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TO THE Unprececlentec! opportunities and challenges face tire Elation and the world as we seelc to improve Truman health through research, prevention, and clinical care. Tire federal government plays a pivotal role in scraping tire opportunities ant! meeting tire challenges thorough tire policies it estab- lisI~es, tire programs it funds, and the leaclership it provides. Motif the pub- lic ant! private sectors are critical to tire clesign and clelivery of health care. Over the next clecacle, demographic trends, growths in chronic illness, ant! emerging disease threats will pose new challenges to health treat must be confronted by our nation and tire global health community. The healths sector now constitutes more titan 14 percent of the nation's Gloss Domestic P~ocluct (GDP)a level projectec! to rise to 16 percent within the next few years. Approximately half taxis amount is spent thorough the public sector, a share also expected to rise in tire coming decacle. Purchasers of care in government ant! tire private sector face clifficult deci- sions about flow to obtain tire best value for these expenclitures. For advice about direst issues, tire Ratio often tories to act institutions created specifically for Elvis purpose: the Institute of Medicine (IOM) of The National Academies. Tire IOM was chartered ilk 1970 as a component of tire National Academy of Sciences. The Institute provides a vital service by working outside tire fra~neworIc of government to ensure scientifically informer! analysis and independent guiclance. The lOM's mission is to serve LO o ~ 7 t To C) Z ~ -2

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[~RMIN[(l 1~E I. (~! ~~ CK] INCA! IS~S (~S IN HI4-A! 7~ as acIviser to the nation to improve health. Tire Institute provicles unbiased, evidence-~'ased, and authoritative information and advice concerning health and science policy to policy-makers, professionals, leaclers in every sector of society, and tire pelvic at large. Tire IOM and Tire National Academies use a unique process to obtain at~tl~oritative, objective, ant! scientifically balances! answers to difficult questions of national importance. Our work is conclucted by committees of volunteer scientists leading national and international expertswho serve without co~pe~sation. Co~ittees are carefully co~nl~osect to assure tl~e requisite expertise and to avoid bias or conflict of interest. Every report proclucec! by our committees u~,clergoes extensive review arch eval- nation by a group of external experts who are anonymous to tire com~nit- tee and Otiose names are revealed only once else study is published. Tire results of direst committee deliberations leave been relied upon for over 30 years to provide policy-makers witty objective scientifically sounc! advice. Tire Institutes work centers principally on committee reports or stud- ies on subjects Caging fiom quality of medical care to flee national small- pox vaccination program; from centers of excellence at the National l'~stitutes of Healths (NIH) to protecting tire elation s food supply. We also convene rouncitables workshops or symposia treat provide an opportunity for public- and private-sector experts to discuss contentious issues in an open environment that facilitates evidence-basec! dialogue. Additionally for 27 yeas s tire IOM leas ~~anagec! The Robert Wood Johnson Healths Policy Fellowships Pros ram clesignec! to train outstanding micI-career health pro- fessio~als ifs academic anti commu~ity-based settings to assume leaclersI~ip roles in health policy and management. local governments also initiate soupiest as does tire IOM itself. Tire majority of our studies anti otiose activities are requested and fund- ed by tire fecleral government. Private inclustry fou~ciatio~s acid state amuck Tire objective in all of our world is to improve decision-making by iden- tifying and synthesizing relevant evidence to inform tire deliberative process. Over its history tire IOM has become recognized through its pro- jects as a national resource of judgment and veracity in tire analysis of issues relating to Truman stealth. Depending on the ~ equest studies may be narrow ilk scope designed to answer very specific and tecI~ical questions or they Nay be broad-basec} examinations that span n~yriac! academic clis-

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47~E I~ ~~.5j]~~] Alit-; 0~~ Mroi6~- ciplines7 inclustries7 and event i~ternatio~al bottlers. Many of tocIay's health news stories concern topics on which we leave reported; others, like cI~ilcI- I~ooci obesity, are currently uncler study. Tire Institute of Medicine is Motif act honorific membership organiza- tion ant] a research organization. Tile Institute's members, elected on the basis of theirs professional acl~ieve~nent and commitment to service, serve without co~npensatio~ in tire conduct of studies and otl~er activities on matters of significance to Stealth. An unusual diversity of talent among Institute ~nembe~-s is assured by tire charter stipulation that at least one- qua~ter be selected fiom outside tire healths professions, from sucks fields as the natural, social, and behavioral sciences, as well as law, aciministra- tio~, engineering, and the humanities. Election to active membership is both an honor and a commitment to serve in Institute affairs. Tire bylaws of IOM specify that no more titan G5 new members shall be elected annually. Tire announcement of newly electec! Novembers occurs at the IOM Annular Meeting in October: Tire number of regular members plus foreign associates and emeritus members is currently about 17400. ~ . . .. .... ~ ~ .. in, .. . ^~R I O I riE 1~ ~~N Taxis booklet provides a brief fool; at tire work of tire Institute ant! I~igI~- li~gI~ts some of tire policy areas titan we believe will be important in tire next several years. It is organizer! into soiree sections. Tire first section illustrates ways tire worst of tire IOM influences policy deliberations ilk a number. of I OCR for page 1