Explained: What is Joe Biden’s ‘cancer moonshot’ project?

“Moonshot” evokes the space race first triggered by president John F Kennedy in 1962 during the Cold War, when he took up the challenge of sending a man on the Moon before the Russians could. His declaration led to the Apollo 11 mission, resulting in the first footsteps taken on the Moon in 1969.

While announcing the programme on Wednesday, Biden said, “We can end cancer as we know it. I committed to this fight when I was vice- president. It’s one of the reasons why, quite frankly, I ran for president. Let there be no doubt, now that I am president, this is a presidential White House priority.”

Cancer statistics in the US

According to the US Centers for Disease Control and Prevention (CDC), in 2018, 17,08,921 new cancer cases were reported and nearly 600,000 succumbed to the disease. In other words, for every 100,000 people, 436 cases of cancer were reported, while 149 people died.

The American Cancer Society notes that excluding non-melanoma skin cancer at least 42 per cent of newly diagnosed cancers in the US, which is about 805,600 cases in 2022 – are potentially avoidable. This figure includes 19 per cent of cancers caused by smoking and at least 18 per cent that are caused by a combination of excess body weight, alcohol consumption, poor nutrition, and physical inactivity.

Significantly, more than 16.9 million Americans with a history of invasive cancer were alive on January 1, 2019. Most of these people were diagnosed many years ago and have no current evidence of the disease.

As per the latest statistics available with the American Cancer Society, the five-year survival rate for all cancers has increased substantially since the early 1960s due to advances in treatment and early diagnosis for some cancers.

The Cancer Moonshot programme revived

On Wednesday, Biden and First Lady Jill Biden encouraged action to catch up with the missed cancer screenings amid the pandemic. An estimated 9.5 million people missed their cancer screenings in the US as a result of COVID-19. According to the American Cancer Society, cancer screening is known to reduce mortality for cancers of the breast, colon, rectum, cervix, lung (among people with a history of heavy smoking) and prostate.

The programme includes various cancer-related projects such as improving immunotherapy, mapping tumours, engaging with patients, addressing drug resistance, early detection and expanding cancer research.

The new goals under this programme include cutting cancer deaths by 50 per cent and improving the experience of people and their families living with and surviving cancer. The goals will be achieved through a variety of interventions such as providing equitable access to cancer screenings, using vaccines (such as in the case of HPV) and evaluating multi-cancer detection tests.

But there are concerns about funding these ambitious targets and revised goals.

In December 2016, the US Congress passed the 21st Century Cures Act, authorizing $1.8 billion in funding for the Cancer Moonshot over seven years. This means the funding is in its sixth year, which some find concerning since so far no announcements have been made regarding pumping fresh funding.

Politico reported that in a letter to lawmakers sent on Thursday morning, the American Association for Cancer Research pressed for 2022 health agency budgets to be boosted, which includes a $400 million budget boost to the National Cancer Institute.

What is the significance of this step?

Biden announced on Thursday, which also happens to be the day his son Beau was born, the formation of a Cancer Cabinet, which will be convened in the coming weeks.

Dr Eric Lander, a well-known figure in the world of genetics and disease research and who heads the White House Office of Science and Technology Policy will be responsible for carving a path for the Cancer Moonshot for 2022 and beyond.

Following the launch of the programme in 2016, Lander had cautioned and said that cancer is not something that can be cured in ten years. He recently told NPR, “…the way you cure cancer is you cure it one bite at a time. It’s 200 diseases, and there’s enormous progress. And the goal of this is to push that progress so that we can cut that death rate by 50%…”.

Overall, the formation of the new cabinet, together with the relaunch of the moonshot programme signals that the matter has now become a presidential priority under the Biden administration.

Soon after Biden was elected president in 2021, and editorial published in Nature Cancer titled, “#ScienceIsBack” made note of the Cancer Moonshot programme calling it a “key” part of Biden’s legacy as vice-president and was hopeful that the initiative would be at a forefront of federal action.

It also said that Biden’s election was followed by relief and optimism by the scientific community especially after the “damage incurred” to the field under the Donald Trump administration.

In April 2020, when the world was just beginning to adjust itself to the realities associated with COVID-19, Trump said during a White House press briefing that people should inject disinfectants to project themselves. He later backtracked and said that the comments were made “sarcastically”.

In contrast, days before his inauguration as president in January 2021, Biden declared to a pandemic-ridden US, “We’re going to lead with science and truth.”

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