The AACR Call to Action
Decades of investment in basic, translational, and clinical research have enabled scientists to develop COVID-19 diagnostics, treatments, and vaccines at a pace never seen before, as highlighted by Senator Roy Blunt. This robust approach to medical research has saved hundreds of thousands of lives from COVID-19 in the United States and increased protection for patients with cancer who are at significant risk of developing serious cases of COVID-19.
Cancer researchers were uniquely positioned to respond to the challenges posed by COVID-19 and have played a vital role in combating the pandemic while continuing their quest to cure cancer. The NCI’s Frederick National Laboratory for Cancer Research, which specializes in HPV, serology, and antibody science, was able to pivot to evaluate COVID-19 antibody tests to ensure that members of the public have accurate information about the levels of their antibody response to COVID-19.
Yet the pandemic also took its toll on cancer research and prevention initiatives. The staggering delays in clinical trial activations and disruptions to ongoing trials resulted in significant financial losses and jeopardized trial outcomes. Cancer screenings are also yet to return to prepandemic levels, contributing to a likely increase in more advanced cancer diagnoses in the years ahead (431)Alagoz O, Lowry KP, Kurian AW, Mandelblatt JS, Ergun MA, Huang H, et al. Impact of the COVID-19 pandemic on breast cancer mortality in the US: estimates from collaborative simulation modeling. J Natl Cancer Inst 2021;113:1484–94..
The pandemic also exposed the need for greater investments in public health and medical research and led to a watershed moment for modernizing how patients receive care. Under the CARES Act, CMS flexibilities to expand telehealth services are only permitted during the public health emergency. As a result, without congressional action, when the public health emergency ends, so would CMS coverage of expanded telehealth.
This Call to Action builds on what was learned during the public health emergency and lists steps that should be taken to rebuild our public health infrastructure, enhance medical research, and modernize how patients receive care and enroll in clinical trials.
Invest in Medical Research and the Workforce
- Offset pandemic-related research costs by providing at least $10 billion for NIH and its grantees in emergency supplemental funding as proposed in the Research Investment to Spark the Economy (RISE) Act of 2021.
- Increase investments in cancer research and prevention by supporting robust, sustained, and predictable growth for NIH and NCI, including at least $3.5 billion and $1.1 billion, respectively, in Fiscal Year 2022 for a total funding level of $46.4 billion for NIH and $7.6 billion for NCI.
- Expand tax policies to encourage philanthropic giving so that nonprofit cancer research organizations can continue to fund high-risk, high-reward research proposals and accelerate the discovery of new treatments and cures.
- Develop a multiyear investment strategy to rebuild capacity of state, local, and federal public health infrastructure, including the health care workforce and the Strategic National Stockpile, so that the United States will be in a better position to combat future pandemics.
- Empower public health officials to speak directly to the public about the science of health emergencies and invest in a comprehensive national public health data reporting system to better track public health threats and diseases, including cancer.
- Support the CDC’s National Center for Chronic Disease Prevention and Health Promotion to reduce the incidence of comorbid chronic conditions that increase the risk of developing cancer or severe symptoms from infectious diseases. These investments should include $559 million in FY 2022 for Cancer Prevention and Control Programs to support comprehensive cancer control, cancer registries, and screening, and devise targeted strategies for public awareness campaigns designed to encourage and build on prepandemic screening levels.
Expand Access to Health Care and Telehealth
- Enact policies that broaden health care coverage and reduce inequities in access to health care, such as expanding Medicaid.
- Deliver a permanent extension of CMS-approved telehealth services and support greater access to telehealth by providing funding, including grants, to support high-speed broadband, reach underserved areas, and address the digital divide.
Strengthen and Modernize Clinical Trial Development
- Support FDA’s regulatory science initiatives and advance the development of oncology products by providing an increase of at least $343 million in discretionary budget authority in FY 2022.
- Increase diversity in clinical trials and alleviate the financial burden on prospective trial participants by reimbursing patients for ancillary trial-related costs, such as transportation and lodging, as contained in the DIVERSE Act.
The past two years of the COVID-19 pandemic have been some of the most challenging ever for public health in the United States and the entire world. Almost one million Americans have died from COVID-19 and millions more continue to suffer from long-term symptoms and major disruptions to everyday life. The pandemic also demonstrated the crucial need for robust investments in medical research and the healthcare workforce. Cancer researchers and clinicians have been on the frontlines helping develop safe and effective COVID-19 vaccines at a record pace as well as caring for severely ill patients.
It is clear that COVID-19 has caused and will continue to cause unprecedented challenges for cancer research and clinical care. In order to restore momentum against cancer, it is vital for Congress to provide essential funding for medical research supported by the NIH and NCI. Robust, sustained, and predictable annual funding increases for the NIH and NCI will foster future scientific advances, maximize returns from prior investments in cancer research, drive economic prosperity, and support new lifesaving cures. It is important to learn from the lessons of this grave chapter in history to improve health equity and prevent a similar crisis in the future.Previous Section: Policies to Combat the Impact of a Global Health Crisis on Cancer Science and Medicine