The historic National Cancer Act of 1971 has often been called “Nixon’s War on Cancer,” but it could as easily have been called “Kennedy’s War on Cancer,” and with perhaps greater justification.
In 1969, in his first year as president, Richard Nixon proposed a fiscal 1970 budget with only a 3 percent increase in appropriations for the National Institutes of Health. Significantly, the proposed appropriation for the National Cancer Institute was $181 million, down 2 percent from the prior year. These actions galvanized philanthropist Mary Lasker to organize a task force on behalf of cancer research that included Benno Schmidt Sr., Laurence Rockefeller, Elmer Bobst, Sidney Farber of Boston’s Children’s Cancer Research Foundation, Lee Clark of M.D. Anderson, and others as members.
Lasker had close ties to the Democratic Party dating back to President Harry Truman; she and others on the panel had very close ties to the Kennedy family. In December 1970, the task force reported to the Senate Subcommittee on Health, recommending markedly increased funding and the creation of a National Cancer Authority independent of the NIH. The then-chair of the committee was Sen. Ralph Yarborough (D-Tex.), who would soon leave the Senate, having lost the Democratic primary to Lloyd Bentsen earlier that year. Ted Kennedy, the junior senator from Massachusetts, was assuming the chairmanship, a position from which he would exercise substantial authority and leadership for his entire Senate career. He welcomed the initiative to expand funding for cancer research and to reorganize the NCI as an independent entity.
Nixon, fearing a challenge from Kennedy in 1972 presidential election, quickly submitted legislation in early 1971 to counter this threat, both on money and organization.
Throughout that year, Kennedy would display the characteristics that have made him an effective legislator over nearly five decades. He had the votes to prevail in the Senate committee, the full committee, and on the Senate floor. Graciously, he allowed the bill to carry the number and title of the legislation sponsored by Sen. Peter Dominick (R-Co.) on behalf of the Administration. He merely substituted the contents of his bill for theirs.
The architect of the legislation emerging from the House of Representatives was Rep. Paul Rogers (DFla.). The principal difference between the two bodies was whether to create a National Cancer Authority as a NASA-like independent agency, which the Senate bill proposed, or to keep NCI within the NIH, as the House bill provided. The House prevailed on this issue.
“What was it like to deal with Ted Kennedy in the Conference Committee,” I asked Rogers.
“It was great to work with Ted on the cancer legislation. He always made his points strongly. But he was also realistic. He felt the goal of getting going on the research was more important than the mechanism,” Rogers said.
In December 1971, Nixon signed the National Cancer Act of 1971 into law, “a Christmas gift” to the American people, he said at the time. Although present at the signing and as responsible for the legislation as any legislator, Kennedy never sought credit in a way that would diminish Nixon’s claim to leadership. But where Nixon had acted out of political expediency, Kennedy had acted out of political conviction. Clear-eyed and bold in purpose, assiduous in seeking common ground with adversaries across the aisle, practiced in the art of compromise on details without compromise of principle, more concerned about practical outcomes than about personal credit—these were then and remain the marks of his legislative efforts.
What impact did the National Cancer Act have? The easiest metric to use is money. Over the years, Kennedy has been indefatigable in support of medical research funded through the NIH, including cancer research supported by the NCI.
The NCI appropriation for fiscal 1971 was $233 million, up from the $190 million final amount for the prior year. By fiscal 1977, the appropriation had climbed to $815 million, three and one-half times that for fiscal 1971.
Notwithstanding the vicissitudes of federal government budgets, the funds continue to be appropriated; the NCI appropriation for fiscal 2005 was nearly $4.9 billion. (The NCI budget dropped to $4.8 billion in fiscal 2006 and remained flat for the past four years.) On the scientific side, advances in the past several decades have been substantial. Clinically, the payoff is being realized steadily.
On May 8, Kennedy chaired a hearing of the Senate Health Subcommittee on “Cancer: Challenges and Opportunities in the 21st Century.” With Sen. Kay Bailey Hutchison (R-Tex.), he announced legislation that they would introduce to address cancer comprehensively, to break down the barriers between research, prevention, and treatment, and to support translational and clinical research. “We must build on what the nation has already accomplished and launch a new war on cancer for the 21st century,” he said (The Cancer Letter, May 9).
Through all of this, Kennedy has never lacked for personal reminders of the scourge of cancer. His son, Edward Kennedy Jr., was treated for bone cancer in 1973; his daughter, Kara Kennedy Allen, was treated for lung cancer in 2003; and his first wife, Joan, was treated for breast cancer in 2005.
Then, barely 10 days after the recent hearing, the country learned that the Senator from Massachusetts had a malignant brain tumor. The news generated “a sharp intake of breath” across Washington and the country, Robert Kaiser would write.
The American people have been fortunate indeed to have such an articulate and tireless advocate for medical research, and especially for cancer research. Kennedy’s understanding of the issues is broadly philosophical, brilliantly political, and deeply personal. One could not ask for more.
Richard A. Rettig is author of “Cancer Crusade: The Story of the National Cancer Act of 1971” (Authors Choice Press, 2005); and recently, with Peter Jacobson, Cynthia Farquhar, and Wade Aubry, of “False Hope: Bone Marrow Transplantation for Breast Cancer” (Oxford University Press, 2007).