From the moment of diagnosis, each cancer patient joins a race against time -- first to the right doctor, then to the right treatment, and, finally, to that hint of remission that everyone hopes will lead to an unambiguous cure. It follows, of course, that the pace of discovery in cancer research and drug development can never be fast enough.
The researchers who make those discoveries have their work cut out for them. I have probed the molecular biology of cancer for more than four decades now, and I am reminded daily in my work at Ludwig Cancer Research that few agents of disease are as recalcitrant as the malignant tumor. Still, I am sure we can do better.
More money couldn't hurt. Where it comes from, within reason, hardly matters. I point this out because a New York Times article this month surveyed the growing role that wealthy donors are playing in financing scientific research, worrying over the potential unintended effects of such support.
The fact remains, however, that American science is these days increasingly starved of funds. In 2013 alone, the U.S. National Institutes of Health (NIH) was forced to slash $1.5 billion from its budget. As a consequence, only one in seven biomedical researchers who apply for an NIH grant today will receive one -- marking an historic low. Although a new budget deal may wipe out the majority of planned cuts for 2014-15, collateral damage from 2013 remains. Private funders, it appears, will have to step up.
The good news is that they evidently are. In January alone, private donors gave close to $1 billion to institutes involved in cancer research. A large chunk of that -- $540 million -- came from Ludwig Cancer Research, on behalf of its founder, the late Daniel K. Ludwig.
Yet the amount of funding is not the only issue. It is equally important to apply those funds correctly. For the sake of accountability, most funders today issue only short-term grants to researchers and, to keep recipients on the straight and narrow, condition their support on countless reporting obligations. Many scientists thus spend a good part of their time applying for gap-filling grants and servicing existing ones. Grant-review processes, meanwhile, tend to reinforce conformity and encourage an overweening attention to quick returns expressed in small-bore papers and safe bets.
Such granting regimes, though well-intentioned, discourage both the informed risk taking that can inspire technological innovation and the fastidious, long-term study that underpins transformative science.
I am well aware that it isn't possible for a researcher to have enough money: Grant writing is to the scientific career what baby hugging is to the political; it comes with the turf. But things don't have to be quite this bad. If funded sufficiently and in the right way -- long-term, with a minimum of red tape -- cancer researchers can be freed up to do more science and thus, perhaps, generate more lifesaving interventions.
Ludwig's approach is worth considering. Over the four decades of its existence, Ludwig Cancer Research has invested $2.5 billion in cancer research at its eponymous centers on four continents -- and, in every case, ensured that its scientists are minimally bothered by grant administration and procurement.
The security afforded by such long-term, no-nonsense funding has, for example, allowed Ludwig scientists to contribute variously and significantly to the development of cancer immunotherapy, which unleashes the immune response to destroy tumors. The strategy has proved so promising that the journal Science named it the top scientific breakthrough of 2013.
Ludwig funding has similarly enabled researchers to contribute to the development of life-saving interventions for cervical and gastrointestinal cancers, among others. And we aren't the only funder that works this way: The Howard Hughes Medical Institute, for example, has long employed similar funding mechanisms to spectacular effect -- investing, as it states, "in people, not projects." Indeed, more and more philanthropists are taking the same tack. The Ragon Institute in Cambridge, Mass., established in 2009, gives its scientists flexibility and the freedom to pursue bold, unconventional ideas in their efforts to conquer HIV and other afflictions of the immune system.
Imagine how much more might be accomplished if more funders picked bright scientists and helped them get to work. The New York Times article suggests that private funding, dedicated as it is often is to headline-grabbing diseases and the pet concerns of donors, can potentially skew scientific research priorities and exacerbate the neglect of basic scientific research. But this is not necessarily true; scientific research is not conducted in a vacuum. Insights gleaned from cancer research can, and often do, shed light on everything from basic immunology to viral diseases such as HIV, no matter who provides the funding. Besides, many private foundations, including Ludwig, deliberately and generously fund a great deal of basic research.
That stands to reason. If we want breakthroughs, we must grant researchers the time and stability to do what they do best, to conduct their investigations as they see fit, to indulge their basic curiosity, to think big and aim high, directed not by the onerous demands and conformist ethos of the grant procurement process but by scientific -- and humane -- necessity.
Researchers may never work quickly enough for those whose lives have been ravaged by cancer -- and any number of other terrible diseases. But, with the right kind of support, they certainly can work a lot faster, and better.