Journal of the National Cancer Institute Advance Access originally published online on May 13, 2008
JNCI Journal of the National Cancer Institute 2008 100(10):696-697; doi:10.1093/jnci/djn167
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© Oxford University Press 2008.
NEWS |
Texas Prepares To Invest Billions In Cancer Research
Texas is moving forward with a $3 billion bond issue that promises to bolster cancer research in the state. Voters approved a constitutional amendment late last year that will allow the state to fund $300 million in cancer research annually over the next 10 years. Those dollars are expected to start flowing sometime next year, once the Cancer Prevention and Research Institute, established under the amendment, is ready to oversee the grantmaking process. Several members were recently named to an oversight committee that will soon take the first steps in establishing the institute by picking a location and director.
Motivated by the death of former Gov. Ann Richards from esophageal cancer in 2006, a group of national and local advocacy organizations, working with both the governor's office and a core group of lawmakers, initiated and lobbied for the constitutional amendment in the state legislature.
"This didn't initiate with the medical community. This initiated with citizens in Texas and members of the legislature who are living in the second-largest state in the country and realized that education and research universities are the future for this state," said John Mendelsohn, M.D., president of the University of Texas M.D. Anderson Cancer Center in Houston.
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And the timing couldn't be better. "With the current, level funding of the National Cancer Institute, bold new initiatives that involve outlays of substantial funds are hard to plan right now," he said.
The state money will not only support the expansion of ongoing research, but it is also designed to leverage funding from the private sector; universities will be required to put up $1 for every $2 they get in state funding.
The amendment laid out specific objectives for the funding: supporting innovative science; attracting new, outstanding researchers to Texas; stimulating collaboration among the state's universities; and promoting projects that will lead to commercial products and economic development. The last objective is reflected in a provision allowing the institute to collect a portion of the proceeds from patents, licenses, and royalties from discoveries produced through state grants.
This return on investment was a key selling point in convincing voters that the amendment was a good deal, said James Gray, government relations director for the Austin branch of the American Cancer Society.
Proponents estimate that, as a whole, cancer already costs Texans about $30 billion a year, and they claim that for every dollar spent on research, $16 is saved in medical costs. That means if the state spends $300 million a year on research, they can save $4.8 billion in spending, according to proponents. Up to 10% of the fund will go directly into the state's prevention and early detection programs, as well. Texas currently spends around $3 million a year on those efforts.
Despite getting the nod from 67% of voters, the amendment had its opponents. Fiscal conservatives, such as the Young Conservatives of Texas, the Harris County Republican Party, and the Texas Libertarian Party, spoke out against the measure over concerns about the large sums of cash being promised. (Paying off the $3 billion bond issue will cost the state $4.6 billion in principal and interest over 20 years.) They also argued that it is not the role of state government to be funding medical research.
"This has nothing to do with whether or not we have compassion or concern for people with cancer. We definitely do. I’m just not convinced this is where our tax dollars should be spent," Peggy Venable of Americans for Prosperity told local television news before the vote.
And some social conservatives worried that the funds might be used for embryonic stem cell research.
In an election primer for their members, the Texas Eagle Foundation wrote of their opposition that the "legislature failed to add language to Proposition 15 that would protect Texas taxpayers from funding embryonic stem cell research. ... TEF has tried, but failed, during the last two legislative sessions to pass a bill that would prohibit human cloning and another law to prohibit taxpayer dollars from funding the gruesome research."
"We did enough polling to know what people think on this issue. So it wasn’t that significant, but [those objections] definitely did get some play," Gray said.
Proponents of the funding—led by Texans to Cure Cancer, a group backed by the American Cancer Society, the Lance Armstrong Foundation, Susan G. Komen for the Cure, and the Texas Medical Association—took a phased approach to their campaign. The first was to bring the cancer community together to generate a consensus. In the second phase, the groups reached out to the legislature to galvanize support and get it passed. A third and final phase was getting it on the ballot and educating voters. The whole process, from the first discussions between lawmakers and local public advocates to approval by voters, took about a year, a relatively short period for pushing through such a major proposal.
"When we did run into obstacles, we could talk about where cancer is right now and the efforts to make this a managed disease. That was quite convincing," Gray said, adding that it didn’t hurt to have the involvement of national advocacy organizations based in the state.
"You have the [Susan G.] Komen Foundation here, you have Lance Armstrong's foundation here, the American Cancer Society's division in Austin. Texas has some significant voices," he said.
Last year, North Carolina's legislature created a $50 million annual fund to support cancer research, joining 16 other states that fund cancer scientists. However, none of those programs approach the scale of the Texas effort. In contrast, Florida's legislature is struggling with how to continue state funding that currently sustains expansions at the H. Lee Moffitt Cancer Center in Tampa in the face of a $37 billion budget deficit.
Proponents of state funding for cancer research hope that the Texas program will push other states in the same direction. Texas has effectively set the standard for competition between the states in terms of attracting medical researchers and industry, said Dan Smith, president of the American Cancer Society's Cancer Action Network.
"Normally, what we see as a pattern is that one state steps out and then another state will step out cautiously behind them and then more and more states will go for them," he said. "I’m not predicting that is what will happen, but I think there will be other states looking at this."
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