The importance of communication and defining what is a social contract

Nicola von Lutterotti reflects on her experience as a Sciana Fellow, building a new social contract for health and wellbeing, and the COVID-19 pandemic

Nicola von Lutterotti is the president of the board of trustees of the Max-Planck Institute for Immunobiology and Epigenetics in Freiburg, Germany. She also supports other institutions like the Stiftung Humboldt Universität and the Stiftung Charité that promote innovations in science and the understanding of science. Nicola regularly writes for the Frankfurter Allgemeine Zeitung and the Neue Zürcher Zeitung and moderates medical conferences. After completing her PhD in high blood pressure treatment at the Medical Faculty of the University in Freiburg, Germany, she spent many years in this research field as a postdoctoral Fellow at Cornell Medical University in New York City and the University of Milan, Italy. She is a member of Sciana's fourth cohort.

Sciana Network: The overall challenge for your cohort is "building a new social contract for health and wellbeing". What does this change mean to you?

Nicola von Lutterotti: In the beginning, we had to grapple a great bit with this topic because there is not a good definition of "social contract". There are so many around. I think most of the groups had quite a problem, and it took us about two and a half meetings in Salzburg to find something we would like to concentrate on. Then, we finally found something that we could all relate to, and this had to do with dignity in old age because the ageing population is growing, especially in the industrialised world.

We figured that many older people get a bit lost and left out, and they're not getting taken care of as they should when they get older. It's not only the health, but it's also the wellbeing. So, this is why we did a survey. We first wanted to define what dignity in old age really means to the cohort, not only ours but also to Cohort 5.

So, we did the survey to find out what that means to everybody. Everybody had to rate what they wanted for themselves when they get older… We found out that to die and age at home is the least important to the people here. The most important aspect is to be socially connected, to be autonomous, and to be able to decide for themselves.

SN: During the COVID-19 pandemic, there was a discussion about building back better, doing things differently, and the opportunity to create new social contracts. Is this something that you've witnessed? What more would you like to see?

NvL: I have to say that I have seen the opposite. I haven't seen a better social contract… What I've seen is that with COVID-19, there were groups that had been left out, such as people with mental health issues and children. They couldn't go to school. They had to stay at home. They couldn't leave their homes… And I think for the young people, COVID-19 was one of the worst things that could happen because at this age, you need to have contact with peers, to be in school, and to be out of their homes… As a society, we haven't really discussed what has gone well and what has not gone so well. There were punctual discussions about that, but there was never a really true analysis about this problem. So, I'm afraid that when the next pandemic happens, we will have the same problem again because people didn't learn.

SN: You have been advocating for science communication because you mentioned that "more emphasis is put on doing research rather than communicating its results to the public". Can you elaborate more on this?

NvL: People who work at universities are publicly funded, and they don't realise that they have a responsibility to communicate what they are doing to the public. There's an absolute need to communicate what comes out of science for different reasons. First of all, I think it's their responsibility to do so. Secondly, if you do not do that, you get very detached.

The public sometimes has a mistrust on what scientists are doing…The more complicated science gets—considering the rise of artificial intelligence—the further the distance between those who know and those who do not know gets. It is a major issue to bridge this gap. Science communication is important to address fear. If the population is too afraid, this can block the development of scientific progress.

SN: What comes to mind when you think about your experience in the Sciana program?

NvL: We couldn't start the in-person program like everybody else due to COVID-19. We had to do the online sessions first, and this was a bit of a problem for many… because if you cannot meet in person with somebody, it's very difficult to bond. I think Sciana is also a lot about bonding. You need to have personal contact with people from the three different countries. And if you cannot do that, it's difficult… So, everybody was really happy to finally go to Salzburg and meet in person.

SN: Part of the Network's mission is to help equip leaders for future challenges in health and wellbeing. Can you provide examples of what you've learned about leadership while participating in this program?

NvL: We learned about compassion and the different types of leadership. But maybe something more practical that I had been involved in is that we have drafted a position paper on recommended reform priorities to policymakers and stakeholders in the Swiss healthcare system. So, all Fellows from different cohorts who are from Switzerland have participated in writing a new paper to get the Sciana Network a bit more known to the Swiss health community. We suggested five key areas for reform and five elements we felt were particularly important.