When President John F. Kennedy made his moonshot speech in September 1962, he thought he had at least two years left in office—over six if he got reelected. Plus, his party controlled Congress, giving him even more power to reach that goal. President Obama announced his moonshot to cure cancer (to be headed by VP Joe Biden) in his final State of the Union address. This week the administration revealed in a memorandum that the program may not be fully fleshed out until the final weeks of Obama's second term—with Republicans likely still holding Congress and perhaps entering the White House.
Can the Cancer Moonshot outlive Obama and Biden, and a possible handover of power to the rival party? It very well could. The effort already seems to have several powerful Republican supporters in the House, and its focus on cutting government bureaucracy and promoting the private sector should appeal to conservatives—even if it means spending more money.
Also, it would be hard to undo something so big and potentially popular. The memorandum that the president signed this week creates a Cancer Moonshot task force that pulls together five departments of the federal government (Commerce, Defense, Energy, Health and Human Services, and the VA). It also pulls in other federal agencies, such as the Office of Management and Budget, draws in major universities, and promises public-private partnerships. The National Institutes of Health (NIH) will coordinate the efforts. It's unclear whether government will grant funding to the private sector, although the memorandum mentions "targeted incentives" as part of the program.
The moonshot may also provide something at least as valuable as money: data. "Almost every cancer center keeps a database of information," wrote Biden in a post on Medium describing the Task Force. "Allowing researchers and oncologists to tap into this treasure trove of information is absolutely vital to speeding up the pace of progress toward a cure." It's not clear if private-sector researchers would also get access to this info, although a Novartis executive already sits on the presidentially appointed National Cancer Advisory Board, and Biden has included biotech execs in his fact-finding meetings.
The president's memorandum also tackles a favorite target of conservatives—federal bureaucracy. One of the task force's seven main jobs is to "identify and address any unnecessary regulatory barriers and consider ways to expedite administrative reforms." Those words could have just as easily come from Republican Fred Upton, chair of the powerful House Energy and Commerce Committee. In fact, they pretty much did, mirroring the text of his 21st Century Cures Act, which passed the House last summer and has been introduced in the Senate. "The Director of the National Institutes of Health shall prepare a plan, including time frames, and implement measures to reduce the administrative burdens of researchers funded by the National Institutes of Health," reads part of the bill.
Upton's bill also provides a lot of money to NIH, an extra $1.86 billion per year from 2016-2020, for ambitious research. Obama says he wants to achieve a decade or more of progress in five years. This bill puts up some extra funding for that time.
The Cures Act isn't just to advance cancer research, but it would codify in law many of the goals Obama and Biden want in their moonshot, including streamlining clinical trails and opening up their databases to more researchers. The bill also aims to get more people into trials: Biden keeps repeating the statistic that only about 5% of cancer patients ever get into such programs. It also requires the FDA to help boost "precision medicine" that targets treatments to patients with certain biomarkers; that jibes with Obama's and Biden's emphasis on tailoring cancer treatments to the specific mutations in each patient.
Upton likely sees a chance to harness the wave of attention on the Cancer Moonshot to boost his own legislation. He tweeted support during the state of the Union address, and the same day that Obama released his memorandum, Upton put out a press release saying, "We welcome the administration’s Moon Shot Task Force to the Cures conversation, and the good news is Congress has already done a lot of the legwork over the last two years." Obama and Biden can likewise harness the support for Upton's bill (it had overwhelming bipartisan support) to keep the moonshot effort going, even after they are gone.