Cure cancer? We haven’t got the guts.
An excellent piece in Sunday’s New York Times, by Gina Kolata, highlights the “play it safe” grant system utilized by the National Cancer Institute (NCI) and how it has led to poor results in the battle to cure cancer.
Since Richard Nixon officially began the war on cancer in 1971, the NCI has spent about $105 billion in grants given over to those charged with solving this deadliest of humanity’s mysteries. And much of that was spent when a billion dollars was still a lot of money.
Yet, after almost 40 years of government spending, we have surprisingly little to show for it as the cancer death rate has only very slightly improved.
The cynics among us will be quick to point out that this failure should come as no surprise. Government budgets, by and large, exist to pay back and make wealthy those who put the decision makers into their positions.
Could it, therefore, be that the poor showing of government investment directed towards curing cancer is the result of the special interests earning billions selling drugs and services to meet the needs of the burgeoning cancer industry? Is this all about a cure for cancer being bad for business?
I don’t think so. If the slow progress on the part of the NCI were the result of special interest lobbying designed to hold back on the flow of government dollars to cancer research, the scientific community would be crying out for more money. For the most part, they aren’t. What we do hear from the scientists is that the government only spends its money on “safe” research designed to show some incremental improvement as opposed to funding riskier, out of the box concepts designed to produce real breakthroughs.
Even the leader of the national health establishment agrees. Dr. Raynard S. Kington, acting director of the National Institutes of Health (which includes the NCI) says,
We have a system that works over all pretty well, and is very good at ruling out bad things — we don’t fund bad research. But given that, we also recognize that the system probably provides disincentives to funding really transformative research.
Put another way, this country just doesn’t seem to have the the cajones to take on the kind of big risks that could spell victory in the war on cancer.
In the field of human sciences – like in almost any area of endeavor – big breakthroughs come from accidental discoveries or out of the box thinking. Great risk of failure inevitably leads to great rewards. Of course, that comes at the price of wasting money on the failures that will turn out to have been screwball ideas. Still, as Dr. Kington confirms, if we don’t spend some money on risky research then we are incapable of moving the ball forward towards accomplishing the goal of Nixon’s war – curing cancer.
Imagine if NASA had been built on the premise that it would take small, safe steps in the nation’s efforts to explore space. Would the agency, established in 1958, have put a man on the moon in just 11 years? Great chances were taken and great casualties resulted, but we were willing to make the big moves and reaped the rewards of winning the space race.
Of course, that was then and this is now. We, as a people, are not who we were in the late ‘50s and early ‘60s.
So why does the government even bother? If they aren’t going to fight to win, why even spend the money?
Kolata sums it up nicely in her description of the National Cancer Institute.
It has become a sort of jobs program, a way to keep research laboratories going year after year with the understanding that the focus will be on small projects unlikely to take significant steps toward curing cancer.
Now that sounds familiar. In the effort to keep the money flowing from Congress, the government health establishment has given up on winning the war in exchange for keeping everybody working under the pretense of trying to accomplish something. Can’t you just see the NCI administrators fretting over getting Congress to approve their annual 7% increase if their failure rate was to increase a few points because they actually tried to do something?
Just like so many of the “wars” we have begun over the years, (see “War on Drugs” and “War on Poverty”), the mission objective has been lost in a sea of budgetary considerations designed to keep people in their phony baloney jobs (credit to Mel Brooks).
Of course, those in government who lost the war on drugs were not casualties of that war just as they were not the casualties of the failed war on poverty.
But the war on cancer is something very different. While government workers, elected and otherwise, can avoid drugs and poverty, a significant percentage of them will not escape cancer. Their uninspired, “business as usual” approach to the fight will, some day, end up taking them, or someone they care about, down – and many of us will go down with them.
Depressing? Absolutely. But all too real and precisely why this is one war in very serious need of a “surge” offensive.