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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
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;
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
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:
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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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
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
biomedical research projects to be funded by the federal government has
assured a broad, non-federal voice in the formation and implementation of
utilized for NIH grants has assured a rigorous assessment of the scientific
merits of research projects for which NIH grant support is being sought.
This process of scientific appraisal carried out by disinterested and
expert scientists has resulted in the use of public funds only for the
The Association believes that, because of the substantial amount of
public funds that are becoming available for the award of cancer research
contracts, it is imperative that these contracts also be subject to
at all stages of the contract process, including
Requests for Proposals (RFPS) and at the final award.
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
In another contract-related issue, the Association recommends that the
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
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
contract actions and thus to allow the Board additional time for consideration
of more import ant, large research and treatment awards.
Language similar in
intent was provided in 1971 for swift consideration of routine research grant
applications, and the Association regards that as a useful precedent for
similar modification now of the contract review mechanism.
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
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
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
availability of such authority.
The Association recommends that Section 407(b) (7) be amended to read
"(7) Support appropriate manpriwer programs of training in
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
the overall Nill programs which has resulted since enactment of the National
This runs the risk of losses in research in important areas of
For example, constriction of work in molecular biology may lamper
-fundamental work necessary for the understanding of the cancerous process.
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.
The Association's recommendation to remove the present 15-center ceiling
on the number of national cancer research and demonstration centers is designed
to avoid possible delays in translating laboratory findings into the care
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.
The Association's fifth recommendation would clarify the scope of the
Section 410(2) of the Act provides authority for the Director of the
National Cancer Institute to construct cancer centers, laboratories, and
Section 410 would remove any doubt over the scope of the construction
authority. The Association therefore recommends that Section 410 be