Conquer cancer Biden's mission to the moon

A couple of weeks ago I wriggled my way into an overcrowded conference room at the World Economic Forum in Davos to listen to US vice-president Joe Biden talk about efforts to cure cancer with a “moonshot” (an American buzzword for high-risk, potentially high-return forms of research).

It was very revealing for two reasons. For one thing, when I saw Biden performing at close quarters, I finally realised why Democratic party elders have been muttering for months that he would be their preferred presidential candidate if Hillary Clinton fails to galvanise the voters.

Biden can connect with an audience with an ease that, sadly, Clinton often lacks: though he arrived woefully late for the moonshot meeting, he oozed such charm that the audience (almost) forgave him. And when he explained why he was involved in the moonshot initiative — namely because his own son died of brain cancer — he was compelling. “I have experienced the dreaded C word, which is the most frightening word that anyone wants to hear walking out of the office,” he said. “Had I run [for president] I would have liked to be the president who changes the face of cancer — we need an absolute moonshot.”

But the more important reason why the session was so revealing was the nature of the people Biden had gathered together. Some — including Toby Cosgrove, president of Cleveland Clinic, and José Baselga, chief physician from Memorial Sloan Kettering Cancer Center — were doctors in the classic sense. But many were not. There were professors from other disciplines, and IT experts such as Bill McDermott, head of SAP software group, who was keen to explain how researchers can use big-data techniques to search for patterns in the mutations of cancers.

There were biologists on the platform too, and a chemical engineer — Paula Hammond, head of chemical engineering at MIT. As Professor Hammond observed, scientists could borrow nanotechnology ideas from chemical engineering to breach biological barriers.

“If you asked a psychologist or philosopher what the role of a chemical engineer in fighting cancer [might be], there would not be a ready answer,” Biden explained. “But my son had cancer and one of the things he was talking about was the blood-brain barrier.”

This disparate collection of people illustrates a bigger point: that many scientists realise that if they want to have any chance of curing cancer, they must break out of their medical silos. One of the key paradoxes in medicine today is that while technologies are increasingly straddling medical silos, practitioners are stuck in their narrow fields more rigidly than before. What Biden — and others — emphasise is that knocking down these silos is almost as important as throwing money at any cancer moonshot (the total price tag for Biden’s project is estimated at $1bn). “When you go home and talk to your friends about a cure for cancer, I bet that none of them say ‘data’ and ‘standardisation’,” he explained. “But we have to find a way to break down those silos. This is crucial.”

Does Biden stand any chance in this respect? If you talk to individuals who are working within the gigantic American health system, it is painfully hard to feel optimistic. Last week, I took part in a medical debate in Baltimore and heard officials describe with horror the silos that beset Washington’s mighty National Institutes of Health (apparently there are 27 different departments in the NIH, which are often reluctant to collaborate). And last year I listened as the actor Michael J Fox, who suffers from Parkinson’s, talked about the silos undermining the search for a cure for that disease too; indeed, one of the reasons Fox created his own research foundation was precisely because he was so horrified by the fragmented pattern he saw.

Nevertheless, even if I am somewhat cynical about Biden’s chances of success, he deserves credit for at least putting the issue on the map; and if anyone has enough political muscle to force change, it just might be him. “I am very rude when dealing with bureaucratic delays,” he said. And it seems that whatever he does — or does not — achieve with his “moonshot” will probably feel more meaningful to him than anything he might have done in Iowa, New Hampshire or elsewhere in the grubby presidential race.

I wish him the best of luck; history sometimes twists in strange ways.