The Scientific Activist

On November 6th (and now during early voting) Texans have the chance to vote on a variety of amendments to the Texas Constitution. One of these is Proposition 15:

The constitutional amendment requiring the creation of the Cancer Prevention and Research Institute of Texas and authorizing the issuance of up to $3 billion in bonds payable from the general revenues of the state for research in Texas to find the causes of and cures for cancer.

The full text of the resolution as passed in May by the Texas House and Senate can be read here and additional information is available here. Upon examination of Proposition 15, I find little reason for Texans not to vote "yes".

The campaign in support of the bill is being spearheaded by the bipartisan Texans to Cure Cancer PAC, which includes cyclist Lance Armstrong as one of its most vocal members. As its name implies, the campaign is somewhat sensational and simplifies the issue in talking about "a cure for cancer". Of course, cancer is an incredibly heterogeneous disease, and no scientist would tell you that we are looking for a universal cure. Instead, we are working to understand the basic biology and using that knowledge to develop drugs targeted at treating specific types of cancers. This strategy has met with quite a bit of success, and a whole host of effective cancer treatments are already in common use. This work has only just begun, though, and further progress depends on continued investment in basic research. Therefore, it's great that the State of Texas is willing to make this additional commitment if voters pass Proposition 15.

My only other minor reservation is the potential makeup of the leadership of the Cancer Prevention and Research Institute of Texas. The Institute will be governed by an Oversight Committee:

• Includes four-year term members appointed by Governor, Lieutenant Governor and Speaker (3 each); Comptroller or designee; Attorney General or designee; and cancer survivors and/or family members of cancer survivors.
• Committee hires an executive director for the Institute.
• Committee approves grant awards recommendations from the Scientific Research and Prevention Programs Committee unless 2/3 vote against recommendation.

The Scientific Research and Prevention Programs Committee recommends which research proposals should be funded:

• 9 voting members appointed by Governor, Lieutenant Governor and Speaker (3 each) to include 3 physicians or licensed health care professionals active in cancer treatment; 3 representatives of a licensed health care facility that treats cancer patients; and 3 representatives of voluntary health organizations interested in cancer.
• 9 nonvoting members who represent Texas public/private higher education/health care institutions.
• Members serve four-year terms.

This means that all voting members of the Scientific Committee and possibly the entire Oversight Committee will be directly appointed by Texas politicians (it's not clear to me who chooses the "cancer survivors and/or family members of cancer survivors"). Currently, all statewide-elected Texas officials are Republicans, and many have demonstrated themselves to be harsh ideologues. With that said, cancer medicine is an area not plagued by idealogical concerns like many others. Although exceptions certainly exist, such as the recent controversy over the HPV vaccine, even conservative Republican Governor Rick Perry was on the pro-medical science side on that one. While worrisome, however, the makeup of these committees shouldn't be a deal-breaker.

Despite a couple of (very) minor reservations, I would strongly encourage Texans to vote in favor of Proposition 15. The bill received a great deal of bipartisan support in the Texas House and Senate (116-26 and 24-7, respectively), and it's a good opportunity for Texas to further develop its research infrastructure for a good cause.