Foreword

Victor J. Dzau, MD

President, National Academy of Medicine (2014–Present)

The past half-century has been an era of astonishing progress for biomedical science, health, and health care in the United States and worldwide. This volume, commissioned to mark the occasion of the 50th anniversary of the founding of the U.S. National Academy of Medicine (NAM; formerly the Institute of Medicine [IOM]), tells the story of that progress.

Operating under an 1863 congressional charter, the NAM is part of the National Academies of Sciences, Engineering, and Medicine (the National Academies)—nonprofit independent institutions that provide objective advice on matters of science, technology, and health nationally and globally. The NAM has more than 2,400 members elected in recognition of extraordinary achievement—more than 75 Nobel Prize winners among them. Through a commitment to volunteer service in the programs of the NAM and the National Academies, our members help to advance the NAM’s mission: To improve health for all by advancing science, accelerating health equity, and providing independent, authoritative, and trusted advice nationally and globally.

Since the NAM was founded in 1970, the nation and the world have seen multitudes of remarkable “firsts”—including the dawn of targeted gene therapies, the near eradication of polio, revolutionary treatments for cancers and cardiovascular disease, and many more. The NAM played both direct and indirect roles in these impressive advances. Yet, in 2020, we also experienced a tragic “first” in COVID-19—the first global pandemic of such size and scale since the 1918 influenza pandemic. COVID-19 continues to exacerbate national and global health inequities, with higher death rates among people of color and resources such as tests and vaccines concentrated in wealthy communities and nations. Compounding this crisis is the persistent and intensifying threat of climate change amid an environment of dangerous misinformation and deepening sociopolitical challenges. As the NAM and other actors respond to these challenges, and as we consider the next 50 years of human progress, it is clear that leadership in health and biomedical science is needed more than ever.

The NAM is uniquely capable of providing such leadership. Throughout its history, the NAM has had a transformative role in health and medical advances of the past 50 years—from spurring HIV/AIDS research to confronting the scale of medical errors to guiding the governance of emerging science and technology to promoting equity as fundamental to the progress of biomedical science, health, and medicine—and much more. NAM members were the architects of many of these breakthroughs,

The collective genius of scientists, clinicians, public health leaders, educators, innovators, and policymakers—all committed to the cause of human progress—is our most powerful weapon against the challenges we face.

alongside countless dedicated scientists, clinicians, educators, and public health leaders worldwide. The milestones chronicled in this volume are a testament to their remarkable work, which has saved and improved innumerable lives.

This volume catalogues key examples of progress in five major fields: biomedical science and technology; diseases and conditions; public health; U.S. health care; and global health. Dozens of NAM members lent their expertise in selecting and reviewing the milestones that are featured. Milestones appear in roughly chronological order, but almost all advances in science and health have antecedents that stretch many years into the past and have impacts that extend many years into the future. Furthermore, no single volume can hope to capture the full picture of progress since 1970, nor every person who contributed to it. Nevertheless, the milestones collected here tell a story of awe-inspiring improvements in human health and well-being since the NAM was founded. The NAM is proud to be a part of this history.

Our work is far from complete. While the advancements in the pages that follow are cause for celebration, we must never tire in our pursuit of a healthier and more equitable future. In our increasingly interconnected and unpredictable world, it is critical that independent, evidence-based advice continues to be the cornerstone of thoughtful and deliberative decision making at all levels. And it is essential that our advice leads to action.

I hope this story will inspire amazement, inspiration, and determination in the scientists and health leaders of today and tomorrow. Look how far we have come—just how far might we go?