We’re Putting Man on the Moon Again: Why Don’t You Know About it?
“Last year, Jill and I re-ignited the Cancer Moonshot that President Obama asked me to lead in our administration,” President Biden said at the 2023 State of the Union. “Our goal is to cut the cancer death rate by at least 50% over the next 25 years.”
This ambitious goal is a reference to the Biden administration’s Cancer Moonshot. The project is under the management of the National Institutes of Health’s (NIH) National Cancer Institute and aims to accelerate the development of cancer treatments.
The good-faith intentions of this project should not be doubted. President Biden’s son Beau died of brain cancer in 2015, and after he left the Vice Presidency, Biden launched a private, albeit short-lived, cancer research philanthropy. Still, a central question remains: the president of the United States is trying to cure cancer, yet you probably haven’t heard about it. Why?
Clinical Trials: A Possible Catalyst?
Public awareness is not just critical to mobilize efforts around cancer prevention, inequity, and advocacy. It is also crucial for the development of cancer treatments, which are often discovered through clinical trials. Studies have shown that fewer than 5% of U.S. cancer patients participate in clinical trials despite the fact that over 70% of the same patients are either inclined or very willing to participate in the trials. By testing innovative therapies, these trials have the potential to both save participants’ lives and expedite official approvals of new cancer treatments that can help thousands more patients battle the disease.
Raising public awareness of the availability of clinical trials, through direct recruitment and media engagement, have proven effective. As Cancer Moonshot called for further research on clinical trial networks through the 21st Century Cares Act five years ago, the project presents ample opportunity to both increase patient participation in clinical trials and reimagine their delivery. In the post-pandemic world, experts have suggested that clinical trials can be transformed to optimize patient experience through remote consent, monitoring, and ready-to-ship therapies patients can take from their own homes.
Cancer Moonshot could help mobilize the public and the government toward what President Biden has called a “truly American moment that rallies the country and the world together and proves that we can do big things.” The project’s progress and potential deserve more attention. But one major roadblock might be standing in the way of raising awareness about Cancer Moonshot: funding.
Cost of the Cure
Progress on Cancer Moonshot has stalled since then-Vice President Biden unveiled the project in 2016, and the project was effectively sidelined in the waning days of the Obama Administration. Meanwhile, only $400 million in funding remains available over the next year from Congress’s original $1.8 billion budget; no proposal for additional funding is currently on the House floor.
The funding gap remains one of the scientific community’s principal concerns. Presently, Cancer Moonshot supports over 70 programs and more than 250 research projects housed at the NIH. Without additional financial support, many of the administration’s cutting-edge efforts, such as the Cancer Moonshot Biobank—a key effort in centralizing relevant genetic data and expanding the scope of research collaborations—may be canceled before they can deliver meaningful results for scientists.
“We don’t want to see reallocation of existing dollars at NIH to pay for this initiative,” Jon Retzlaff, Chief Policy Officer of the American Association for Cancer Research, told Science in 2016.
Today, the sentiment remains the same. Scientists have suggested a “scaled-up, redoubled, and accelerated” approach to Cancer Moonshot that has the potential to deliver on the project’s stated goals. President Biden has continued to urge Congress to reauthorize the 1971 National Cancer Act, which established the National Cancer Institute and would “lock in” further funding. But this approach is still pending on the legislative side.
Organization and Outreach
Cancer Moonshot’s 2022 reboot aims to incorporate the perspectives of all stakeholders, from bureaucrats to patients.
On the administrative side, Cancer Moonshot has called for improvements on inter-government cooperation through a ‘Cancer Cabinet’ spearheaded by recently-appointed project coordinator Dr. Danielle Carnival. The ‘Cancer Cabinet’ aims to improve interagency cooperation between representatives, taking a “whole-of-government process” touted from President Biden’s personal commitment down to the grassroots.
Interagency cooperation not only fast-tracks cooperative efforts and cuts administrative red tape, but also allows the 2022 Moonshot reboot to expand its scope beyond scientific research. As a White House fact sheet explained, beyond “ending cancer as we know it,” Cancer Moonshot seeks to improve services for cancer-afflicted patients and families, detect diseases faster, and address health inequities present at the core of cancer treatment. As Dr. Carnival told POLITICO in February, “We’re going to have to reach more people with the tools we already have and those we develop along the way. The purview is much broader than research.”
The broadened scope on interagency involvement and comprehensive cancer care has achieved promising results in its early stages––expanding both the administration’s reach to contend with challenges associated with cancer and its efficacy in treating the disease itself.
In September, the Department of Health and Human Services announced that it would expand partnerships with 11 community health centers nationwide to provide underserved populations with cancer screening and early detection services in support of Cancer Moonshot’s goals. In February 2023, the Environmental Protection Agency, with funding from the Inflation Reduction Act, accelerated plans to clean up hazardous landfills, mines, and other infrastructure, protecting Americans from further cancer risk. The Department of Veterans Affairs’ PACT Act has enlarged the suite of medical services available to veterans previously exposed to toxic substances, including streamlining cancer benefits claims. Most recently, the Department of Energy shared its progress in mobilizing its own resources to improve drug manufacturing and developing therapies to treat rare cancers.
Outside of these measures, President Biden has declared that improving academic research sharing is a further goal of Cancer Moonshot. Through the Office of Science and Technology Policy, Biden has called for academic journals to immediately provide public access for public-funded research programs by 2026. In an attempt to expedite this policy, under the guidance of the National Cancer Institute, Cancer Moonshot has mandated that all of its grantees submit plans to make their research public as soon as possible.
These initiatives, among many others, have been highlighted by Dr. Carnival herself as critical components of the Biden Administration’s commitment to addressing cancer at a variety of levels and through complementary methods––attempting to enact cultural change within community health, bureaucratic practice, and even academia. As Carnival said of Cancer Moonshot’s comprehensive working scope this February, “we are just getting started.”
Spreading the Word
The most critical challenge Cancer Moonshot faces is a lack of public awareness. The project was mentioned in 2016, 2022, and 2023 State of the Union Addresses (and this year, President Biden spent more time speaking about cancer than China), but its significance to Biden has been largely underreported.
Over 10 national and international outlets covered the speech from the angle of fraying U.S.-China relations, while fewer than five even substantively mentioned Cancer Moonshot as a part of President Biden’s “Unity Agenda.” As these stories continually emphasize external threats to America rather than how we can solve issues at home, Cancer Moonshot’s message is drowned out by other domestic priorities and geopolitical tensions.
Due in part to the gap in the program during the Trump years, the White House has encountered challenges in sustaining the would-be bipartisan message that eliminating cancer is a national priority. In the meantime, other issues have arguably surpassed cancer research within public health discourse, including the opioid crisis, the human costs of climate change, and new medicare provisions embedded in the Inflation Reduction Act. In the process, an issue that could be highly bipartisan—popular with the 1.8 million Americans who are affected by cancer every year—has instead gone largely unnoticed.
Still, the White House has not given up on making its call to action heard. The Biden Administration has reminded the public of Cancer Moonshot through seasonal messaging during National Colorectal Cancer Awareness Month and provides updates on the initiative’s progress. Additionally, First Lady Jill Biden has delivered remarks at national forums like the American Cancer Society and traveled to various research centers nationwide to spread the word.
A Limitless Future
Cancer Moonshot has the potential to change thousands of lives. It has the potential to be a forum to address health inequality and an incubator for cutting-edge research; it could be a centerpiece of community engagement and a catalyst for American industrial renewal. The project could reignite an American “national purpose,” paving the way for the U.S. to one day work internationally on comprehensive cancer care.
In his February 2022 speech reigniting Cancer Moonshot, President Biden said, “I promise you we can do this. For all those we lost, for all those we miss, we can end cancer as we know it.” If Americans can rally around Cancer Moonshot, the proper funding, resources, and implementation may just follow to make this goal a reality.