In this episode of In the Headlines, Paul Goldberg, publisher of The Cancer Letter, and Jacquelyn Cobb, associate editor, discuss the “doomsday scenario” facing academic cancer centers that would follow the success of President Trump’s move to limit indirect costs to 15% for NIH-funded institutions.
The topic of indirect costs has been “something you don’t talk about in polite company,” Paul said, and while a drastic cut would gut academic research, oncology leaders say that conversation about indirect costs could help the field.
Also in this episode is a behind-the-scenes look at last week’s cover story about federal agencies purging websites to fall in line with President Trump’s executive orders banning any mentions of DEI, health equity, or “gender ideology.”
As part of the purge, FDA removed a series of oral histories, including one by the former FDA associate commissioner of women’s health, Marsha Henderson.
“Getting rid of oral histories has a name. It’s erasure,” Paul said.
The Cancer History Project was able to preserve the oral history of Marsha Henderson. It can be read in last week’s issue.
The stories mentioned in this podcast include:
- Federal judge blocks Trump administration’s move to limit indirect costs to 15% for NIH-funded institutions. The move could gut academic cancer research
- “Page Not Found:” HHS agencies purge web pages that hint at DEI, health equity, and gender
- Senate Finance Committee advances RFK Jr. to likely confirmation, with Bill Cassidy (R-LA) casting the deciding vote
- Guest column by W. Kimryn Rathmell: Communication—We need more, not less
- LLS former CSO: Immunotherapy, precision medicine redefined blood cancer treatment
- Physicians and biopharma should improve accessibility of cancer trials
- Marsha Henderson: “You have to continue to push for what you think is the right thing for public health.” Preserving an oral history by the former FDA associate commissioner of women’s heath
This episode was transcribed using AI transcription services. It has been reviewed by our editorial staff, but the transcript may be imperfect.
The following is a transcript of this week’s In the Headlines, a weekly series on The Cancer Letter podcast:
Jacquelyn Cobb (00:00): This week on The Cancer Letter Podcast: What does this mean for cancer centers and cancer research if indirect costs are capped at 15%?
Paul Goldberg (00:12): I think that’s a doomsday scenario for most institutions, for many institutions, or at least that’s what they’re saying. And that said discussion of the subject is something that’s actually good for everyone. You know, the reason this is such a mystery is that people have been saying, oh, don’t talk about direct costs. Well, you know, you create a secret and then something like this happens.
You’re listening to the Cancer Letter podcast. The Cancer Letter is a weekly independent magazine covering oncology since 1973. I’m your host, Paul Goldberg, editor and publisher of The Cancer Letter.
Jacquelyn Cobb (01:00): And I’m your host, Jacquelyn Cobb, associate editor of The Cancer Letter. We’ll be bringing you the latest stories, groundbreaking research, and critical conversations shaping oncology.
Paul Goldberg (01:10): So, let’s get going.
Jacquelyn Cobb (01:20): Welcome to the first episode of The Cancer Letter Podcast, In the Headlines. How are you doing today, Paul? I see you have the beautiful bookshelves behind you. You’re in Vermont; right?
Paul Goldberg (01:31): I am. It’s beautiful here. It’s snowing.
Jacquelyn Cobb (01:34): Yeah.
Paul Goldberg (01:35): Skiing has been great at Trapp Family Lodge. They’re not our sponsor, but I like them.
Jacquelyn Cobb (01:41): <laugh>. Oh, I’m jealous. Being in Boston proper, there’s not quite many opportunities for skiing, but hope to escape next weekend, maybe. I heard there’s more snow coming, but—
Paul Goldberg (01:50): Sledding.
Jacquelyn Cobb (01:51): True! I did sled this weekend, actually, so that was fun. First time maybe ever. I don’t know if I’ve done that as a child, but yeah.
So, I’ll take us through sort of what we went through the issue this week. This week, NCI and other government agencies, FDA, CDC, were scrambling to make their websites comply with President Trump’s executive orders, basically trying to eliminate all traces of DEI, health equity, and gender. So, we had a coverage of that, that was really incredible by our director of operations, Katie Goldberg. She put together—not a complete, but a quite comprehensive table of websites that were taken down, including grants that their webpages are taken down as well. So, if you’re concerned about the status of your grants webpage you can definitely check out that really great table that Katie put together.
We also had a story about the Senate Finance Committee advancing RFK Jr. to the next level, the next step in his confirmation, his likely confirmation.
We had a great guest editorial by former NCI Director Kimryn Rathmell on the importance of communication, especially in the light of the communication ban from the government agencies.
And then we had some guest editorials from a variety of or about a variety of topics. We had the LLS former CSO talk about the history of the field as he retires from his position. And also a great guest editorial about improving accessibility of cancer clinical trials.
Our “In the Archives” this week was another incredible feat by our director of operations, Katie Goldberg, where she found one of the—basically an oral history that was taken down in the website purge from the lead story and highlighted it. And definitely, definitely worth checking out. It’s a wonderful profile of Marsha Henderson and her incredible career. So—
Paul Goldberg (04:02): To me, one of the most interesting things that happens in the government is when people try very hard to comply with orders.
Jacquelyn Cobb (04:10): Mm-hmm.
Paul Goldberg (04:11): And in this case, I don’t know if they went too far, because the times have never been like this, but one of the things that they’ve done at FDA was get rid of oral histories. So, now getting rid of oral histories has a name. It’s erasure. And what was the name of—let’s talk about the person whose oral history they’ve erased.
Jacquelyn Cobb (04:39): Yeah. Marsha Henderson. She was the former FDA Associate Commissioner of Women’s Health. And she had an incredible career. Henderson is a Washington, DC native, and she grew up in a middle class black neighborhood shortly after the city was desegregated. The oral history that she had on FDA’s website was taken right as her retirement from FDA was imminent, I believe, or she had just retired. One of the two.
Paul Goldberg (05:10): Well, yeah, I was there when, when women’s health research was becoming a priority for the United States Government. I wonder if it means that women’s health research is no longer a priority.
Jacquelyn Cobb (05:23): Well, that’s the issue with the websites is that, you know, we understand that DEI and gender are, you know, not priorities of the government. Maybe even a harsher set of words can be said for that. But especially for the grants and some of the other websites, the fate of the website doesn’t necessarily mean—it doesn’t necessarily correlate to the fate of the actual grant or the actual program. So, it’s yet to be seen exactly how that’s gonna play out.
Paul Goldberg (05:47): Well, which is why I’m so happy that we have the Cancer History Project, because when history is being erased in one place it can pop up in another. So history does have a way of being preserved. So, Jacquelyn, I think we should probably switch to the special report stories that happened as we were just as we pushed the publish button last week.
Jacquelyn Cobb (06:15): Yep, yep, yep. The special report came out yesterday about the indirect costs, the proposed cap on indirect costs. Paul, please take it away.
Paul Goldberg (06:26): Oh, so we finished the issue and I was returning calls. So, I called this friend and we’re talking, it’s about around probably 4:15 p.pm Friday. And then she says, “Oh, shit.” <laugh>.
And I say, “Huh?” As one should <laugh>.
And he said, “Well, they’ve just dropped the indirect costs down to 15%.”
And I said, “Oh, shit.”
And then, you know, I think a lot of people had very busy weekend. I think every, this is an issue that does not just involve NIH.
Jacquelyn Cobb (07:09): Yeah.
Paul Goldberg (07:10): This is an issue that involves all of research for science. In fact, when you look at that NIH document that they published the guidance, it just says grants, but it really probably also includes cooperative agreements and and also contracts. So, that’s where it’s going. And it’s not just NIH. No, it’s probably going to be DOE. It’s probably gonna be, you know, every agency you can think of.
Jacquelyn Cobb (07:43): Mm-hmm.
Paul Goldberg (07:43): So we’re talking about billions and billions of dollars.
Jacquelyn Cobb (07:47): Yeah. Yeah, absolutely. And I mean, this is potentially, I mean, the federal judge in Massachusetts is trying to stop this move from happening, or at least delay it. Right. But the way it was written is that the indirect cost can be dropped even retroactively on existing contracts. Correct?
Paul Goldberg (08:10): Well, you’d need to kind of get rid of the laws of the United States <laugh>. I don’t know if that’s a problem at this point. But given the current legal climate, this is not one of the mysteries of law. This is something that could be resolved by a very smart middle school civic student.
Jacquelyn Cobb (08:36): Yeah.
Paul Goldberg (08:36): So, no, you can’t do that. Will they do that? Who knows. So, among those busy people this weekend, were the lawyers in the 22 attorneys general’s offices who by Monday morning filed an injunction requesting an injunction. And, and very quickly on Monday, the judge basically granted the injunction, and it’s going to be in court on February 21st. It’s worth looking at that.
Then at the same time also on Monday, the organizations representing universities as well as 13 research universities filed suit. Now it’s probably, I hate to call anything a no brainer, but I already have <laugh>. But we can certainly guess what the judge is going to say.
But what we can’t guess is what the administration is going to do.
It seems that some of the other of its actions are being challenged in court as well, and statements are being made, really hints by Elon Musk and JD Vance that perhaps the administration doesn’t need to worry about judicial review, which actually goes back to the foundations of the United States. You know, Marbury versus Madison. I learned my civics well, <laugh>, that was in middle school. So, yeah, we’ve got problems, folks. It’s also really clear that this is, this is something—indirect costs. Should we go back to just talking about indirect costs for a little bit?
Jacquelyn Cobb (10:39): What exactly are indirect costs, Paul?
Paul Goldberg (10:41): Indirect costs are the costs that are negotiated usually by a grant, the institution receiving a grant or a contract or co-operative agreement. And those institutions basically negotiate with the government over what their costs are, what their actual costs are. This structure goes back to 1940 to the war effort. So, literally 1940. So, this issue is 85 years old. But it’s also a part of the functioning of the government and academia that is extremely difficult for people to understand and analyze.
It’s also not been an issue on which the government has wanted to talk very much. It’s kind of like something you don’t talk about in polite company. And this, by the way, is not the first time even Trump pays attention to this, because in the 2017 budget, I believe in the first budget proposal he submitted, the proposal was to pay no more than 10% of indirect costs.
And at that time—by the way, this is really interesting, because the rates were also not something that they wanted to apply to the Department of Defense, which was also interesting.
But at that time, the friends of NIH and Friends of Research and overall friends of science organized and defeated that piece of that proposal. And what happened next is every year the appropriations bills since have been saying you cannot go back and reverse and renegotiate.
Now, this is interesting, because these rates are very varied. Some of them, for some institutions, they’re fairly low, maybe 28% or something. So, for them, this will be another huge hit. And for others it can go above 60%, 80%. I mean, particularly vulnerable are the basic science centers, or most of them. So, those can go into the eighties and nineties percentage. So, basically the government gives you a million dollars, it also gives you indirect costs. And in 1940, by the way, indirect costs were 50%.
Jacquelyn Cobb (13:40): Wow. So, what does this mean for cancer centers and cancer research, if indirect costs are capped at 15%?
Paul Goldberg (13:48): I think that’s a doomsday scenario for most institutions, for many institutions, or at least that’s what they’re saying. And, but that said, discussion of the subject is something that’s actually good for everyone. The reason this is such a mystery is that people have been saying, “Oh, oh, don’t talk about indirect costs.”
Well, you know, you create a secret and then something like this happens. But it is understandable. It’s very opaque that somebody would come up with this idea. Now, here, the argument is very interesting that the same institutions accept lower indirect costs from private foundations, such as, say, the Gates Foundation. They keep mentioning that, and that’s true. Or, or the American Cancer Society. And, and many institutions, actually, some institutions do not accept those grants because they’re gonna be losing money.
There are two fallacies here. One of them is that some of the calculations of indirect costs that the government uses are different from the calculations that, say, the American Cancer Society or Gates Foundation uses. And in fact, some of these include some of the same costs except they’re direct costs.
You kind of have to recalculate all this. The other part that’s also interesting is that the reason these organizations can accept lower and direct costs from private foundations is that they’re getting fairly reimbursed by the government.
Jacquelyn Cobb (15:41): Mm-hmm.
Paul Goldberg (15:43): So those are the two possibilities. Now, how do you oppose this? It’s interesting that the only attorneys general that joined the suit come from the blue states. The red states really need to be involved in this somehow, because guess what? Red states have a lot of research.
Jacquelyn Cobb (16:07): Yep.
Paul Goldberg (16:08): A lot. I haven’t done a comparison, I haven’t seen anybody do a comparison, but a lot of people are now, a lot of the organizations are preparing to oppose this. And that means some grassroots work now in primarily red states.
Jacquelyn Cobb (16:30): Wow.
Paul Goldberg (16:31): Now, if you have a university in your city, surely jobs depend on this. If you strangle research, well, you know those young investigators aren’t gonna go and buy a pizza or buy a house, or a beer, which is actually important for young investigators, <laugh>, despite what the healthcare establishment says.
Jacquelyn Cobb (16:59): <laugh>
Paul Goldberg (17:01): It’s a story actually we are working on, but probably won’t publish anytime soon, because of Trump and the transition. So, it may be four years before we look at that. <laugh> It seemed like such a big deal. I know Jacquelyn almost has a story to go on this.
Jacquelyn Cobb (17:19): I know, the story’s basically ready to go, and I would love people to know what I know about it, but there’s too much news. Too much news.
Paul Goldberg (17:27): The title is something like, “Can I Have a Beer Tonight?”
Jacquelyn Cobb (17:30): Yep.
Paul Goldberg (17:30): Yep. Anyway, you can have a beer tonight. You probably need a beer tonight.
Jacquelyn Cobb (17:34): Yeah.
Paul Goldberg (17:35): And it seems like last weekend, lots of people were in need of a beer, but probably couldn’t have one because they were working too hard.
Jacquelyn Cobb (17:45): Yep, yep. Needed full faculties. <laugh>.
Paul Goldberg (17:47): Yeah. Literally <laugh>, in every sense of the word <laugh>. So, yeah. Yeah. It’s to be continued in ways that are fundamental and constitutional. The courts are gonna be involved, and probably the most…I don’t know how effective lobbying is.
Jacquelyn Cobb (18:10): Yeah. Yeah. Well, I think it’s an interesting idea. In your story, you have Kimryn Rathmell, Ned Sharpless, Wafik El-Deiry, all saying that, you know, what you just said, the fact that we do need to address indirect costs as a topic, but just doing it so abruptly, you know, as Wafik El-Deiry said, on Friday evening, is maybe not the best way to go about it. So, definitely an interesting thing to…
Paul Goldberg (18:34): You have to think about it. But, also, Ned said something really interesting, which is that given a choice between more R01s and more shiny buildings, most researchers would say more R01, but I’m not so sure that that’s the choice being presented here. It’s not going to be more R01s, or at least maybe that’s something that to be discussed. But then again, also there’s a question that every dean in America and college president is asking is, “Where do we put these researchers, should they get R01s?
Jacquelyn Cobb (19:14): Yeah.
Paul Goldberg (19:14): So I don’t know, but it is a ton of money. It is a pile of money that a lot of people are looking at, and a lot of people should be looking at.
Jacquelyn Cobb (19:25): Yeah, for sure.
Paul Goldberg (19:26): Just don’t do it with an ax. Don’t use an ax after you’ve looked. You think about it.
Jacquelyn Cobb (19:31): Yeah.
Paul Goldberg (19:32): Think about the health of Americans and research.
Jacquelyn Cobb (19:37): Yeah, absolutely. Ned Sharpless, of course, being Norman Sharpless, former director of NCI.
Paul Goldberg (19:42): Indeed.
Jacquelyn Cobb (19:43): Yes. And we’re just getting news now that the Doctors For America group was granted its motion for its temporary restraining order on the HHS agencies taking down webpages. So, HHS agencies have to restore old versions of their websites by 11:59 PM tonight. So, live update. Tonight being Tuesday. So, that’s a live update as we’re recording this podcast on Tuesday at around noon. An absolutely fascinating update
Paul Goldberg (20:24): This just in!
Jacquelyn Cobb (20:25): Yeah. <laugh>
Paul Goldberg (20:26): But, it’s also really interesting when—and dystopian to some extent—to think about, here’s somebody who is diligently getting rid of history, getting rid of recommendations that had been thought through, and then now they may need to restore what they had taken down. I hope they kept copies, if not…
Jacquelyn Cobb (20:49): They’re archived.
Paul Goldberg (20:52): They can come to The Cancer Letter and we will be very happy to work with them.
Jacquelyn Cobb (20:57): <laugh> Well, copies legally must be kept. They must be archived, but yes, we have backups if needed.
Paul Goldberg (21:05): <laugh>. Yes. I’m, this is spoken by the luddite-in-chief, me <laugh>.
Jacquelyn Cobb (21:12): Well, thank God we have Katie <laugh>.
Paul Goldberg (21:14): Indeed.
Jacquelyn Cobb (21:15): All right. Well, this was a great wrap up. Anything else you wanna talk about, about this week or the special report, Paul?
Paul Goldberg (21:22): Well, I think we covered a lot of ground.
Jacquelyn Cobb (21:24): Absolutely. Absolutely. And I’m sure there will be a lot more to talk about by Friday and by next week. The news is coming in fast.
Paul Goldberg (21:32): It’s a great time to be a reporter. <laugh>
Jacquelyn Cobb (21:36): Thank you for listening, and we will see you next Wednesday.
Paul Goldberg (21:38): Thank you.
Jacquelyn Cobb (21:41): Thank you for joining us on The Cancer Letter podcast, where we explore the stories shaping the future of oncology. For more in-depth reporting and analysis, visit us at cancerletter.com. With over 200 site license subscriptions, you may already have access through your workplace. If you found this episode valuable, don’t forget to subscribe, rate and share together, we’ll keep the conversation going.
Paul Goldberg (22:02): Until next time, stay informed, stay engaged, and thank you for listening.
