Texas Cancer Research Initiative: Not Immune To Criticism

The cancer research initiative recently passed by the Texas Legislature and awaiting approval by voters was one of the biggest “warm fuzzies” past by the Texas Legislature in many years. However, as with all things, it is subject to some criticism. It was only a matter of time before we saw things like this:

There’s just one problem: A lot of health care experts think the initiative is a bad idea.

“The issue is whether it makes sense for a state to front the money for research whose benefits presumably will be spread around the nation,” said Seth Chandler, a law professor with the University of Houston’s Health Law and Policy Institute. “It’s nice and altruistic, but is it sound fiscal policy? I’m skeptical.”

Chandler is among those who say the initiative promises more than it can deliver, targeting a problem that’s already a national priority when there are other worthy Texas causes, and using a financing mechanism — debt — that will drive the final price tag well above the advertised $3 billion.

Sound fiscal policy? It may be true that it isn’t sound fiscal policy. After all, all research like this can appear to be giant black holes sucking up money. But, it’s the hope of an eventual payoff in terms of an actual cure that can make even the largest of such research black holes well worth it.

But, the possibility of back scratching by the research community is another problem critics of the initiatives cite as a possible problem:

The initiative is modeled on California’s $3 billion stem-cell program. Tied up in legal challenges involving alleged conflicts of interest until a state appeals court upheld it this year, the program recently began awarding its first grants. It was narrowly approved by voters in 2004.

Architects of the Texas initiative tout cancer research’s noncontroversial appeal. The initiative transforms the 22-year-old Texas Cancer Council into the Cancer Research Institute of Texas, which would distribute funding based on competitive grant applications. A panel of scientists would decide on the most deserving applications.

Observers of the California program said Texas’ initiative appears less susceptible to possible conflicts of interest. But they said that still remains a danger because representatives of institutions that receive research funding will have influence in deciding who gets money, even though they won’t vote on the scientific committee.

Again, that may be true. And, as long as Rick Perry is in the governor’s office, this may be a real issue. However, one hopes that everyone’s commitment to finding a cure will result in a conflict-free process.

And, there is the criticism that this simply won’t lead to a cure:

But how much of a difference would Texas’ investment make? Some skeptics say it’s hubris to suggest the initiative could lead to a cure, as the initiative’s literature suggests and as Perry mentioned when he signed the legislation.

Nelson told the Houston Chronicle she wouldn’t have pushed the bill past legislative hurdles if she didn’t think “it would result in cures in the next 10 years, hopefully less.”

But critics note that decades of cancer research show that progress has come in small, incremental steps — rarely dramatic breakthroughs, never cures. Researchers say the realistic goal is to make cancer a chronic, treatable disease, not eradicate it.

Moreover, $300 million a year, though a lot for a single state, represents just a fraction of the disease’s overall research budget — 5.4 percent of the $5.5 billion the National Institutes of Health doles out annually for cancer research. Additional federal funding comes from the Department of Defense and National Science Foundation.

“Texas’ investment sounds like a lot of money — and it’d certainly be welcome in this era of shrinking cancer budgets — but no one should be deluded into thinking it’s going to produce a cure,” said Kirsten Goldberg, editor and publisher of the Cancer Letter, a weekly newsletter about cancer research. “This is a marathon, not a sprint.”

Truly, a state could commit its entire budget to cancer research and it may not result in a cure. But, the fact is that Texas has finally decided to do something, and that it is a substantial sum of money. Whether it leads to small breakthroughs that could lead to a cure or an actual cure, it is necessary.

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