Note: President Joe Biden in February launched a “Cancer Moonshot” initiative that aims to reduce the death rate from cancer by 50% in the next 25 years. This is a part of a series of posts with cancer experts offering suggestions to help the Moonshot succeed. The related, upcoming 3rd Forbes China Healthcare Summit” on August 27 (August 26 ET) will address “New International Directions For A Reignited Moonshot” as its main theme this year. Registration is free. For more information, please contact: [email protected]
Greg Simon knows first-hand how hard it is to shake up Washington, D.C. Starting in 1985 after getting a law degree from the University of Washington, he has held top jobs in Congress, and was chief domestic policy advisor to then- Vice President Al Gore. He later founded or co-founded alliances and businesses such as FasterCures, the Milken Institute Philanthropy Advisory Service with support from the Bill & Melinda Gates Foundation and Mike Milken; advised CEOs of Sony, Cisco, Sega and AOL, among others; and served as a Pfizer senior vice president for worldwide policy and public engagement. He came full circle back into politics in 2016 as executive director of the White House Cancer Moonshot Task Force created by President Barack Obama and placed under then Vice President Joe Biden. There, in less than a year, he created more than 70 partnerships. Simon has received awards around the world for advancing the fight against cancer.
Today, at 70, the spirited advocate runs his own consultancy, Simonovation. I talked to Simon recently about the new Cancer Moonshot launched by current President Joe Biden in February and how he suggests the White House should go about it.
“If there is one thing the new Moonshot should do,” he noted, “it is focus on social justice in the distribution of the treatments, cures and screening,” he said. “I don’t just mean Black people; I mean people in health deserts, and underinsured people in remote rural areas who don’t have access to a hospital.” Interview excerpts follow.
Flannery: What should be a top goal of the new Moonshot?
Simon: First, measure and audit. You can’t change anything if you can’t measure what actually got done from the first Moonshot. The NCI set up literally a hundred subcommittees to deal with the recommendations of the Blue-Ribbon Panel from the original Moonshot. Those recommendations were divided into ten areas, which were very good, and then they divided those into ten subcommittees each. So you get this huge bureaucracy. Did they actually fund Moonshot-style programs? Or did they just relabel old programs, which is often the case?
Then, if there is one thing the new Moonshot should do, it is focus on social justice in the distribution of the treatments, cures and screening. I don’t just mean Black people; I mean people in health deserts, and underinsured people in remote rural areas who don’t have access to a hospital. We have a dozen hospitals within 30 minutes of my home in Bethesda, MD. In my hometown in Arkansas, there are no cancer doctors in a town of 20,000 people. They have to come from Memphis. I always joke, “You can only get cancer in my hometown on Tuesdays or Thursdays when the doctors come over.”
There are so many cancers that we can cure now that people of color and people in bad economic situations never have access to. We lose people every week who pull the plug because they can’t afford the treatments. They don’t want to bankrupt their family and (they) die. They choose to die without the extra step that well-off people do. Without insurance, they don’t get screened, they don’t get the new drugs, and they don’t get preventive help. It’s still true, as the American Cancer Society said many years ago, the biggest determinant of who dies from cancer is who has insurance and who does not. It’s that simple.
Flannery: How do you size up the room for wider collaboration in international trials?
Simon: The international opportunity is huge. I’m especially a big fan of international collaboration now that we’ve gone through Covid. We know we can do trials much better than we used to. There’s no reason for everything for the trial culture to be in the analog age in a broadband era. The NCI just renewed the Moonshot agreement with Korea and Japan. Earlier, we had other members.
There are huge opportunities, though with opportunities, come responsibilities. We need to have trust in other countries’ systems. And there’s been a lot of controversy about trials in China, and a lot of controversy about controls, the accuracy of data and the reporting of bad news. Those have to be addressed up-front. It is a slippery slope to either ignore other countries because of those problems, or to just assume they’re going to be fixed. You really need a close eye because you’re touching patients’ lives.
It’s not geopolitical: you cannot do anything anywhere else that you couldn’t do here. And yet the opportunities to recruit cancer patients around the world is so vital.
Flannery: What can be done to encourage even faster private sector investment in cancer drugs?
Simon: Stop demonizing the private sector. The NIH and NCI should be collaborating with the private sector, on order of magnitude more than they do. This industry has a lot of games they play. The industry charges too much. If you want to demonize the medical research community in the private sector, all you are doing is creating an ivory tower in the government that never works on the ground.
Flannery: Anything else that should be embraced?
Simon: A broad outreach program. There is a huge community of people who really wanted to be part of the original Moonshot and they want to be part of this one. I really applaud (current Cancer Moonshot coordinator) Danielle (Carnival) for starting with community outreach because the benefits of the Moonshots one and two are not a government command and control agenda. It is a grassroots-up agenda from the cancer patient community, the cancer doctor community and the cancer researcher community. And Danielle is all over that. And I applaud that.