because, first, its financial sights are not set high enough, and, second, if it tried to raise five times as much, it would, in all probability, find it impossible to raise anywhere near the 10 or 12 million dollars a year necessary for the research job to be done. Even if it were to succeed, miraculously, in doing so during certain years, it would almost certainly find the going too hard in other years. There is a rise and fall in the tide of gifts for benevolent, charitable, and social service giving in the United States, due to many causes. The fact that it occurs is known to every organization dependent upon voluntary contributions. If collections were poor some year, what would happen in the cancer-research field? The answer is clear-budgets would be cut, important projects would be dropped, men would be released, other projects would skimp along, the research scientists and medical men would lose morale, and the sad story of the blight of retrenchment would be told again. Cancer research would experience the same sort of set-back that almost every research project dependent on gift funds has experienced in the past. Again, let it be clear that I do not criticize the American Cancer Society. I say, all honor to these men and women who are setting out to try to fill the aching void in cancer research. But I do not think public donations and drives are the way to finance cancer research. There is a better waythe way I am here to champion. My thought and recommendation is simply that if these bills pass, American Cancer Society should go on with its good work, but that there might be a division of efforts with correlation between it and the agency established to administer the fund provided for in the Neely and Pepper bills. The American Cancer Society could well concentrate on the work it has done so well for so many years, namely, lay education, cancer diagnosis and treatment. These need to be carried on with increased intensity, and with a widening of service, which may well tax all they can raise from public drives for funds. The new Cancer Foundation could then be left with an all-out responsibility for basic research in the clinical, biological, chemical and physics sciences, coupled with professional education. LET UNITED STATES HEALTH SERVICE ADMINISTER CAMPAIGN It has been suggested that the United States Public Health Service, as an existing public institution, could continue with its present activities, and also administer the research of the new Cancer Foundation. This idea has merit, because it would make it possible to take advantage of the experience and trained approach of the United States Public Health Service. NATIONAL SCIENCE FOUNDATION There is no need for any conflict between the purposes and operation of the proposed National Science Foundation provided for in the Senate Bill 1850, introduced by Senators Kilgore and Magnuses. The work of the National Science Foundation will be in the basic sciences, and although it includes medical research in its field, its work will be done largely in fields other than cancer. There could and should be harmony and reciprocity between it and the new Cancer Foundation, for much found out by each would be of value to the other. This cancer war must be carried on by an institution dedicated to determination of the causes, prevention, earlier detection means, and ultimate control of that dread disease. I would like to emphasize what may be shown by others in more detail, that the appropriation said, to be contemplated for the National Science Foundation is $40,000.000 this year, and that eventually four to five times this amount may be appropriated annually. It is my understanding that the appropriation provided for by the Pepper and Neely bills, is to cover a period of many years, and that it is probable that no more than 10 or 12 millions will be required in any 1 year after the buildings and equipment are provided. AN INDEPENDENT AUTHORITY FOR CANCER Whatever means is to be adopted for administration, whether by adaptation of the facilities and experience of the existing United States Public Health Service, or independently organized along the lines of the National Science Foundation provided for in Senate Bill No. 1850, I believe that there should be a centralization of authority which will promote in every way possible the furtherance of research in the field of detection, causes, treatment, and cure of cancer in all its forms. An alternative but less satisfactory position for the National Cancer Foundation that would adequately provide for its purposes would be to incorporate it into the Senate Bill 1850 as an additional full fledged division ranking with the Division of Health and Medicine, and the other seven divisions. event it should have its own committee and special appropriation. On my consideration thus far I do not advocate this procedure. FULL USE OF EXISTING SCIENCE AND SCIENCE BODIES In this In planning the work of a national cancer foundation, the fullest use should be made of the many recognized scientific, technical, and engineering associations, and of the proposed National Science Foundation and all the other Government organizations engaged in scientific research. The Cancer Foundation should not have the sole responsibility for the original development of the so-called natural or basic sciences of physics, chemistry, mathematics, and biology. It should seek out and to employ to advantage the scientific knowledge accumulated in application to the solution of the cancer problems in the 20 or more fields of endeavor already established, as well as any more they may find reason to believe fruitful. This does not mean that research will not be pressed in chemistry and physics and biology. On the contrary, any lead to possible success should be pressed to the fullest extent, without neglecting to urge other scientific associations and governmental agencies to pursue basic research which promises to be helpful in cancer research. FRANKLIN DELANO ROOSEVELT'S INTEREST IN CONTINUATION OF MEDICAL RESEARCH Nearly 18 months ago President Roosevelt gave us a pretty good idea of his views on the importance of research in general and medical research in particular, in the latter he wrote November 17, 1914, to Dr. Bush, the director of the Office of Scientific Research and Development. Let's quote a few of the paragraphs of this letter in full, because they are phrased so strongly. May I invite your particular attention to the second paragraph relative to war on disease: "First: What can be done, consistent with military security, and with the prior approval of the military authorities, to make known to the world as soon as possible the contributions which have been made during our war effort to scientific knowledge? "The diffusion of such knowledge should held us stimulate new enterprises, provide jobs for our returning servicemen and other workers, and make possible great strides for the improvement of the national well-being. "Second: With particular reference to the war of science against disease, what can be done now to organize a program for continuing in the future the work which has been done in medicine and related sciences? "The fact that the annual deaths in this country from one or two diseases alone are far in excess of the total number of lives lost by us in battle during this war should make us conscious of the duty we owe future generations. "Third: What can the Government do now ard in the future to aid research activities by public and private organizations? The proper roles of public and of private research and their interrelation, should be carefully considered. "Fourth: Can an effective program be proposed for discovering and developing scientific talent in American youth so that the continuing future of scientific research in this country may be assured on a level comparable to what has been done during the war?" In his statement of the duty we owe to the scientific development for future generations, he showed how seriously he regarded the problems of cancer and heart disease (the two which killed more each year than the war did). In effect he suggested a direct and immediate approach to the problems. There doesn't seem to be much doubt about Franklin Roosevelt's position in the Neely proposal for Government action against cancer. VII. FAVORABLE ACTION URGENTLY NEEDED NOTHING MORE IMPORTANT I sincerely believe that the decision which will be made in this Congress with reference to these bills, ranks in importance with anything with which the world is faced. In its effect on lives, and our economy, it is of vast importance. No more important decisions were made at Yalta or Teheran. Nothing more important was posed for decision when the general staff met for the last time to decide to move across the English Channel or on the day when this Congress met to take that dreadful decision to declare war, nothing more important was posed for decision. Even the tremendous problems of peace, of reconversion, of the United Nations, seem somewhat less formidable as compared with our worst enemy-cancer. To date our attacks on cancer are still in the stage of wishful thinking. For more than 2,000 years we have been after the problem, and yet today with our surgical skill and with the use of X-ray and radium, we are still employing much the same methods as the early Egyptians who used the knife and flame to cut out or burn out the cancerous flesh as the only way of stopping its course. If you provide this money called for in this bill, I believe with all my heart that we will find the cause and cure of cancer. If you do not, I believe that though the problem may eventually be solved, it will be only after many, many long and unnecessarily wasted years, and at a frightful additional cost of life, and untold misery. SEVEN LEAGUE BOOT STEPS These bills propose to gather the best scientists together. I hope that this will be done in 6 to 10 fully equipped institutions where the strides will not be "tiny steps" but seven league boot strides, where men will not grow discouraged and lose their morale; where men will be encouraged by the giant progress that is being made by all of them; and where brilliant and eager carcinologists may in their scientific lives find the road and the light. What could not be done by lone and disillusioned scientists can, I verily believe, be accomplished if an army of scientists is given the money and facilities, and promised continuity of program. What is needed is not what we have had. Snipers and sappers and scouts peck away at the entrenched enemy. It takes an army to engage the enemy, to outmaneuver and outflank, and to win the war. HOW MUCH NEEDED? How much money is needed? A hundred million dollars should do for a start, if appropriated now to cover the whole project. Such decisive action would make possible an organization of men of top rank, because they would know that their projects would not be dropped before they were successfully completed. It will probably not cost more than $10,000,000 a year, after the first year in which buildings and equipment would raise the cost somewhat. What does this hundred million represent? A paltry 70 cents for each man, woman, or child in America-about 7 cents a year for a 10-year war. It means the equivalent of about $6, or 60 cents a year for each of the 17,000,000 Americans now living who will die of cancer unless we get busy right away with a plan such as this to save them. It is the cheapest insurance procurable-a few cents a year for each of us, over whom the odds of 1 to 8 hang like Damocles' sword. WHO WOULDN'T VOTE FOR IT? I have seldom talked on this subject of cancer with anyone who had not lost a loved one, had cancer victims among his or her friends, or seen someone close to him die cancer's terrible agonizing way. Such facts usually come out in the first few minutes of conversation, for they are present in the minds of people who have seen their loved ones die of cancer in rack of body and torture of mind from living for months under the sentence of death. How would the American public vote on this subject if it came to a vote? It is not hard to believe that if a national referendum or an initiative measure could be put before the voters of this Nation, an overwhelming vote of approval such as has never before been recorded in favor of man or project, would be the result. GIRD UP OUR LOINS If we were to be told by a competent authority that in the next 51⁄2 years a million American citizens would die of infantile paralysis, smallpox, or scarlet fever, would we not, as soon as we recovered from the horror of it, plunge ourselves into 89471-46- -13 action to try to prevent it? I cannot but think that we would. The country would organize at once, the press and radio would be full of plans to prevent it, our planes would fly everywhere with serums and antitoxins. We would gird up our loins and arm ourselves to do active, dramatic, and effective battle. Witness what happened in the recent smallpox scare on the Pacific coast-two or three deaths in Seattle and the lines which formed at doctors' offices awaiting vaccination looked like nylon stocking rushes. From Los Angeles to the Canadian border nearly everyone is having his arm scratched. But the estimate of a million to die of cancer in 51⁄2 years is not too high. The estimate of 175,000 deaths from cancer this year and 200,000 by 1951 are authoritative estimates. The trend is upward. Unless we can stop it going up and turn it downward, a million more will surely die of cancer before the end of the year 1951. We are spending all too little for cancer research, medical treatment, clinical diagnos's--relative to the deaths, per year, only $1 for cancer for each $100 for infantile paralysis; last year only $1 for each cancer death for every $11 for tuberculosis a death. This situation is a challenge to American science and medicine, and to the Government of the United States. The challenge will be accepted with alacrity by science and medicine if ample funds and assurance of continuity are provided by Congress. I hope that Congress will answer the challenge by supporting the Neely bill in an all-out fashion. Cancer has won every battle in the war since the dawn of civilization. But the war can still be won! Senator CLAUDE PEPPER, EXHIBIT 7 MARINE EXPERIMENTAL STATION OF THE North Truro, Cape Cod, Mass., June 24, 1946. Senate Office Building, Washington, D. C. DEAR SENATOR PEPPER: Thank you for your telegram. I appreciate your confidence in my judgment. If it were at all possible I would be in Washington for the hearings on S. 1875 on June 27. Unfortunately, I am still in the doctor's care following an operation and cannot make the trip just now. I will, however. send in a statement for inclusion in the record and hope that it may be useful in clarifying the issues. I have the greatest admiration for your aims and for the way in which you are constantly trying to sift out the real facts essential to the attaining of those aims. I do not always agree with you as to what those facts are, but I hope you will accept my sincere regards. Cordially yours, PHILIP R. WHITE. STATEMENT RE S. 1875 BY PHILIP R. WHITE, DIRECTOR OF GENERAL PHYSIOLOGY, THE INSTITUTE FOR CANCER RESEARCH, PHILADELPHIA, PA. I am thoroughly in favor of Government participation in and support of a program for the investigation of the causes, prevention and cure of cancer, and consider the amount of $100,000,000 a reasonable sum to be set aside for that purpose. To that extent I am in favor of the aims of the Pepper-Neely bill. There are. however, certain underlying facts which impell me to oppose the passage of this or any similar bill at the present time. These facts are partly external to, partly internal in the bill itself. External facts against S. 1875. There is before Congress at the present time a bill, sponsored by Messrs. Kilgore, Magnuson, Saltonstall, John on, and others for the establishment of a National Science Foundation. This bill has been very carefully worked out, after exhaustive testimony, and represents the best thought of a number of our outstanding scientists, legislators, and jurists. It deserves every possible support and it is my hope to see it passed and put into effect at an early date. The proposed Foundation includes, among others, two divisions which cover territory included in the scope of S. 1875, that for biological research and that for public health. It is my belief that once this foundation is established,. the need of a separate cancer research foundation will disappear, its functions being absorbed into those of the Public Health Division and the Biological Research Division of this National Science Foundation. It is my further belief that the introduction of S. 1875 at this time, because of its immediate personal appeal, is likely to divert a good deal of support from the more recondite and less easily appreciated Science Foundation, and result in Congress failing to pass the latter. This would, I believe, be a real calamity. On this ground I would strongly urge that S. 1875 and H. R. 4502 be withdrawn and that all the support which they have aroused be swung to the incorporation of their objectives in the National Science Foundation. Internal facts against S. 1875. The Pepper-Neely bill provides for the mobilization of outstanding experts "at some convenient place in the United States." This wording indicates that the authors have in mind the establishment of a single centralized research center. From Mr. Neely's discussion of the bill at the preliminary hearings of May 7 and 8 and from the testimony of witnesses at that time it is clear that Mr. Neely and many of his supporters have in mind a "Manhattan project" for the solution of the cancer problem. It is my conviction, based on years of experience in biological and cancer research and a considerable acquaintance with other sciences, that this objective shows a profound failure to understand the nature of the cancer problem and the atomic bomb problem and the fundamental differences between the two. The atomic bomb problem was solved by the establishment of a closely centralized organization, financed with $2,000,000,000. It is a monument to the industrial and technological abilities of our Nation. Yet, in spite of constant reiteration on the part of the scientists involved, the public in general and Mr. Neely in particular have not yet comprehended the fact that there was no scientific research carried on by the Manhattan projects. The scientific research had been done by Meitner and Haan in Germany and Sweden, by Bohr in Denmark, by Chadwick in England, by Fermi in Italy, by Curie-Joliot in France. These investigators, not a single one of whom was an American, working in an American laboratory, established the facts upon which the atomic bomb was based. The Manhattan project took those facts and carried out first the pilot development and then the manufacture of a product based on those facts. But the Manhattan project was not a research laboratory but an industrial plant. The fact that not an American name was involved in the scientific background is crying evidence, not of any low level of American scientific ability but of our consistent failure to give adequate support, both moral and financial, to true science. Now, in the case of the cancer problem we are faced with a real scientific problem, not an industrial problem. We are kidding ourselves if we think it can be solved by industrial methods. We are kidding ourselves if we hope for a solution by mobilizing experts at some convenient place in a Manhattan project. We are kidding ourselves in the Neely-Pepper bill. For we know almost none of the basic facts necessary for the solution of the problem. We do not know what cancer is, how it arises, or what maintains it, nor why it sometimes is cured. We do not even know who are the men competent to attempt its solution. The recent report of the first year's activities of the committee on growth of the American Cancer Society contains one group of statistics which I commend to your attention. This committee had available two funds of $150,000 each for support of research in chemical and biological problems related to cancer, and two funds of $100,000 each for physics and clinical investigation. The percentages distributed at the end of the year were: Biology, 47 percent; chemistry, 55 percent; physics, 80 percent; but clinical investigation only 10 percent. They were able to find only a single project, directed by a single man, which seemed worthy of support in this field, compared to 43 projects in the basic sciences. What is needed, therefore, is not a centralized project for the exploitation of known facts, but a broad dragnet for the acquisition of facts as yet unknown. And scientific facts have a curious way of revealing themselves not in industrial laboratories but to isolated, struggling investigators in remote and usually academic institutions. The National Science Foundation is so organized as to aid these isolated investigators in an effective manner such as can never be done by a centralized authority. For this reason, again, I would prefer to see the objectives of the bill attained through the National Science Foundation rather than through a new and overlapping cancer foundation. I am therefore opposed to S. 1875. |