STATEMENT OF SENATOR EDWARD M. KENNEDY
DANA FARBER CANCER INSTITUTE WEINBERG LECTURE
Thank you, Ed Benz, for that generous introduction. As always, it's a privilege to work with you and Dana Farber. Your leadership has made the Institute a source of immense pride for our state.
It's an honor to give this lecture today, and to be here with James Weinberg, Andrew's father, and Stephen Sallan, Andrew's doctor. As many of you know, Dr. Sallan and Dana Farber helped my son, Ted, and my daughter Kara and our family through their illnesses, and we're forever grateful for all you did.
It's a special honor to be the first non scientist to give the Weinberg lecture, and I hope I can bring a worthwhile perspective on the role of health policy in developing new strategies for combating cancer.
It's an honor as well to give this lecture in the Jimmy Fund Auditorium. We all know what a difference the Fund has made in the lives of children with cancer.
This week, I've been thinking a great deal about the hope that medical research can bring to those who suffer from serious conditions such as Alzheimer's Disease, Parkinson's Disease, spinal cord injury, diabetes and especially cancer. On Tuesday, the Senate approved legislation to unlock the hope that stem cell research can bring to patients and their families across America. That legislation passed by a strong bipartisan majority, with approval from both supporters and opponents of a woman's right to choose.
Our strong vote in the Senate, matched by strong bipartisan support for the legislation in the House and throughout the nation, is a tribute to the hope and vast potential of that research. Sadly, President Bush chose to exercise his veto power for the very first time to reject this powerful vote for progress.
But that veto does not extinguish our hope in the promise of that research or end our determination to see that scientists can unlock the potential of stem cell research to seek new cures for the patients who so urgently need them. We'll try again next year and hope for success.
Such hope is what I feel whenever I come to Dana Farber. This is the place where hope so often becomes reality.
For the patients and their families who come here, this is one of the most important places they will ever visit in their lives. For those you treat, their lives are divided into a time before cancer and a time after. It is a tribute to your skill and your dedication and your genius that so many patients can look back after years of healthy life and say, "Dana Farber made it possible."
You're the ones who make it possible for your patients to walk out these doors and enjoy the precious moments of lifethe holidays with family, the joy of children, the games at Fenwayfree from the ravages of cancer. You're the ones who bring joy to the faces of those who pace anxiously in the halls and in the waiting rooms, hoping for good news from the surgeon or the oncologist.
At Dana Farber, you have made the extraordinary routine, and patients across Massachusetts and throughout the world have benefited. The progress will continue on into the future, thanks to the astonishing research being done at the Institute today.
In this century of the life sciences, cancer researchers are extending the boundaries of knowledge every day. Their innovations are opening doors of hope for the 1.3 million people who are diagnosed with cancer every year. In recent years, we've seen improved treatments and new methods of prevention for breast cancer, cervical cancer, lymphoma and leukemia, to name only a few.
Scientists here at Dana Farber are leading the way to a better future for patients. Your discovery of cells that cause leukemia will greatly increase our understanding of the difference between cancer cells and normal cells, so that new and targeted drugs can be developed. Other research at the Institute, uncovering the key genes that allow skin cancer to spread, capitalizes on the human genome project. Perhaps most exciting is your finding that there is a small family of genes that control cancers. This oncogene engine is a prime target for research and drug development, and may well lead to miracle cures for families suffering from a range of cancers.
Your success today is a tribute to the vision and leadership of many dedicated doctors and civic leaders, but none more so than the man it was my privilege to know for many years, Sidney Farber. His pioneering work in children's cancer research led to the first successful induction of remission for children with leukemia. Even while raising funds to create what is today the world's most distinguished Cancer Institute, he continued to innovate in cancer research and clinical pediatric care.
It is impossible to know how many lives Sidney saved, how many scientists he inspired, and how many children he touched, with his great compassion and hope.
But his contributions were never limited to the hospital or the clinic. From the early 1950s to his death in 1973, he was a dazzling witness at countless Congressional hearings on cancer research. He was a captivating speaker, and I remember him bringing his optimism and excitement to the halls of government. His brother called him a Amedical diplomat, and he certainly was.
Sidney knew my brother, President Kennedy, who considered him an astute adviser and personal friend. I learned a great deal from him during my own early years in the Senate, when he was setting the tone for future cancer policy. When I became chairman of the Health Subcommittee in 1971, I had the opportunity to help bring Sidney's vision for cancer research into reality.
Sidney and our great friend Mary Lasker were committed to creating a comprehensive, cutting edge National Cancer Institute that would do for cancer research what NASA had done for space exploration. But implementing that vision required long, difficult negotiations with scientists, physicians, and politicians, as well as an Administration that initially opposed every move we made.
Through months of hearings and discussion on our proposed legislation to reorganize and revitalize the National Cancer Institute, Sidney led academic researchers and patient advocates alike, in support of a shared vision for the conquest of cancer. From the earliest suggestions of a National Cancer Authority until the last months before passage of our Senate bill, he testified countless times in support of that vision.
We all had to fight hard to create the extraordinary medical innovations we enjoy today, and we have to fight just as hard now to maintain that progress. A culture of innovation and discovery and high quality health care does not just happen. It must be nurtured or it will wither.
In the 1990's Congress made a commitment to doubling the budget of the NIH, resulting in new breakthroughs, such as the mapping of the human genome and the greater understanding of the basic workings of the body's cells. The benefits of federal funding were not confined to research labs at hospitals and universities, but were multiplied by private investment in the dynamic young biotechnology firms that help bring the breakthroughs in the laboratory to the bedsides of the patients.
Unfortunately, instead of building on the progress of recent years, the current Administration is undermining it. Under the President's budget proposal, NIH will receive a billion less next year than is needed to keep up with inflation. Its budget will be flat for two years running. That has not been allowed to happen in more than half a century.
If these budget recommendations are enacted, 18 of the 19 NIH institutes will effectively lose funding, which means that NIH will fall behind in the search for new cures. The National Cancer Institute will receive $237 million less than needed to keep pace with inflation. More than 4 out of 5 new grant proposals will have to be rejectednot for lack of merit, but for lack of funds.
In an essay in the current edition of the journal Cell, Dr. Robert Weinberg of MIT warns that such cuts will result in a "lost generation" of young scientists, who will turn away from discovery in frustration at being unable to find support for their research, thus robbing American science of the creative young minds it needs to thrive in the future.
Another essential part of bringing new and better drugs to patients who need them is an effective Food and Drug Administration. Its role is essential in balancing the need to get effective treatments to patients quickly with the need to assure that the new treatments are safe.
Here again, however, progress is being undermined. Politics is too often replacing sound science as the basis for FDA decisions. FDA must have the resources, the authority and the independence from political interference it needs to safeguard public health. I'm working now with the chairman of our health committee, Senator Mike Enzi, on legislation to help the agency do the job the American people are counting on it to do, and I look forward to hearing your ideas and suggestions as we continue to work on that legislation.
Smoking is the number one preventable cause of death in America. One of the most important actions we can take as a nation to substantially reduce this public health menace is to give the Food and Drug Administration broad authority to regulate tobacco products. We cannot in good conscience allow the federal agency most responsible for protecting the public health to remain powerless to deal with the enormous risks of tobacco, the most deadly of all consumer products.
Two years ago, a large bipartisan majority of the Senate voted to grant the FDA authority to regulate tobacco products. It was a major step forward in our long-term effort to enact this legislation. Unfortunately, the legislation was blocked by the House Republican leadership. I have reintroduced the FDA bill in the current Congress and I am urging my colleagues to take the final steps necessary to make this extraordinarily important health legislation the law of the land.
The stakes are vast. Five thousand children have their first cigarette every day, and two thousand of them become daily smokers. Nearly a thousand of them will die prematurely from tobacco-induced diseases. Cigarettes kill well over four hundred thousand Americans each year. That is more lives lost than from automobile accidents, alcohol abuse, illegal drugs, AIDS, murder, suicide, and fires combined. Our response to a public health problem of this magnitude must consist of more than half-way measures.
We must deal firmly with tobacco company marketing practices that target children and mislead the public. The Food and Drug Administration needs broad authority to regulate the sale, distribution, and advertising of cigarettes and smokeless tobacco.
The tobacco industry currently spends over eleven billion dollars a year to promote its products. Much of that money is spent in ways designed to tempt children to start smoking, before they are mature enough to appreciate the enormity of the health risk. The industry knows that more than 90% of smokers begin as children and are addicted by the time they reach adulthood. If we are serious about reducing youth smoking, FDA must have the power to prevent industry advertising designed to appeal to children wherever it will be seen by children.
The tobacco industry has a long, dishonorable history of providing misleading information about the health consequences of smoking. These companies have repeatedly sought to characterize their products as far less hazardous than they are. They made minor innovations in product design seem far more significant for the health of the user than they actually were. It is essential that FDA have clear and unambiguous authority to prevent such misrepresentations in the future. The largest disinformation campaign in the history of the corporate world must end.
Recent statements by several tobacco companies make clear that they plan to develop what they characterize as "reduced risk" cigarettes. This legislation will require manufacturers to submit such "reduced risk" products to the FDA for analysis before they can be marketed. No health-related claims will be permitted until they have been verified to the FDA's satisfaction. These safeguards are essential to prevent deceptive industry marketing campaigns which could lull the public into a false sense of health safety.
If our nation is serious about preventing disease, FDA regulation of tobacco products is an essential step we must take.
Even the best new treatments are of little value if avoidable medical errors hinder their effective use. Everyone in the nation knows that Boston was the cradle of the American Revolution, and they are learning that Boston is the birthplace of a new revolution in health care quality too.
Here again, Dana Farber is leading the way. You had the vision to seek new ways to improve the quality of care. You had the leadership to act where others had failed. You recognized early that providers must improve their use of information technology to prevent dangerous and even lethal medical mistakes.
As part of the Partners Healthcare family, Dana-Farber has been at the forefront of the health information technology revolution for more than a decade. You were the home for a computerized prescription project begun by Partners in 1992, which has led to a specialized system to prevent prescription errors in cancer patients undergoing chemotherapy.
Today Dana Farber is a recognized leader in patient-centered electronic health systems, with a number of innovative health IT initiatives in the pipeline. Your unique approach is to integrate safety and personal care, so that new technology is easier for doctors and their patients to adopt. In 2003 Dana-Farber began phasing in electronic medical records with built-in patient safety features. A parallel initiative, currently in development, will enable patients to consult their doctors and make appointments online using the Patient Gateway. They will also be able to record any symptoms between visits to their doctor, by using a health diary that is part of the patient's electronic medical record.
I understand you're now developing a bar-coded wristband, so that cancer patients can be matched against their chemotherapy prescription at every stage of treatment, from the physician's office to the pharmacy to the laboratory. By tracking chemotherapy electronically, you're ensuring that clinicians and care-givers don't accidentally give a patient the wrong drug.
Such leadership is paying off. Fewer than 3 percent of chemotherapy orders at Dana-Farber contain errors, compared with an estimated 20 percent of such orders at other hospitals. I look forward to future such successes, and to hearing about the expansion of the Institute's information technology to Children's Hospital, to improve the quality and safety of pediatric care.
We in Washington have our responsibility as well. Innovative institutions have shown that we can reduce medical errors by moving away from a culture of blame and shame and cover-up to a new culture in which health professionals can report their errors and near misses in an environment where such events are seen as an opportunity for learning and improvement, not punishment.
Last year, Democrats and Republicans achieved a strong bipartisan success when Congress finally responded to the call of the Institute of Medicine's landmark report, "To Err is Human," by establishing a national system for health professionals to report information on medical errors and near errors, without fear that these reports would be used against them.
Also last year, the Senate approved bipartisan legislation to improve the use of information technology throughout the nation. We have work to do to make sure that this needed legislation is approved by the House and signed into law, but I'm optimistic we'll succeed.
We are reminded once again of the urgency of our task by yesterday's report from the Institute of Medicine, showing that medication errors harm 1.5 million Americans every year, and cost the health care system over $3.5 billion annually. Electronic health records and other innovations can sharply reduce this unacceptable toll, and further delay in modernizing our health system is unacceptable.
Our greatest challenge of all is to see that every American can share in the benefits of this new century of the life sciences. Sadly, the nation is drifting farther and farther behind in reaching this goal. Six million more Americans now lack health care coverage than at the start of the decade.
Even those who have insurance too often find that it provides coverage in name only. When disaster strikes, they learn to their horror that needed services are not covered, and the medical bills keep coming. Half of all bankruptcies in the nation today are caused by unpaid medical expenses.
Our hospitals in Boston are an example to the nation of caring for the poor and the medically under-served. And our state government has just showed the nation that it is possible to enact health reforms that provide quality coverage to every citizen.
At work in the Senate, I'm inspired by the commitment and dedication of the doctors, nurses, and staff at Dana Farber. You're proof that with dedication and a commitment to excellence anything can be accomplished. In World War II, the Army Air Force had a motto that could just as easily apply to Dana Farber: "The difficult we do immediately. The impossible takes a bit longer."
But not much longer, I would add, in the case of Dana Farber.