Is the Biden administration’s cancer fight focused on diversity over scholarship?
Andrea Ruth
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President Joe Biden’s quest to find a cure for cancer is one of the few policy aims that has strong bipartisan support in Congress. Biden also has personal motives, losing his oldest son, former Delaware Attorney General Beau Biden, to brain cancer in 2015 at age 46.
In 2016, then-President Barack Obama signed the 21st Century Cures Act that launched the “cancer moonshot” and put then-Vice President Joe Biden in charge for their remaining months in office. The program provides $1.8 billion over seven years for initiatives in the fight against cancer.
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Biden set a very high bar, one that experts said would not happen in such a short time span, when in 2019, during a campaign stop in Iowa seeking the 2020 Democratic presidential nomination, he promised to “cure cancer.” Since beating former President Donald Trump in 2020 and taking office, Biden’s administration has tempered that expectation. The current goal is to cut the death rate from cancer by 50% by 2045, and Biden now speaks of “ending cancer as we know it.”
Whatever the merits of the cancer moonshot program, money for research is not much of a problem. The federal government’s National Cancer Institute has a budget of $6.4 billion, and private nonprofit groups raise billions every year for research. There is a question over whether another $1.8 billion spread out over seven years will have any significant impact.
Unlike hypertension or diabetes, cancer behaves differently in all patients. Breast cancer is unique, as is lung cancer, and since the genomes are different for each case, two people with liver cancer may not respond the same way to similar treatments. Oncologist and Pulitzer Prize-winning author Siddhartha Mukherjee wrote in his book The Emperor of All Maladies that most tumors are a “genetic bedlam” with “mutations piled on mutations upon mutations.”
A critical factor in the cancer moonshot program will center on how the money gets spent. As part of what the administration calls Biden’s “unity agenda,” the White House announced it was allocating $5.4 million for a “cohort of Cancer Moonshot Scholars,” which it described as “a program … to support early-career researchers and help build a cancer research workforce that better represents the diversity of America.”
Though the amount of money is small relative to the overall federal budget, it will provide more opportunity for criticism as Biden and his administration focus on diversity and “equity” as a goal as opposed to direct policy. Earlier this year, Biden issued an executive order titled “Further Advancing Racial Equity and Support for Underserved Communities Through The Federal Government.” In it, Biden boasts of having “embedded a focus on equity into the fabric of Federal policymaking and service delivery.”
Biden’s “equity agenda” faces battles in Congress and in the courts. Two years ago, courts blocked Biden’s farmer’s debt relief program in the American Rescue Plan because it only made the relief available to minority farmers. In June this year, a federal judge in Texas ruled the Biden administration could not use a new federal agency, the Minority Business Development Agency, to discriminate based on race. The Cancer Moonshot Scholars program will no doubt raise similar concerns, questioning why the administration chooses to focus on diversity as opposed to finding the best scholars to battle cancer, regardless of their race or ethnicity.
Studies have shown that fewer cancer deaths are achievable, not only through better treatment and new cancer drugs but through a focus on better day-to-day health. While Biden’s goal is to reduce cancer deaths by 50% by 2045, much of that focuses on sped-up treatment discovery. However, the American Cancer Society said optimized prevention methods alone could reduce cancer deaths by 33.5% by 2035. That prevention includes further smoking cessation, better dietary habits, weight loss, exercise, less alcohol consumption, etc. It also includes expanding access for early detection, such as colonoscopies and mammograms.
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Keith Humphreys, a public health professor at Stanford University who served as a drug policy adviser to Obama and former President George W. Bush, told Politico earlier this year, “It’s terrific when we develop new treatments for cancer, but it certainly is always better to prevent something than to treat it.”
It’s difficult to determine how much, if any, of the cancer moonshot money will get spent on promoting preventive measures for cancer. The administration announced “agenda items” about prevention, but the only preventive measure taken so far was the Food and Drug Administration’s proposal to ban the sale of menthol cigarettes.