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Good intentions aside, should the Pentagon fund cancer research?

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By Walter Pincus
Monday, September 27, 2010; 7:53 PM

Top Pentagon officials are to appear before the Senate and House Armed Services committees Tuesday and Wednesday to support Defense Secretary Robert M. Gates' ambitious effort to reduce Defense Department overhead by $100 billion in the next five years and to eliminate redundant spending.

Although members of Congress generally welcomed Gates' approach, the few who faced immediate reductions that affected their constituencies were less supportive. For example, Sen. James Webb (D-Va.) has called for Gates to provide "full justification" for the plan to eliminate the Joint Forces Command located in the Norfolk area.

The Pentagon has described the command, established to encourage collaboration in training and deployment among the services, as becoming "over time an unneeded extra layer and step in the force management process."

Two Joint Forces Command programs over the past two weeks raise questions about its unique relevance. In mid-September it sponsored, along with the National Defense University, a two-day conference entitled "Rise and Fragmentation of Great Powers," held at Old Dominion University. Analysts and academics talked about Russia in particular.

Last week at Camp Pendleton, Calif., it sponsored, along with the Office of Naval Research, an interactive training tool called "Future Immersive Training Environment." There, Marines spent time with actors and others in realistic war scenarios replicating what they may face in Afghanistan.

I won't mention the approximately $500 million spent annually on military bands.

But there are even more controversial budget-cutting targets within the Defense Department's $700 billion budget if Gates really meant what he said when he indicated that even spending on health issues would be reviewed. For example, he might take a look at the roughly $200 million the Defense Department spends each year on cancer research through programs run primarily by contractors.

I am not against cancer research - far from it. But I raise the Pentagon's cancer-research program because it is a textbook illustration of how money over the years for worthwhile and some not-so-worthwhile government undertakings have been funded through the Pentagon because it is so easy to get Congress to approve money in the defense budget. Be honest: Items get approved in the name of defense that would never make it if found in the budgets of other departments.

In1992, Congress first inserted $25 million into the Army's Research, Development, Test, and Evaluation budget to pursue research on breast-cancer screening and diagnosis for military women and dependents of military men. The program has taken on a life of its own: The next year, a grass-roots effort by the National Breast Cancer Coalition lobbied to get that amount increased to $210 million, specifying it was for support of a peer-reviewed competitive grants program in breast cancer research.

The Army was not staffed to run a program of this nature. It turned management over to its Medical Research and Materiel Command, which created the Defense Department Breast Cancer Research Program (BCRP), which continues to administer it today. But to establish a research program to dispense the money, the Army had to turn to the Institute of Medicine, the nonprofit, nongovernmental health arm of the National Academies of Science.

The Institute of Medicine recommended an investment strategy to support scientific initiatives that had a two-tiered system of peer review. Its report also emphasized the importance of "channeling the research funds in directions that stimulate innovative ideas, involve interdisciplinary research, enhance the use of existing research resources, and reward scientific excellence among all disciplines."

Congress has continued to appropriate additional funds to the BCRP, totaling $2.36 billion through fiscal 2009. Through that time, 40,301 proposals have been received and 5,542 awards have been funded or recommended for funding. The Army's Medical Research and Materiel Command contracts out staff support to handle the peer-review process and the applications process, and to help with oversight of the research.

The process takes time.

For example, the $150 million approved by Congress for fiscal 2009 was not planned for final distribution until this month, according to the Pentagon. Another $150 million was approved for breast cancer research in the fiscal 2010 budget, and the Senate Appropriations defense subcommittee has approved an additional $150 million for fiscal 2011.

Two other cancer-research programs have been begun in recent years. The Defense Department Prostate Cancer Research Program will get $80 million next year and $10 million will go to its Ovarian Cancer Research Program.


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