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The Trump Administration Is Destroying Cancer Research, Among Other Things
The New York Times has an important story out today covering the destruction that the Trump administration has brought to the National Institutes of Health and cancer research more broadly (Trump is Shutting Down the War on Cancer; free link). I've been watching this play out on social media and in bits and pieces in the news over the last 9 months, so it's nice to have a broader view of what has happened. But before going further, it's important to understand that the effects are not limited to a federal bureaucracy that the average American has no reason to think about in daily life. The NIH is the life blood of medical research in this country because it distributes grant money to universities and other institutions throughout the country. While the NIH does conduct some of its own research, its bigger function is to enable decentralized research throughout the country. The medical research that happens at your local university or hospital is largely funded by NIH grants.
The basic story is that, like the Nephite dissenters and Lamanites charging straight into the heart of Zarahemla (Helaman 1:18-20), the Trump administration (especially OMB director Russell Vought), came into power with a plan to essentially destroy the NIH, and they have been very successful in spite of fortifications that were intended to prevent such things.
In a matter of months, the Trump administration has canceled hundreds of millions of dollars in cancer-related research grants and contracts, arguing that they were part of politically driven D.E.I. initiatives, and suspended or delayed payments for hundreds of millions more. It is trying to sharply reduce the percentage of expenses that the government will cover for federally funded cancer-research labs. It has terminated hundreds of government employees who helped lead the country’s cancer-research system and ensured that new discoveries reached clinicians, cancer patients and the American public. And the president’s proposed budget for the next fiscal year calls for a more-than-37-percent cut to the National Cancer Institute — the N.I.H. agency that leads most of the nation’s cancer research — reducing it to $4.5 billion from $7.2 billion. Adjusting for inflation, you have to go back more than 30 years to find a comparably sized federal cancer-research budget.
How was any of this even possible? The American people, through their representatives in Congress, had already allocated this money for research. When a president withholds congressionally appropriated funding, it is called impoundment, which Congress placed strict limits on in 1974. But Vought has insisted that the president is within his rights to refuse to disperse these funds. And he has argued that any money that hasn’t been spent by the end of the fiscal year should be returned to the Treasury — a move known as a pocket rescission, which is considered illegal by the Government Accountability Office and other legal experts.Last summer I attended a talk by a diabetes researcher where, after presenting her science content, she briefly spoke about how her university was being denied their grant funds without any explanation as to why, or how or when it could be restored, and that layoffs were not far away.
Whether the new administration’s actions are legal or not, it has succeeded in blocking the disbursement of a lot of congressionally appropriated funds. Between Jan. 20 and Aug. 20, the N.I.H. paid out $4.31 billion less in grants than it did during the same period last year. The N.C.I., for its part, paid out $842 million less. And these numbers don’t account for the many other billions of dollars in grants and funding that have been terminated or frozen since Trump took office.
It's worth noting that Vought's intention to do these kinds of things were known prior to his Senate confirmation, and Senate Appropriations Committee chair Susan Collins expressed disagreement with it. However, in an example of the now-typical Republican practice of refusing to exercise quality control and leave the problems to someone else, she voted to confirm Vought anyway, explaining, "If there are impoundments, I believe it will end up in court, and my hope is the court will rule in favor of the 1974 impoundment and budget control act." Well, so far that hasn't been going great. Unfortunately, even IF the courts eventually rule against this impoundment/recission stuff, a lot of damage has already been done. Some of it may never be undone.
This all sounds so cartoonishly stupid, evil and, shall we say, not great for America. The big question is WHY? There seem to be two parts to the answer. First is that the MAGA wing of the Republican party has consolidated at lot of anti-science types. Per the article:
But a very different attitude toward American science now prevails on the right wing of American politics. The Covid epidemic is largely responsible. Caught between a deadly pandemic and the government’s oppressive countermeasures, many Americans sought someone to blame. A variety of vaccine skeptics, antigovernment MAGA types and wellness influencers and a discrete cohort of doctors and medical experts offered them a candidate: the scientific establishment. Their collective disaffection soon congealed into a powerful political force of its own, and a fringe movement to undermine the credibility of America’s scientists went mainstream.This same mindset has taken over states like Florida, where the state government is removing all vaccine requirements, including for basic childhood diseases like measles and polio [1]. However, while the pandemic may have added accelerant, it is too simplistic to blame it all on the pandemic. These attitudes have been festering within the right since before Trump became president (example 1, example 2). I also think the article is missing how this dovetails with the right's fetish for cutting government spending.
The second and probably lesser reason for this destruction is the unlimited confidence of the tech bros.
It’s perhaps no surprise that the Trump administration’s attack on America’s biomedical research system has been embraced by the disruption-addicted tech right. A government-run research system of sustained investment, collaboration and incremental progress no doubt looks anachronistic to a culture of individual visions, competitive silos and overnight growth — and all the more so with the leaders of various generative-A.I. companies making far-fetched promises to cure cancer in a matter of years.Reading between the lines, it seems that our tech overlords convinced the Trump administration that the money going into scientific research would be better spent by giving it to them so that artificial intelligence could do the scientific thinking.
Look, A.I. can be a useful tool in scientific research, but even putting aside the well-known examples of its untrustworthiness, A.I. as we know it will always face a fundamental problem in science: it does not generate new knowledge. It excels in making predictions based on previously accumulated knowledge, but those predictions will always need to be tested against reality. You will always need humans to be creative, generate and test hypotheses, perform experiments, make observations, and interpret the data. A.I. can help as a tool in the process, but you still need people to think and do the work, and A.I. doesn't think or do the work [2]. (But that kind of realism doesn't help you win contracts worth billions of dollars.)
This is all such a senseless tradgedy, and I hope that you will remember it the next time you wonder why scientists haven't solved whatever health problem you or a loved one are facing [3]. But as they say, elections have consequences. On the bright side, you won't miss the treatments or cures that never get invented.
Notes:
1. In announcing the change, the Florida surgeon general--I am not making this up--compared vaccine mandates to slavery. The price of freedom now includes unlimited diseases. That's some price inflation.
2. What about robots? Robots can be great for repetative tasks, but even then they need human oversight. But most scientific tasks require a human touch. Do you think that a robot is going to dissect the spleen out of a mouse? And even if robots could operate independently, it just would not be economically feasbile to replace all the scientists with A.I. powered robots.
3. Obviously, it's not the entire story. There are also economic and regulatory considerations, and some problems are just really hard to solve.
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