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Moonshot, They Say

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.

47 comments on “Moonshot, They Say”

  1. oldnuke says:

    Amen. You can’t spend your way to solving medical problems. We need a methodical spending program without a lot of wasteful peaks and valleys. Spending ten times more will not “get your there” ten times faster (kind of reminiscent of Frederick Brookes’ Mythical Man-Month”).

    Not to mention that the Veep is totally unqualified to lead anything involving science or medicine.

  2. Ash says:

    The other vacuous comparison is always to the Manhattan Project, another example in which the principal problem to be solved was an engineering problem, not a basic science one.

    1. dstar says:

      No, actually, the Manhattan project is a very good comparison.

      The Manhattan project was a gamble — it was not at all certain that an atomic bomb could be produced in the time needed, or even at all (that an atomic explosive could be made was pretty clear, but the device might not have been small enough to be transported as a bomb, for example, and they were only *mostly* certain that the first detonation wouldn’t result in a chain reaction setting the entire atmosphere on fire).

      People also tend to underestimate the size of the Manhattan project; the total number of people working on it over the entire timeframe was well over half a million — and people weren’t the primary expense.

      That said, I suspect a research effort involving half a million researchers, technicians, etc. would probably make some significant advances… but one of those might be that the problem of something better than we have now is inherently unsolvable except on a cancer-by-cancer (or worse, case-by-case) basis.

  3. JAB says:

    From inside the Institute, I have to agree, but hopefully it can be a slow and steady application of money, not a burst like the stimulus money. If all it does is to increase the R01 pay line to >20% and bolster the intramural program and the Cancer Centers, that would be a good thing. Money has been pretty tight at NCI the last few years so a lot of good ideas, compounds and projects have gone begging.

    Speaking of moon shots, I just visited Kennedy Space Center on vacation and they’ve really done a good job of presenting the history (and future) to the public, compared to the last time I visited in 1998. Expensive ($50) but worth it.

  4. a. nonymaus says:

    If we have to swallow moonshot rhetoric, we should get moonshot funding. According to this report:
    the Apollo program and the Manhattan project each consumed about 0.4 % of the United States GDP during their course. Fundamental scientific problems aside, where is the money going to come from? It would require congress to actually raise taxes or something.

    1. Hap says:

      Or cut something else, which lots of people also don’t want (actually, they do, but they can’t agree on what).

      Moonshot rhetoric sounds too much like the lead-in for another episode of Short Attention Span Theater.

    2. Morten G says:

      From your numbers I get ~$65 billion per year for 4 to 8 years. And NIH budget currently is, what, $30 billion?

  5. simpl says:

    A warning finger like this article is okay, but shouldn’t be allowed to torpedo the concept. The job for Joe Biden will be to string together higher levels of funding for sufficient years, and we have seen many successful examples of single persons dedicating their efforts to an area of medical progress, having lost a family member, so that is credentials enough for me.
    There have been half a dozen breakthroughs in cancer in the last decade. It is one of the stranger phenomena of Pharma research that just when a breakthrough reaches the medics, the lab benches are being cleared for the next big thing.
    However, as we know, the pharma side of cancer treatment is not about fighting one disease, but adapting a range of central cellular functions, And half a dozen steps forward, with good, even synergistic, progress, are really not nearly enough.
    So why not up the funding, and continue in neighbouring areas where the progress hasn’t yet been so spectacular? I take the announcement as a signal of recognition that the wind-down in US cancer research was likely premature.

  6. Don Ciappenelli says:

    Grim Reaper – What we need is a crash program to rid society of these frauds. Perhaps an additional vaccination at the time infants get their DPwP, because surely these clowns are infected with something bad. This would rid the world of people who grow up and become a menace.

  7. z says:

    There’s a difference between upping the funding and establishing a kind of Apollo project for cancer. It’s like the recent increases in funding for NASA compared to a proposed manned mission to Mars (which still seems much more doable than curing cancer – settling on mars/another exoplanet might be closer).

    There technically is a kind of way that a whole lot of money could be used to “cure” cancer, but it won’t be probably what people think or want when they think of curing diseases.

    If we somehow got the safety, ease of use and economics of preforming “routine” cancer detection and treatments, there could be a system that greatly reduces the impact of most cancers.
    There is already research into non-surgical cancer treatments that can be used indiscriminately (heat, freeze, sonar, etc.).
    It is still science fiction to develop these technologies to the point that it can be used as often and easily as brushing your teeth, but much less so than a cure cancer pill or such.

  8. Dave says:

    Do we even have a clue as to what causes cancer yet? The last I checked, there were reported to be a variety of causes. However, one interesting approach involves the violation of the Hayflick Limit:

    Presumably involving Telomerase operating without control? Maybe?

    There’s also been some interesting analysis regarding the HeLa cell line, with regards to genes being transferred from a virus, and a possible alteration in the number of chromosomes!


  9. Magrinho says:

    Not to mention that is impossible to fake curing cancer.

    Sorry, I had to say it.

    At least it’s Friday.

  10. Anon says:

    Just think: If the project succeeds and we get a miracle cure for cancer, ten years down the line we’ll have millions more pensioners producing nothing in retirement, taking more social security benefits, requiring more healthcare, and dying from more costly diseases like AD.

  11. SteveM says:

    The subtext of this latest nascent boondoggle out of Washington is how stupid and clueless those idiots in DC actually are. Biden is a genuine dope and Obama is a nitwit mediocrity masquerading as a pathological narcissist.

    BTW, I was in Union Station in DC years ago waiting for a train. The station was quiet, almost serene. And then the quietude was shattered by the booming voice of a Beltway Vulgarian – “Tell those f***heads to …!” It was Joe Biden with his coterie of lackeys arriving from Delaware.

    1. oldnuke says:

      There are some people in Delaware who are going to be very happy when Biden is out of office. Every time he comes to town, traffic is even more fouled up than usual. You should see all of the drama at the airport in Wilmington.

  12. milkshake says:

    If they want to speed up cancer cures, they should reform FDA, and give it money to hire more qualified people who would review the backlog of applications. They also need more people to ensure good manufacturing practices with makers of essential generic medicines. (Not just in South Asia).

    Reforming a good part of US patent law is also overdue.

    1. Phil says:

      “If they want to speed up cancer cures, they should reform FDA, and give it money to hire more qualified people who would review the backlog of applications.”

      I’ll emphasize reform first, give money later. Paying people more doesn’t make them better at their jobs. It’s going to take some housecleaning.

      This also goes for the backlog of generic applications Derek mentioned in another recent post (for which comments seem to be disabled?).

      1. Vader says:

        Paying people more only makes them do a better job if it improves their morale. This can happen, but I don’t think it’s common.

        On the other hand, paying people more means you can probably hire better people in the future. This assumes you have positions to fill and there are better people out there to hire. And the effect takes quite a while to kick in — probably considerably longer than the 2-year horizon that seems to be in effect in American politics, since this is the basic election cycle.

    2. Emjeff says:

      So…,we should reward government failure with more funds? Leaving aside the question of where we would get those funds when the country is running a trillion dollar deficit, why should we hand over funds to people who have demonstrated that they can’t get the job done? Anyone asked for an end of phase 2 meeting lately? Meetings are being held now for requests made in September, considerably over the PDUFA timelines. Great values for our user fees.

      1. zero says:

        How do you propose that the agency should reform itself while simultaneously reducing the backlog without making mistakes that will kill people and without spending any more money than they already do?
        It’s fine to be angry about a situation like this but an understaffed, underfunded agency that is not currently able to keep up with their obligations simply does not have the resources to do what you want them to do. It costs money to retrain people, to change policies, to ensure safety.
        Spending money on a problem like this is not rewarding a failing agency, it is spending the money necessary to turn the agency around. If they were a private company I would agree, we should not give them any cash and should instead look to select a new company as a supplier or contractor. The FDA is not a private company. We cannot fire them. They are obligated by the law to do what they do.
        Our options are to do nothing or spend more money to improve things. If you are so concerned about the deficit then ask yourself why we spend so much money on unnecessary military hardware, even on programs the Pentagon itself no longer wants?

  13. watcher says:

    To me, giving more money directly to NIH is largely a waste of money, time, effort. The money and resources needs to be put where it can do the most good, and that is not necessarily NIH. Funding pharmaceutical companies and biotechs that are actually working on new drugs would be better used of the money. Extra money to FDA for more expeditious review and greater help to the sponsoring groups would be useful. Money to fund studies to evaluate side effects and outcomes in real life, not just limited phase 2 and/or 3 studies is greatly needed. Funding to support faster, greater access to proper medically trained people, including the training of more oncology, hematology, radiation physicians in centers who work seamlessly, along with support groups for patients (nurses, nutritionists, people knowledgeable enough to answer questions (who don’t have to have MDs) are essential areas that would make one’s existence when undergoing treatment much easier. Finally, more support for rare types that today get no attention due to the limited patient populations is greatly needed.

    1. The Observer says:

      Watcher – Pharma already gets lots of money – they are called tax breaks. Speeding up FDA approval rates is great, but it doesn’t make the drugs better. Understanding cancer biology through extramural grants has led to some great target ID successes. Having trouble thinking of a Pharma-led target ID success (except when the academics transitioned their discovery to pharma, like Agios). NIH funding would go a long way to support the rare and neglected component of disease states.

  14. Brett says:

    You’d think that “gradually escalating funding” would be a political winner for a candidate for office. They could say, “We grew the [insert agency] budget by X amounts, meaning more treatments for you, etc”. But instead it seems to be subject to the same issue that infrastructure maintenance has in the US, where politicians love cutting ribbons and building new stuff but don’t care nearly as much for actually maintaining what they have.

    1. Hap says:

      It’s that way lots of places, I think – foreign aid/government spending elsewhere focused on new infrastructure with little thought to future maintenance because maintenance is unattractive to donors (and maybe they didn’t trust that money without an easily verified endpoint would end up where the recipients said it would).

      1. Phil says:

        “It’s that way lots of places” – including corporate America. Seen the same thing happen, unveil some new strategy and make lots of lofty promises to the board, next year never bother to look back at what worked and keep funding it. No, that was last year’s strategy, now we need to throw money at this new thing!

        1. tally ho says:

          really good point. there’s plenty BST (bright shiny things) disease in both the private and public sectors to go around. management/leadership tends to be most afflicted by BST, particularly as you get closer to the top. perhaps BST-susceptible genes well be decoded by another moonshot (e.g. ENCODE) and by that time CRISPR will be used to inoculate BST junkies (e.g. government and corporate leadership) from BST disease. however, human behavioral evolution has a long ways to go…

  15. Virgil says:

    I prefer the Winston Churchill-esque explanation… Cancer is a mystery wrapped up in an enigma, wrapped in dogshit

    1. SteveM says:


  16. Argon says:

    Let’s set up some academic HTS centers again. That all worked out well if you like to throw money away.

  17. SteveM says:

    I’ve lived in DC for a long time – too long actually. The intrinsically flawed thinking that is baked into the sclerotic, rancid system down here is a refusal to acknowledge the positive probability that a policy won’t work and also be oblivious to the law of unintended consequences.

    You see that now with Obamacare. I.e., crummy plans with outta sight deductibles that provide the poor sap policy holders with access to health insurance but not health care because they can’t afford the first dollar expenses.

    And of course the “nation building” fiascoes in the dystopian Islamic sandbox that flushed 2 TRILLION+ of American Green down the toilet.

    Obama and Gas-Bag Joe Biden are just more of the same. Toss out a bunch of contrived “war against” somethings and hope one of them sticks to rescue a busted presidency.

    Moreover, those guys are also oblivious to the fact that there are only a limited number of good ideas out there. And flooding the cancer R&D ecosystem with money will mean funding a lot of marginal ideas. When some of that money could have been better spent somewhere else.

    I’m not saying increased anti-cancer funding intelligently applied would not be useful. Just that intelligently applying anything by those nitwits is an oxymoron.

  18. Gene says:

    Cure cancer? Which cancer? What constitutes a cure?

    Every. Cancer. Is. Different. When my wife had her thyroid removed, she had three different tumors of three different types. If it had been anything other than thyroid, treatment for each type of cancer would have been different. As it was, a shot of I-131, four days of isolation, and she’s been cancer-free (NOT cured) for 4 years.

    How about we just come up with cancer treatment that doesn’t turn the patient into a hairless, barfing invalid?

    1. GrouseMan says:

      The biggest disservice to cancer patients was the continuous pharmaceutical industry upheaval that has occurred starting with Pfizer’s take over of Warner-Lambert 15 years ago. As a result the whole industry started to follow suit, and put all pharma research in jeopardy. Because of the uncertainty scientists experienced while this was taking place, R&D productivity I believe went south, and policy’s shelved a lot of things that more recently been taken off the shelf dusted off and looked at with fresh eyes perhaps. Likely reinventing something that they probably don’t even realize they had in the first place because of the way the organizations, an mergers dealt with their R&D Knowledge. They lost a tremendous amount of it when they let people, go and when people left because of management policies, one of which is the ever present, wasn’t invented here bias against ideas coming from the taken over company.

      I spent many years doing anticancer drug discovery. After a take over, that unit was shut down, and nearly no one involved in that effort offered a position in the smaller anticancer effort at another site. Years later stuff shelved because of this consolidation and not invented here attitude was dusted off because nothing else was being discovered or was far enough along. But by then the real knowledge surrounding these drug candidates, had to be rediscovered, because those holding this knowledge had moved on. I could not continue in Anticancer drug discovery, because I did not want to continue in the upheaval that I saw and knew to be likely to continue. My wife had a tremendously good job, in an industry, that was small, and jobs few in her specialty. I could not ask her to start over half way across country. So I had to find something else.

      Well 8 years later, my wife was diagnosed with terminal cancer. Am I angry hell yes! I have to now wonder, had the whole industry not gone merger insane, could we have had better treatments for her? I think yes. Certainly at least one of the checkpoint inhibitors would have been much further along now than it is currently. For terminal cancer patients its all about time and keeping things stable, while having a good quality of life until the next new potential cure comes along. Most don’t make it that far. The current treatments are not pleasant. But indiscriminately throwing money at the problem will only result in people sponging off the government tit. I guarantee most of the money will go to pie in the sky, proposals promoted by well meaning con artists trying to fund their business, instead of to established researchers, that need to fund well designed clinical trials. Something that is often even difficult for establish big Pharm to do well. Lots of clinical trials are done on a shoestring and many poorly designed.

      There are no engineering solutions here. As Derek said, compared to the moon shot, and Manhattan Project, this is like a Toddler trying to do string theory calculations to unify gravity into the standard model.



    2. Brett says:

      To me, a “cure” for cancer would be something like a vaccine that greatly blunts tumor formation in general – like if we somehow found out how to give humans the cancer-resistance that naked mole rats have.

      What I’m realistically hoping for is a broad set of extremely effective treatments linked to a very good system of identifying what type of tumors need what types of treatments. You’d then take a “cocktail” of treatments that hits your cancer and drives it into remission for more or less indefinite periods of time (i.e. until you die of something else). As you said, cancer is such a diverse set of diseases (and diverse set of tumors within the same disease) that a single “cure” is totally ridiculous – it’s going to be a mix of treatments, just like how we don’t have a cure for “The Virus” in the form of a magic antiviral drug.

  19. anon says:

    Wouldn’t perfected CRISPR be sufficient for a cure for cancer?
    There are likely an overwhelming number of genetic changes that would have
    curative results in cancer.

    Furthermore, very effective anti-cancer drugs have already been developed (Consider BRAF drugs in melanoama), though resistance soon develops. With CRISPR wouldn’t it be possible to CRISPR the cancer cells back to their pre-resistance genotype? This would give the pharmas a product that they could sell to patients over a greatly extended time horizon (= more profit).

    1. Dave says:

      I was just reading about the Philadelphia Chromosome over the weekend, and it’s propensity to cause Leukemia:

      There have been some treatments developed for this, although not really a cure.


  20. matt says:

    I agree with the “let’s not do this again” sentiment, and especially with the identification of the fuzziness of the goal, the lack of a deadline, and the near certainty of half-hearted dedication (or less) to the idea.

    Let’s look again at the speech where Kennedy first introduced his goal, and key paragraphs about commitment that have not been repeated by the many subsequent “Moon Shot Cargo Cult” imitators:

    “Let it be clear-and this is a judgment which the Members of the Congress must finally make-let it be clear that I am asking the Congress and the country to accept a firm commitment to a new course of action, a course which will last for many years and carry very heavy costs: 531 million dollars in fiscal ’62-an estimated seven to nine billion dollars additional over the next five years. If we are to go only half way, or reduce our sights in the face of difficulty, in my judgment it would be better not to go at all.

    “I believe we should go to the moon. But I think every citizen of this country as well as the Members of the Congress should consider the matter carefully in making their judgment, to which we have given attention over many weeks and months, because it is a heavy burden, and there is no sense in agreeing or desiring that the United States take an affirmative position in outer space, unless we are prepared to do the work and bear the burdens to make it successful. If we are not, we should decide today and this year.”

    Kennedy’s goal of landing on the moon would have been just as unsuccessful, even though it was specified with laser precision in the way “curing cancer” is not, if the US funded it as lackadaisically and as short in duration as the President’s little one- or two- year funding push. These are intertwined, though: a laser-precise goal, with a relatively fixed deadline, allows and encourages greater expenditure of effort, because you can measure progress and get excited, and you can see the deadline approaching and know that greater exertion can be applied because its duration will be short.

    The flip side to that is after the deadline, after the goal is reached (or failed), funding and effort must inevitably decline. That WILL mean students and researchers unable to find work or funding in the field, and will produce disappointment and disillusionment, just as certainly as layoffs at any company do. And oh, the squealing like a stuck pig that results when an academic community feels like it is being shortchanged in funding!

  21. steve says:

    There are several cancers that have been curable for quite some time now. Not all cancer is a death sentence. The idea of putting together a concentrated effort is not ridiculous especially with the advances that have recently being made in immunotherapy. We have a new understanding of the malignant process, how immunoediting works, how to activate suppressed responses through checkpoint inhibitors and other modalities and how to reverse immunosuppression caused by tumor recruitment of Tregs, expression of IDO, etc. The idea that harnessing these new technologies in a concerted could result in cures for a number of cancers is not far-fetched nor is the idea that they could be developed faster with a coordinated effort and more money. I have a feeling that many of those who are so opposed to it are irrationally opposed to anything Obama might suggest, as we’ve seen over and over these past 8 years. Can’t we even find it in ourselves to try and come together for the fight against cancer?

    1. Anon Immuno/Micro says:

      As has been said now a few time both the space and atomic bomb programs represented a mix of new science and, mostly, optimized/scaled-up engineering. I wonder if anyone closer to the medical side of things can comment on the scalability of personalized immunotherapies? It seems like harnessing a persons own immune system would provide a potential treatment to a variety of cancers so long as they are not in a privileged organ/system. If this is the case then it really would be more of an engineering challenge to produce a moderately expensive kit (like a super Qiagen kit) for sampling tumor, extracting lymphocytes, raising tumor-active clones, and re-introduction into the patient. This is obviously a simplification, but this line of attack would seem more amenable to a moonshot style of funding.

  22. TMS says:

    The documentary series “Emperor of All Maladies” has a nice montage of all of the previous “wars” on cancer in one of the early episodes complete with video/news reports of their announcements. Worth checking out on Netflix.

  23. Mark Thorson says:

    We had a War On Cancer in the Nixon Administration, and where did it get us? We haven’t had a War On Alzheimer’s Disease yet, and Hillary Clinton has a plan that will get us a cure by 2025!

    I mean, like, you wouldn’t lie about something important like that, right? It would really be a big betrayl to promise something like that if you couldn’t deliver.

  24. Steve says:

    Pretty silly comment. The war on cancer that was initiated by Nixon was at a time when there was new information on the pathogenesis. It was thought that treating a few oncogenes would cure the disease. It took a lot of time and money to understand that cancer is usually caused by a multitude of genes (though there are cancers with single gene drivers like bcr/abl that can be treated with Gleevec) and involves many different clones that mutate at high frequency. Now it’s thought that the only way to eliminate that kind of complexity is with an equally complex modality like immunotherapy, which is getting cures in cancers that have failed all other treatments. It might be wrong but I’d rather put the money into that than fund another aircraft carrier. I’d also support putting more money into Alzheimer’s research if we had a similar breakthrough treatment modality.

  25. Dr. Manhattan says:

    Joe has the answer already; in this Saturday’s Boston Globe:
    “Biden says politics impeding cancer cure”
    “Vice President Joe Biden launched a ‘‘moonshot’’ initiative Friday to hasten a cure for cancer, aiming to use his final year in office to break down barriers in the medical world he says are holding back progress on eradicating the dreaded disease.”

    WOW, It’s the politics! To a hammer, everything looks like a nail.

  26. Andre says:

    If you want to get a flavour of what the “moonshot” initiative is all about then you need to watch the podcast of yesterday’s session at the World Economic Forum in Davos (Switzerland), which was chaired by Joe Biden. Here is the link:

    There were ten persons (Francis S. Collins, Sylvia Mathews Burwell, Jennifer Doudna, Paula T. Hammond, Elizabeth Blackburn, David B. Agus, Charles Sawyers, José Baselga, Delos M. (Toby) Cosgrove, Bill McDermott) on the panel. Since Joe Biden spoke most of the time starting with a 20 minute introduction…. After introducing the members of the panel, there was not much time left to discuss anything of substance. For example, Jennifer Doudna spoke for a total of 3 minutes…

    What a waste of everyones time! The whole exercise probably costed the US and Swiss Taxpayers a couple of million dollars for security, planes, helicopters and the entire entourage of staff that was accompanying the Vice President.

  27. Anu says:

    A moonshot does not cure cancer. There are many factors that we don’t know about the initiation of cancer. Many of the illness like diabetes, many kinds of viral diseases are completely curable because we are targeting the cause of these diseases. Like this, cancer can be completely curable only if we completely understand its cause and target that. None of the anti-cancer drugs in market are not doing this job and cancer still exist as incurable. To understand the real cause of cancer will take long time and dedicated research. A large lump of money for a short period is not enough for this. Stable funding and dedicated labs should be our priority to cure cancer. Many of the novel ideas and findings are not being studied these days and one reason is the low pay lines for investigator initiated research, Increasing NIH paylines for R01s and funding good grants in a long run will find a cure for cancer.

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