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Legislative Update
Senators Reid (D-NV), Hatch (R-UT), Clinton (D-NY), and Murkowski (R-AK) introduced S.579, the Breast Cancer and Environmental Research Act. Representatives Lowey (D-NY), Myrick (R-NC), and Capps (D-CA) introduced the companion bill, H.R.1157. A bipartisan majority of 70 Senators and 287 Representatives cosponsored the bill. After months of negotiations between NBCC, bill sponsors, Committee Chairs, NIH and Senators with concerns about the legislation, a bipartisan version of S.579 was agreed to and passed by the Senate Health Education Labor and Pensions (HELP) Committee in February 2008. Majority Leader Reid then offered the Senate HELP-passed bill twice on the Senate floor, the second time offering a time agreement to appease those with objections. Both times, consideration of the bill was objected to by one Senator who was able to keep the bill from proceeding to a vote.
In May 2008, the House Health Subcommittee of the Energy and Commerce Committee (E&C) held a hearing on the Breast Cancer and Environmental Research Act. Committee members made statements in support of the Senate HELP-passed version of the bill, with just one Member opposing both the HELP-passed version and the bill as introduced. NIH testified that it was “very satisfied” with the changes made by the HELP Committee. Despite the overwhelming bipartisan support for the HELP-passed version of the bill, and despite NIH satisfaction with it, the House E&C Committee marked up a substitute bill that no longer met the goals or intent of either the original bill, or the HELP-passed version. Following House passage of the E&C bill, the full Senate passed this version as well. The President signed it into law on October 8, 2008.
The bill that was enacted into law did not include any of the elements of the bill NBCC developed and had been working for years to pass, and that two-thirds of Congress supported. While it may be a tool we can use in a small step toward reform, it ultimately misses an opportunity to create an innovative model at NIH that could potentially lead to the answers we so desperately need. Please click here to read our full statement on the legislation that became law.
Purpose and Summary of the NBCC-Supported Legislation
Because breast cancer is a complicated disease that occurs in an environmentally complex world, the causes of the vast majorities of breast cancer have yet been determined. It is generally believed that the environment plays some role in the development of breast cancer, but the extent of that role is not understood. The NBCC-supported Breast Cancer and Environmental Research Act was intended to result in a national strategy to study the links between the environment and breast cancer and to foster innovative models at NIH. The legislation NBCC envisioned would have:
- Authorized the National Institutes of Health (NIH) support a collaborative, peer-reviewed grant program to study environmental factors that are believed to contribute to breast cancer. Key components of this research program would have been:
- Competitive, peer-reviewed grants to support multi-institutional, multi-disciplinary research collaborations on the potential links between breast cancer and the environment;
- A broad definition of environment;
- Involvement of trained consumers at all levels of the decision-making process;
- Collaboration between grantees; and
- Participation of community organizations.
- Authorized $40 million per year in fiscal years 2008-2012 for these purposes
Background on the NBCC-Supported Legislation The Breast Cancer and Environmental Research Act resulted from two Environmental Policy Summits sponsored by NBCC. Summit participants emphasized the need to correct the persistent under-funding of research in this important area, while also increasing opportunities for innovative research. The Breast Cancer and Environmental Research Act was developed to satisfy the recommendations and accomplish the goals set forth at the Summits.
In 2003, in response to NBCC’s advocacy, report language was inserted in the Labor-HHS Appropriations bill and the National Institute of Environmental Health Sciences (NIEHS) announced joint funding with National Cancer Institute (NCI) for four research centers to study environmental exposures that may result in early puberty and predispose a woman to breast cancer. Funding for all the centers combined is $5 million per year over seven years, for a total of $35 million.
While these centers were a positive first step, it is important to note that these centers differ from the research envisioned by the bill. The current centers are single institutions and all focus on one risk factor as directed by NIH: the environmental determinants of mammary development and early puberty. The bill, on the other hand, would establish a peer-reviewed research program leading to a broad national (or global) research strategy on the environment and breast cancer. It would not establish centers, but rather collaborations of multi-institutional, multi-disciplinary research teams, looking at the broad spectrum of environmental exposures and breast cancer risk. The bill would create a national network of researchers and consumer groups collaborating to identify and pursue overarching questions surrounding this issue. This approach would move away from the previous attempts to look at specific geographic regions, specific exposures or narrow questions. It would responsibly use federal funds in a strategic, overarching approach, thereby saving time, funds and other resources.
Summary of the Bill that Became Law
The bill that was enacted does not accomplish any of the goals the NBCC-supported bill envisioned. Instead, it establishes yet another advisory committee at NIH. This bill: - Establishes an Interagency Breast Cancer and the Environment Coordinating Committee that will share and coordinate information on existing breast cancer research programs at not only NIH, but at other Federal agencies, and make recommendations on how to improve them. (There are numerous advisory committees that now exist at NIH and several more that have been established by the NIH reauthorization legislation. It may take years to determine how they interact, and which have any real power.)
- Would advise NIH and other Federal agencies in soliciting collaborative, multi-institutional proposals to study breast cancer. The bill also states that this committee can advise on:
- A broad definition of environment;
- Public participation in breast cancer research decisions
- Disseminating information about breast cancer research to the public
- Expanding public-private partnerships in collaborative research
- Contains no grant program, and
- Has lost the focus on breast cancer and the environment.
Encouraging Transparency and Innovation at NIH ince its inception, the National Breast Cancer Coalition has been fighting to change the systems of breast cancer research to cultivate and nurture innovation, inspire new thinking and new investigators, and encourage multi-disciplinary collaborations. NBCC believes that if the status quo remains in place at the National Institutes of Health (NIH) and the National Cancer Institute (NCI), we will never eradicate breast cancer.
The National Breast Cancer Coalition and its hundreds of member organizations and tens of thousands of individual members are not alone in advocating for changes at NIH. Billions of dollars have been spent at NIH on cancer research and yet, progress in fighting the disease has been incremental. Recent articles in Newsweek and Time highlight the need for creative, innovative, new approaches: “There is no more common refrain among critics of how the war on cancer has been waged: that innovative ideas, ideas that might be grand slams but carry the risk of striking out, are rejected by NCI in favor of projects that promise singles.” (Newsweek, Sept. 8, 2008, Sharon Begley)
Trying new ideas is sometimes risky – they don’t always work. But, what also hasn’t worked is business as usual. The approach set forth in the NBCC-supported Breast Cancer and Environmental Research Act would have been a step toward a new direction at NIH. The approach set forth in the NBCC-supported Breast Cancer and Environmental Research Act would have been a step toward a new direction at NIH. Unfortunately, it appears that key members of Congress view NIH as sacrosanct. The public has little knowledge of where NIH funding goes, and not for want of trying to find out. The mechanisms for research have been static. NIH needs to be more open to innovation and the NBCC-supported bill would have been a small step toward introducing a proven research model, and a new way of thinking at NIH.
For more information on this or NBCC’s other legislative priorities, please contact NBCC’s Government Relations Department at (202) 296-7477, or refer to the National Breast Cancer Coalition’s website at www.stopbreastcancer.org . |
