A budget proposed by President Donald Trump would set NIH and biomedical research back 15 years, said former Vice President Joe Biden, addressing members of the American Association for Cancer Research on April 3.
“That’s not hyperbole,” Biden said. “The chance of getting a grant would almost certainly reach a historic low, because grants are funded for multiple years, and NIH is committed to funding the existing grants already in 2018.
“Simply by proposing to end our long tradition of bipartisan support for medical research and other sciences, we could be deterring millions of bright, ambitious youngsters from high schools through graduate school from pursuing a career in science,” Biden said.
“This is tragic. We cannot let it happen. … And by the way, I can think of so many other things to cut that money from. Oh, God bless me. Starting with the $1.3 trillion in tax loopholes that aren’t collected every year.”
Less than three months ago, when Biden left the White House, he secured the authorization of $1.8 billion for cancer research over seven years. The money is still slated for NCI, but after the surprise of the Trump budget blueprint that calls for slashing NIH by 18.3 percent, nobody knows what to expect (The Cancer Letter, March 17).
“There’s one problem today that didn’t exist when I spoke to you a year ago,” Biden said at the AACR meeting. “The president of the United States is not only not doubling down on our investment; he’s proposing draconian cuts not only to biomedical research, but also the entire scientific expertise, across the board.”
Trump’s blueprint proposal could cut research grants by up to 90 percent, Biden said at AACR’s 2017 annual meeting in Washington, D.C.
“This is no time to undercut progress, for God’s sake. This is no time to let up. It’s time to double down,” Biden said. “The damage is already being done, because the message is being sent out to the world and the brilliant young folks like a lot of you who are just in graduate school now, making their final decisions what path they’re going to follow, and undergraduate school, deciding what they are going to do.”
Biden’s remarks come one year after NCI began the process of identifying scientific opportunities for investment via the Beau Biden Cancer Moonshot, a wide-ranging public health initiative—named after Biden’s late son—aimed at doubling progress in cancer research over the next five years (The Cancer Letter, April 1, 2016).
The moonshot was passed by Congress in December as part of the 21st Century Cures Act, a $6.3 billion health care reform bill designed to modernize clinical trials and accelerate progress in research (The Cancer Letter, Dec. 9, 2016).
Biden said the moonshot yielded an “unprecedented level of collaboration” in cancer research, especially in oncology bioinformatics and data sharing. Throughout 2016, the then-vice president used his charisma, the power of the White House, and his vast reserves of political capital to cajole and shame—even threaten—allies and government agencies into action.
“I’m a lawyer, I’m not a researcher. But I know how government works and doesn’t work,” Biden said at the AACR meeting. “I know a little bit about collaboration. We can do more together than we can by working alone.
“Secondly, I told you last year that I would get an additional $1 billion for the moonshot scientific priorities, and you all said, ‘Ain’t he a nice man. Well intended.’ Well, I was wrong. I got you $1.8 billion in additional funding.”
Biden said he will soon launch an organization named the Biden Cancer Initiative to continue his work on the moonshot (The Cancer Letter, Jan. 6).
“The bad news for y’all is, I assure you I’m not going anywhere,” Biden said. “The reason I’m going to stay involved is because, for the first time in 45 years, there’s some real, significant movement and collaboration, which, in my view, is where the solution is most likely to lie to double our rate in the fight against cancer: engaging cancer centers, drug companies, insurance industries, patients, the government.”
Yoder: Republicans in Congress remain committed to NIH
At a panel discussion that followed Biden’s speech, Rep. Kevin Yoder (R-KS) said Republican members of Congress will not renege on their support for NIH and biomedical research. Yoder is a member of the House Appropriations Committee and chairman of the Legislative Branch Subcommittee.
“These are different times, I understand, politically, and people may be a little nervous about where Congress is going and what Washington may do as it relates to funding,” Yoder said at the meeting.
“So, I guess first and foremost, I’m here to reassure you that this continues to be a priority for this Congress, for the elected representatives in Washington to fund cancer research, to fund the NIH, to make good on our promises in the moonshot and legislation passed in the 21st Century Cures Act that was just passed a few months ago.
“Congress really hasn’t changed, regardless of who operates the White House, this continues to be a heavy priority for us. Part of that is because many of us see this as not another line item on the budget, not some part of some budget war, but something that really is fundamental to who we are as an American people and a prioritization of what matters in this country, in this Congress. This is an issue that, of course, affects both political parties equally. The disease of cancer is not something that affects Republicans and Democrats in a disparate way.”
Yoder assured the audience that Rep. Tom Cole (R-OK), deputy majority whip, senior appropriator on the House Budget Committee and chairman of the House appropriations subcommittee on Labor-HHS, as well as Sen. Roy Blunt (R-MO), vice chairman of the Senate Republican Conference and member of the Senate Appropriations Committee, remain committed to investing in science.
“We’re going to unify and join forces to send a message to all of you, to send a message to young researchers across the country that are thinking about, ‘Should I go into the field of cancer research or should I go in to some other field?’ to reassure them and let them know that our commitment is strong, that our commitment is unwavering,” Yoder said.
“We are unified in our quest to go to war on cancer and to cure this disease and treat this disease, and to come up with new innovative ways to solve this disease in as many ways as possible. We know that the federal government plays a key role in that.
“So, with the moonshot and with the work all these men and women are doing and that all of you are doing, we’re here to be your ally and to let you know that the support will continue to be there, regardless of who operates the White House.”
Pazdur: FDA oncology center a lasting legacy of moonshot
One of the “longest lasting legacies” of the moonshot is the creation of the FDA Oncology Center of Excellence, said Richard Pazdur, director of the OCE and the FDA Office of Oncology and Hematology Products (The Cancer Letter, July 1, 2016).
“What this is, is an attempt of the FDA to integrate the oncology programs that had existed in different centers of the FDA and bring the expertise of all the oncologists together at the FDA,” Pazdur said at the meeting.
“Not only does it have an implication for getting out drugs faster, not only does it have an implication for regulatory work, but it also has implications for having the FDA be involved with other academic centers and professional groups. And, actually, developing regulatory science and the science that we will use in the regulation of drugs and drug development in general.
“So, I think the Oncology Center of Excellence is probably, for the FDA, the most important part of the moonshot project. But in addition to that, there were several other issues that we brought forth, and that included looking at how we do clinical trials, are there better ways of doing clinical trials. These include seamless trial designs where we really merge phase I, II, III testing together, taking a look at eligibility criteria, making them reflect more real-world situations, taking a look at large simple trials.
“In addition to that, I think the third prong of that for the FDA was really to take a look at, ‘Can government work better? Can government work together?’ and we’ve partnered with the NCI closely in developing projects that we want to work on.
“We want to work on, for example, greater disclosure of information before drugs are approved so the NCI has a realization of what is going on in the regulatory world from our perspective. So again, a lot of it is better communication with government agencies, also.”
Lowy: NCI going forward with moonshot vision
“First, the NCI, in the 3.5 months since the moonshot act was passed, now has at the NCI website more than 15 different funding announcements for trying to implement and to start implementing different aspects of the Blue Ribbon Panel recommendations, which we look forward to being able to fund during this fiscal year,” Lowy said at the meeting.
“The second part is we also have created implementation teams that are in the process of discussing and prioritizing how to move forward with further development, with new awards in FY 18 and FY 19. And in the spirit of the Cancer Moonshot, this is designed to greatly accelerate the pace of cancer research and for people to work together.
“The third point I want to make is, the NCI can’t do this alone. Instead, we are looking forward to partner with the private for-profit sector, with private philanthropy, with advocates, and many other groups. Vice President Biden talked about international agreements that we made, and we look forward to this being really a global effort to deal with this terrible disease.”
Responding to a question from a member of the audience about Trump’s proposed cuts, Lowy said that NCI requires sustained increases in appropriated dollars to fund more research ideas than it can currently afford.
“Needless to say, this is complicated. If cancer research were simple, it would’ve been resolved a long time ago,” Lowy said. “But we are continually faced with many more outstanding, meritorious applications than we have resources for, and we continually need to strike a balance between the needs and the opportunities.
“We run out of money long before we run out of perfectly great ideas to test, so the more resources we have, the more those ideas we can support.”