Advancing science, promoting peace.

![Figure][1] Peter C. Agre CREDIT: JOHNS HOPKINS MALARIA RESEARCH INSTITUTE Founded in 2008, the The American Association for the Advancement of Science’s (AAAS’s) Center for Science Diplomacy uses scientific engagement to facilitate communication between the people of the United States and citizens of other countries around the world on issues of mutual interest. Clinical and translational medicine represents an important arena of investigation ripe for 21st-century science diplomacy, beginning with—although by no means limited to—infectious disease research. ![Figure][1] Vaughan Turekian CREDIT: AAAS Over the past half-century, the U.S. government focus on serious human rights violations committed by three countries—Cuba, the Democratic People’s Republic of Korea (North Korea, DPRK), and Myanmar (Burma)—have presented substantial challenges for policy-makers. In retaliation for these violations, all three countries face stiff sanctions and embargoes imposed by the United States and others. Although not yet meeting their political objectives, such sanctions and embargoes have had obvious impacts on the health and well-being of ordinary citizens. Within this geopolitical context, a team of scientists (including representatives from AAAS, universities, and other science associations) partnered with regional experts from several highly regarded United States–based nonprofit organizations and made visits to Cuba, DPRK, and Myanmar; the trips were funded by the Richard Lounsbery Foundation. As private American citizens, we brought a message of good will, formed by a shared interest in science and science-based solutions to problems, that would have been greeted with great suspicion if delivered by officials of the U.S. government. In partnership with the New America Foundation, our scientific team arrived in Havana in November 2009. We were the first AAAS delegation to visit Cuba since 1997. The economic hardships, in part a result of the 50-year embargo, were apparent from the crumbling 19th-century Havana architecture. In contrast, the campuses of the Cuban Center for Genetic Engineering and Biotechnology and the Finlay Institute Center for Vaccines Research and Production were modern. We attended scientific lectures presented by senior Cuban officials, but few younger scientists were present. Political posturing was minimal, and the discussions focused on medical science. Infectious disease research has long been an interest in Cuba. In the 1880’s, Havana physician Carlos Finlay recognized that Aedes mosquitoes were the vectors responsible for Yellow Fever transmission, long before the Walter Reed Commission confirmed this work in 1900. Notable advances by post-revolutionary Cuban biotechnology include the development of several vaccines, such as the first agent specific for type B meningococcal meningitis. Implementation of vaccines and other advances in translational medicine through public health initiatives are a priority in Cuba. Standard prenatal care is provided in even the most remote rural areas. Malaria has been eradicated in Cuba despite remaining endemic elsewhere in the Caribbean. United Nations statistics confirm that the average life span in Cuba is equivalent to that in the United States. Nevertheless, access to reagents and equipment reduce the scope of Cuban science. Leadership from the University of Havana revealed that despite the substantial interest of their students in medical science, opportunities for laboratory research are limited. In our meeting with leaders of the Cuban Academy of Sciences, it was agreed that collaborative scientific activities would be mutually beneficial to Cuba and the United States. The U.S.–DPRK Science Engagement Consortium—representing AAAS, the U.S. Civilian Research and Development Foundation, Syracuse University, and the Korea Society—arrived in DPRK in early December 2009. Although impeccably clean, Pyongyang projected an air of seriousness and austerity, indicative of a country suspicious of the outside world and on military alert for more than a half-century. Uniformed soldiers were seen frequently, reflecting the massive size of the North Korean military—1.2 million active-duty soldiers. Our hosts from the State Academy of Science served as both facilitators and translators who granted us permission to visit all of the civilian research institutes and universities that we requested. We met primarily with program directors and senior scientists, including representatives from the Branch Academy of Biology and the Branch Academy of Cell and Genetic Engineering. Although these scientists often acknowledged that they had never met Americans before, we were routinely received with enthusiasm. The facilities for biological and agricultural research were modest. Yet, the well-established collaboration between the U.S.’s Syracuse University and DPRK’s Kim Chaek University of Technology has revealed that the DPRK’s young scientists win international computer programming competitions even when they are held in English. The talent and motivation of young Korean scientists should not be underestimated. Our final day of visits led us to the impressive new Pyongyang University of Science and Technology (PUST)—an English language university being built with private donations from the United States. When it opens, PUST will provide an opportunity for American scientists to meet and teach the best and brightest students in North Korea. Given the large resource investment in terms of equipment and personnel required to undertake globally competitive biomedical research, it is not surprising that our cursory look did not reveal world-class research. There was little doubt, however, that if and when the DPRK government commits to developing its human resources in biomedical sciences—increasing and promoting more international expert exchanges from abroad and taking the steps needed to increase access to the latest research and other resources available at little to no cost on the World Wide Web—they possess a cadre of talented and engaged young scientists ready to make great strides. In partnership with the U.S. Collection Humanitarian Corps, we arrived in Myanmar in April 2010. Still recovering from the 2008 cyclone that killed nearly 130,000 people, laborers worked outside despite temperatures as hot as 116˚F. A very young country with a long history, most of its 59 million people live in rural villages. We visited government ministries of forestry, health, and science and technology in the new capitol in the interior, Naypyidaw. Multiple young life scientists, environmental scientists, and individuals undertaking projects in applications of science traveled many hours by bus to meet with us. Members of the national malaria control group indicated that great disease burden exists, and it will be impossible for neighboring countries to stem their malaria problems until control is achieved in Myanmar. We also met with the university science faculty in Yangon (Rangoon). Several requested our help in organizing sabbatical scientific experiences, but these are currently limited by political sanctions and mutual lack of trust. Ultimately, in this ever more integrated world, issues of global health require greater access to patients, samples, and information about emerging diseases in order to address these health needs quickly. One need only look at the high-profile and potentially devastating H5N1 virus still circulating throughout parts of Asia to see the value for such access to data and samples. And there are other such diseases—current or in the future—that will require a level of scientist-to-scientist interactions independent of national and international politics. Large challenges still face us. Official Cuban and U.S. positions have not changed in more than five decades. Aggressive posturing is occurring on the Korean peninsula after the recent sinking of a naval vessel. Elections are scheduled in Myanmar, but despite pressure from outside countries, confined opposition leader Aung Sang Suu Kyi will not be allowed to participate. While the ideological differences separating our respective governments are large, we found that the scientific bodies in these three countries welcomed U.S. scientific engagement. Whatever the trajectory of the politics, these connections can go a long way in advancing science and promoting peace. [1]: pending:yes