What Science Can Offer

Originally Published at Science & Diplomacy. Read the original here

I don’t know.

It’s an essential phrase to science. It was one of the many steep learning curves of becoming a scientist—learning the importance of “I don’t know.” It’s not what you might expect, given the popular image of scientists as arbiters of information, moving from one “Eureka!” moment to the next at a fast clip. But in reality, taking seriously the separation of fact from fiction, science proceeds deliberately, acknowledging its own imperfection.

Each scientific advancement is incremental and imperfect—what Ezekiel Emmanuel recently called a “partial picture of the way the world is.”

Not knowing is well within the comfort zone of scientists because it’s the space they occupy: right at the edge of knowledge. Declaration of what you don’t know and what else could explain your findings is baked into the process. Expressions of doubt and “what-if” are quantified and declared right up front.

The basic structure of scientific papers is: here is exactly how I did my experiments (so that you can do them too and check my work); here’s what I found; here’s what I think the findings mean; but, to be clear they could also possibly mean something else; and here’s what I don’t know yet but we should collectively work to figure out.

As global scientists race to understand the novel coronavirus SARS-CoV-2, and the human disease it causes, COVID-19, this essential phrase—I don’t know; we don’t know—stands in stark contrast to the blame game of politicians (I know what to do but my political rival doesn’t, listen to me); the rhetoric of nationalism (we know best, they do not); authoritarians (I alone know and therefore I alone can fix it); and the ethos of commentators (I’ve known something for a few minutes and here’s what I just thought of to say about what it means).

Another unique aspect of the scientific method is its universality. It is the same across nations and political ideologies. Its universality allows scientists to come together across nations, working toward a common end, even when the politics and ideas guiding their individual communities may be drastically different.

The two infectious disease experts at the helm of the U.S. coronavirus response, Drs. Anthony Fauci and Deborah Birx, share a background in national and global HIV/AIDS research and public health programming. Fauci co-developed and Birx most recently led PEPFAR (the President’s Emergency Plan for AIDS Relief), the U.S. Government’s initiative to address global HIV/AIDS. Launched in 2003, PEPFAR has invested over $80 billion to understand, prevent, and treat HIV/AIDS worldwide, especially in hardest-hit sub-Saharan Africa.

Tackling the massively complex issue of HIV/AIDS worldwide required the will to try, well before the path to success was clear. I had the pleasure of working for both Fauci and Birx at various stages of my career. When I went to work for PEPFAR in 2011, over eight years into the program’s existence, our motto was still “building the ship as we sail.” Reliance on the scientific method—coordinating efforts, sharing our work, both the successes and the failures—allowed the program to save lives and prevent new HIV infections while learning in real time.

To this day, interventions to prevent and treat HIV/AIDS are not one-size-fits-all. The risk, stigma, prevention and treatment options for HIV vary widely from community to community, country to country.

So to be successful, PEPFAR also taught us that scientists alone cannot solve complex problems. To truly “build the ship while we sail,” requires coordination between scientists—clinical trialists, social scientists, mathematical modelers and more—but also community leaders, political leaders, hospital and community health systems, supply chains, religious leaders…the list goes on. Such coordination is a messy business. But that messy business is possible to finish when you start from the principles of the scientific method.

COVID-19 requires unprecedented coordination across nations and disciplines at a time of increasing nationalism and authoritarianism. We are all scared and desperate for answers. Authoritarians or smooth-talking political pundits may be especially appealing given our fears. But ultimately, neither hold the answer to what we are dealing with now. The answer to “when will this end?” or “how will this end?” at this moment is: we don’t know. But, in contrast to commentators or politicians, science will provide the answer. Not overnight. And likely not all at once. But rather, deliberately, with incremental progress and course-correction that should not be misconstrued as weakness.

When and how will this end? We don’t know. But scientists are working on it.