The future of innovative medical research under the Department of Defense is in jeopardy.  Due to four provisions (Sections 733, 891, 892, and 893) in the U.S. Senate version of the National Defense Authorization Act (NDAA) of 2018, medical research under the Department of Defense will become very limited.   Furthermore, programs like the Congressionally Directed Medical Research Program (CDMRP) will be eliminated.

This is a big deal because CDMRP under the Department of Defense is a high-risk, but high-reward, program by supporting highly innovative medical research that many private entities will not support.

Take the story of Dennis Slamon, a cancer physician-scientist at UCLA, and his crazy idea of using a human-made antibody to cure cancer in 1993.  Established academics thought that inhibiting cell growth with this antibody was farfetched.   That same year the National Breast Cancer Coalition, a consumer advocacy group, presented President Bill Clinton with a 2.6 million-petition signature. The group urged the President to develop a comprehensive plan that would end the breast cancer epidemic. In response, Congress, through the Department of Defense, created the CDMRP.

Dr. Slamon was given a research award through CDMRP to test a highly innovative antibody drug called trastuzumab (Herceptin).  He wanted to see what effects Herceptin, a drug that specifically targets HER2 receptors, would have on breast cancer cells in his laboratory and on mice with these tumors.

Women with “HER2 positive” have horrible outcomes with traditional chemotherapies. About 20% of women with breast cancer have an over-expression of HER2 in their tumors, which directs cancer cells to grow out of control and divide rapidly. Women with this “HER2 positive” type of breast cancer will have their cancer recur more quickly, and they die sooner.

Results from Dr. Slamon’s laboratory research turned out to be a huge success.  Subsequently, this led to human clinical trials that showed astonishing results.   Women with “HER2 positive” breast cancer, were living much longer when given Herceptin.  For some women, the cancer never returned.  As stated in the book, The Emperor of All Maladies, the results from the clinical trials of Herceptin were “simply stunning…not evolutionary, but revolutionary.”


Dr. Slamon’s research revolutionized, not only breast cancer treatment but also the emerging field of “targeted therapy”—drugs that target specific cancer genes or proteins.

The CDMRP was instrumental in supporting the early laboratory research of Dr. Slamon so he could test the efficacy of Herceptin.

Since 1993, CDMRP evolved to include innovative medical research, not only of more cancers, but also rare diseases and diseases that affect veterans, like Gulf War Syndrome, PTSD, and brain/spine injuries from combat.

The program supported the first double hand transplant on a combat wounded amputee.

The program also contributed to the world’s first thought-controlled bionic leg.

But now, due to the language in four provisions of the NDAA 2018 bill in the Senate, research funding for many diseases and cancers will be eliminated under the CDMRP.

Because of this devastating consequence on medical research and innovation, over 100 medical and health organizations wrote a consensus letter to Senators John McCain (R-AZ) and Jack Reed (D-RI), who lead the Senate Committee on Armed Services. These organizations urged the Senate committee to nullify the four provisions.

That letter, however, did not deter the Senate’s plan. So in September, the Senate passed their version of the bill with these four provisions in it. While the Senate version significantly limited medical research, they agreed to an increase in military funding–providing $700 billion–to fund various military and warfare operations.

What seems nonsensical is why the Senate would decrease funding for medical research when it is a tiny fraction compared to the $700 billion. In 2016, CDMRP granted a little over 1 billion dollars for biomedical research to scientists—that is just 0.14% of that $700 billion.

The bill is now undergoing conference between members of the House and Senate to work out the differences between their versions.  The House did not include these four provisions that will limit medical research.  Many medical organizations are asking people to call or write their House representative to oppose these four provisions during conference with the Senate.

The future of innovative medical research in the Department of Defense now hangs on this conference debate in Congress, and the impact from these letters or calls received from concerned constituents.  A final decision is expected early next week, then it will go to President Trump’s desk for him to sign.

Francis Collins, the director of NIH, recently stated to Congress, “Our nation has never witnessed a time of greater promise for advances in medicine.” Advances in our understanding of the human brain are giving us new insights into diseases like autism and Alzheimer’s. Immunotherapies in cancers are giving us hope for some cancers that were certain death sentences. Vaccine developments, like the HPV vaccine, are giving us the potential to prevent many cancers.

Now is the ideal time to continue our investment in scientific and medical research.  This will keep America a global leader in both science and biomedical innovation.  Instead, we are witnessing yet another instance of lawmakers in D.C. that seem more interested in funding wars, while continuing to make drastic cuts in science and medical research programs.

Over 2 million signatures from concerned citizens compelled Congress to create the CDMRP in 1993. Ironically, unless concerned citizens demand the removal of the four provisions in the NDAA 2018 bill, Congress will pass a bill that is going to destroy the CDMRP.  Sadly, a great era of innovative medical research under the Department of Defense will become history.

I am a gynecologic oncologist, a husband, and a father. My blog is mostly about our healthcare system and well-being, but occasionally I get inspired to write about other "stuff" too.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: