Up on the Hill

Up on the Hill

George W. Sledge, MD, FASCO

May 13, 2011
In a previous blog, I discussed “Hill Day,” the annual pilgrimage that your ASCO volunteers make to our nation's Capitol in support of federal cancer research funds. Hill Day was yesterday (May 11) and was followed in short order by today's Government Relations Committee at ASCO headquarters. I am now headed home to my wife and patients.

Hill Day is a mixture of the exhilarating and the exhausting, of the encouraging and the depressing. With our colleagues from sister organizations, we visited the offices of both Democrats and Republicans in both the House and the Senate.

What did we hear? On both sides of the aisle there is a commitment to continue to support the National Institutes of Health, and the NCI as one of its principle components. In the recent budget round, the NCI took a hit, though not a large one given the tough economic times and the prevailing concerns regarding the rapidly escalating federal debt. In the offices I visited, I had no sense that the NCI was viewed with anything other than respect by our lawmakers. The NIH as a whole, in addition to its role as a mediator of improved health, is viewed as an engine for job growth in the United States.

So far so good. But we also heard that there is little likelihood for an increase in federal research funding in the near future (“maybe for the next decade” we were told in the office of a senior leader). Our friends on the Hill say that the best we can expect is flat-line funding. They consider this something of a victory. But flat funding, adjusted for inflation, is actually a real decline in resources, with fewer young scientists getting their first grant and fewer clinical trials speeding new therapies to the clinic. This is disconcerting to those of us who believe that a) a half million cancer deaths per year is too many and these deaths should be an area of renewed, not diminished, focus; and b) that we will not cut our way to economic strength, but will only grow through a sustained investment in the technologies of the future, several of which are clustered in the life sciences, particularly those leading our attack on cancer.

The other disconcerting message I heard, at least disconcerting as an American citizen, is the increasing polarization on Capitol Hill. "They don't talk to us anymore" was what I heard from one staffer, referring to her colleagues on the other side of the aisle. This concerns me because of the increasing politicization of scientific issues in Washington that we have seen in recent years. I would hate for our shared passion, the conquest of cancer, to be dragged into the crossfire. For the moment, though, the bipartisan support of cancer research is holding.

As citizens we have a responsibility to educate and inform our lawmakers about issues of importance to us. I was told, in office after office, that our representatives do listen to the signals they receive from their district. We have called on our membership over the years to contact their elected representatives on issues of importance to their society. Too often, perhaps, these issues have focused on economic matters.

Think about writing a letter to the editor, or composing an Op-Ed for your local paper, that stresses the importance of federally funded research to the health of average citizens. If you know a congressman or senator, make sure they know that the NIH is part of Washington that works, and that you care about the sustenance of the organization that, more than any other, has led to our pre-eminence in biotechnology.

Do it for your patients, and do it for your kids. As I was flying to Washington earlier this week I read a Newsweek article on China's growing genomic industry. The Chinese government will, by next year, have invested $124 billion into health care infrastructure over a 3 year period, and $1.5 billion in the Beijing Genomic institute’s new center in Shenzhen. More power to them: the Chinese people deserve both health and prosperity. The article quotes a Boston’s Monitor Group as saying that China is “poised to become the global leader in life-science discovery and innovation within the next decade.” We Americans need to be bold about our future as well, not pretend that "American Exceptionalism" will preserve our scientific dominance in the absence of genuine investment in science and education.

I know that it is easy to be cynical about the political process, or to feel one’s insignificance to those in power. I certainly have fought this feeling in myself, even as I was walking between offices on the Hill yesterday. Certainly I was met with polite indifference in more than one office. But in some offices, I felt we served a genuine educational role for truly interested staffers. So play an active role. It is your duty as citizens of a free society, and your responsibility as champions for our patients.


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