Summary

Advances in military medicine are hard won during war but easily lost during peace. Though mortality rates of U.S. troops on the battlefield have improved significantly since World War II, the battlefield mortality rate at the beginning of a war often exceeds the battlefield mortality rate at the end of the previous war. Researchers attribute this phenomenon to erosion, during interwar years, of military readiness to provide combat healthcare. The Perelman School of Medicine at the University of Pennsylvania estimates that better maintaining military medical readiness could have prevented more than 100,000 combat deaths over the past 80 years.¹

Loss of life following survivable injury is not unique to the military. Tens of thousands of U.S. civilians succumb to potentially preventable trauma-related deaths every year.² Since military medical advances are frequently adopted by the civilian healthcare sector,³⁴⁵the White House,working with key federal agencies, should expand military-civilian partnerships (MCPs) in trauma care to achieve a national goal of eliminating preventable deaths. Such an initiative will save lives on the battlefield and the home front — with the ultimate goal of reaching zero preventable deaths.⁶

Challenge and Opportunity

An unprecedented percentage of service members wounded on the battlefields of Iraq and Afghanistan over the past 20 years made it home to their loved ones. This success is due to the professionalism of our uniformed healthcare providers and their innovations in responding to combat trauma — innovations that include moving blood products closer to the battlefield to lessen the effects of immediate and severe blood loss, deploying resuscitative surgical-system teams close to troops in enemy contact, splitting operations of forward surgical teams in two to increase coverage, and distributing tourniquets to every deployed service member.⁷

During times of peace, though, our military medical community loses its readiness to save life and limb on the battlefield. Statistics from the “War on Terror” illustrate the tragic consequences that arise when military medical readiness erodes during interwar years. Between October 2001 and June 2011, 4,016 U.S. combat troops died before they reached a military hospital. Of those, 976 (almost 25%) died from what are assessed to be battlefield-survivable injuries.⁸ A survey of general surgeons who provided deployed casualty care between 2002 and 2012 found that the majority of respondents felt underprepared to meet the demands of battlefield injuries.⁹

A key reason for interwar deterioration of military medical readiness is that during times of peace, Department of Defense (DoD) priorities shift from treating combat trauma to ensuring the general wellness of active-duty service members, their families, and other beneficiaries at Military Treatment Facilities (MTF) administered by the Defense Health Agency. While beneficiary care is an essential personnel benefit that should not and must not be diminished, it is also essential to recognize that the MHS does not provide sufficient training opportunities to maintain the proficiency of military medical personnel in treating battlefield trauma.¹⁰ An independent study conducted by the Institute for Defense Analysis found alarming misalignment between the top ten diagnoses on the battlefield in Iraq and the top 10 diagnoses in MTFs: while the former encompassed a variety of combat-related traumas, the latter were generally less serious (consistent with what one would expect for a predominantly young and healthy patient population). This divergence suggests that the primary missions of uniformed healthcare providers — (1) treating complex combat-related traumas, and (2) serving the needs of a family health practice — are not mutually supportive.¹¹

Recognizing that the MTFs were not providing the necessary trauma-related training to maintain battlefield medical readiness, Congress has directed DoD to establish partnerships with civilian medical academic institutions and major metropolitan hospitals that host level I trauma centers. These partnerships are intended to ensure that the military’s wartime medical specialists¹² are continually exposed to the volume and types of complex trauma necessary to ensure they are trained and prepared to rapidly deploy to an area of armed conflict.

These MCPs currently include the U.S. Army Trauma Training Center at Miami Dade Ryder Trauma Center in Florida, California’s U.S. Navy Trauma Training Center at USC/LA County, and the three U.S. Air Force Centers for Sustainment of Trauma and Readiness Skills located at the University of Maryland, the University of Cincinnati, and St. Louis University.¹³ While individually admirable, these MCPs constitute a patchwork that does not substitute for a coordinated national approach to curbing loss of military and civilian life from potentially survivable injuries. Because of this concern in Congress, section 757 of the FY 2021 NDAA directs DoD to conduct a systematic review of its MCPs to enhance the readiness of the military medical force to provide combat casualty care. The White House, working with the Departments of Defense (DoD), Health and Human Services (HHS), Homeland Security (DHS), and Veterans Affairs (VA), should build on results of the review and move quickly to expand military-civilian partnerships (MCPs) in the context of a national goal of eliminating preventable deaths.

Plan of Action

In 2016, the National Academies of Science, Engineering, and Medicine published a report¹⁴ explaining the need to establish a coordinated military/civilian national trauma-care system and presenting an action plan for achieving this goal. Below, we outline an updated, four-part version of the National Academies action plan. These actions will collectively shore up our nation’s military medical readiness, with benefits for American troops and American civilians alike.

Part 1

The White House should reaffirm its commitment to maintaining the quality of healthcare received by DoD beneficiaries, while also establishing national goals of (1) achieving zero preventable deaths from trauma-related injury and (2) minimizing trauma-related disability. It should be clear that these goals align both with the DoD’s mission of ensuring that uniformed medical personnel are prepared to provide battlefield healthcare and with HHS’ objective of strengthening the civilian healthcareworkforce to meet American needs. The White House should encourage partnerships between military and civilian trauma-care units to help achieve this goal.

Part 2

Within six months, the White House should establish a “Zero Preventable Deaths” task force overseen by the White House Office of Science and Technology Policy and cochaired by the HHS Assistant Secretary for Preparedness and Response and the Joint Chiefs of Staff Surgeon. The task force should be responsible for:

• Building on the MCP efforts of the DoD by convening federal agencies (including DHS, the VA, and the Joint Chiefs of Staff) and other governmental, academic, and private-sector stakeholders to identify intermediate objectives, policies, and actions needed to achieve zero preventable deaths.
• Assigning accountability and responsibility for
  • Ensuring development of best practices, data standards, and research across the continuum of trauma care,
  • Evolving a data-driven research agenda to support trauma care,
  • Overcoming any policy or legislative complications resulting from the establishment of the military/civilian national trauma-care system, and
  • Executing a strategic communications plan for the effort.
  • Securing appropriate congressional appropriations and private sector funding to support the goals of eliminating preventable deaths and minimizing preventable disabilities.

Part 3

The combatant commanders establish the medical requirements for their battle plans and the secretaries of the military departments are responsible for training and equipping their branch’s healthcare professionals to meet these demands. It’s the role of the Secretary of Defense to hold them accountable. The defense secretary does this by:

• Designating the Joint Chiefs of Staff Surgeon to be his representative to the task force.
• Ensuring that military department’s train and equip their forces to the combat- casualty-care personnel and system-support infrastructure requirements of combatant commanders.
• Confirming that the Undersecretary of Defense for Personnel and Readiness and the Assistant Secretary of Defense for Health Affairs have established medical-readiness policy and oversight consistent with the goals of the task force.
• Institutionalizing the military departments support for the military/civilian national trauma-care system.

Part 4

The Secretary of Health and Human Services should position the Assistant Secretary for Preparedness and Response of HHS to lead civilian efforts of the task force. This role includes:

• Coordinating with governmental (federal, state, and local), academic, and private-sector partners to establish a national approach for improving trauma care preparedness for mass-casualty incidents.
• Integrating military/civilian trauma-care partnerships into the American College of Surgeon’s Verification, Review, and Consultation Program.
• Developing and implementing guidelines for establishing an appropriate number, level, and location of MCPs within a region based on the needs of the population and the training requirements of the military departments.
• Taking the leadership role for trauma-care research.
• Developing measures of effectiveness and measures of performance for themilitary/civilian trauma care system.

Frequently Asked Questions

1. Why is now the time to establish a national goal of zero deaths to survivable injuries?

We have just ended our country’s longest period of war and our military doctors are at their best. If we do not act now, much of what they have learned will be lost and some number of troops will die needlessly on future battlefields.

read more

2. Would expanding MCPs improve the quality of healthcare provided to civilians?

Yes. During every armed conflict, the uniformed medical community makes incredible advances in preventing the deaths of our troops on the battlefield. MCPs ensure that civilian healthcare providers benefit from those advances.

read more

3. Does expanding MCPs break faith with servicemembers and other DoD beneficiaries by weakening the quality of their healthcare?

No. The only priority more important than providing DoD beneficiaries access to the highest-quality healthcare available while the force is in garrison is saving the lives of our soldiers, sailors, airmen, marines, and guardians while the force is on the battlefield. And as discussed above, improving the readiness of military healthcare providers improves quality of care for all Americans.

read more

4. Do DoD beneficiaries have access to quality healthcare at the MTFs?

Yes. But we should ask ourselves if the quality of some of the care delivered in the MTFs could be better. The medical community recognizes that high caseload volumes increase provider experience, which equals better outcomes for patients. But with a few exceptions (usually associated with newborn care, pregnancy, and maternal health), high volumes of work are not characteristic of the MTFs. For example, the consulting group CNA found that the best outcomes for knee replacements are observed in facilities that do 200 or more procedures a year. Only 13% of all knee replacements conducted in MTFs were conducted at MTFs that did 200 or more a year.

read more

Summary

In the mid-20th century, the United States test-detonated dozens of nuclear weapons in the Republic of the Marshall Islands (RMI). Using the RMI as a test site for nuclear- weapons research allowed the U.S. to better understand the effects of such weapons and their destructive capacities — but at significant cost. Conducting nuclear tests in the vulnerable RMI harmed human health, fomented distrust in research sponsored by the U.S. government, and fueled tensions with the Marshallese. Fallout from the tests undermined U.S. influence in the Pacific, cooperation over ecological restoration, and the reputation of the U.S. research enterprise. Building back relations with the RMI (and other allies that have long supported the United States) is crucial for enabling the Biden Administration to undo the adverse effects of Trump-era policies on international relations and the environment, especially amid rising threats from China and Russia.

To that end, the Department of Energy (DOE) and Department of Interior (DOI) should adopt provisions for conducting nuclear research with and in the Marshall Islands that will: (i) increase transparency and trust in American research concerning the Marshall Islands, and (ii) elevate Marshallese voices in the fight for preservation of their lands. These provisions are as follows:

1. All collected data should be translated into Marshallese and shared with RMI officials and relevant stakeholders.
2. When appropriate (e.g., when security and privacy considerations permit), collected data should be published in an easy-to-access online format for public consumption.
3. All research should be clearly laid out and submitted to the RMI National Nuclear Commission (NNC) in accordance with the NNC’s Nuclear Research Protocol.
4. The United States should coordinate with the NNC, the College of the Marshall Islands (CMI) Nuclear Institute, regional agencies, and other relevant nongovernmental organizations and local stakeholders to ensure that local knowledge is considered in the design of nuclear-related research and data projects.
5. All possible steps should be taken to include the participation of Marshallese residents in research ventures and operations.

The current administration should announce its intention to achieve net-zero soil loss by 2050. This target aligns with President Biden’s plan to “mount a historic, whole-of-Government-approach to combating climate change,” would help fulfill the administration’s commitment to achieving a net-zero-emissions economy by 2050, and is key to protecting our nation’s agricultural productivity.

Healthy soil is essential to food production. Less well recognized is the vital role that soil plays in climate modulation. Soil is the largest terrestrial carbon repository on the planet, containing three times the amount of carbon in Earth’s atmosphere. Soil represents a potential sink for 133 billion tons of carbon (equal to 25 years of U.S. fossil-fuel emissions). Using soil to offset emissions generates significant co-benefits. Carbon sequestration in soil nourishes soil ecosystems by improving soil architecture and increasing water-holding capacity. Deeper and more fertile soil also supports biodiversity and enriches natural habitats adjacent to agricultural land.

Over two-thirds of the United States is grassland, forestland, and cropland. Land practices that increase the amount of carbon stored underground present a relatively low-cost means for President Biden’s administration to pursue its goal of net-zero carbon emissions by 2050. But lost soil can no longer serve as a carbon repository. And once lost, soil takes centuries to rebuild. Increasingly extreme climate events and soil-degrading industrial farming practices are combining to rapidly deplete our nation’s strategic soil resources. The United States is losing 10.8 tons of fertile soil per hectare per year: a rate that is at least ten times greater than the rate of soil production. At this rate, many parts of the United States will run out of soil in the next 50 years; some regions already have. For example, in the Piedmont region of the eastern United States, farming practices that were inappropriate for the topography caused topsoil erosion and led to the abandonment of agriculture. The northwestern Palouse region has lost 40–50% of its topsoil, and one-third of the Midwest corn belt has lost all of its topsoil.

Soil loss reduces crop yields, destroys species’ habitats that are critical to food production, and causes high financial losses. Once roughly half of the soil is lost from a field, crop yields and nutrient density suffer. Maintaining a desired level of agricultural output then requires synthetic fertilizers that further compromise soil health, unleashing a feedback loop with widespread impacts on air, land, and water quality — impacts that are often disproportionately concentrated in underserved populations.

Climate change and soil erosion create a dual-threat to food production. As climate change progresses, more extreme weather events like intense flooding in the northeastern United States and prolonged drought in the Southwest make farmland less hospitable to production. Concurrently, soil erosion and degradation release soil carbon as greenhouse gases and make crops more vulnerable to extreme weather by weakening the capabilities of plants to fix carbon and deposit it in the soil. Halting soil erosion could reduce emissions, and building stable stores of soil carbon will reduce atmospheric carbon.

Prioritizing soil health and carbon sequestration as a domestic response to the climate and food-security crises is backed by centuries of pre-industrial agricultural practices. Before European occupation of tribal lands and the introduction of “modern agricultural practices,” Indigenous peoples across North America used soil protective practices to produce food while enhancing the health of larger ecosystems. Some U.S. farmers adhere to principles that guide all good soil stewardship — prevent soil movement and improve soil structure. Practices like no-till farming, cover cropping, application of organic soil amendments, and intercropping with deep-rooted prairie plants are proven to anchor soil and can increase its carbon content. In livestock production, regenerative grazing involves moving animals frequently to naturally fertilize the soil while allowing plants to recover and regrow. If all farms implemented these practices, most soil erosion would halt. The challenge is to equip farmers with the knowledge, financial incentives, and flexibility to use soil-protective techniques.

This document recommends a set of actions that the federal government — working with state and local governments, corporations, research institutions, landowners, and farmers — can take towards achieving net-zero soil loss by 2050. These recommendations are supported by policy priorities outlined in President Biden’s Discretionary Budget Request for Fiscal Year 2022 and the bipartisan infrastructure deal currently under negotiation in Congress. Throughout, we emphasize the importance of (1) prioritizing storage of stable carbon (i.e., carbon that remains in soils for the long term) and (2) addressing environmental injustices associated with soil erosion by engaging a broad group of stakeholders.

Firm commitments to restore degraded land will establish the United States as an international leader in soil health, help avoid the worst impacts of climate change, strengthen food security, advance environmental justice, and inspire other countries to set similar net-zero targets. The health of our planet and its people depend on soil preservation. Our nation can, and should, lead the way.

Plan of Action

Action 1. Become a signatory of “4 per mille,” the international initiative encouraging countries to collectively increase global soil carbon by 0.4 percent per year.

The United States should officially join the international effort, “4 per mille” (4p1000), and commit to increasing stable soil carbon by at least 0.4 percent per year. By signing onto this effort, President Biden would send a powerful message of appreciation for U.S. conservation farmers and signal to the rest of the world that soil and forest management are important strategies for mitigating and adapting to climate change.

Detractors of 4p1000 have raised concerns about its feasibility, measurement, and accountability. These arguments obscure the target’s intent: to motivate a global effort to sequester carbon in soil and avert the worst of anthropogenic climate change. The target gives countries a tangible and common goal to work towards as they identify and implement the soil-carbon sequestration strategies that will work best in their respective domestic environments.

Before COP26, the White House Office of Science and Technology Policy, in partnership with the Secretary of Agriculture and the Biden administration’s climate change leaders (John Kerry and Gina McCarthy), should develop a strategy to accompany the United States’ endorsement of 4p1000 and garner endorsements of the agreement from other nations. A central pillar of this strategy should focus on developing and deploying inexpensive methods to estimate soil carbon. These new tools would help farmers track their net carbon increases and ensure that carbon emissions from soil are not negating their efforts.

This action could be supported by funds allocated to the Department of State for multilateral climate initiatives, Department of Interior funding for ecosystem resilience among all land-management agencies, and USDA’s renewed investment to engage landowners to combat climate change and increase participation in voluntary conservation.

Action 2. Invest in a data repository for agriculture and soil carbon. 

Advances in soil health of agricultural systems, like advances in human health, will depend on the sector’s capacity to aggregate and refine big data. This capacity is needed to develop comprehensive decision-support tools underpinned by hyperlocal data in a publicly accessible and well-maintained database

USDA’s Agricultural Research Service currently supports a data repository through its National Agricultural Library (NAL). The NAL repository houses datasets generated by USDA researchers and other USDA-funded research. Unfortunately, the NAL repository is poorly equipped to handle data originating from additional sources. Nor does the NAL repository support the industry-wide annotation system needed to make data searchable and comparable.

A new repository is needed. The National Library of Medicine (NLM) offers an excellent model in GenBank. By helping researchers compare genes, this open-access bioinformatics tool deepens our understanding of health and accelerates development of medical treatments. GenBank connects to similar databases worldwide, and researchers contribute to and search the databases with associated software. The National Weather Service (NWS) similarly compiles a massive set of weather data that supports research and generates income from business services. Both GenBank and the National Weather Service’s databases have supported an explosion of resources, products, and services, from diagnostic medical tests, precision medicine, and genetic testing to weather apps for phones. These databases also feature budgets an order of magnitude larger than the budget for USDA’s NAL.

A right-sized investment in a broad agricultural research database at the NAL, including data generated with proprietary smart-farm technologies and other public-private collaborations, is the future of modern agriculture and agriculture research. Nationally available, high-quality, and curated agricultural data would seed a wealth of new services and companies in the sector. The database would also support the implementation of reliable, locally tailored, and situationally relevant soil-management practices and decision tools that provide precision health practices for soil.

Specifically, we recommend that USDA take the following steps to establish a broad agricultural data repository:

• Increasing the NAL’s budget by at least tenfold (moving closer to the level of funding enjoyed by the NLM) as its storage capacity expands.
• Working with the NLM and the NWS to learn from their decades of experience in building robust public data repositories.
• Constructing a repository that can house a broad range and large volumes of agricultural data, as well as the software needed to make the data findable, accessible, interoperable, and reusable. The database should accept data from research projects, farming operations, and Farm Bill conservation programs. Care must be taken to ensure that data from farms is anonymized and confidential.
• Hiring specialists to develop software for extracting, standardizing, formatting, and uploading data directly from research and farming equipment.
• Working with research- and farm-equipment designers to ensure their products can collect data in a format that matches USDA’s database requirements and is easy to use by farmers and farmworkers.
• Offering training and tools to familiarize researchers and students with the repository’s structure and assets and encourage researchers and students to link data to publications using Persistent Unique Identifiers (PUIDs).

These steps could be carried out using discretionary funding at USDA earmarked for investments in research and development capacity of farmers. These steps collectively align with the administration’s goal to “support a multi-agency initiative aimed at integrating science-based tools into conservation planning and verifying stable carbon sequestration, greenhouse-gas reduction, wildlife stewardship, and other environmental services at the farm level and on federal lands.”

Action 3. Invest in targeted research to reduce soil erosion and increase carbon sequestration.

General factors contributing to soil loss and mitigation principles are universal. Still, the most effective combination of specific practices for reducing soil erosion and increasing carbon sequestration depends on local soil type, slope, soil condition, land use, and weather. In many farming settings, regenerative practices can increase soil carbon and eliminate soil erosion in as little as one or two growing seasons. But matching best practices to a given location can be complex.

For example, intensive tillage is the most soil-erosive practice in agriculture. Reducing the use of this practice has been an important goal for soil-preservation efforts over the last four decades. Organic farms frequently use intensive tillage because organic certification prohibits the use of genetically engineered plants or herbicides—even though herbicide treatment provides excellent weed control and genetic engineering has made it possible to suppress weeds using herbicides without damage to the engineered crop plant. Reducing soil erosion on organic farms hence requires research into new methods of weed control.

The USDA National Institute of Food and Agriculture (NIFA) and the National Science Foundation (NSF) should jointly fund competitive grants for research into practices that reduce soil erosion, increase the nutrient density of food, and sequester carbon stably. Priority projects of these grants might include:

• Alternatives to intensive tillage for weed control, such as intercropping with competitive plant species, inhibiting weed growth with compost or other additives, planting cover crops that leave a residue that inhibits weeds but not crop plants, or application of weed-killing compounds that are acceptable under organic-certification requirements.
• Decision-support tools that help farmers choose strategies to reduce erosion in a financially viable manner.
• Methods to increase soil-carbon stability.
• Rapid, inexpensive tests to track soil carbon. Such tests would improve accountability and precision of farmer efforts to sequester carbon.
• Methods to integrate remote-sensing data with on-the-ground measurements of soil erosion

As with Action 2, these steps could be carried out using discretionary funding at USDA earmarked for investments in farmers’ research and development capacity. These steps collectively align with the administration’s goal to support a multi-agency initiative to integrate science-based tools into conservation planning and verify stable carbon sequestration, greenhouse-gas reduction, wildlife stewardship, and other environmental services at the farm level on federal lands.

Action 4. Develop financial and educational programs that help farmers transition to soil-protective practices.

Soil-protective practices have agronomic and economic benefits. Farmers using continuous no-till methods save several thousand dollars each year due to reduced fuel and labor investments. But economic returns on soil-saving practices can take several years to accrue. Growers are rightly concerned about their financial solvency in the short term should they implement such practices, as well as about yield reductions associated with no-till agriculture in some cases. USDA should (i) provide financial assistance to help producers transition to soil-saving practices and (ii) offer training to help producers realize maximal benefits of soil-protective practices at each phase of the transition.

For instance, USDA’s Farm Service Agency (FSA) could offer loans based on cost-saving projections from reduced need for synthetic inputs and increased potential yield once the transition to soil-protective practices is complete. For example, loans could cover the cost of the first five years of projected lost income per acre. At the end of this term, USDA’s Risk Management Agency (RMA) could offer discounted crop insurance rates because the now-healthier soil would engender a more resilient system less likely to experience catastrophic losses during floods and droughts. Farmers could use savings on insurance costs to repay loans and keep premiums constant once repayment begins.

Participation in the loan program could be contingent on farmers’ capacity to maintain soil-protective practices for at least ten years. During the initial five-year loan period, soil-health specialists affiliated with USDA could provide farmers with training on measuring progress, collecting data, and uploading that data to a centralized database. Outcomes across participating farms could be tracked and iteratively inform best practices during the transition period. After the initial five-year period, farmers could qualify for a five-year loan-forbearance period if they demonstrate continued participation in the program.

USDA could also offer direct payments to farmers participating in soil revitalization. Another Day One Project policy proposal recommends that the USDA offer incentive payments for climate-smart practices that produce ecosystem services if the producer cannot find a buyer through an ecosystem-services market. 

Specifically, we recommend that USDA take the following steps to develop financial and educational programs that help farmers transition to soil-protective practices:

• Create bridge loan products for farmers based on projected savings, potential yield increases, and ecosystem services provided by transitioning to soil-enhancing farm practices.
• Provide a seed investment for an ecosystem services market.
• Enact a “Good Farmer Discount” on crop insurance for producers already practicing soil conservation and regeneration.
• Hire or train soil health experts through USDA Extension offices to support farmers transitioning to soil-protective practices with ongoing education and training.

These steps could be supported by discretionary funding at the Department of Treasury earmarked for investments in American communities and small businesses and USDA funds dedicated to growing rural economies. These steps align with President Biden’s commitment to expanding the role of Community Development Financial Institutions (CDFIs), which offer loans to start-ups and small businesses in rural communities and create new markets for reaching a net-zero carbon economy by 2050.

Action 5. Develop circular economy practices for young entrepreneurs supporting soil conservation.

Small businesses have a significant role in post-pandemic recovery by providing jobs and combating the climate crisis through innovation. The path to a net-zero carbon economy by 2050 must include circular economy principles that design waste out of economic cycles, keep products and materials in use, and regenerate natural systems. Additionally, closing education gaps and creating new paths to secure jobs for young people who did not complete high school has transformational effects on economic opportunities, health, and life expectancy.

USDA, the Small Business Administration (SBA), and the Minority Business Development Administration (MBDA) should jointly develop a “Ground Up” program that (i) engages the agriculture industry in identifying circular-economy business opportunities and (ii) engages young people without a high-school education in starting small businesses that conserve, restore, and protect soil and other natural resources. Ground Up would fill gaps created by the uneven and insufficient USDA Extension workforce in underserved and under-resourced communities. Ground Up would also provide more extensive business and entrepreneurship training than is typically possible through Extension programs. By leveraging relationships with industry partners, program participants could be connected to byproducts—or “wasted resources”—they need to start a circular business and access to mentoring and markets required to sell their products and services profitably. For example, a Ground Up enterprise might incorporate grounds from commercial or residential coffee-making operations or municipal waste into commercial compost production. The Participants who complete the Ground Up program would be eligible for nointerest federal business loans, with repayment required once the business was profitable. The federal government could partner with Community Development Financial Institutions (CDFIs) to share the cost of loans and build connections among young entrepreneurs, Extension professionals, and potential partner businesses.

Specifically, we recommend that USDA and the White House take the following steps to develop circular economy practices for young entrepreneurs supporting soil conservation:

• Establish the “Ground Up” program with $25 million per year for five years. This funding would cover the costs of training instructors, building partnerships with industry, and supporting administrative staff. This funding would also initially cover the costs of loans to eligible small businesses, though loan repayment would replenish these funds in the long term. A comprehensive program evaluation should be conducted at the end of the five years to evaluate program accomplishments and suggest improvements for the next program iteration.
• Direct its Extension offices to collaborate with the SBA to design and implement “Ground Up” training and propose a program founded on circular economy principles.
• In collaboration with the SBA, build and leverage relationships with industries and localities to supply start-up resources and secure advance-purchase commitments that curb investment risk.
• The White House can demonstrate support by hosting a public launch event for the “Ground Up” program. The launch event would highlight commitments from cities and industry partners to participate in and advance the program.

These steps could be implemented using discretionary funds within USDA, SBA, and MBDA earmarked to support innovative multi-agency business opportunities for rural and minority entrepreneurs. These steps align with the SBA’s commitments help small businesses combat climate change and invest in underserved entrepreneurs; the USDA’s mandate to grow rural economies and foster innovation in the agricultural sector, as well as USDA’s dedication to increasing and protecting biodiversity through good farm stewardship; and the MBDA’s economic-development grants aimed at addressing long-standing racial inequity for minority-owned firms.

Action 6. Support diversity in the agricultural workforce pipeline.

People of color, including Black, LatinX, and Indigenous people, are underrepresented in agriculture and agricultural sciences. To begin addressing this underrepresentation, the Biden administration should ensure diversity in its proposed Civilian Climate Corps (CCC). The CCC is envisioned as a modern-day equivalent of the Depression-era Civilian Conservation Corps work-relief program. The new iteration focuses on enhancing conservation and climate-smart practices across the country. The new CCC represents a terrific way for the Department of the Interior (DOI) to train a diverse workforce in climate- and soil-smart land-management practices with clear pathways to careers in technical assistance, agribusiness, and academic agricultural research, among others.

The administration can boost diversity in agricultural research by directing the USDA’s Office of Civil Rights and the National Institute of Food and Agriculture (NIFA) to conduct an in-depth assessment of challenges faced by researchers of color in agricultural science and develop discipline-wide plans to address them. The administration can also increase research funding and funding for research infrastructure targeted at underrepresented populations. Students from disadvantaged backgrounds are more likely to choose fields with reliable funding. The relative lack of funding for agricultural sciences, as evidenced by outdated educational infrastructure and shrinking training programs, puts agriculture departments at a stark disadvantage compared to the modern facilities (and reliable post-graduate incomes) of other scientific departments (e.g., biomedicine). The National Science Foundation (NSF) should support research and facilities at Historically Black Colleges and Universities (HBCUs) to demonstrate and communicate programmatic stability and cutting-edge innovation in agriculture.

Specifically, we recommend that the Biden administration take the following steps to support diversity in the agricultural-workforce pipeline: 

• Direct the Secretary of the Interior and Secretary of Agriculture to (i) prioritize and focus on diversity in recruitment in their strategy for the proposed Civilian Climate Corps, and (ii) ensure that the CCC includes professional development programs that connect participants to careers in agriculture. Boost direct support for graduate student fellowships from 1.5 to 5% of USDA’s total extramural research budget. Graduate fellowships put research dollars in the hands of students, and fellowships can be targeted at underrepresented populations. Increasing direct support would provide students with reliable funding while sending a powerful message to those students that they belong in the agricultural sciences and are needed.
• Integrate fellowship programs with USDA’s 1890 National Scholars Program so that students at the 1890s HBCUs and other minority-serving institutions (MSIs) have a clear path toward further academic study in agricultural science.
• Increase award size for Higher Education Challenge Grants and the Higher Education Multicultural Scholars Program.
• Require every NIFA grant proposal to include a diversity statement and record of training diverse scientists; mandate consideration of these materials in funding decisions. Proposals for conference grants should additionally address plans for ensuring accessibility and inclusion at the conference.

These steps could be supported by funding allocated at USDA, NSF, and DOI to increase racial equity, specifically the participation of historically underrepresented people in the Civilian Climate Corps and farming, science, and engineering more broadly.

Action 7. Fund existing and proposed advanced research projects agencies (ARPAs) to invest in soil-saving research.

USDA’s research agencies tend to fund low-risk research that delivers incremental changes in agricultural practices. This essential research provides many strategies for stemming soil loss, but remarkably few farms employ these strategies. The nation needs paradigm-shifting advances that farmers will use. The Advanced Research Projects Agency (ARPA) model can help realize such advances by investing deeply in bold ideas outside of mainstream thinking. Several existing and proposed ARPA programs are well-positioned to invest in soil-saving research.

ARPA-Energy (ARPA-E) in the Department of Energy (DOE) is already funding high-impact agricultural research that protects soil. ARPA-E has invested in one soil-centered project, ROOTS, to develop “root-focused” plant cultivars that could dramatically reduce atmospheric carbon. The agency is also gearing up for a new project on carbon farming. These projects match ARPA-E’s energy-focused mission, which includes reducing greenhouse gases in the atmosphere. However, ARPA-E does not have the mandate to invest in specific agricultural projects that build and protect soil. Two additional ARPA-style entities have been proposed that could do so instead: ARPA-I (infrastructure), included as part of the bipartisan Infrastructure Investment and Jobs Act, and AgARDA, a USDA-based ARPA-style agency authorized by the 2018 Agriculture Improvement Act (Farm Bill). If funded, ARPA-I, AgARDA, or both could invest in groundbreaking research to drive soil protection.

To leverage the ARPA model for transformative advances in soil-saving research, we recommend that the Biden administration:

• Expand the potential for soil-saving projects at funded ARPA agencies (e.g., ARPA-E) that align with the missions of their parent departments.
• Prioritize a strategic plan for AgARDA that includes ARPA-style independence in its management, an allocation plan for its authorized annual $50 million budget, and structures to empower funding risky but potentially catalytic agricultural projects.
• Promote the role of soil at proposed ARPA agencies (e.g., ARPA-I).

These steps could be supported by discretionary funds allocated to the DOE and USDA. Cumulatively, the President’s most recent budget request directs $1.1 billion to DOE to support breakthroughs in climate and clean-energy research and solutions. Specifically, mitigating and adapting to the climate crisis involves more than inventing cleaner energy; new technologies that help farmers protect soil and fix carbon into the land will also be essential for correcting extreme imbalances in the global carbon budget.

Action 8. Develop criteria and funding for “Earth Cities.”

People feel helpless and fatigued about climate change at the local level partly because they lack the agency to make positive steps to remove greenhouse gases from the atmosphere. The White House should deepen its relationships with mayors and nonprofit coalition groups of cities—such as C40, U.S. Conference of Mayors, and the National League of Cities— to engage urban communities in combating hazards related to climate change.

Like the Arbor Day Foundation’s “Tree Cities” program that encourages communities to steward their tree resources, a national “Earth Cities” program would recognize cities leading the way on urban soil stewardship and management. Criteria for receiving the “Earth City” designation could include implementation of a centralized municipal composting program, large-scale replanting of public parks and rights-ofway with native grasses and perennials that have soil-health benefits, creative management of excavated soil and rock generated by urban construction, becoming a signatory to the 4p1000 initiative, and observance of World Soil Day on December 5. Taking steps to become an “Earth City” and prioritizing soil management at the municipal level offers communities a way to make a positive difference and experience benefits locally while addressing global climate challenges.

Recent research demonstrates that temperatures can vary as much as 20 degrees across different neighborhoods within the same city. Urban heat islands often overlap with communities of color and low-income households in areas with few trees and large amounts of heat-trapping pavement. In these historically redlined communities, rates of heat-related illness and deaths are also higher than wealthier, whiter, and cooler parts of town. Additionally, meeting green building codes and keeping federally supported housing projects affordable has become increasingly difficult in urban centers. Tending to soil health by reusing excavated soil, planting trees and tall grasses on site, and creating more green spaces can inexpensively mitigate the urban heat-island effect while increasing access to nature in historically under-resourced communities. A partnership between soil experts at USDA, pollution and environmental-hazard experts at EPA, and affordable housing programs at the Department of Housing and Urban Development (HUD) would support cities with funding and implementation and further strengthen program viability by tying federal support to local soil stewardship practices.

Specifically, we recommend that the Biden administration take the following steps to recognize and support cities striving to preserve soil and enhance soil-carbon sequestration:

• Work with USDA, HUD, and EPA to convene a coalition of mayors, soil experts, private industry, developers, nonprofit organizations, and local soil stewards to design the “Earth Cities” program, including establishing qualifying criteria.
• Create an earmarked fund at HUD that supports developers with low-income housing tax credits for implementing and maintaining soil stewardship practices in alignment with the “Earth City” designation.
• Provide seed funding to municipal agencies via state Environmental Protection Agencies to develop soil conservation and restoration programs at the local level.

These steps could be supported through earmarked funds at EPA for the Accelerating Environmental and Economic Justice Initiative, HUD funds to modernize and rehabilitate public housing, infrastructure, and facilities in historically underfunded and marginalized communities; and USDA funds that encourage conservation and increased biodiversity on private land.

Action 9. Plant deep-rooted perennials on median strips to foster carbon-rich soils for multi-benefit surface transportation.

As a part of President Biden’s plan to invest in multi-benefit transportation infrastructures, a policy to populate median strips with deep-rooted prairie perennials presents a means to restore soil carbon and simultaneously sustain essential pollinators in agricultural and other ecosystems. Highway medians are supposed to be at least 50 feet wide for safety, creating a minimum of 6 acres of median per mile of highway. The 47,000 miles of U.S. Interstate and 160,000 miles of other highways amount to nearly 300,000 and 1 million acres, respectively, of median strips in the United States. Each acre could sequester 1.7 tons of carbon per year until the soil’s carrying capacity is reached.

Deep carbon stores of soil in the Midwest resulted from centuries of growth of perennial plants that store most of their carbon in their roots. The crops that replaced the prairies shunt most of their carbon to the harvested aboveground tissues, leaving little in the soil. Corn roots, for example, represent only 1% of the plant biomass by the end of the growing season, whereas the roots of perennials—which can grow to as deep as 15 feet underground—can account for as much as 70% of the plant’s biomass. Between 2009 and 2015, 53 million acres of U.S. land was converted from native vegetation to cropland, leading to a loss of 2% of the soil carbon stored in that land per year. This loss translates to 3.2 gigatons of carbon dioxide released into the atmosphere—equivalent to almost one-half of annual U.S. fossil-fuel emissions.

One way to mitigate soil loss is by planting highway median strips with the native, deep-rooted perennials that simultaneously nourish pollinators, enrich soil, and sequester copious amounts of carbon. The Department of Transportation (DOT) could coordinate a large-scale highway-replanting initiative through the effort proposed in the bipartisan infrastructure bill to rebuild the interstate system. In parallel, federal and local “Adopt-a-Highway” programs could enlist citizens, businesses, and municipalities in seeding median strips with native plants.

Specifically, we recommend that:

• President Biden issues an Executive Order mandating that DOT invest 0.5% of federal highway construction and repair budgets in planting native plants in median strips. The Departments of Transportation and Agriculture could design the program jointly to consider both soil health and highway safety.
• The USDA develop a federal program to contract with farmers to produce the seed supply necessary for large-scale planting of medians.
• The administration institutes a federal policy to plant carbon-sequestering perennials alongside new and upgraded road and rail lines.

The administration could pursue these steps using discretionary funds allocated to the Department of Transportation to support competitive-grant programs for infrastructure. The administration could also leverage part of the $110 billion allocated in the bipartisan Infrastructure Investment and Jobs Act towards infrastructure upgrades, including upgrades focused on climate-change mitigation, resilience, and equity.

Summary

The Biden-Harris Administration is confronting multiple challenges that require a coordinated, innovative, and flexible response by the federal government. The recently released FY22 President’s budget sets a solid foundation for leveraging the capacity of the federal workforce, along with necessary science, technology and innovation expertise from the private sector, to meet the challenges ahead.

However, hollowed out agencies and technical skills gaps mean agencies lack the capacity to implement needed programs. Agencies have to rapidly scale up personnel, ensure they have the necessary skills, and implement underutilized hiring mechanisms to fill out talent gaps.

While the goals laid out in the budget will allow agencies to address climate, continue to fight the COVID-19 pandemic, rebuild the economy, and increase equity across government programs and services, it requires a sustained focus on building and hiring diverse expertise to accelerate progress on these initiatives – which increasingly rely on modernized IT infrastructure and equitable delivery of services.

This is an historic opportunity, driven by critical need, to focus on driving systemic change across government to equip all federal agencies with the capacity required to build back better while bolstering and reinvigorating the federal talent pipeline.

The following proposals are offered as ways to tackle hiring challenges, build a diverse technical talent pipeline, and continue to rebuild the public trust in government and interest in serving. The Day One Project and its partners stand ready to assist in fleshing out and supporting the proposals below.

Summary

With the Biden-Harris Administration and Congress together pursuing major infrastructure investments, there is an important question as to how best maximize potential economic and environmental benefits of new infrastructure. Reforming the National Environmental Policy Act (NEPA) is one of the most straightforward and impactful ways to do so. Currently, many major infrastructure projects are delayed due to significant, NEPA-mandated requirements for environmental-impact review. Such delays are frequently exacerbated by vague statutory requirements and exceptional litigation risks. Updated guidance for environmental reviews under NEPA, coupled with strategic judiciary reforms, could expedite infrastructure approval while improving environmental outcomes.

Congress and the Biden-Harris Administration should strive to clarify environmental regulatory requirements and standing for litigation under NEPA. Specific recommended actions include (i) establishing well-defined and transparent processes for public input on governmental environmental-impact statements, (ii) shortening the statute of limitations for litigation under NEPA from two years to 60– 120 days, and (iii) requiring that plaintiffs against governmental records of decision must have previously submitted public input on relevant environmental-impact statements.

Summary

The Biden Administration should enhance the efforts of the U.S. Patent and Trademark Office (PTO) to defend against fraudulent trademark registrations. Since 2015, the PTO has struggled to cope with a rising flood of fraudulent trademark applications originating mainly from China. One study indicates that as many as two-thirds of Chinese trademark applications for certain classes of goods include falsified evidence that the applicant is using the mark in commerce in the United States — a requirement for trademark registration under U.S. law. High proportions (up to 40%) of these fraudulent applications survive the PTO’s application-review process and result in fraudulent trademark registrations.

Urgent action is necessary. The PTO reports that the trademark application rate has recently surged to extreme levels, which has doubled the number of applications awaiting examination. Many of these applications likely contain fraudulent claims of use. Identifying and denying fraudulent claims will help ensure that only those businesses that are actually using their trademarks in U.S. commerce benefit from the U.S. trademark system. In addition to creating a fair playing field for companies (both American and foreign) that abide by the rules, countering fraudulent trademark registrations will support American economic recovery from the COVID-19 pandemic by providing small businesses with robust protection for brand names of new products.

Summary

Enabling government data to be freely shared and accessed can expedite research and innovation in high-value disciplines, create opportunities for economic development, increase citizen participation in government, and inform decision-making in both public and private sectors. Each day government data remains inaccessible, the public, researchers, and policymakers lose an opportunity to leverage data as a strategic asset to improve social outcomes.

Though federal agencies and policymakers alike support the idea of safely opening their data both to other agencies and to the research community, a substantial fraction of the United States (U.S.) federal government’s safely shareable data is not being shared.

This playbook, compiled based on interviews with current and former government officials, identifies the challenges federal agencies face in 2021 as they work to comply with open data statutes and guidances. More importantly, it offers actionable recommendations for Executive and Congressional leadership to enable federal agencies to prioritize open data.

Paramount among these solutions is the need for the Biden Administration to assign open government data as a 2021 Cross-Agency Priority (CAP) Goal in the President’s Management Agenda (PMA). This goal should revitalize the 2018 CAP Goal: Leveraging Data as a Strategic Asset to improve upon the 2020 U.S. Federal Data Strategy (FDS) and emphasize that open data is a priority for the U.S. Government. The U.S. Chief Technology Officer (CTO) should direct a Deputy CTO to focus solely on fulfilling this 2021 CAP Goal. This Deputy CTO should be a joint appointment with the Office of Management and Budget (OMB).

Absent elevating open data as a top priority in the President’s Agenda, the U.S. risks falling behind internationally. Many nations have surged ahead building smart, prosperous AI-driven societies while the U.S. has failed to unlock its nascent data. If the Biden Administration wants the U.S. to prevail as an international superpower and a global beacon of democracy, it must revitalize its waning open data efforts.

Summary

The National Science Foundation (NSF) and the Department of Energy (DOE) should invest in a cohort of civic technologies that advance the next generation of American infrastructure while prioritizing individual privacy protections.

Our nation’s infrastructure is in urgent need of upkeep and replacement. The next generation of American infrastructure should be designed and built to be resilient, energy efficient, and integrate harmoniously with network communications, autonomous vehicles, and other “smart” systems. Emerging civic technologies — such as sensors, computers, and software that can support billing and payment, manage public resources, monitor integrity of structures, track traffic flows, and more — can improve the performance of future infrastructure and improve community livability. However, the public often believes that civic technologies invade individual privacy and enrich tech companies. Public distrust has disrupted multiple civic-technology projects around the world.

The federal government should invest in a suite of research and development (R&D) activities to develop new, sensor-based civic technologies that inherently preserve privacy in a manner verifiable by citizens. The federal government should also invest in complementary activities to promote adoption and acceptance of such “privacy-at-the-sensor” technologies. Such activities could include setting standards for the privacy properties of civic technologies, establishing technology test beds, funding public grants to encourage adoption of privacy-preserving sensing technologies, and creating partnerships with external stakeholders interested in civic technologies.

The Biden Administration should (i) direct the Federal Communications Commission (FCC) to take simple administrative steps to promote transparency in the broadband-internet market and (ii) allocate funds through competitive grants and low-interest loans to projects that will increase broadband-market competition. Transparency, funding, and competition will lead to lower prices for consumers and greater adoption of residential broadband. The latter has been proven to increase economic competitiveness while also supplying myriad other social benefits.

Summary

Women have a right to contraception, regardless of circumstance. But this right has recently come under threat. Starting in 2016, multiple federal and state regulations pulled critical funding to reproductive and family-planning services. The COVID-19 crisis amplified the challenges Americans face while attempting to receive basic healthcare resources like birth-control pills. To reverse this worrying trend and ensure universal access to contraception in the United States, the federal government should approve over-the-counter (OTC) birth-control pills — thereby removing the need for a prescription to protect women’s health and prevent unintended pregnancies.

Specifically, the Biden-Harris Administration should commission the Food and Drug Administration (FDA) to create an OTC Monograph for oral contraceptives (i.e., birth- control pills). An OTC Monograph is a rulebook established by the FDA that gives specific instructions on the manufacture, distribution and marketing of non- prescription, OTC drugs. Circumstances are right for this action. 2020’s CoronavirusAid, Relief, and Economic Security (CARES) Act established the OTC Monograph Reforms, creating a new and efficient process to produce OTC drugs. The CARES Act also provided the FDA’s Department of Non-prescription Drugs with $110 million over five years1 to produce more OTC drugs. Oral contraceptives are ideal OTC candidates, having been proven safe and effective for 60 years. It is time for the United States to follow the example set by more than 100 countries to date and provide women with OTC birth-control pills.

Summary

The majority of people living in the African continent access their news and information from broadcasted television and radio. As African countries follow the directive from the International Telecommunication Union (ITU) to migrate from analog to digital broadcasting, there is an urgent need to sequester the continent’s broadcast signal distributors (BSDs).1 BSDs provide the necessary architecture for moving broadcasted content (e.g., television and radio) into the digital sphere.

Most BSDs in Africa are owned and operated by Chinese companies. Of 23 digitally migrated countries, only four BSDs (Burkina Faso, Ghana, Guinea, and Zimbabwe) are officially known to be outside the influence of China-based companies. The implicit capture of the BSD marketplace by the People’s Republic of China (PRC) threatens African democracies and could undermine international partnerships among African nations and with the United States. Excessive Chinese control over African BSDs also raises security concerns and impedes establishment of a robust, competitive, and rules-based global market in communications infrastructure.

The United States should therefore consider the following actions to support African civil society, media regulators, and legislators in securing an information ecosystem that advances democratic values:

• Creating a Program on Traditional and Digital Media Literacy within the Department of State’s Bureau of African Affairs 2021 Africa Regional Democracy Fund.
• Supporting a Regional Digital Broadcasting Coordinator for each of the five African sub-regional groups, via the Digital Ecosystem Fund and the Digital Connectivity and Cybersecurity Partnership.
• Enhancing U.S.-based competitiveness by expanding the Digital Attaché Program to promote alternative BSDs in Africa.
• Leveraging the U.S.-Africa Leaders Summit proposed in the U.S. Innovation and Competition Act to advance a regulatory and liability framework governing the relationships among BSDs, content producers, and constitutional protections.

Summary

President Biden made advanced manufacturing a major policy priority during his campaign, including calling for a significant expansion of manufacturing programs to reach 50 communities through new manufacturing-technology hubs. Expanded manufacturing programs will invest in our nation’s long-term competitive innovation capacity. However, building these programs successfully requires a thoughtful and practical implementation plan. This memo presents two categories of recommendations to improve the U.S. advanced-manufacturing ecosystem:

1. Improve the existing Manufacturing USA institutes. Some new institutes are needed, but the Administration should concentrate first on strengthening support for the 16 existing Manufacturing USA Institutes, renewing the terms of institutes that are performing well, and expanding the reach of those institutes by launching more workforce-development programs, regional technology demonstration centers, initiatives to engage small- and mid-sized manufacturers and build regional manufacturing ecosystems.

2. Implement a multi-part strategy for collaboration among the Institutes: First, the Administration should create a “network function” across the Manufacturing USA Institutes because firms will need to adopt packages of manufacturing technologies not just one at a time. This could be supported by the National Institute of Standards and Technology (NIST) and would combine the advances of different Institutes and package them to be integrated and interoperable for easy adoption by firms. Second, a NIST-led traded-sector-analysis unit should be created to evaluate the manufacturing progress of other nations and inform Institute priorities. Third, the Administration should provide research and development (R&D) agencies with resources to build manufacturing-related R&D feeder systems (e.g., an expanded pipeline of manufacturing technologies) that aligns with Institute needs. Fourth, the administration should establish an Advanced Manufacturing Office within the White House National Economic Council to coordinate and champion all of the above, as well as numerous other manufacturing programs.