Leaders magazine, a “worldwide magazine that deals with the broad range of leadership thoughts and visions of the world’s most influential people,” recently interviewed Nancy Brinker, Founder and Chief Executive Officer of Susan G. Komen for the Cure. In the article titled “A Large Mission” Brinker discussed Komen’s work, progress, and intentions for the future.
The article began in the usual way, reminding readers of Nancy’s famous promise to her dying sister Suzy, a promise to do whatever she could to end breast cancer. Then she stressed, as she often does, that Suzy had faced breast cancer at a time when the social climate surrounding breast cancer was one of “invisible silence.” It’s true that the C word was only ever murmured with hushed tones if at all, and breast cancer was then a silent killer. Brinker stressed that she wanted to “end the shame and hopelessness” caused by breast cancer. In articulating her desire to do something to fulfill her promise to her sister, she stated further;
We saw the weaknesses in the system. People didn’t know how little money was going to research at the time – only $20 to $30 million of support for breast cancer research was coming to the National Cancer Institute, which was fairly new at the time.
With this statement readers learn (or remember) that prior to the rapid expansion of breast cancer advocacy in the late 1980s and early 1990s there had been a dearth of breast cancer research. Nixon’s war on cancer had only been declared in 1971 and the National Cancer Institute was still an immature entity at the time of Komen’s founding in 1982.
Brinker’s statement about research might even lead readers to assume that research was a major impetus behind its stated mission, to “cure” breast cancer. After all, how might a disease be cured? Treatment, and the research used to find, evaluate, and improve treatment. Accurate diagnostics, and the research used to develop, test, and refine diagnostics. Prevention, and the research used to locate the causes of a disease, learn its pathways, and prevent it from occurring in the first place. Education, based on the evidence amassed from bodies of systematic research. Cure relies on research. There’s no reasonable way around it.
Unfortunately, something odd happened on the way to the cure. After thirty years in the nonprofit foundation business, research is no longer the focal point if it ever really was. In fact, today Brinker frequently argues that research is a “helpful” component but not the pathway to eradication. Nancy states;
It’s always helpful to support research, but it’s not enough to do that; if you want to eradicate death by disease, you have to involve every sector of society…To that end, we have more than 120 affiliates throughout America, all of whom are grassroots based organizations who leave 75 percent of what they raise in their communities, focused on low resource people. So they provide education, screening, and some treatment, while 25 percent of what they raise goes back into our national grant pool.
Education. Screening. Some treatment. And a national grant pool. We’re baffled. In 1982 research seemed to be a key mechanism to finding a cure. The National Breast Cancer Coalition continues to prioritize research funding through the Department of Defense and has set a new deadline to reorient research efforts in a coordinated way. Community-based organizations around the nation have formed their own partnerships with researchers and clinics because there isn’t enough research being done on a federal level. Yet 25 percent of monies raised by affiliates are sent back to Komen central allegedly for research.
Okay, how does it add up?
As one of our archived articles reports succinctly from Komen’s own audited financial statements, Komen’s research program in 2010 comprised only 19% of the organization’s total resources. The remainder went to education (37%), screening (12%), some treatment (5%), fundraising and other general overhead (27%). Research clearly is not the priority for the organization, and Brinker brings this point home in the Leaders interview stating, “it isn’t useful to just fund research.” The pie chart below is a visual representation of where Komen’s commitments lie.
Program Services & Other Expenses 2010
Source: The Cancer Culture Chronicles blog
Okay, we get it Nancy. It isn’t useful to just fund research. That’s why it’s such a small part of Komen’s program budget. Brinker reiterates this point;
Today, knowing what we know, it isn’t useful to just fund research; to say you’re helping one woman at a time is not enough. You need to fund the research, but also to make sure that as you’re doing that, the clinical changes are occurring.
Is ensuring clinical change part of Komen’s program allocations? Where is that? How is it accomplished?
At the same time that Nancy Brinker and Komen clearly perceive research to be a minor part of curing breast cancer, the leadership fights over ownership of the trademarked phrase “for the cure” [i.e., see the articles under the category lawsuits] and consistently talks about its strong commitment to research over the years despite the fact that they believe it to be a minor part of eradicating the disease.
Just this week Komen issued another effusive press release in which Komen announced that it will fund $55M toward research grants at 56 institutions across the United States and internationally, with $3M granted to support various patient support conferences and programs in 2011.
Susan G. Komen for the Cure® Commits Nearly $58 Million in 2011 to Tackle Toughest Issues with New, Innovative Approaches to Breast Cancer Research
Global Breast Cancer Leader Focuses on Development of Breast Cancer Vaccine, Creating More Effective Therapies and Reducing Disparities in Treatments for African Americans and Other Ethnic Groups
That’s interesting. It sounds like a lot of money too. Note that $58M is a decrease of about $17M from last year’s research allocation. Why the decline in research funding? Komen had record revenues in 2010 of $389M. Maybe research is getting less and less important to finding a cure for breast cancer. At a whopping $58M, only 15 percent of Komen’s resources for 2010 were allocated to research the following year.
FIFTEEN PERCENT. FIFTEEN PERCENT. FIFTEEN PERCENT. FIFTEEN PERCENT.
Yet, the number ringing in our ears from Brinker’s regular statements about the “national grant pool” is that 25 percent of money raised from affiliates goes to research. Unfortunately, that’s 25 percent of a different number altogether. The Komen shell game plays on as Brinker herself touts the organization’s funding of cutting-edge research. She states,
Our goal at Komen is to fund research with the greatest potential to make a difference and save lives in the shortest period of time. That means putting our dollars toward cutting-edge research that is high-risk, with potentially huge rewards.
Okay, we’re baffled again. If research is not Komen’s priority when it comes to funding, how can the organization expect to “make a difference and save lives in the shortest period of time.” High risk research could potentially result in some great finding that moves the state of science forward in such a profound way that cure is just around the corner. Maybe. But that’s not how medical research has worked in the past. Science moves in fits and starts. Incremental at best. Breakthroughs happen, sure. Wouldn’t Komen increase the odds of breakthroughs in science if it funded more research?
And what does Brinker mean by the “shortest period of time?” How exactly is that to be measured? Someone diagnosed with stage 4 breast cancer is likely to want to see the shortest period of time as sometime about…NOW. That’s unlikely, we admit. Will it happen next year? In ten years? Should we wait another thirty years and keep throwing pink parties in the meantime to celebrate minor successes? When asked by Leaders whether she felt we were any closer to finding a cure, Nancy Brinker said,
I believe we’re about halfway there. For 20 years, most of our research funding went to cancer biology. Now we’re focusing only on taking that biology and moving it toward a translational component.
Okay, 20 years. Is that the “shortest period of time?” What does it mean to be halfway to a cure anyway?
Time is important to a cancer patient. Ten years or twenty years makes a huge difference. It’s important to researchers and physicians too who want to do the best for their patients. Treat them well. Give them hope for a future. It’s not nice to throw around time frames without a clear plan to back it up. And what does Nancy mean when she goes on to say that,
The board asked me to take over as CEO to shape and fashion the organization because we’re all working on the 2020 plan…..
What is the 2020 plan? That’s ten years from now. Clock ticking. Is she referring to the the National Breast Cancer Coalition’s 2020 Deadline, the campaign oriented to eradicating breast cancer by 2020? Or does Komen have it’s own 2020 plan?
We really hope Nancy will tell us WHEN we can expect to “end breast cancer forever,” and how Komen will achieve this lofty goal without making research the priority.
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