In 2014, Robert D. Truog, Center for Bioethics of Harvard Medical School's Department of Global Health and Social Medicine, wrote an open letter to President Barack Obama and other U.S. leaders supporting the creation of pilot projects to study forms of compensating live kidney donors.[15] A number of health professionals, transplant professionals, ethicists, lawyers, religious leaders, academics, and other supporters co-signed the letter. In the letter, and in an earlier paper published in the New England Journal of Medicine, Truog addresses the urgent need for additional kidney donors; the transplant procedure's low safety risks; the significant decrease in financial costs, morbidity, and mortality rates associated with kidney transplants; and the ability to implement a system of compensated kidney donation with stringent government regulations and ethical safeguards.[16]