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Dr. Laurie Glimcher, President and CEO of the Dana-Farber Cancer Institute, told the Boston Chamber of Commerce on Friday that for cancer care, "It truly is the best of times and the worst of times." Research and treatment have been advancing rapidly, she said, but the political climate "threatens to send us backwards," if the Affordable Care Act is undermined and proposed cuts to the federal budget for biomedical research go through.
An excerpt from her remarks as prepared:
For me, personally, this has been a roller-coaster ride.
I was honored to be a member of the blue ribbon panel convened by Vice President Joe Biden to shape his “Cancer Moonshoot.” In December of 2016, I was present when President Obama signed into law the 21st Century Cures Act, which included $1.8 billion in new dollars over seven years for cancer research and care.
However, a few short months later, the Trump Administration released a “skinny budget” that cuts funding to the National Institutes of Health, which is the agency that distributes most federal support for biomedical research in the United States, by more than 18%. And it is unclear how the Moonshot dollars, intended to be additive, fit into the picture.
This more-than-decimation of the NIH budget has to be put into context. Over the last ten years, NIH funding had already dropped by more than 13% in constant dollars — a source of great frustration to many physician-scientists, given the incredible potential we see before us in immunotherapy, in genome editing, in more efficient sequencing, in our ability to find insights within massive amounts of disparate data.
Now, to cut NIH funding almost 20% beyond that.... Since much of the NIH budget is devoted to ongoing grants, it is possible that the NIH may not be able to fund any new work at all in 2018.
Meanwhile, other countries — particularly China and South Korea — have been increasing their investments in biomedical R&D at a scorching pace, and the resulting generation of intellectual property. President Trump says it’s a bad thing that so many of the things we use are now made in China. Imagine how much worse it would be if they also were invented there.
As we consider moonshots, it is worth pointing out that at the height of the Space Race in the mid-1960s, the United States spent more than three times as much on R&D as a percentage of the federal budget as we do today. That spending funded discoveries that led to commercial lasers, the Internet, GPS, the cell phone, the entire biotechnology industry, and a host of medical advances, including the ones I’ve been talking about.
Now, with the stroke of a pen, our innovation engine may grind to a halt.
Even setting aside the lives that could be saved, the foolishness of this is extreme, just in terms of cost-benefits. For example, caring for people with Alzheimer’s, and other dementias, costs the United States over $200 billion per year, much of that paid for by Medicare and Medicaid. Because of the growth and aging of our population, the bill for Alzheimer’s is expected to rise to more than $1.1 trillion in 2050 —and we cannot even treat these patients, because we have not yet discovered an effective treatment.
If we could find a treatment that would merely delay the onset of Alzheimer’s by five years, we could save $220 billion within the first five years — seven times the $32 billion we spent on the NIH in 2016.
Cancer prevalence also rises with aging, and cancer costs are projected to reach $158 billion a year in 2020. Again, if we can turn this into an easily manageable disease, the nation would come out way ahead.
Before I end, I want to consider what this new political climate means for us in the Greater Boston area.
With the world’s greatest ecosystem in biomedicine, we have a lot to lose. Five of the ten largest private employers here are teaching hospitals — and three more are research universities. As you would expect, Greater Boston receives more NIH funding than any other city in the country. The nearly half a billion dollars in Massachusetts NIH grants likely to vanish under the Trump budget are a serious concern for our innovation-based economy.
At Dana-Farber alone, we could lose $23 million in the first year. Here is what really keeps us awake at night: the reality that declining federal support for biomedical research is discouraging the next generation of young scientific talent, who are not able to get funding for their projects.
This loss of intellectual capital is going to hurt Boston-based businesses as well. NIH-funded research centers like Dana-Farber are an essential training ground for young physician-scientists, many of whom go on to build careers at pharmaceutical or medical device companies, or who launch new companies of their own.
These early-stage businesses also rely on NIH grants in order to research and develop promising new biotechnologies and survive the valleys of death that could keep important treatments from reaching the market.
This is fuel for the vibrant life sciences startup community in Boston and Cambridge, which adds vitality to every other sector represented in this room — restaurants, hotels, real estate, financial services, software, retailing.
We face another threat as well: California. There is a cautionary tale in the way that Route 128 lost its dominance to Silicon Valley in information technology in the 1980s.
Silicon Valley clearly benefitted from more powerful social networks and a more freewheeling exchange of information. And now, our friends on the West Coast are coming for our crown in biomedicine: In 2004, California voters strongly supported a ballot initiative that created the California Institute for Regenerative Medicine and provided $3 billion for stem cell research.
And the enormous wealth generated in technology means that many California universities and medical centers are awash in philanthropic support for research—including major health care initiatives, like one recently launched by Facebook CEO Mark Zuckerberg and his wife Priscilla Chan.
In Boston, we are used to being the best. But we cannot be complacent. We need to push forward on everything from digital health care to STEM education. We need to rally all sectors of our regional economy, including both philanthropy and government, to maintain our intellectual leadership.
And we need to join forces, rather than to engage in cutthroat competition, given the degree to which we all gain strength from the biomedical cluster we have created here.
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