WASHINGTON — In one of the most emotional moments of his first major address to Congress, President Biden on Wednesday called on lawmakers to help him “end cancer as we know it.”
The bold pledge came after Biden gave a high-profile endorsement of his administration’s proposal to create a new biomedical research agency aimed at developing “breakthrough” treatments for conditions including cancer, Alzheimer’s disease, and diabetes.
In his address, Biden urged lawmakers to create a new agency within the National Institutes of Health known as the Advanced Research Projects Agency for Health, modeled after a Pentagon office known as DARPA that has helped to develop technological breakthroughs like the internet and GPS.
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The problem here is that the analogy and the stated mission don’t line up. DARPA works because it selects problems to try and solve based on the properties of the problem and the idea that revolutionary advances are needed to solve the problem. HARPA, as presented, is going to be asked to support riskier solutions to pre-defined problems. We already have a NCI, NINDS and NIDDK looking at Cancer, Parkinson’s and Diabetes. If you want more risk taking in those specific portfolios you don’t need a whole new NIH center, you just need a funding mechanism. There is precedent for this, of course: ARRA funded high risk, high reward projects across NIH centers. When that money ran out, funding for high risk work stopped and high risk grant submissions dropped off.
The Biden administration needs to decide if it wants to advance R&D spending on a specific list of diseases, if it wants to provide long term support for risk taking that NIH centers will not take themselves or if it wants to allocate more resources to translating research to commercial availability. Each of these has a different set of potential policy solutions.
I have no idea if restructuring some part of the process NIH uses to further research and treatment of disease is a good idea or not, but what does it mean to say of the proposed new agency “It would have a singular purpose, to develop breakthroughs to prevent, detect and treat diseases like Alzheimers, diabetes and cancer?”
How are those disease alike? Because research is needed to fully understand them? Are “breakthroughs” even necessary with diabetes, which is already preventable, detectable, and treatable? Is it reasonable to assume “breakthroughs” are even possible for that condition?
I am not trying to purely dump on Biden, who may be able to advance his causes, but there has been, throughout his career, and dangerous simplemindedness about him – when he believes in his cause, he moralizes and passes some kind of big legislation -always thinking big, dangerous in itself if you do not think it all through – and the big legislation has massive unintended consequences he seems to never even consider.
What is alike about Alzheimers, diabetes, and cancer is that they all effect enormous numbers of the American people. They are long term, chronic conditions that can devastate the entire family emotionally and financially. They consume a considerable portion of resources in the healthcare system. However, I was unaware that diabetes is already preventable? What about the Type I diabetics that are born with diabetes through no fault of their own or their mother’s? There is always much, much more we can learn about all of these diseases, including diabetes. What about no more children born with diabetes? Would that be a good enough breakthrough?
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To be clear, I voted for Mr. Biden. But the idea of a new “war on cancer” isn’t new — it dates back to Nixon.
Further, I see no justification (in his speech or elsewhere) for making this new agency independent of the NIH.
Will be curious how others feel.