Budget Proposal Highlights Progress and Opportunities in Cancer Research

Last week NCI released The Nation's Investment in Cancer Research, an annual report intended to directly inform the President about the progress and opportunities in our continuing efforts against cancer and to justify the administration’s budget request to Congress for an additional $2.1 billion to fund the Nation’s battle against cancer.

At a time of great economic challenge, the report, which is often referred to as the “bypass budget,” demonstrates how NCI’s deep commitment to outstanding science benefits all Americans. As the 2010 report shows, cancer is a model for studying the biology of all diseases. It can also inform our thinking about the delivery of health care, the development of electronic medical records, and a health care system based on the uniqueness of each individual that employs a new generation of targeted therapies.

The Nation's Investment offers NCI’s professional judgment on strategic programs that could hasten our research progress against cancer while also bringing new therapies, earlier detection, and better methods of preventing cancer to all people.

There is much work to be done. The burden of cancer is rising around the world, and by the year 2010, cancer is expected to replace heart disease as the number-one killer. The Nation's Investment aims to be realistic while also showing how additional investments could be used optimally in the future.

For fiscal year (FY) 2010, NCI’s proposed budget to sustain our current level of activities is approximately $5.1 billion, while the proposal to accelerate progress is an additional $2.1 billion. By comparison, NCI’s FY 2008 budget was approximately $4.8 billion. Though we have operated with what has essentially been a flat budget for the last 5 years, we have actually experienced a significant budgetary decline due to biomedical inflation. When you account for this inflation over the last 10 years, our 2008 appropriation actually represented a purchasing power equivalent to $3.5 billion.

This lost purchasing power has had serious consequences for the cancer research community and, by extension, our patients who carry this burden. In particular, we are deeply concerned about how these changes will affect the next generation of scientists, who are critical for maintaining our nation’s position as a global leader in science, and whose important work is an integral part of our economy.

Were it to receive additional funding, NCI’s first job would be to help increase America’s research capacity by funding scientists, fostering the next generation of researchers, and supporting the development of technology and infrastructure. The report also details how NCI strives to put its science to work for patients, such as our expanding drug discovery platform.

In an era when research is unearthing seemingly unlimited molecular targets and causal pathways in cancer, we must make sound decisions about which ones to pursue and then move agents that target them efficiently into development. NCI is already focusing on ways to enhance the entry of early stage drug candidates into the therapeutics pipeline.

Without question, while there are many needs for increased investment, I believe the greatest is the need for new infrastructure that can optimize translational research in this era when disease and patients are being matched with solutions of highly specific agents.

The Nation’s Investment is an excellent resource for identifying NCI’s priorities and getting a glimpse of the important work on the horizon. But even as we focus on budgets and resources for current and soon-to-be-launched projects, we have to ponder the longer term and investigate possible new directions and avenues for progress.

With this in mind, last month NCI’s Executive Committee convened a group of renowned scientists, some of whom represented disciplines that have not traditionally studied cancer, to consider NCI’s future directions. The meeting, “Conversations about the Future of Cancer Research,” produced many provocative discussions, ranging from how cellular architecture may influence cancer risk to the role of bioenergetics and environmental stress on tumor development. Among the ideas discussed at the meeting, there was a consensus that the tumor microenvironment warrants additional attention.

It was gratifying to witness the prolific exchange of scientific ideas. In fact, several participants said they had discovered new perspectives on their life’s work.

At a time when fresh thinking is in demand, this couldn’t have been a better meeting. We are all energized. Both the retreat and The Nation’s Investment demonstrate NCI’s best efforts to generate the new ideas needed to continue our momentum in understanding cancer and translating the science into better care for patients.

Dr. John E. Niederhuber
Director, National Cancer Institute