Too Few Funds to Fight Cancer in US

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By Robert Weiner and Patricia Berg

With more than 500,000 cancer deaths in the United States each year, the underlying buzz all around the just concluded San Diego meeting of the American Association for Cancer Research, with 17,000 scientists from throughout the nation and the world, was, "Where is the federal government?

AACR is comprised of 27,000 scientists dedicated to the conquest of cancer, and they are saving lives every day. The physicians and researchers are making discoveries shattering the old death sentence of cancer - the death rate has declined 2 percent a year since 2002. Still, 1,500 Americans a day die from cancer, points out cancer survivor Cindy Geoghegan of Komen for the Cure, the world's largest private breast cancer research funding provider.

Despite fear of the torturous physical slide of cancer - people's No. 1 health fear - federal funds for research into early diagnosis, treatment and cures are plummeting. The National Institutes of Health has lost 2 percent of its budget to inflation in real dollars every year for the last seven years, a 14 percent decline, points out leukemia researcher Michael Sheard of Childrens Hospital Los Angeles. Ellen Sigal, chairwoman of Friends of Cancer Research in Arlington, Va., and the chair of a forum at AACR on alternative funding mechanisms, confirmed Sheard's numbers.

When we asked Sigal why there is the drop in federal funds, she responded, "We have a deficit and a war." If funding potential disease cures is part of the price of Iraq, it is no wonder that 70 percent of Americans oppose the war and want its cost to end in the scheme of priorities.

"We have no money at NCI," joked National Cancer Institute Deputy Director Anna Barker - but the laughter in the room was not a happy one. She went on, "NCI is a $5 billion operation but the budget has gone down in real terms, so we are seeing real changes in the granting program."

NCI now funds fewer than 10 percent of requested research projects, down from 25 percent a decade ago. President Clinton had doubled NIH's budget - explaining many of the amazing recent breakthroughs - but now, with the budget dropping, private organizations are desperately trying to pick up the pieces so that innovative science can continue. Public-private opportunities do exist at NCI including new biomarker projects under a 53-group consortium, but few were funded after a necessarily rigid application process.

The bar is now impossibly high for many new discoveries. At NCI, researchers "must show real leads, not discovery," says Barker. You have to show your process works before you can get money to test if it does. Columbus would have never discovered America. Barker agrees that "to lead the world, we have to redouble, not back off, our investment."

Yet cancer scientists share the blame. When we asked why the "professional consensus" at NCI is only requesting a $1 billion increase in research for 2009, the AACR expert panelists gave two reasons: "complacency" and a feeling of "the limits of entitlement." Because the NIH budget had been doubled a decade ago, scientists feel that is all they can get.

Scientists should show the same vision in their funding requests from government as they do in their search for disease cures. Did Halliburton and Blackwater stop asking their share of the now $12 billion per month and nearly trillion dollars so far that the Iraq war is costing American taxpayers, after Americans had been promised six years ago that the total would be $50 billion to $100 billion? Wouldn't we rather see additional costs for visionary medical cures for cancer than a war causing cancer to our economy?

The private sector is a pale substitute for the real power of the federal government. Mark Hurlbert, the Avon Foundation's senior adviser for grants and partnerships, gave the numbers that tell the story. For breast cancer alone, $600 million annually comes from NCI, and the Department of Defense has provided $2.2 billion total since 1992, versus Komen $900 million since 1988, Avon $520 million since 1992, Revlon $110 million since 1992. Komen's current round will be able to fund only about $100 million of $600 million in requests, and Komen officials say the scored quality difference between approved and many unapproved projects is minuscule. Jonathan Simons of the Prostate Cancer Foundation described exciting developments but similar dollar shortages.

Another aspect of the funding shortage is that we may be losing an entire generation of scientists who opt to do other things. With no money for their research, scientists have no choice but to select fields that can pay.

One in two men and one in three women will develop some form of cancer during their lives, according to the Centers for Disease Control. It is tragic that private volunteer organizations have to scramble to pick up the pieces of the federal government, who with all its power, could be driving scientists closer to curing this dread disease."