Cancer Investigation
ISSN: 0735-7907 (Print) 1532-4192 (Online) Journal homepage: http://www.tandfonline.com/loi/icnv20
Funding for Cancer Research John E. Ultmann, Marguerite Donoghue & Terry L Lierman To cite this article: John E. Ultmann, Marguerite Donoghue & Terry L Lierman (1991) Funding for Cancer Research, Cancer Investigation, 9:6, 707-709, DOI: 10.3109/07357909109039884 To link to this article: http://dx.doi.org/10.3109/07357909109039884
Published online: 11 Jun 2009.
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Cancer Investigation, 9(6), 707-709 (1991)
Funding for Cancer Research John E. Ultmann, M.D.*, Marguerite Donoghue, R.N., M.N.,?. and Terry L. Lierman, B.A., M.A.?. *University of Chicago Cancer Research Center Chicago, Illinois 60637 tCapifol Associates, Inc. Washington, 0.C. 20003
“Health is the first wealth of a nation,” said Senator Warren Magnusen in a 1975 speech rededicating the Clinical Center at the National Institutes of Health (1). The Center, which is the largest hospital in the world devoted solely to medical research, has since been renamed the Warren Magnusen Center for Clinical Research in recognition of the Senator’s support of biomedical research throughout his 46 years in the Senate. While many would agree with Senator Magnusen’s statement, the national commitment to its underlying principles has clearly diminished in the intervening years. As the health needs of America have become more pressing, promising avenues of research have gone unexplored because of a lack of resources. In polls taken in February and March 1990, the general public and members of Congress were asked to rank the importance of five areas of federally funded research: health, environment, energy, space, and weapons. Health research was considered the top priority by the general public and the Congress, with ratings of 59% and 50%, respectively. In contrast, funding for weapons research was ranked fifth by the general public and fourth by the Congress (2). Despite the views expressed in this poll, the actual
allocation of research dollars in the 1991 President’s Budget Request placed weapons far ahead of health. The White House requested $39 billion for weapons research while asking less than $7.9 billion for NIH research and $2.3 billion for National ScienceFoundation research. We do not hold out any hope that this will be dramatically altered for fiscal year 1992, given the national commitment of resources over the past decade. From 1980 to 1989, research and development in the Department of Defense increased 89% in inflation-adjusted dollars. In contrast, research and development in domestic programs, including medical and cancer research, decreased by 9 % in inflation-adjusted dollars. In the past 27 months we have spent more for research and development in the Department of Defense than we have spent in the 104-year history of medical research funded through the National Institutes of Health (3). In a recent analysis of five industrialized countries, the United States ranked fourth, behind Japan, West Germany, and France, in the percentage of our gross national product (GNP) devoted to research and high technology (4). Clearly, our fiscal priorities are out of line with the stated concerns of the people and of many Congressional representatives who guide public policy. Today there is 707
Downloaded by [Flinders University of South Australia] at 00:18 19 March 2016
708
little public will or political leadership to change these priorities. It is imperative to create the public will and to bring our fiscal priorities in line with the needs and wishes of the public. It is estimated that in 1990 we have spent in excess of $600 billion on health care costs. This expenditure represents approximately 12% of our GNP, with expenditures related to cancer screening and treatment accountingfor approximately 5 % of the GNP. At the same time we devote only .3 % of the GNP to medical research. Here again our priorities seem questionable. As a nation, we spend far more on the treatment of illness than we do on the tools that could prevent and cure them. We place greater emphasis on medicines, hospitalization, and other medial care costs than on the basic and applied research that could sharply reduce these expenditures as well as the discomforts associated with them. Yet the track record for medical research has been remarkable, and the economic benefits are indisputable. Studies indicate that the return for every $1.00 invested in medical research is as high as $13.00 (5). These dollars reflect the savings from reductions in absenteeism, lost productivity, and direct and indirect medical expenses; this does not even take into consideration the improvement in quality of life. Diseases that once killed or disabled hundreds of thousands of people have been controlled or eradicated. Progress in cancer research has enabled us to cure many cancers that once were fatal, and many other cancers can now be managed and controlled for longerperiods of time. As an example, a 17-year federal investment totalling $56 million led to the development of effective therapies for testicular cancer that have yielded a 91% cure rate, an improvement of nearly 50% over the former rate. The economic benefit of this success is estimated to be approximately $166 million per year. Another example is an NIH-sponsered study of breast cancer, the National Surgicaland Adjuvant Breast and Bowel Project, in which the federal investment totaled $11 million. As a result of the study, we are saving $170 million per year, which represents a 1,545 % return on the investment. It has been almost two decades since the passage of the National Cancer Act, through which the President and Congress designated cancer research and the quest for a cure as one of the nation’s highest priorities. Much of the public momentum and political support which culminated in the passage of that landmark legislation have eroded. However, the research advances and opportunities have never been greater in the history of medical research. As a result of the efforts and previous funds provided to our
Ultmann, Donoghue, and Lierman
National Cancer Program, our biological research is in the midst of a virtual revolution. Rarely does a day go by without reports of exciting breakthroughsand new advances in research. Annually, 1,040,OOO people are diagnosed with cancer, and every year 500,OOOpeople die. However, the National Cancer Institute (NCI) has received the smallest percentage increase of all NIH Institutes for the past decade, and real funding for cancer research has actually decreased. In 1980, the NCI’s budget was $958 million. For 1991, the NCI budget is $1.7 billion. The 1991 appropriation reflects a funding level of $900 million in 1980 inflation-adjusteddollars, for a 47 % reduction in purchasing power. After inflation adjustments(i.e., $958 million in 1980 to $900 million in 1991), NCI funding actually decreased 4.6%. Further, for FY 1989 and 1990, the NCI’s final appropriation was below the President’s Budget Request because of NIH administrative taps to provide funding for other research areas and salary increases. In FY 1991, the NCI’s final budget will be just slightly above the President’s Budget Request. Yet the spin-offs from cancer research have had tremendous impact in virtually every other area, most notably in AIDS and cystic fibrosis as well as other immunologic and genetic diseases. The most appropriateunderwriter of medical and cancer research has been, and will continue to be, the federal government. Medical research, like many other forms of basic research, is a high-risk enterprise and demands a large-scale sociebl commitment that is best led by our federal govemment. When Congress and the Administration have been convinced that a program was worthy of investment, the necessary resources have been found, even in times of fiscal constraint. As examples, the Supercollider Superconductor, the Hubble Space Telescope, the Savings and Loan bailout, Star Wars,and the Human Genome project have all received substantialappropriationsduring the past decade. At the same time, concern over the deficit has prevented the crucial increase recommended in the By-Pass Budget, a Congressionally mandated frequently referred to as a “needs” budget, which provides the resources needed to pursue critical cancer research opportunities. Federal support has been the cornerstone of American medical research, which is beginning to be weakened by the lack of adequate resources. A disruption of federal research funding threatens all of us because a strong medical research enterprise is the best protection for our nation’s “first wealth.”
709
Editorial
REFERENCES 1. Magnusen W: United States Senator. Remarks upon rededication
Downloaded by [Flinders University of South Australia] at 00:18 19 March 2016
of the Clinical Center at !he National Institutesof Health,July 1975, Bethesda, MD. 2. Nationwide Public Opinion and Congressional Poll, MarketFacts, Inc., February 1990 and March 1990, respectively.
3. Senate Committee on Appropriations, United States Senate,
Appropriations FY 1991, 1990. Science and Engineering Indicators, National Science Foundation, Division of Science Resources Studies, 1989. 5. Weicker LP: United States Senator. Remarks upon formation of Research!America, Instituteof Medicine, Washugton, DC,January 1989.
4.
ISSN: 0735-7907 (Print) 1532-4192 (Online) Journal homepage: http://www.tandfonline.com/loi/icnv20
Funding for Cancer Research John E. Ultmann, Marguerite Donoghue & Terry L Lierman To cite this article: John E. Ultmann, Marguerite Donoghue & Terry L Lierman (1991) Funding for Cancer Research, Cancer Investigation, 9:6, 707-709, DOI: 10.3109/07357909109039884 To link to this article: http://dx.doi.org/10.3109/07357909109039884
Published online: 11 Jun 2009.
Submit your article to this journal
Article views: 3
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=icnv20 Download by: [Flinders University of South Australia]
Date: 19 March 2016, At: 00:18
Downloaded by [Flinders University of South Australia] at 00:18 19 March 2016
Cancer Investigation, 9(6), 707-709 (1991)
Funding for Cancer Research John E. Ultmann, M.D.*, Marguerite Donoghue, R.N., M.N.,?. and Terry L. Lierman, B.A., M.A.?. *University of Chicago Cancer Research Center Chicago, Illinois 60637 tCapifol Associates, Inc. Washington, 0.C. 20003
“Health is the first wealth of a nation,” said Senator Warren Magnusen in a 1975 speech rededicating the Clinical Center at the National Institutes of Health (1). The Center, which is the largest hospital in the world devoted solely to medical research, has since been renamed the Warren Magnusen Center for Clinical Research in recognition of the Senator’s support of biomedical research throughout his 46 years in the Senate. While many would agree with Senator Magnusen’s statement, the national commitment to its underlying principles has clearly diminished in the intervening years. As the health needs of America have become more pressing, promising avenues of research have gone unexplored because of a lack of resources. In polls taken in February and March 1990, the general public and members of Congress were asked to rank the importance of five areas of federally funded research: health, environment, energy, space, and weapons. Health research was considered the top priority by the general public and the Congress, with ratings of 59% and 50%, respectively. In contrast, funding for weapons research was ranked fifth by the general public and fourth by the Congress (2). Despite the views expressed in this poll, the actual
allocation of research dollars in the 1991 President’s Budget Request placed weapons far ahead of health. The White House requested $39 billion for weapons research while asking less than $7.9 billion for NIH research and $2.3 billion for National ScienceFoundation research. We do not hold out any hope that this will be dramatically altered for fiscal year 1992, given the national commitment of resources over the past decade. From 1980 to 1989, research and development in the Department of Defense increased 89% in inflation-adjusted dollars. In contrast, research and development in domestic programs, including medical and cancer research, decreased by 9 % in inflation-adjusted dollars. In the past 27 months we have spent more for research and development in the Department of Defense than we have spent in the 104-year history of medical research funded through the National Institutes of Health (3). In a recent analysis of five industrialized countries, the United States ranked fourth, behind Japan, West Germany, and France, in the percentage of our gross national product (GNP) devoted to research and high technology (4). Clearly, our fiscal priorities are out of line with the stated concerns of the people and of many Congressional representatives who guide public policy. Today there is 707
Downloaded by [Flinders University of South Australia] at 00:18 19 March 2016
708
little public will or political leadership to change these priorities. It is imperative to create the public will and to bring our fiscal priorities in line with the needs and wishes of the public. It is estimated that in 1990 we have spent in excess of $600 billion on health care costs. This expenditure represents approximately 12% of our GNP, with expenditures related to cancer screening and treatment accountingfor approximately 5 % of the GNP. At the same time we devote only .3 % of the GNP to medical research. Here again our priorities seem questionable. As a nation, we spend far more on the treatment of illness than we do on the tools that could prevent and cure them. We place greater emphasis on medicines, hospitalization, and other medial care costs than on the basic and applied research that could sharply reduce these expenditures as well as the discomforts associated with them. Yet the track record for medical research has been remarkable, and the economic benefits are indisputable. Studies indicate that the return for every $1.00 invested in medical research is as high as $13.00 (5). These dollars reflect the savings from reductions in absenteeism, lost productivity, and direct and indirect medical expenses; this does not even take into consideration the improvement in quality of life. Diseases that once killed or disabled hundreds of thousands of people have been controlled or eradicated. Progress in cancer research has enabled us to cure many cancers that once were fatal, and many other cancers can now be managed and controlled for longerperiods of time. As an example, a 17-year federal investment totalling $56 million led to the development of effective therapies for testicular cancer that have yielded a 91% cure rate, an improvement of nearly 50% over the former rate. The economic benefit of this success is estimated to be approximately $166 million per year. Another example is an NIH-sponsered study of breast cancer, the National Surgicaland Adjuvant Breast and Bowel Project, in which the federal investment totaled $11 million. As a result of the study, we are saving $170 million per year, which represents a 1,545 % return on the investment. It has been almost two decades since the passage of the National Cancer Act, through which the President and Congress designated cancer research and the quest for a cure as one of the nation’s highest priorities. Much of the public momentum and political support which culminated in the passage of that landmark legislation have eroded. However, the research advances and opportunities have never been greater in the history of medical research. As a result of the efforts and previous funds provided to our
Ultmann, Donoghue, and Lierman
National Cancer Program, our biological research is in the midst of a virtual revolution. Rarely does a day go by without reports of exciting breakthroughsand new advances in research. Annually, 1,040,OOO people are diagnosed with cancer, and every year 500,OOOpeople die. However, the National Cancer Institute (NCI) has received the smallest percentage increase of all NIH Institutes for the past decade, and real funding for cancer research has actually decreased. In 1980, the NCI’s budget was $958 million. For 1991, the NCI budget is $1.7 billion. The 1991 appropriation reflects a funding level of $900 million in 1980 inflation-adjusteddollars, for a 47 % reduction in purchasing power. After inflation adjustments(i.e., $958 million in 1980 to $900 million in 1991), NCI funding actually decreased 4.6%. Further, for FY 1989 and 1990, the NCI’s final appropriation was below the President’s Budget Request because of NIH administrative taps to provide funding for other research areas and salary increases. In FY 1991, the NCI’s final budget will be just slightly above the President’s Budget Request. Yet the spin-offs from cancer research have had tremendous impact in virtually every other area, most notably in AIDS and cystic fibrosis as well as other immunologic and genetic diseases. The most appropriateunderwriter of medical and cancer research has been, and will continue to be, the federal government. Medical research, like many other forms of basic research, is a high-risk enterprise and demands a large-scale sociebl commitment that is best led by our federal govemment. When Congress and the Administration have been convinced that a program was worthy of investment, the necessary resources have been found, even in times of fiscal constraint. As examples, the Supercollider Superconductor, the Hubble Space Telescope, the Savings and Loan bailout, Star Wars,and the Human Genome project have all received substantialappropriationsduring the past decade. At the same time, concern over the deficit has prevented the crucial increase recommended in the By-Pass Budget, a Congressionally mandated frequently referred to as a “needs” budget, which provides the resources needed to pursue critical cancer research opportunities. Federal support has been the cornerstone of American medical research, which is beginning to be weakened by the lack of adequate resources. A disruption of federal research funding threatens all of us because a strong medical research enterprise is the best protection for our nation’s “first wealth.”
709
Editorial
REFERENCES 1. Magnusen W: United States Senator. Remarks upon rededication
Downloaded by [Flinders University of South Australia] at 00:18 19 March 2016
of the Clinical Center at !he National Institutesof Health,July 1975, Bethesda, MD. 2. Nationwide Public Opinion and Congressional Poll, MarketFacts, Inc., February 1990 and March 1990, respectively.
3. Senate Committee on Appropriations, United States Senate,
Appropriations FY 1991, 1990. Science and Engineering Indicators, National Science Foundation, Division of Science Resources Studies, 1989. 5. Weicker LP: United States Senator. Remarks upon formation of Research!America, Instituteof Medicine, Washugton, DC,January 1989.
4.
