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against cancer, and that additional provisions could be included in other

sections of the Public Health Service Act which would help assure that

collateral research efforts in the other institutes are not impaired because

of continual shifts in policy and manag

nt or because of reductions in

funding and personnel.

In order to improve the national cancer program, the Association

recommends that:

1. the scientific review provisions of the National Cancer Act be

amended to add external peer review of research contracts to the present

authority for peer review for research grants and programs,

and to allow

the National Cancer Advisory Board to delegate to the Director of the

National Cancer Institute final authority over routine procurement contracts;

2.

the research training provisions of the National Cancer Act be

amended to mandate the utilization of present research training programs

in the struggle against cancer;

3. authorizations for cancer research and control programs be extended

for three years;

4. the present 15-center ceiling on the number of cancer research and

demonstration centers be removed; and

5. the NCI Director's construction authority be expanded to include

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authority for basic research laboratories and biohazard control.

In addition, the Association recommends the following because of its

concern with the overall integrity of the federal biomedical research effort:

1.

that the general authority of the Secretary to enter into research

congracts, which is to expire June 30, be extended indefinitely;

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33-088 0.74 - 15

2.

that general language requiring the timely obligation and expenditure

of funds appropriated for cancer research and for related purposes be added

to the subcommittee's legislation; and

3.

that present language providing for Presidential appointment of the

NIH Director be modified to require Senate confirmation of the nomination and

to specify a fixed term of office for the NIH director.

Each of these recommendations deserves some more detailed comment.

Peer Review of Contracts

The use of non-federal scientists to review grant applications for

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biomedical research projects to be funded by the federal government has

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assured a broad, non-federal voice in the formation and implementation of

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utilized for NIH grants has assured a rigorous assessment of the scientific

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merits of research projects for which NIH grant support is being sought.

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This process of scientific appraisal carried out by disinterested and

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expert scientists has resulted in the use of public funds only for the
support of biomedical research which has met the highest standards of excellence.

The Association believes that, because of the substantial amount of

public funds that are becoming available for the award of cancer research

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contracts, it is imperative that these contracts also be subject to

scientific scrutiny

at all stages of the contract process, including

Requests for Proposals (RFPS) and at the final award.

The collective

judgments of assembled outside experts will help to assure that contract

related decisions are based on scientific merit.

The process of

peer review has been recognized as an effective mechanism in assuring

maximum scientific returns for public investments in research grants. A

similar maximum return should also be sought for similar investments in

research contracts.

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In another contract-related issue, the Association recommends that the

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present requirement of National Cancer Advisory Board review of all contracts

be modified to exclude such routine matters as normal procurement contracts,

nt of the

of laboratory supplies, for example. Such authority could be delegated by

mation a

the Board to the NCI Director.

The intent of the recommendation is to free

the Board from the burden of routine administrative review of such recurring

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contract actions and thus to allow the Board additional time for consideration

of more import ant, large research and treatment awards.

Language similar in

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intent was provided in 1971 for swift consideration of routine research grant

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applications, and the Association regards that as a useful precedent for

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similar modification now of the contract review mechanism.

Research Training

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The research training programs of the National Institutes of Health

have provided specially trained research manpower in critically short

specialized areas of research needs, such as virology, which are becoming

of increasing importance in the continuing quest for the causes and cures

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These programs have assured the constant flow into research fields

of individuals with advanced training in the biomedical sciences who are most

likely to produce the new ideas and pursue the new and unknown paths into

the cancer complex.

The continuing need for these young researchers and the programs which

train them has been recognized in legislation currently pending in the

Congress, HR 7724, which would assure that research training is to be

continued. The amendment the Association is recommending is designed to

insure that the National Cancer Institute will be able to utilize the research

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training authority which the pending research training legislation provides.

The amendment mandates the availability of research training authority for

the NCI rather than providing

as the present law does

only discretionary

availability of such authority.

The Association recommends that Section 407(b) (7) be amended to read

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"(7) Support appropriate manpriwer programs of training in
fundamental sciences and clinical disciplines to provide an
expanded and continuing manpower base from which to select
investigators, physicians, and allied health professions
personnel, for participation in clinical and basic research
and treatment programs relating to cancer, including the use
of predoctoral and postdoctoral training grants (including
both stipends and nstitutional support), fellowships, and

career awards."
Authorizations

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The Association recommends further substantial authorization levels

for a broadly based balanced national cancer effort.

Perhaps more important than the detailed comments and suggestions which

the Association has already advanced is its concern about the imbalance in

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the overall Nill programs which has resulted since enactment of the National

This runs the risk of losses in research in important areas of

Cancer Act.

medicine.

For example, constriction of work in molecular biology may lamper

-fundamental work necessary for the understanding of the cancerous process.

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Therefore, the authorization levels for the national cancer program must

be considered in close relationship to the projected support levels for the

other NIH research institutes and divisions..

The Association is concerned about what happens when one takes the total NIH research appropriations over the last five years, and extrapolates

the next three years,

If one assumes that the NCI authorizations are

appropriated in full, then the expenditures for the NCI would increase about 12 percent per year, but all other activities would be either

unchanged or, in some instances, be forced to decline.

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uthority to

:

The Association's recommendation to remove the present 15-center ceiling

ly discretion

on the number of national cancer research and demonstration centers is designed

to avoid possible delays in translating laboratory findings into the care

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to cancer care and to be maximum professional access to cancer research,

the development of a national network of cancer centers must not be hampered

by rigid legislative barriers.

In order to best serve the needs of the

population, the establishment of additional comprehensive cancer centers may

be essential in speeding the nation towards its dual objectives of making

comprehensive cancer treatment available to all Americans and intensifying

research efforts aimed at understanding and conquering this dread disease.

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The Association's fifth recommendation would clarify the scope of the

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nce in

Section 410(2) of the Act provides authority for the Director of the

tional

National Cancer Institute to construct cancer centers, laboratories, and

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Section 410 would remove any doubt over the scope of the construction

authority. The Association therefore recommends that Section 410 be

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