Cuts to Cancer Research Loom Large

If enacted, what could they mean for the future of oncology?

Naveed Saleh, MD, MS

Disclosures

June 16, 2017

In his 2016 State of the Union address, President Barack Obama announced the $1.8-billion "Cancer Moonshot" program, to be led by then-vice president Joe Biden. According to a White House press release, the Cancer Moonshot focuses "on making a decade of progress in preventing, diagnosing, and treating cancer in 5 years, ultimately striving to end cancer as we know it."[1]

Fast forward to March 2017, and the goals of the Cancer Moonshot seem little more than pie in the sky to the many oncology researchers, cancer specialists, and patients who pinned their hopes on this ambitious undertaking. President Trump's budget blueprint for fiscal year 2018 proposes a $5.8 billion cut to the National Institutes of Health (NIH) budget, reducing NIH spending by about 20%, to $25.9 billion.[2]

The President's proposal for substantial cuts in funding would be devastating for not only the biomedical community but also patients suffering from diseases.

The National Cancer Institute (NCI) is part of the NIH and dominates the funding of cancer research in the United States. Oncology researchers are gravely concerned about what funding cuts to the NIH would mean for the future of their own life's work and the health of millions of people living with cancer. "The President's proposal for substantial cuts in funding would be devastating for not only the biomedical community but also patients suffering from diseases," Michael A. Caligiuri, MD, director of the Ohio State University Comprehensive Cancer Center and president of the American Association for Cancer Research, said in an interview.

What We Know

So far, we have few details of how cuts to cancer research funding will play out and how the NCI will be affected specifically. Moreover, Trump's proposed budget cuts will have to be passed by Congress, and historically there has been strong bipartisan support for cancer research. In fact, in the wake of Trump's proposed cuts to the NIH, Congress allocated an additional $2 billion to the NIH in their budget agreement for 2017. This extra money will be assigned before the end of this fiscal year, in September 2017.

[C]ancer researchers have for decades known that such a bureaucratic approach to the funding of cancer research threatens progress in the field.

Nevertheless, in an April 2017 memo[3] sent to the heads of federal agencies, budget chief Mick Mulvaney wrote that "[a]gencies should begin planning for these reductions now, as achieving associated personnel reductions takes time to implement and realize savings." Specifically, Mulvaney recommended that agencies consider the following factors when conducting analyses to reform the federal government and reduce the federal civilian workforce:

  • Is the agency or program duplicative?

  • Is the agency or program nonessential?

  • Is the role of the federal government appropriate, or could the activities be better served by another (state, local, private) entity?

  • What is the cost benefit?

  • Is the agency or program efficient and effective?

  • Does the agency or program meet the needs of the public effectively?

Of note, cancer researchers have for decades known that such a bureaucratic approach to the funding of cancer research threatens progress in the field.

In a 2008 paper published in Molecular Oncology, Eckhouse and coauthors[4] wrote, "Bureaucracy and over-management remain constant dangers to progress.... The intellectual underpinnings of cancer research are radically different from the usual input-output model and, as John Cooper, former President of the Association of American Medical Colleges put it, 'In the Cancer Conquest program, the targets are diffuse, unseen and largely unknown' (US Senate, 1971)."

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