needs of their host offices at the Department of State. Further, ambassadors must approve the placement of fellows at embassies, and the heads of departments need to be willing to create incentives and innovate within legal statutes to fill staffing needs. Natsios stressed the importance of leadership to make USAID less risk-averse, which may also require changing incentive structures.

Following the plenary remarks and discussions, participants joined one of three breakout sessions with speaker presentations, followed by discussion.

BREAKOUT SESSION: STRENGTHENING ORGANIZATIONAL STRUCTURES FOR SCIENCE, TECHNOLOGY, AND HEALTH INTEGRATION

Dan Reifsnyder (University of Virginia and former Deputy Assistant Secretary of State at OES) recounted something he was told when he worked at the Department of State: “Science policy is science money—no money, no policy.” This underscores the importance for offices at the Department of State to have funds to advance their priorities through agencies like the Environmental Protection Agency or the Department of Energy (DOE), which have the technical expertise but lack the legislative authority to work internationally. The Global Climate Change Initiative²⁶ is an example of an initiative housed within State’s OES Bureau that pooled funds for various agencies (e.g., Treasury, DOE) to apply towards efforts at those agencies that were tied to Department of State objectives, which dramatically enhanced OES’s influence. He urged that this should be a model for elevating ESTH at the Department of State in the future.

Alex Dehgan (Conservation X Labs and former chief scientist at USAID) reflected on working at the Department of State and the need for scientists to be on the front lines of policy and planning, and for leadership to understand the integration of science into broader national security interests. He noted that the U.S. system of traditional diplomacy is founded in place-based thinking around sovereign states and boundaries. However, this is no longer sufficient in an era where challenges cross boundaries and are rooted in science. Dehgan stated that there is great potential for science to serve as the scaffolding of official bilateral relationships and engagement, and can work best in our most challenging relationship as evidenced from scientist-to-scientist engagement with Iran. The government should leverage the world’s positive perception of U.S. science for diplomatic and development objectives.

David Sandalow (Columbia University and former Assistant Secretary of State and acting Undersecretary of Energy) challenged the participants to advance progress on the issues highlighted in the session. He noted similar issues have been discussed for at least two decades. Sandalow identified three areas for reform: (1) strengthening the Foreign Service (e.g., rethinking training, making ambassadorial appointments through functional bureaus, creating an S&T career track, and active recruitment of experts with the right skillsets); (2) strengthening ties between the Department of State and other agencies and elevating the value-add of State (e.g., access to foreign ministries in other countries, political profiles); and (3) finding ways to bring in experts outside of government and from the national labs. He also reflected on the U.S. reputation for excellence in these S&T issues as one asset of foreign relations that can be strengthened.

The discussion covered a wide breadth of the different organizational and bureaucratic needs for the Departments to adequately address these issues, including personnel, partnerships, the role of Congress, and portfolios at State. Participants noted the importance of the Departments recognizing that different expertise is needed to effectively manage grants and finding ways to incentivize and promote this talent that does not fall into management tracks. Several participants noted that technical talent could be better leveraged, including from universities, and networked alumni of fellowship programs, and partnerships were identified as a means for doing this. Participants discussed challenges of the current silos in appropriations between domestic and international funds and the 4-year cycle of funding and noted that champions in Congress can be critical to elevate efforts to fund high-level priorities (e.g., climate change in the Obama administration.) The participants discussed that the breadth of the portfolios of the Undersecretary of Economic Growth, Energy, and the Environment and OES may require a rethink to better manage the issues and increased need for diplomatic engagement on them. At the same time, it was acknowledged that past efforts to stand

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²⁵ See: https://ndupress.ndu.edu/Portals/68/Documents/prism/prism_8-4/prism_8-4_101-119_Natsios.pdf?ver=2020-06-12-101119-517.

²⁶ See: https://2009-2017.state.gov/documents/organization/250737.pdf.

up new offices (e.g., Bureau of Energy Resources, Special Envoy for Climate Change) have not been easy. Finally, one participant proposed that the National Academies create a taxonomy to differentiate the ways in which science is integrated in foreign affairs that can help identify where improvements can be made in those specific categories (e.g., how to use science to improve the results in areas such as water or agriculture vs. science needed to devise disarmament monitoring or measuring methods).

BREAKOUT SESSION: ELIMINATING STRUCTURAL RACISM AND PROMOTING INCLUSIVITY AND DIVERSITY

Christopher Richardson (BDV Solutions and former Foreign Service Officer) stressed the need to recognize the history of the Department of State, including how it barred Black people, women, and others from joining their ranks from 1920-1980. Since the 1940s, there have been conversations on how to increase diversity at State. Current reform efforts should be informed by the past.

Ambassador Bonnie Jenkins (Women of Color Advancing Peace, Security and Conflict Transformation, WCAPS) agreed that the problem of discrimination is not new but it has not been challenged in a sustained way. Jenkins said that the recent Government Accountability Office (GAO) report²⁷ and events like the killing of George Floyd are shedding light on the broken system, and the question is how to keep the issues in focus. She stressed the need to provide entry points to USAID and State for early and mid-career talent, mentorship programs, training on diversity, equity and inclusion (DEI), and a review of security clearance processes. At the system level, there is a need to institute exit interviews, revisit the promotion process, use blind applications, develop affinity groups, and designate lead DEI contacts. As a sign of momentum, through the OrgsInSolidarity movement,²⁸ more than 250 non-governmental organizations and individuals have signed the WCAPS’ Statement and its 12 commitments.

Sudip Parikh (AAAS) noted similarities between the recommendations for State and those for the science community. AAAS’s approach has been to periodically release draft plans for feedback to maintain momentum around this conversation. Parikh acknowledged that AAAS acts as a gatekeeper—publishing in Science is a gateway for a career in science, and obtaining a AAAS S&T Policy Fellowship is a gateway to a career in policy. AAAS has a role to play in ensuring everyone has access to joining the meritocracy that is science. Parikh noted that demographics of selected AAAS fellows or program recipients tend to mirror those of their selection committees and that looking at these kinds of data may be valuable for USAID and the Department of State.

Jason Bair (GAO) summarized the recent GAO studies on diversity at USAID²⁹ and the Department of State.⁶ He highlighted some progress, for example, from 2002−2018, where there were modest increases in the proportion of racial or ethnic minorities in the workforces at both USAID and State. However, persistent challenges include: significant variance among racial and ethnic groups (e.g., a decline in the proportion of African Americans, but an increase in proportions of Asian and Latino Americans, especially at State); persistent discrepancies in the proportion of minorities in management; and significantly lower promotion rates for minorities compared to whites, even when controlling for other factors. The GAO also found that disparities are larger in the civil service compared to the foreign service. Bair stressed that recruiting diverse talent is not the biggest problem; instead, it is promotion and retention at the mid-career level. He concluded that the Department of State and USAID must commit to understanding the root causes of these issues in order to solve them.

In the discussion, Richardson elaborated that the problem at State is not recruitment or even retention but a hypercompetitive culture based on test taking. To move forward, Bair noted that State and USAID should learn from other organizations doing well in terms of DEI (e.g., based on the Partnership for Public Service annual survey data).³⁰ As one example, Bair noted that personal performance assessments at GAO are tied to meeting diversity goals, which effectively drives behavior. One participant noted that the diversity gains discussed at State and USAID have been in administrative staff, while technical and policy staff diversity remains low, and additional mechanisms for hiring diverse technical staff are needed. Andrew Hebbeler (Nuclear Threat Initiative) stressed that while the AAAS S&T Fellowship is very important, it cannot be the solution for State and USAID’s technical talent needs, and Bair noted that fellowship programs like the Pickering, Rangel, and Payne Fellowships have not improved the long-term diversity of State or USAID. Bair stressed that sustainable change must come directly from the Secretary of State.

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²⁷ GAO, Department of State: Additional Steps Are Needed to Identify Potential Barriers to Diversity, GAO-20-237 (Washington, D.C.: Jan. 27, 2020).

²⁸ See: https://www.wcaps.org/orgsinsolidarity.

²⁹ GAO, USAID: Mixed Progress in Increasing Diversity, and Actions Needed to Consistently Meet EEO Requirements GAO-20-477: Published and publicly released: Jun 23, 2020.

³⁰ See: https://ourpublicservice.org/publications/2019-best-places-to-work-in-the-federal-government-rankings.

BREAKOUT SESSION: PROMOTING SCIENCE, TECHNOLOGY, AND HEALTH FOR INNOVATION AND DECISION-MAKING

Klaus Tilmes (Independent consultant and formerly at the World Bank) noted that the PEPFAR and Feed the Future programs provide important blueprints for mobilizing science, technology and innovation partnerships with global impact. He observed that decisive leadership at the top is critical and that leadership on data, networks, platforms, and related policies influence the ability to respond to the current challenges. Data partnerships with private companies need to be expanded to better target services and work with startups in local ecosystems to keep up with rapidly changing data applications. Governments are increasingly looking for advice on data and technology policies, including regulation of AI, data privacy ethics, cybertechnology, and e-commerce. With development and diplomacy increasingly turning digital, new approaches are needed to transform into data-driven organizations and improve organizational readiness, agility, and skills. He called for the cultivation of a ‘data mindset’ and the development of data protocols to permit greater interoperability to address shared problems across borders. Finally, Tilmes advocated for new financing options for science, technology, and innovation.

Alex ‘Sandy’ Pentland (MIT Connection Science) opened by highlighting that computational social science shows that development can be much more scientific. As one example, he cited research showing that economic growth at the neighborhood scale can be predicted by the diversity of goods and services.³¹ He acknowledged that the main barrier is getting the data, which are mostly privately held. There needs to be a shift from storing data centrally to using algorithms to make specific queries, providing greater security and auditability, and minimizing legal risks. This “federated data,” or “secure multi-party computation,” approach can derive insights from private company data without needing to own or control it. Taking this approach further, governments can create all digital platforms for their currency and commerce. For example, the Swiss government has recently set up Swiss Trust Chain, a unified, encrypted platform, making every transaction in Switzerland fully and instantly auditable without risking the security of the data. These platforms will transform the world of data and governance, but the U.S. has not been building them. To illustrate, Pentland suggested that in 5 years, the U.S. government may need to “beg Singapore for the data it needs to operate in the Indian Ocean area.”

Steven Kern (Bill & Melinda Gates Foundation) discussed how his organization is integrating data to inform future investments. He noted that one of the biggest barriers to accessing data is building and maintaining trust. He agreed with the federated approach to data introduced by Pentland, but noted that the data must be standardized for this approach to be efficient and for the results to be validated. Other important components to consider are engaging with local communities and responding to their needs, ensuring sustainability beyond the pilot phase, and leveraging partner investments, which are areas where the Department of State and USAID can play a role, Kern said.

Participants highlighted barriers to adopt these kinds of practices at State, including old, locked computer systems and a culture that values individual expertise. Pentland noted that there may be technology solutions to some of the hardware challenges and noted that using “census-level” data can avoid privacy issues. While dashboards were identified as a good way to create decision support tools for the government, there are limitations if there is not a modern mindset that accompanies them and realizes the “mission-critical” need to augment our knowledge and how computational tools can be deployed with mal intent (e.g., Q-Anon conspiracies). A participant asked about accounting for trust, to which Pentland noted that trust is between people while technology systems should be focused on reliability. Kern added that shifting responsibility to the community can help find agents to scale trust. Tilmes highlighted a rise in digital authoritarianism, with several participants noting the need to strengthen data privacy, protection, and governance systems around the world, and proposed the need to develop a database for trusted data algorithms as a global public good.

CONCLUSION

The final day of the workshop featured a summary by planning committee co-chairs Andrew Hebbeler and Cathy Campbell (CRDF Global, retired). They highlighted some of the key points over the course of the workshop, including:

• Science in the 21st century requires novel approaches that are long-term, interdisciplinary, multisectoral, and global in scope.

• The COVID-19 pandemic has highlighted the strong dependency of U.S. and global stability and security on human health and revealed discrepancies in the national and international capacity to act and the propensity to act.

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³¹ Chong, S.K., Bahrami, M., Chen, H. et al. 2020. Economic outcomes predicted by diversity in cities. EPJ Data Science. 9(17). https://doi.org/10.1140/epjds/s13688-020-00234-x.

• For many of the challenges in STH and diplomacy in the next decade, new, or revised global governance structures are needed that emphasize the true intellectual contribution of all the partners, leverage resources, and embrace openness and transparency.

• There is a need to define the values, principles, and practices on which the global science landscape has been built. The United States should identify new ways to partner with countries on science, to deepen integration with like-minded countries, and create positive incentives for values-anchored behaviors.

• The American foreign policy enterprise should work to elevate and integrate STH expertise into scalable, systemic, and top-down strategic approaches beyond the project level.

• U.S. foreign policy agencies need ESTH expertise, interaction with experts outside government, and stronger communications to explain the critical role of ESTH in foreign policy.

• Addressing the challenges will require recasting how the U.S. thinks about foreign policy, including new ways of strengthening the government’s policymaking process to ensure that S&T are central, not subordinate, to foreign policy, diplomacy, and development and ways of creating incentive structures within State and USAID that reflect this priority.

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WORKSHOP PLANNING COMMITTEE: Cathy Campbell, Co-chair, CRDF Global (retired); Andrew Hebbeler, Co-chair, Nuclear Threat Initiative; Michael R. Nelson, Carnegie Endowment for International Peace; Jonathan Pershing, William and Flora Hewlett Foundation; and Annica Wayman, University of Maryland, Baltimore County.

DISCLAIMER: This Proceedings of a Workshop in-Brief was prepared by Mahlet N. Mesfin and Teresa M. Stoepler as a factual summary of what occurred at the meeting. The statements made are those of the rapporteur(s) or individual meeting participants and do not necessarily represent the views of all meeting participants; the planning committee; or the National Academies of Sciences, Engineering, and Medicine.

REVIEWERS: To ensure that it meets institutional standards for quality and objectivity, this Proceedings of a Workshop in−Brief was reviewed by DeAndra Beck, Michigan State University, and Cathy Campbell, CRDF Global (ret.). Marilyn Baker, National Academies of Sciences, Engineering, and Medicine, served as the review coordinator.

SPONSORS: This Workshop was supported by the National Academies of Sciences, Engineering and Medicine. For additional information regarding the Workshop, visit: https://www.nationalacademies.org/our-work/science-technology-and-health-capabilities-within-the-department-of-state-at-an-inflection-point-workshop-series.

Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2020. Science, Technology, and Health Capabilities Within the Department of State and USAID at an Inflection Point: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. https://doi.org/10.17226/26016.

Policy and Global Affairs

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