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Biden Cancer Initiative’s Greg Simon

Greg Simon is the president of the Biden Cancer Initiative, formerly called The Cancer Moonshot, the goal was to try to make ten years of progress in five years. It was kicked off by President Obama and led by Joe Biden. Greg has been involved since the outset. Brett Johnson: So, Greg, what is the mission of the Biden Cancer Initiative? Greg Simon: Our mission is very similar to what we did in The Cancer Moonshot in the White House, which is to double our rate of progress in the prevention, detection, diagnosis, treatment and survivorship of cancer. We are not a funding organization, we’re not a service organization, we are trying to change our system to be able to harness the people, the knowledge, the science and the patient community to really accelerate our works against cancer by changing the way we do business. BJ: That’s a bold mission. How do you change the way people approach these things? GS: Well, we like to say that you can either persuade them or shame them. Vice President Biden often says that he has two talents; he can convene people and he can shame them into doing the right thing. That’s a little facetious. What we do is we hold a mirror up to the system the way it is, and we show people how different it is from what people think is our system. I like to say that we’re trying to create the cancer research and care system that you think we already have. Most people think that people share data all the time; they don’t. Most people think that doctors anywhere know what’s going in with the doctors in the biggest institutions, so that you get the same treatment that they do in New York or Boston. Well, that’s not true. Most people think that they can get their medical records, or they can share them or they can easily move them; you can’t. Even though they belong to you. Most people think that when a trial fails, that everyone learns about so you don’t do it again. Not true. I could go on and on. There are so many things that we assume about a good system that are not true in our current system. So, we convene patients, leaders of institutions, our researchers, doctors and try to get them to adopt new ways of doing things. BJ: So, how did you get involved in all of this? What’s your background? GS: Well, I was minding my own business in New York, running my own company. I got a call from Biden’s Chief of Staff asking me to come meet with him. Now, I had worked with Biden’s Chief of Staff during the Clinton administration, when I was Vice President Gore’s Chief Domestic Policy Advisor. He and I, the Chief of Staff, had worked on some pretty complicated things like the Telecommunications Act of 1996, that completely revamped the telecommunications industry. He said that he needed somebody who knows how to deal with complicated issues, who knows science policy (and I had been on the Health Science Committee for six years as a Staff Director), and who knows cancer politics. I had started FasterCures for Mike Milken back in 2003, which focused on more than cancer but certainly cancer was a big part of it. I said to him ‘well, unfortunately, that sounds like me.’ What he didn’t know, was that I had just finished six months of chemotherapy for chronic lymphocytic leukemia. So, it was perfect timing for me to change what I was doing. I met with Biden and that went really well, and next thing I knew I was in the White House. BJ: Wow, that’s amazing. So, from a 30,000 foot pitch perspective, where are we at today with progress on cancer? Where do you see us going? GS: The good news is that we’re much farther along than we’ve been because progress does happen more quickly now given our incredible tools, the number of people and the amount of money involved. I like to remind people that when Nixon declared the War on Cancer in 1971, he had no army, no weapons and no strategy; he just wanted to start it and that was a good thing. Now, 47 years later, we have millions of patient’s experience to learn from. We have thousands of trained doctors in sciences that didn’t exist in 1971. We have phenomenal tools that can take you down to the individual cell for analysis. So, I divide cancer these days into three kinds. There are the ones that we’re treating very successfully, which is most breast cancers, testicular cancer, most prostate cancers. There are cancers that we have no luck with right now, such as liver cancer, brain cancer, pancreatic cancer and lung cancer, although that one is getting better. Then, there are the ones that are in between. I have friends who have died from multiple myeloma, and I have friends that have lived 20 years with multiple myeloma. I have friends that have survived breast cancer, my sister included, and I have recently lost a friend to breast cancer. So, there are a number of cancers where it’s very personal about whether you will survive or not based on the nature of your particular survivor, your access to healthcare and your ability to be able to withstand the treatment, which can often be very brutal. While we’ve made a lot of progress, we should be making much more progress, and that’s why we’re doing what we’re doing. BJ: What’s the approach that you’re taking? Can you tell us about your strategy? GS: Our strategy is to identify some of the critical areas where we can do better. Then, we tap some of the brightest people in that field and other fields, because often innovation comes from outside the field you’re trying to change. What we do is ask them, people aren’t sharing data, or there’s not a standard way of measuring the response to an immunotherapy drug, how can we change that? Who is doing the best job in changing that, and how can we scale what they’re doing? So, we don’t start with a blank sheet of paper and just come up with something that’s never existed in the world. We try to find something that’s working, but is not yet the standard and then figure out what we have to do to make it widely adopted and widely followed. We’re doing that with data sharing, data standards, new ways of doing clinical trials, patient navigation, prevention, access to therapies and the cost of therapies. Those are six working groups that we’re doing, as I just said, where we pull in some of the best people in the country and we ask them who is doing the best job at finding a solution to this problem. Then we go and figure out who the key players are that need to adopt this model. BJ: Interesting. How do you measure success in this undertaking? GS: Well, it’s difficult, because while there are some quantitative measures like how many open journals, how much data is put on clinicaltrials.gov or cancer.trials.gov. How many pediatric clinical trials are being started this year, compared to last year? While there are a lot of quantitative measures, we also focus on some of the cultural and qualitative measures. Are people really starting to change the way they think about it and talk about it? Are patients being consulted more quickly and earlier in the process of designing clinical trials, for instance? Do we know what a patient considers to be a good quality of life, at the end of their life, if their cancer is not curable? There are a lot of qualitative measures that we look at in terms of whether the major institutions just paying lip service to these changes, or are they actually coming to us and saying ‘you know what, you’re right, we want to change the way we’re doing it, will you work with us?’ That’s how we really measure success, with the number of people willing to stand up and put their hand up and say ‘we’re willing to take a chance on doing things differently because we can’t be doing things the way we did 50 or 100 years ago,’ which we still are, in a modern world where we have unlimited computing power, unlimited communications ability and a real dire need as more and more people are diagnosed with cancer. BJ: In terms of engagement and involvement, can you quantify the number of organizations you work with and the number of people you work with? Is that a measurement you have? GS: Well, let me put it this way. When we were in the White House, we did a summit called The Cancer Moonshot Summit in June of 2016. We had 400 people in Washington, and 7000 people self organized 270 simultaneous meetings around the country in every state, including Puerto Rico and Guam, to be part of our Cancer Moonshot Summit. That showed us that this had gone from a program to a movement, because I would never have expected that many people to say ‘yes, we want to be a part of this.’ We’re doing a summit in September, and we have close to 300 community summits already identified where people are willing to do their own workshop on the same day that we’re doing a workshop in Washington. That tells us that there are thousands and thousands people that want to be involved. There are scores and scores of companies and organizations that contact us. Every time I give a talk, I get approached by 20 to 30 companies or universities or non-profits. One of our greatest assets is the good will of the public, because they know that Joe Biden and Jill Biden are coming at this from a profoundly personal way without any alternative agendas or ulterior motives. That’s something that we rely heavily on, to use the phrase ‘the kindness of strangers.’ We get offers of help from every corner of society, and it’s often more than we can even handle. BJ: Interesting. So, how have you funded this effort? GS: The old-fashioned way. We went to foundations and individuals to raise money. We raised between $4,000,000 and $5,000,000 which we focused on our programs and our staff, which is relatively small. As I mentioned, we don’t give out grants, so we didn’t have to raise hundreds of millions of dollars. We’ve gone to some major funders, that way we don’t have to spend all of our time raising money. It gave us the chance to get up and running very quickly. We launched the Biden Cancer Initiative in June of 2017 after we incubated it inside the Biden Foundation, which is a separate organization from us now. We started inside the Biden Foundation, and then launched as an independent 501(c)(3) in June of 2017. BJ: Can you tell us a little bit about the organization itself? GS: Well, Joe and Jill Biden are the co-chairs. We have a phenomenal board of people like Liz Jaffee, an immunotherapy pioneer at Johns Hopkins. Eric Lander, the head of the Broad Institute. Taboo from The Black Eyed Peas. Erin Andrews from the NFL and Dancing with the Stars, who is a cancer survivor, as is Taboo. David Agus, a prominent cancer doctor in California. David Bradley, owner of The Atlantic. Kurt Grote, a partner at McKinsey who helped us get launched, and many others I can name that comprise our board. Our advisory committee has an equally stellar group of people who help us look at the individual programmatic challenges that we have. We have 8 permanent staff and a few interns all the time, but we’re a fairly lean and mean organization. BJ: Does Joe Biden have a chance to get actively involved? GS: He is heavily involved. Now, he’s got a lot of things to do. He’s got a PAC for helping people in the midterm elections, he’s got a foundation for foreign policy at the University of Pennsylvania, he has the Biden Foundation which focuses a lot of social issues such as LGBTQ equality, opposing violence against women and campus sexual assault issues that he’s prominently been involved with when he was Vice President and previously as Senator. So, we get him in three or four days a month, which is a lot given how much he has got going on. He is heavily involved, gives a lot of speeches, meets with our board on a regular basis, meets with our working groups. He is knee deep into what we’re doing. BJ: Can you tell us about the town halls and the community summits, and how those are going to work? GS: Well, we’re focused on people doing new things. As you know from the Cancer Moonshot Report, which people can find online at www.medium.com if they search Cancer Moonshot, we’ve catalyzed nearly 80 initiatives when we were in the White House from the private sector, public sector and academic sector. We’re not about white papers, we’re not about just talking about it, we’re trying to actually launch new initiatives that can double our rate of progress. So, our summit on September 21st is focused on a workshop in Washington about some of the issues I mentioned earlier. The summits around the country, each will pick a topic that they want to focus on and we have created video content for each of those topics as a conversation starter, so to speak. Then, at the end of the day, we have a town hall with Vice President Biden and some of our board members where people from the audience here in Washington, but also people around the country, can tune in and ask questions directly of Vice President Biden and the BCI board. That’s how we learn what’s on people’s minds. When the Vice President and Dr. Biden go around the country meeting with people in coffee shops and ice cream parlors, it’s not always giving speeches in big halls, we learn a lot about what people’s problems are and what they want to about it. That’s the point of the town hall. BJ: What impact do politics have on this? For example, the midterm election, does that have any impact on this? GS: As the Vice President likes to say, cancer is the only bipartisan issue left in America. A Republican congress authorized $1.8 billion for The Cancer Moonshot before Obama left. Mitch McConnell named that part of the bill ‘The Boe Biden Cancer Moonshot Act’ after Biden’s son. We’ve had two years in a row now where the Republican congress has appropriated the money that was authorized in that bill to the tune of over $300 million a year. For new Cancer Moonshot related funding, not the old program. So, all of that is to say that we have been working very well with both parties and with both houses of congress and the administration. We are very excited about that. In fact, we are a safe space where people from both parties can come together and agree that this needs to be a national priority, and I’m very happy that this is the way it works. BJ: Very good. So, do you have any final thought as to what the key takeaway should be for people as they consider what you guys are trying to do? GS: Well, the question I get all the time is ‘how can I be involved?’ My answer is that you don’t always have to have money or be at a major institution to be involved. People can organize a community summit on the 21st of September in their living room, with people they know who have cancer or whose families have had cancer. People can help people get to their treatment, watch their children, water their plants, help raise money to pay for expenses of being in a clinical trial or commuting to a cancer center. People can help educate other people about the stigma that’s attached to certain cancers that should not be there. There are just so many things that people can do. We have put on our website, www.bidencancer.org, a call to action where we invite people to tell us what they want to do and we will try to figure out a way to help them. We also gather stories about how people turn their cancer fears into what we call ‘cancer fierce.’ How to take the anxiety, the depression and the fear of cancer and become a fierce warrior in your fight against cancer. We get some amazing stories that people have shared with us wherever we go, as a way of inspiring other people to know that there’s always hope. BJ: Terrific. That’s terrific insight on a really wonderful initiative, and we’re really excited for you and happy to help. Thanks for joining us today. GS: Thank you, Brett, my pleasure.

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