The 1937 National Cancer Act: precedent for the 1948 National Heart Act
We would be negligent in our historical account of the National Heart Act and the Institute it created if we failed to toss a bone to the mavericks who established the precedent of separate institutes within NIH for research on particular diseases. In fact, it was Congressman Maverick (D., Texas) who in 1936 first introduced a bill devoted to cancer research, the National Cancer Act. And it was Maverick’s contemporary, Senator Bone (D., Washington), who submitted his bill simultaneously for a National Cancer Institute, paired with an identical bill introduced in the House by his colleague, Warren Magnusen. Bone had been advised by President Roosevelt about the strategy to tack amendments onto proposed appropriations, and so attached his to a bill for a popular health cause, venereal disease control.
Historian Stephen Strickland tells us, without identifying the obstructionist, that Senator Bone’s only antagonistic colleague abruptly withdrew his objection shortly after his wife developed cancer. He then became the 95th Senate signatory of the bill (Strickland, 1972). When a wave of public endorsements descended upon Congress favoring these legislative proposals on cancer, a compromise bill, the National Cancer Act, was briskly joined by both houses and enacted in July 1937.
In fact, however, the landmark legislation had to override powerful opposition to a National Cancer Act and Institute from the medical community. For example, the USPHS advisory council on cancer was against it. The chairperson of the separate National Cancer Advisory Council, James Ewing, declared skeptically: “This solution [to cancer] will come when science is ready for it and cannot be hastened by pouring sums of money into the effort” (ibid., 14). And the American Medical Association raised a characteristic shriek against “socialism:” “The danger of putting the government in the dominant position in relation to medical research is apparent” (ibid.). But in 1937 the deed was done. And with it the road was paved for the now-numerous national institutes for discrete diseases and for the centralized system and organization of research around NIH.
All this institutional construction had emerged from the acknowledged success of World War II national research policy, its organization and funding. Since those times, most researchers today owe their sustenance, and the U.S. its world leadership in research, to all those who built NIH into the international power and center of scientific medicine.
But the increasing fractionation into specialties of this national research strategy, with its many agencies and special interests, along with bench and clinical dominion over extramural investigation priorities in the system, have rarely been questioned and never adequately evaluated. In any case, heart enthusiasts owe much to the earlier advocates for cancer. (Henry Blackburn)
Strickland, S. 1972. “Politics, Science and Dread Disease. A Short History of the United States Medical Research Policy.” Harvard University Press, Cambridge.