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March 10, 1971
STANFORD UNIVERSITY SCHOOL OF MEDICINE
Department of Genetics

Mr. Lee Goodman
Subcommittee on Health
Senate Labor Committee
U.S. Senate

Washington, D.C. 20510

Dear Mr. Goodman,

I am grateful for an opportunity to record my views concerning
the pending bill, S, 34, for a National Cancer Authority.

May I call attention to the closing paragraph of the attached
article on the "Cancer Crusade", as it was written and appeared in .
many newspapers a few weeks ago.

When the idea of a separate agency for Cancer was first proposed
I favored it as a way to solve the problems summarized in that writing.
Since then, a number of developments have led me to believe that a
separate agency for cancer, while an improvement over some recent
history of health research, is not the best choice among new directions.
These developments include the President's new found but unambiguous
commitment to health research in general, and to cancer in particular;
evidence of a new balance, consistency and efficacy in the administration
of HEW under Mr. Richardson's leadership, and the commendable and re-
markably articulate commitment to the integrity of basic scientific work in
the health field expressed by the new science adviser to the President,
Mr. Edward David.

Mr. David, with some specificity, has addressed some of the dis-
advantages of extracting cancer work from the NIH, with which I firmly
agree. These would have been more than outweighed by the disadvantages
of attempting to mount a new initiative in the prevailing context of the
last several years. If the Congress and the President are now able to
unite in framing a strong commitment to a broadly based attack on the
cancer problem, I would agree with Mr. David's formulation,

The problems that had beset health research within NIH were not,
in my view, attributable to administrative weakness within NIH nearly
as much as to the hindrances that NIH itself had to face within the
HEW bureaucracy, This issue having finally reached well-deserved public
attention, I would urge the subcommittee to press for a reorganization
that would meet Mr. David's present formulation, and.at the same time
repair the faults observed by the Senate Panel for the Conquest of Cancer,

Vib over

LT. J. P. KENNEDY, JR. LABORATORIES FOR MOLECULAR MEDICINE, DEDICATED TO RESEARCH IN MENTAL RETARDATION ‘
MOLECULAR BIOLOGY HEREDITY NEUROBIOLOGY , DEVELOPMENTAL MEDICINE
Mr. Lee Goodman -2- 3/10/71

To that end, I would now advocate that the Cancer Agency not be
separated from NIH. Rather all health research should be knit
together within a single agency, specifically an augmented and
strengthened NIH, administered by an Assistant Secretary for Health
Research reporting directly to the Secretary.

Whatever detailed bureaucratic arrangement is adopted, the
civilian advisory councils have played an indispensable role in
maintaining the scientific integrity of federal research grants
programs. The draft bill S. 34 does not maintain an adequate line of
authority for the new Cancer Advisory Board, This should certainly be
no weaker than the Councils of the several institutes of NIH. I am
myself painfully aware of some delays in the functioning of these
councils, especially in response to opportunities for quick starts
on innovative ideas; but this problem can be remedied by strengthening
the councils. Specifically the councils should be enabled to delegate
their authority to approve grants to the director, when procedures
validated by the Council have been implemented, There are many other
administrative problems, too detailed to go into here, that are a
consequence of perhaps unduly strict interpretation (or draftsmanship)
of the enabling legislation for the institutes -- I am sure you could
get voluminous and competent testimony from the directors, Again in
agreement with Mr. David, I would argue that the country would be
better served by reinvigorating the NIN as an integral unit than by
inventing new streamlined procedures for the benefit of an excised
and transplanted cancer authority.

Sincerely yours,

Joshua Lederberg
Professor of Genetics

Ju/rr