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Science lessons for the next president

George W. Bush won the 2000 presidential election after promising to be a "compassionate conservative" who would cut taxes, promote education, and boost the economy. His presidency, however, soon became dominated by the 2001 terrorist attacks and the wars in Afghanistan and Iraq. But history will note that two science-focused events bracketed the 9/11 attacks. A month earlier, Bush wrestled with whether to allow federal funding for research involving stem cells taken from human embryos. And just a week after the attacks, someone mailed anthrax-filled letters to media outlets and politicians, killing five people and prompting the White House to launch a massive effort to improve bioterror defenses.

New presidents typically move into the White House neither expecting to spend much time on such arcane technical issues, nor prepared to. But history shows that, ready or not, every president ends up grappling with a host of science-related policy issues or crises.

President Gerald Ford, for instance, spent much of 1976 dogged by what the media dubbed the swine flu fiasco. After a new strain of the H1N1 swine flu virus appeared in soldiers, public health experts urged a massive vaccination campaign. Some 40 million Americans got the vaccine, but the effort was plagued by missteps, and the flu turned out to be less dangerous than believed. Some analysts believe the episode contributed to Ford's loss to Jimmy Carter that year.

Many scientists derided President Ronald Reagan's attempt to build a space-based laser system that could shoot down Soviet missiles as a Star Wars fantasy. But Reagan's muscular foreign policy, intended to demonstrate U.S. technological superiority over what he called "the evil empire," also included two major civilian science projects: the Space Station Freedom, which evolved into today's International Space Station, and the Superconducting Super Collider, a giant particle smasher that Congress ultimately canceled.

What science-related issues will the next president face? Climate change is sure to loom large, as will the annual debates over how much the government should spend on basic research and which fields are likely to provide the biggest short-term economic payoff. Technological advances, from self-driving cars to genome engineering, will pose new regulatory challenges. And surprises such as disease outbreaks, oil spills, and natural disasters are all but certain.

In each case, a little science savvy might help a president better understand the issues and how best to respond. With that in mind, we offer the winner of next month's election a crash course in six areas of science that are likely to demand attention in the Oval Office over the next 4 or 8 years.

During the Ebola epidemic, scientists anxiously monitored the virus (blue) for signs that it was changing.

Science Source

Evolution promises unpleasant surprises

Pathogens change faster than our defenses

What the science says: The viruses, bacteria, fungi, and parasites that cause disease in people, farm animals, wildlife, trees, and crops are in an arms race with their hosts. Unfortunately for us, they often gain the upper hand, evolving the ability to evade or overrun host defenses and potentially becoming deadly superbugs. And because many disease-causing agents reproduce so quickly—the gut bug Escherichia coli can double its numbers in as little as 17 minutes—they can outrace our ability to develop new treatments. This fundamental process has helped produce bacteria that can resist antibiotics and deadly flu viruses that can jump from animals such as birds, bats, and pigs to humans, posing the threat of a global pandemic that could kill millions. Bacteria and other organisms can even trade genes through a process called lateral transfer, accelerating the spread of traits like drug resistance.

Why it matters: Evolving pathogens can threaten our food and water supplies, natural resources, and health. In the United States, 2 million people develop antibiotic-resistant infections each year, and 23,000 die. Globally, the World Health Organization estimates that in 2015 there were 580,000 new cases of tuberculosis resistant to the two most powerful drugs used against this disease. Increasing drug resistance in malaria, HIV, and other major diseases threatens to undermine control efforts. And recently emerged threats, such as the Zika and Ebola viruses, are certain to evolve in ways that can be hard to predict. To develop treatments, scientists often must work with the most dangerous pathogens in laboratories, and sometimes even engineer new strains; this creates the possibility of accidental or intentional releases that could have dire consequences.

Pending policy issues: The United States needs to be ready for serious epidemics, and even a global pandemic. Readiness requires international cooperation and coordination, because diseases respect no borders. Experts say disease surveillance systems need improvement, along with diagnostic tools and treatments, but obtaining funding for these activities has proven problematic. Policies must ensure that work with the most dangerous agents is done in safe, secure laboratories—but regulations must not stifle needed research. The next president will also need to implement the U.S. National Action Plan for Combating Antibiotic-Resistant Bacteria, launched in 2015 to curb the overuse of antibiotics in health care and agriculture, which has spurred the evolution of resistant strains. And the new administration will have to find ways to create incentives for drug companies to develop new antibiotics, which have little profit potential, to replace ineffective drugs.—Elizabeth Pennisi

Surgeons prepare a genetically modified pig lung for transplantation experiments.
Chris Maddaloni/Nature

The genome-editing revolution beckons

CRISPR raises tough ethical issues

What the science says: CRISPR is a new gene-editing technology that makes it easier, faster, and cheaper than ever before to alter the DNA of any organism, from bacteria to people. It is based on a molecular system that single-celled creatures evolved to defend against invading viruses. CRISPR is a major departure from earlier genetic-engineering techniques, including transcription activatorlike effector nucleases and zinc finger nucleases, which were costlier, slower, and less precise. CRISPR readily snips DNA, which allows scientists to cripple a gene, add in DNA, and even mix genes from unrelated organisms.

Why it matters: A powerful tool for basic research, CRISPR could also lead to new treatments for genetic disease in humans, pest-resistant crops with higher yields, and disease-resistant livestock. But uses of CRISPR could also raise profound ethical and regulatory concerns. It could allow the creation of human embryos with modified genes in their germ line—eggs and sperm—meaning the changes would be passed on to future generations. And, in an approach known as gene drive, CRISPR could be used to permanently alter the genome of an entire species in ways that could shift its evolutionary path and ecological role, or even wipe it off Earth. In principle, gene drive could give an endangered species a boost, wreck the genetic defenses that allow some weeds to resist herbicides, or drive a disease-carrying mosquito to extinction.

Pending policy issues: One big question facing the government is whether it should fund CRISPR editing of human embryos for research purposes. More troublesome is the prospect that CRISPR could be used to make babies that are free of known genetic defects and even have enhanced traits, such as better night vision or a stronger pitching arm. The next president will also face debate over whether the government should regulate plants and animals altered with CRISPR in the same way it treats other genetically modified (GM) organisms. (The U.S. Department of Agriculture has already said that using CRISPR to modify crop DNA in ways that could occur naturally is not covered by existing regulations on GM crops.) And what limits should be placed on potentially powerful gene drives?—Jon Cohen

Floods, like this one in North Carolina earlier this year, will become more common as sea level rises.
© Carlo Allegri / Reuters

Seas are rising sooner than you think

Regional variation means Atlantic shorelines are already at risk of flooding

What the science says: There's a political truism that also applies to understanding one of the most pressing problems created by human-driven climate change: All sea level rise is local. As the world warms, its oceans are swelling by an average of 3.2 millimeters a year; they have risen by nearly the height of a playing card since 1993. Some 40% of this increase stems from the physical expansion of water as it heats. The rest is mostly caused by melting mountain glaciers and, especially in recent years, retreating ice sheets in Greenland and Antarctica. If current emission trends continue, the seas could rise by a half-meter or more by century's end.

But these tidy figures hide a harsh and more complex reality: Because of regional geology, ocean currents, and shifts in gravitational pull caused by changes on Earth's surface, such as the melting of massive ice sheets, the ocean does not rise evenly everywhere. That means some U.S. shorelines are at much greater risk of near-term flooding than others. Although the erosion of southern Louisiana is well-known, for instance, much of the East Coast is sinking as Earth's mantle, deep below, continues to adjust in complex ways to the disappearance of weighty ice age glaciers. From Maryland to the Carolinas, groundwater pumping is exacerbating subsidence. And Atlantic currents that whisk warm, tropical water north, and, ultimately, away from the coast, have weakened in recent years, allowing water to slosh toward land. Together, these forces mean East Coast sea levels are rising at double the global rate, and at triple the average in Virginia and many points north.

Why it matters: Nearly 40% of the U.S. population lives near the coast, and shorelines host extensive infrastructure—including roads, rail lines, ports, military bases, and energy, water, and sewer plants—that will cost billions of dollars to protect or replace. Already, shorefront communities in hot spots of sea level rise, such as Hampton Roads, Virginia, and Miami Beach, Florida, are seeing tidal floods—even on sunny days—that clog traffic, poison lawns, and corrode utilities. Key ecosystems are also at risk of inundation, such as wetlands and aquatic grass beds that help protect coastlines from storms and provide important nursery grounds for economically important fish. This rising stage also allows stormwaters to surge deeper and higher inland, exacerbating their damage.

Pending policy issues: Given that some increase in sea level is now inevitable as a result of past emissions, how can the federal government best help communities prepare for and adapt to rising waters? How can policymakers prevent initiatives involving many agencies at the local, state, and federal levels from duplicating effort or engaging in turf wars? Who should decide when communities build defenses, or simply retreat? What research should be funded on climate and adaptation? (Local planners, for instance, would benefit if researchers could reduce the uncertainty in projections of sea level rise over the next century, by better understanding how ice sheets in Greenland and West Antarctica are melting.) Above all: How can the world reduce the global emissions of greenhouse gases that are driving sea level rise? —Paul Voosen

Alzheimer's disease, detectable in this brain image, is on the rise.
Living Art Enterprises / Science Source

Brain health should be top of mind

The personal and budgetary costs of Alzheimer's disease and other maladies are immense

What the science says: The human brain, with its 86 billion neurons and trillions of connections, orchestrates everything from understanding and memory to movement and sleep. Throughout life, its networks of neurons are constantly resculpted by influences including learning and experience, lifestyle, injury, and disease. Some areas of the brain also grow new neurons, contrary to the long-standing idea that the number is fixed very early in life. Neuroscientists are poised to discover how the brain works in unprecedented detail, thanks to advances in large-scale computing and revolutionary new tools such as optogenetics, which allows investigators to prod neurons into action and watch them work in real time.

Why it matters: Brain health touches us from cradle to grave, and when brain disease strikes, the costs—personal and budgetary—are staggering. By 2025, at least 7 million Americans are expected to suffer from Alzheimer's disease, which causes memory loss, personality changes, impaired reasoning, and, eventually, death. This year alone, treating and caring for Americans with Alzheimer's and other less common dementias cost $236 billion, with government health programs shouldering two-thirds of the cost. At the other end of life, the prevalence of autism, a disorder of language and social communication, rose by 123% between 2002 and 2012. That year, one in 68 U.S. children was affected; costs to each affected family are estimated at about $60,000 annually.

Other brain health issues abound. Learning disabilities are a big issue in classrooms; mental illness is common in the homeless, in addicts, and in prison inmates; and concussions have become a major concern in sports. The military faces the burden of treating traumatic brain injuries and the psychological aftereffects of combat. Effective diagnostics and treatments could make a huge difference.

Pending policy issues: The new president will have to plan for a ramp-up in spending on care for elderly people with brain disease, and decide how high a priority to place on spending for brain research. Since 2014, federal agencies have spent more than $750 million on the Obama administration's Brain Research through Advancing Innovative Neurotechnologies Initiative; and the next White House will determine how it evolves. At the same time, advocacy groups are pushing for expanded spending on research into maladies from pediatric brain cancer to Alzheimer's disease. Funding for Alzheimer's grew by some $350 million in 2016, and Congress may dole out at least as big an increase in the coming year. In the meantime, many law enforcement agencies are seeking more cash assistance for programs related to mental health in prisons and criminal justice proceedings. Balancing these competing priorities will be a challenge in the current budget climate, especially as mandatory spending on programs like Medicare expands, limiting available funds. —Meredith Wadman

Smart drones and other weapons could ultimately make their own decisions about when to attack.
Benjamin Shearn / Getty Images

Machines are getting much, much smarter

Advances in artificial intelligence carry promise and peril

What the science says: After years of halting progress, artificial intelligence (AI)—which aims to give machines a humanlike ability to gather information, learn, and make independent decisions—is taking off. More powerful processors, together with sophisticated pattern-seeking algorithms that learn from massive data sets and the surrounding world, have turned science fiction into everyday reality: phones that understand speech, vehicles that navigate on their own, machines that can trounce humans in complicated games. This past March, a largely self-taught computer program beat one of the world's best human players of the board game Go—an achievement AI experts hadn't expected for another decade. Researchers have also built systems that can accurately recognize images, help make investment decisions, and help control traffic flows and energy use. And they have figured out ways of helping advertisers place ads more effectively on the internet.

Why it matters: Although experts say we are still decades away from machines that truly think like humans, narrower applications of AI are already having an impact on society. Products and services from self-driving cars to systems that guide medical care and treatment could bring major benefits, including increased labor productivity, lucrative new markets, and fewer deaths from traffic accidents and medical mistakes. But AI brings worries, too. It will enable employers to automate more tasks and displace workers, and economists predict that some low-wage jobs will be among the first to be eliminated, possibly increasing economic inequality. Letting machines make their own decisions also raises profound ethical, legal, and regulatory questions. Who is responsible if an autonomous car crashes, a piece of software wrecks an investment portfolio, or a sensor switches a stoplight to green at the wrong time? The stakes are even higher on the battlefield, where the military is exploring the possibility of fielding autonomous lethal weapons that would make their own decisions about when to fire.

Pending policy issues: Many companies are eager to get self-driving cars on the road and autonomous aircraft into the skies, and want federal regulators to quickly clarify the rules. The next president will also have to decide how much the federal government should spend on AI research. (It currently invests about $1 billion a year.) And the administration will need to keep a close eye on AI's impact on the economy, workforce, and national security if the United States doesn't want surprises as this technology ripples across the planet. —David Malakoff

New York City officials boosted police presence in Times Square after the Boston Marathon bombings in 2013, but people tend to overestimate the likelihood of such events.
© Lucas Jackson / Reuters

We aren't so great at assessing risk

Gut instinct can lead to poor policy

What the science says: When experts calculate risk, they rely on statistics, but ordinary people tend to rely on their guts. Both approaches have their pitfalls, says Paul Slovic, a pioneer in the psychological study of risk at the University of Oregon in Eugene. "There is wisdom and foolishness on both sides of the divide," he says.

One downside of gut assessments is obvious: They lead us to overestimate the chances of horrible things happening and underestimate more familiar risks. For example, since the attacks of 9/11, terrorists have killed at most a few hundred Americans. Over the same period, car accidents have killed more than 500,000 and heart disease roughly 8 million—perils we tend to take in stride.

At the same time, the instinctive dread we feel regarding a terrorist attack or plane crash doesn't necessarily scale up to larger humanitarian crises where many thousands of people risk starvation, deprivation, or death. "We underreact to the statistics of catastrophe," Slovic says. We also tend to underestimate more diffuse threats that unfold slowly over time or across a wide area—such as the economic and public health impacts of climate change. The next president needs to understand how gut-level assessments can lead to misperception of risk.

Expert risk assessments, on the other hand, may seem totally objective because they're based on numbers. But even experts have to make judgment calls about which numbers really matter, and how to express the risk. In evaluating the threat from a toxic chemical leak, for instance, they might describe the risk simply in terms of the number of expected fatalities (likely to be low), or as the percent increase in risk of a rare cancer (which could be large). Changing the endpoints can alter the perception of risk, and of course experts themselves can have different biases and agendas.

Why it matters: Misperception of risk can push a president to overreact to lesser threats and underreact to greater problems, or to embrace policies that may make people feel good but end up being costly and ineffective—or even counterproductive. And how a president communicates with the public about risk can mean the difference between sowing panic and maintaining calm. Talking realistically about risks in advance—as opposed to promising absolute protection—may help prepare people for the inevitable disasters and minimize calls for a policy response that's out of proportion to the actual threat. To do this effectively, the president will have to maintain the public's trust, which is much harder to earn than it is to lose. Understanding the basic psychology of risk can help avoid missteps.

Pending policy issues: The next president will face a lengthy list of policy decisions surrounding known risks, including terrorist attacks, foreign conflicts, domestic crime and violence, flu pandemics, and natural disasters. But there will be emerging issues, too, including the potential risks of new technologies such as DNA editing and autonomous cars. With each, the challenge will be correctly assessing the risk, communicating it to the public, and developing sensible policies that can win support from voters, affected industries, and local, federal, and state policymakers. Greg Miller


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