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Solution to Asbestos Public Health Crisis

January 21, 2005

The Honorable Arlen Specter
Chairman, Senate Judiciary Committee
711 Hart Building
Washington, D.C. 20510

Re: Solution to Asbestos Public Health Crisis

Dear Senator Specter:

As you have acknowledged, asbestos disease in this country is a public health crisis. We the undersigned are doctors and scientists who have expertise in the diagnosis, causation, prevention and treatment of malignant mesothelioma, the signature cancer for asbestos exposure. Mesothelioma is painful tumor with a dismal prognosis, and our mission is to increase the funding of the medical research that will, we believe, eventually solve the problem.

On January 11, 2005, Billy Speicher, a mesothelioma patient, implored his government to help find a cure. We were pleased that in response you acknowledged that asbestos disease is more than a litigation crisis and that the government should play a leadership role in funding medical research. You indicated that you, as a member of the Labor-HHS subcommittee, would look into how much of the National Cancer Institute's nearly $5 billion budget is earmarked for basic and applied research on mesothelioma.

We also looked into this question, and here is what we found. From 2000 to 2003, the NCI spent on average $2.1 million per year on grants which use the word "mesothelioma" in their abstract. This amount is far less than .1% of the NCI's 2004 budget. Unlike other cancers, the NCI does not even have a formal budget for mesothelioma research, nor does it solicit grants relating to the treatment or cure of mesothelioma. Mesothelioma kills between 3,000 and 4,000 Americans annually (the exact number is unknown since this country does not have a nationwide registry unlike many others). Cervical cancer, which has a similar mortality profile (viz., about 4,100 deaths per year), in 2003 received $71.3 million from the NCI. To put those numbers into perspective, the NCI allocated $17,340 for each cervical cancer death, but only $933 per mesothelioma death. Clearly, mesothelioma is under-funded when compared to other cancers.

Of the patients diagnosed with mesothelioma every year, approximately 32% were exposed to asbestos while serving in the U.S. Navy or while working in U.S. Navy shipyards. However, neither the Department of Defense nor the Department of Veterans Affairs has a program for the detection, prevention, treatment or cure for mesothelioma. Meanwhile, Congress has since 1992 appropriated over $3.4 billion to the DOD for Congressionally Directed Medical Research Programs (CDMRPs). A substantial portion of those billions has been targeted for breast, ovarian and prostate cancer research -- cancers that are not specific to military service. Mesothelioma, on the other hand, is clearly a service-connected injury for veterans who worked with and around asbestos.

We believe the Federal Government must take the lead in solving the national tragedy of mesothelioma. Mesothelioma has been a known occupational cancer for over 50 years. Billions of dollars have been consumed by asbestos litigation, most of which has been absorbed by transaction costs. Thousands of veterans and civilians have already died as a result of asbestos diseases, and the mortality rate for asbestos cancers is expected to climb over the next 10 years, as millions of tons of asbestos remain in place in schools, buildings, homes and workplaces throughout the country, subjecting millions of Americans to an increased risk of cancer. The asbestos epidemic will continue to haunt us for decades, unless we take long overdue curative action.

In 2002, MARF proposed a comprehensive $140 million mesothelioma research and treatment program, which is 0.1% of the projected value of the $140 billion federal asbestos trust fund you are endorsing. The program addresses the public health program at all levels: prevention, early detection, education, treatment and cure. The program would foster collaboration between public and private researchers, create nationwide treatment networks, promote and fund innovative research, attract top scientific and medical talent, and provide meaningful treatment options. In particular, the program would:

  • Establish a competitive peer review grant program;

  • Fund Ten (10) Centers of Mesothelioma Research/Treatment Excellence ($2.5M per year for five (5) years);

  • Fund the Admiral Elmo Zumwalt Registry and Clinical Database;

  • Fund the Congressman Bruce Vento Blood & Tissue Bank; and

  • Target Research Priorities, which include:

    • Biomarkers for early detection and prediction of recurrence;
    • Biological therapies (immunotherapy, gene therapy, novel chemotherapeutic compounds);
    • Strategies for prevention (inhibit pathways transforming normal to malignant cells); and
    • Pain Management (mesothelioma is an extremely aggressive and painful tumor).

The current version of the FAIR bill incorporates only a portion of MARF's proposal. Unfortunately, the need to fund medical research has always been drowned out by the often shrill debate over who pays and how much. Because asbestos disease is a public health crisis, and because the U.S. Government must play a leadership role in solving the health problem, we believe present and future asbestos disease patients are best served by a direct appropriation for a CDMRP for mesothelioma. The need to alleviate the suffering, extend survival, prevent needless death and create hope should not be tied to the fortunes of an asbestos litigation reform bill, which historically has failed to resonate with the American people in general and asbestos victims in particular. Compensating victims does not in itself solve the health crisis, and the two issues should be treated separately.

The U.S. Government has a role and so does industry, which for years mined, milled and processed the once ubiquitous mineral fiber. As you have said repeatedly, since 2000, over 40 former asbestos companies have sought reorganization under Chapter 11 of the Bankruptcy Code. Experts project that the aggregate value of all pending asbestos debtors' settlement trusts will exceed $65 billion (this number does not include the value of the 10-15 existing Chapter 11 asbestos debtor trusts). A substantial portion of the future trusts will be siphoned off by management fees. Yet none of that money is required to be set aside for peer-reviewed competitive research grants to help alleviate the suffering of current claimants or extend the lives of future claimants. We implore Congress to amend the Bankruptcy Code to mandate that a reasonable percentage of existing and future asbestos settlement trusts be allocated to a medical research trust, which will target and fund meritorious research programs designed to detect, prevent, treat and cure asbestos cancers. The former asbestos companies will walk away from the bankruptcy courts, cleansed of their tort liabilities, and leave behind a legacy of 27 million Americans with dangerous levels of carcinogenic asbestos fibers in their lungs, fibers which one day may generate lung cancer or mesothelioma, for which the median survival at present is 12.3 months for those patients fortunate enough to qualify for chemotherapy.

We believe we can find the Achilles heel in mesothelioma. Even with limited funding, we have been able to make meaningful improvements in the survival of mesothelioma patients. But to declare victory against this terrible tumor which has exacted such a heavy toll on Navy veterans, and which over the next 15 years will likely rear its ugly head in the lung and abdominal linings of the brave men and women who responded to the 9/11 terrorist attack at Ground Zero, we cannot continue to rely on private donations alone. We need the resources and the commitment of the U.S. Government. The Government has the awesome power to replace despair with hope, nihilism with optimism, defeatism with a can-do spirit, and rhetoric with action.

We appreciate your efforts to help our patients survive the ravages of a tumor that does not respect rank, power, age, sex, fame or political affiliations. We would be pleased to meet with you and your staff to articulate the details underlying MARF's proposals.

Sincerely,

Steven Albelda, M.D.
Vice Chief and Director, Lung Research
University of Pennsylvania
Philadelphia, Pennsylvania
Raphael Bueno, M.D.
Division of Thoracic Surgery
Brigham & Womens Hospital
Boston, Massachusetts

Robert B. Cameron, M.D.
Associate Professor of Clinical Surgery
UCLA Medical Center
Los Angeles, California

Steve Hahn, M.D.
Department of Radiation Oncology
Philadelphia, Pennsylvania
Michael Harbut, M.D.
Center for Occupational and
Environmental Medicine
Royal Oak, Michigan

Hedy Lee Kindler, M.D.
University of Chicago Medical Center
Section of Hematology/Oncology
Chicago, Illinois

Ulf Jungnelius, M.D
Pfizer, Inc
Executive Director
Oncology Clinical Development
New London, Connecticut
Dan Miller, M.D.
Surgical Director, Thoracic Oncology
Winship Cancer Institute
Emory University
Atlanta, Georgia

Harvey Pass, M.D.
Professor of Surgery and Oncology
Karmanos Cancer Institute
Detroit, Michigan

Lary A. Robinson, M.D.
Director, Div. of Cardiovascular &
Thoracic Surgery
H. Lee Moffitt Cancer Center &
Research Institute
Victor Roggli, M.D.
Professor of Pathology, Duke University
and Virginia Medical Centers
Durham VA Medical Center
Durham, North Carolina
W. Roy Smythe, M.D.
Professor & Chairman
Texas A&M Univ. Health Sciences Ctr.
Scott & White Hospital and Clinic
Department of Surgery
Temple, Texas
Daniel Sterman, M.D.*
Director, Interventional Pulmonology Program
Clinical Director, Thoracic Oncology Gene
Therapy Program
Associate Professor of Medicine in Surgery
University of Pennsylvania Medical Center
Philadelphia, Pennsylvania
Joseph R. Testa, M.D.
Cancer Genetisist
Fox Chase Cancer Center
Philadelphia, Pennsylvania
Eric Vallieres, M.D
Thoracic Oncology
Swedish Cancer Institute
Seattle, Washington
Claire Verschraegen, M.D.
Director of Experimental Therapeutics
Cancer Research and Treatment Center
University of New Mexico
Albuquerque, New Mexico

Nicholas J. Vogelzang, M.D.
Director, Nevada Cancer Institute
Las Vegas, Nevada

Bret Williams, M.D.
Mesothelioma Patient
Hillsborough, North Carolina


* President, International Mesothelioma Interest Group, http://www.imig.org. The International Mesothelioma Interest Group (IMIG) is a multinational scientific organization composed of researchers, clinicians and others dedicated to research into the causes and cures for Malignant Mesothelioma.

Cc: Senate Judiciary Committee:
Sen. Saxby Chambliss (R-GA)
Sen. John Cornyn (R-TX)
Sen. Larry Craig (R-ID)
Sen. Mike DeWine (R- OH)
Sen. Lindsey Graham (R-SC)
Sen. Charles E. Grassley (R-IA)
Sen. Jon Kyl (R-AZ)
Sen. Jeff Sessions (R-AL)
Sen. Patrick J. Leahy, Ranking Democratic Member, VT
Sen. Joseph R. Biden, Jr. (D-DE)
Sen. Richard J. Durbin (D-IL)
Sen. Russell D. Feingold (D-WI)
Sen. Dianne Feinstein (D-CA)
Sen. Edward M. Kennedy (D-MA)
Sen. Herbert Kohl (D-WI)
Sen. Charles E. Schumer (D-NY)

Sen. Harry Reid (D-NV)
Sen. Patty Murray (D-WA)

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