Several people have asked me what I think about the cancer “moonshot” to be led by Joe Biden, as announced in the recent State of the Union. I can’t do better than echo Jonathan Gitlin here: spare me the damned moon shots. This is not the sort of problem that’s likely to be vulnerable to a sudden infusion of cash, and there’s a real chance that funding things that way will, in the end, just make things slightly worse. I know that it’s just not in the nature of science (academic science, especially) to turn down funding, and no doubt there will be people lining up for the money. But that doesn’t make it a good idea. Gitlin’s been through it before:
Unfortunately, this isn’t the first or even second time we’ve had a poorly defined science project dropped on us by the current, well-meaning occupant of the White House. In 2013, we got the BRAIN Initiative. Last year it was the Personalized Medicine Initiative.
In both cases, the pattern was flashy announcement first, followed by a year or more of meetings, workshops, and conference calls where researchers and policy makers had to sit down and work out what the actual scientific questions were supposed to be and what could they actually accomplish with the amounts of money on offer (which in both cases I’d argue were inadequate for the problem at hand).
In my final year at NIH, I saw all the consequences all too well. Colleagues lost weeks of time to planning meetings at a time when we were already understaffed for the day-to-day challenge of keeping the wheels on the science bus. All the while, funding rates for NIH grants dropped into the single digits, and labs closed up shop as scientists gave up on their dreams and went to work in more stable careers.
Exactly. This is the sort of flashy political initiative that members of both parties are prone to – and at the higher levels, I’ve no doubt that they think that this is going to do some good and might be just what’s needed. It isn’t. It signals virtue, and compassion, and seriousness, and all sorts of things that public figures very much like to display, but biological problems don’t care much about how good your intentions are or how nice things sound in a speech.
An even bigger problem, one that’s been with us for a long time now, is that the whole “moonshot” idea is a terrible one. As gets pointed out every single time this comes up, although to no avail, going to the moon was easier. It was a tremendous engineering feat, especially under the time constraints, but the basic principles were well known. Trying to cure cancer in this way would be like trying to go to the moon without really knowing how rocket engines actually work, without being quite sure if Newton’s laws of motion would hold up, and with some real uncertainty in the position of the moon. It can be hard to explain this to people who haven’t done such research, and it’s probably impossible to explain it without sounding like you’re engaging in special pleading and making excuses. But it’s true.
I mean, during the Apollo program you could say exactly where the moon would be relative to the spacecraft, and given that spacecraft’s weight and engine performance, you could calculate exactly what you needed to do to have the two intercept. How much fuel to burn to leave Earth orbit, and for how long, how much to burn to enter lunar orbit in turn, and you could set it all up so that you’d be passing right over the designated landing area at exactly the time predicted. Try that in biology: can we look at a person and say whether or not they’ll get cancer, or what kind? We cannot. Can we do that on the level of an individual organ? Nope. How about an individual cell in a dish – can we say if it’ll turn cancerous? Sorry. There are just far too many factors at work, many of which depend on each other, and many of which we’re not even clear about yet. Forget going to the moon – you wouldn’t want to jump off a chair if our knowledge of physics was as inexact as our knowledge of human biology.
Gitlin’s right: we don’t need another big, flashy initiative, no matter how nice it sounds. We need steady, sustained work in this area, which means steady funding, and not yanking people around to serve on committees to see how to get some of the fast cash, which will disappear, anyway.