title: The Cost of Biological Terrorism.
abstract: Most Americans are or will be facing a threat more real than crimes or terrorism-it is the threat of cancer. Indeed, one-fourth of all Americans alive today will ultimately die from cancer. Yet the level of funding for cancer research in 1998 and beyond remains in doubt. The Senate Appropriations Committee has proposed a higher funding figure than the House and the difference will be resolved in negotiations this September. President Clinton has recommended a meager 2.5% increase in spending on cancer. This sum is simply not enough. Although Americans may fool themselves into thinking the government has been at war against cancer, the current funding ceiling for the National Institutes of Health (NIH) budget demonstrates that this so-called offensive is little more than a skirmish. Careful scrutiny of this budget reveals that every time a citizen pays ten dollars in taxes, only one penny goes to cancer research. What the government is spending in cancer research would not buy or maintain two stealth bombers-hardly evidence of a major military strike. For those of us fighting the deadly scourge of cancer, the 1,550 Americans killed each day by this disease are painful and enduring casualties. Imagine five fully loaded jumbo jets crashing with no survivors on the same day. These headlines would generate fast and effective calls for funding for improved safety regulations, and yet cancer takes this number of lives daily-and in one year more lives than all the U.S. combat fatalities in this century. And yet there is a virtual silence as Congress meets to determine the level of monies to direct to cancer research efforts which might halt this carnage. In the past, medical research stopped the horrors of pain associated with amputations and operations conducted without anesthesia, and research stopped the epidemic of polio and the massive deaths from typhoid fever. Soon research will stop the deaths from AIDS. Will cancer be prevented or cured within your lifetime? It should and can be, but only if Americans speak up and demand Congress do its part to advance promising research by supporting NIH and efforts to control cancer. Cancer has stricken almost every family and we urgently need more defense. We must not sit waiting quietly any longer. It is time for a wake-up call to arms, to declare a war effort that demands results. The U.S. paid thirty times more for the Gulf War than the annual budget allotment for cancer research, and five times more to maintain the space program. Today, three-fourths of all cancer research grants approved by critical scientific review still go inactive. These instances represent more lost opportunities, more lost time, more lost lives. We must do better than this. Cancer strikes at the heart and fabric of our society. For the 1.3 million Americans diagnosed with cancer this year, the cost to our economy will exceed $100 billion. Thus, the $2.4 billion now being spent on research is insufficient medically and morally. Several clear-sighted congressional leaders who understand the critical need for increased funding have worked to assure expanded resources for the NIH and for cancer research. Unfortunately, their voices are too often drowned out by legislators with different agendas. Even with limited funds, America's past 25 years of cancer research has paid off. We have already cured some types of cancers, especially those that strike our young people. From 1973 to 1990, the cancer death rate from birth to 19 years of age decreased 38%; from 20 to 40 years, 20%; and from 45 to 54 years, 10%. Over this same period, the government invested $56 million on testicular cancer research. This effort yielded a 91% cure rate and produced an annual savings of $166 million that will last forever. The financial investment was repaid in six months, and the victims have an increased life expectancy of 40 years. These examples and others are proof of the principle that the support of cancer research pays off. However, we have not yet won such hard-fought victories on the more prevalent forms of cancers such as breast, prostate, and lung. Whether it is by cure or prevention, cancers must also be controlled and it can only be accomplished through research. On December 23, 1971, President Richard Nixon signed the National Cancer Act that was to provide, ".a total commitment of Congress and the president. to provide the funds. for the conquest of cancer." Somewhere this contract with America got lost. We are now faced with more losses. The new upheaval in American medicine threatens clinical research in cancer investigation to test new therapies and to support the training of new research soldiers to join the battle. The bottom-line approach of insurance and managed care policies no longer cares about these essential components; they say it is no longer their responsibility. This loss of financial support, combined with the tepid endorsement of funding of research from the government, occurs just when there is an explosion of new discoveries and opportunities becoming available to attack cancer. It is time to dramatically increase our efforts and no time to retreat. If we really want to defend against the terrorism of cancer, we need to attack it with a real war effort. If we can go to Mars, we can go to war on cancer, but only if Americans can speak louder than their elected government leaders. They need to hear our opinion, now.
authors.affiliation: Urology, Oncology, Pharmacology and Molecular Science, Johns Hopkins University, Baltimore, Maryland, USA.
authors.initials: DS
authors.lastname: Coffey