The Forum at Harvard T.H. Chan School of Public Health

The future of the Affordable Care Act (ACA) is unclear. Republicans have decided not to vote this week on the Graham-Cassidy bill, but promised to revisit ACA repeal-and-replace efforts. Democrats announced recently a single-payer health care proposal. And another hurdle for the ACA looms. With open enrollment beginning on November 1, questions remain about the stability of the ACA insurance exchange marketplace, particularly around the fate of cost-sharing subsidies and other factors that affect enrollment, affordability and access to varied plans. This Forum brought together health and public policy experts from across diverse perspectives to look at what’s next for the Affordable Care Act. What can Americans expect and where does health care reform go from here?

This Forum event was presented jointly with Reuters on September 27, 2017.

Watch the entire series at ForumHSPH.org.

In labs and in clinical trials, scientists are seeking ways to rewrite DNA, a building block of life. Tools such as zinc-finger nucleases (ZFNs), TAL effector nucleases (TALENs) and, more recently, CRISPR/Cas9 have the power to seek out and replace faulty DNA. The possibilities seem almost limitless: with the ability to edit DNA at will, researchers theoretically could wipe out malaria-causing mosquitos, make disease- and pest-proof crops without the need for pesticides, and cure genetic diseases, such as sickle cell anemia and cystic fibrosis. Cancer is another target, with human clinical trials using CRISPR already underway, while, in separate efforts, HIV has been reportedly eliminated in mice thanks to the tool.

But scientists and ethicists alike are worried about the speed at which the gene editing field is moving — and the implications of the results. In this panel, we discussed the promises and challenges presented by gene editing for individual and public health. What scientific and ethical hurdles must be overcome before tools like CRISPR and others can move safely and more widely out of the lab and into fields, farms, and hospitals

This Forum event was presented jointly with NBC News Digital on May 19, 2017, as part of The Andelot Series on Current Science Controversies.

Watch the entire series at ForumHSPH.org.

“Lose belly fat.” “Build muscle.” “Lower your cholesterol.” “Improve your sex drive.” Browse the shelves of any supermarket or pharmacy, and you will find dietary supplements that promise to do all this, and more. Supplements are a multi-billion-dollar business, and today more than half of American adults take them, many at the advice of their doctors. But dietary supplements can have real risks. They are not required by federal law to be proven safe “to the FDA’s satisfaction” before hitting the market, raising concern among critics about a perceived lack of safety oversight and consumer education.

Using the latest science as the basis for discussion, Forum experts examined the risks and benefits of supplements. How effective are they? What about dosages — or interactions with prescription medications? Should supplements be subject to more stringent rules and tests? What role should doctors, pharmacists, and drugstores have in helping consumers make safe, educated choices about supplements? This panel attempted to help sort the facts about supplements and health.

Part of The Dr. Lawrence H. and Roberta Cohn Forums, this event was presented jointly with PRI’s The World & WGBH on May 11, 2017.

Watch the entire series at ForumHSPH.org.

Opioid overdoses claim the lives of 91 Americans every day, according to the Centers for Disease Control and Prevention. In this Forum event, four former governors offered candid insights into how government policy can help, exploring what works and what doesn’t. They spoke about experiences within their own states, as well the broader national epidemic. Topics included prescription drug monitoring programs; treatment vouchers; naloxone use; and crackdowns on illegal supply streams. The governors also discussed the goals of the 21st Century Cures Act to fight the epidemic and the role of the Trump Administration’s opioid task force.

Presented May 5, 2017, jointly with PRI’s The World & WGBH News.

Watch the entire series at ForumHSPH.org.

On the whole, American drinking water is safe. However, more than a year after toxic lead levels forced a federal state of emergency in Flint, MI, 63 percent of Americans report that they worry a great deal about polluted drinking water. This statistic comes from a new Gallup poll indicating that water pollution ranks the highest of six environmental concerns among respondents. While pipes in Flint are expected to be replaced with the help of a $97 million settlement, there are other cities with histories of unsafe lead levels — or other toxins — in drinking water. These contaminants can threaten health, particularly among children. This Forum grappled with safekeeping American drinking water supplies. Does the drinking water infrastructure need replacement? How would such an effort look? Do public alert systems help? What about other potential lead exposure sources? What is the role of regulation in a time of proposed deep cuts to EPA funding? What does the public need to know? This timely discussion was held in advance of Earth Day.

Presented April 20, 2017, jointly with The Huffington Post.

Watch the entire series at ForumHSPH.org.

Building on two previous Forums about race, criminal justice and health (from February 2015 and October 2015), this event examined specific approaches and models to address the complexities of race and policing. Experts in law enforcement, public health, community relations and the law spoke. Subjects included safeguarding law enforcement and communities, promoting more effective communication and de-escalation techniques, and narrowing the social, economic and health gaps that persist between underserved and middle-class America. The emphasis was on local and state approaches.

This event was presented jointly with PRI's The World & WGBH on March 27, 2017.

Watch the entire series at ForumHSPH.org.

California, Massachusetts, Maine, and Nevada became the latest states to legalize recreational marijuana, bringing to 28 the number of states that have okayed the drug for medicinal use, recreational use, or both. Even more states have rules that allow certain kinds of cannabis extracts to be used for medical purposes. At the same time that state legalization is increasing, the Trump administration is signaling that it may ramp up enforcement of federal drug laws, even when they come into conflict with state laws allowing recreational marijuana use. State and local governments may find themselves on uncertain legal ground. Meanwhile, policymakers navigating this new landscape are also working largely without the benefit of a solid foundation of scientific evidence on the drug’s risks and benefits. In fact, a new National Academy of Medicine report describes notable gaps in scientific data on the short- and long-term health effects of marijuana. What do we know about the health impacts of marijuana, and what do we still need to learn? This Forum brought together researchers studying marijuana’s health impacts with policymakers who are working to implement new laws in ways that will benefit and protect public health.

Part of The Dr. Lawrence H. and Roberta Cohn Forums, this event was presented jointly with The Huffington Post on Friday, March 24, 2017.

Watch the entire series at ForumHSPH.org.

How can common chemicals affect our health? This Forum at HSPH was presented jointly with The Huffington Post.

Watch the entire series at ForumHSPH.org.

The passage of the 21st Century Cures Act has drawn both applause and criticism. A sweeping bipartisan effort with multiple components, the law dramatically boosts funding for medical research, particularly in areas such as cancer and brain disease. The law also relaxes regulatory processes for pharmaceuticals and medical devices. In doing so, the law’s supporters point to the potential for faster treatments benefiting from a streamlined approval process. Critics raise concerns that safety and efficacy might be compromised, with potentially devastating consequences. And the law also has been questioned for failing to explicitly address high drug prices, a growing public issue. These debates are unfolding as the Trump administration is expected to imminently announce its choice for a new FDA commissioner, who will head an agency directly impacted by the Cures act. In this Forum, experts will explore the implications of the law for biomedicine, regulation, pharmaceuticals and patient advocacy.

This Forum event was presented jointly with STAT on February 27, 2017.

Watch the entire series at ForumHSPH.org.

How can common chemicals affect our health? This Forum at HSPH was presented jointly with The Huffington Post.

Watch the entire series at ForumHSPH.org.