Portal de Periódicos da CAPES

September 11th

2001; Wolters Kluwer; Volume: 23; Issue: 12 Linguagem: Inglês

10.1097/01.cot.0000315009.16627.71

1548-4688

Robert C. Young,

FigureWe are, in so many ways, still digging out from the rubble of September 11. We all know that in a few hours on that beautiful, late summer day, something ended, and something began, but it is too early to assess what it means or where it will lead. We are in the CNN portion of experiencing this new history, the breaking news of day-to-day and even hour-to-hour developments. While we may lack perspective, we are faced with a multitude of questions, questions that pertain not only to the future, but also to the more routine matters of running our lives and our organizations. One question raised by the events of September 11 is the impact on giving to causes other than the relief effort. Nearly a billion dollars have reportedly flowed into relief funds since that day, from every imaginable source. Hip hop rappers, athletes, talk show hosts, and corporations have all made large and well-publicized contributions. Convenience stores have collected nickels and dimes. The response has come from the soul of America, from the desire of many to do something positive, to give even a little piece of ourselves to help the healing process and overcome the horror. The focus on the relief effort is appropriate and affirming, but the question remains as to whether it will have a lasting effect on cancer-related and other non-relief-related fundraising. The issue is compounded by an uncertain and faltering economy that was teetering on the brink of recession before that day. Notwithstanding the dual reasons for concern, I believe we can be reasonably confident about the future of cancer-directed philanthropy. This somewhat counterintuitive conclusion rests on two central observations. According to the Trust for Philanthropy, American giving has increased progressively by a whopping 400 percent in current dollars and by 64 percent in inflation-adjusted dollars over the last 20 years.1 Indeed, every year save one in the last 40, total giving has increased. In good times giving increases a lot, in bad times it just increases a little. In the last 30 years, there is little or no evidence that giving has declined during periods of recession. Even war has not been a deterrent to giving. For three of six acts of war that the Trust examined, the Fall of France, the Korean War, and the Gulf war, giving in the year in which the event occurred grew faster than it had the prior year. For the other three, Pearl Harbor, the Cuban Missile Crisis, and the US bombing of Cambodia, the growth was slower than in the prior year, but remained on the positive side. This clearly shows that our capacity for giving is not finite. Philanthropy in the United States is not a zero sum game. Americans will give if the rationale is powerfully presented and the cause is just. Cancer is one of those critical problems that will not wither away just because we face other crises. Terrorist bombings do not influence the incidence of cancer. The toll taken by cancer will not decline just because our attention appropriately shifts to improving our security at home and waging war on terrorists worldwide. Cancer deaths will remain very high—a half million Americans a year—if we do not press on with our efforts to improve the prevention, detection, and treatment of cancer. The public will respond with support if our message is clear and compelling. It is likely that the same spirit that fostered the outpouring of contributions to the relief effort will spill over to address this country's cancer problem as well. Other sources of support for this country's cancer needs are also under pressure. The government is justifiably preoccupied with the anti-terrorist effort. Although there is no indication that either the administration or Congress intends to forego its commitment to funding for cancer and biomedical research, most would agree that these agendas are not likely to receive the focused attention that they did prior to September 11th. While it would be foolish and shortsighted to scuttle the domestic agenda, to compromise the infrastructure we have struggled to build, there are now increased elements of unpredictability and unexpected consequences. Billions of dollars will be allocated to domestic security, rebuilding efforts, and industry bailouts. The NIH budget had been predicted to fare well in the next few years, but priorities could now shift. We may well see efforts to double the budget in five years become an effort to double the budget in more years. Not because of loss of interest but merely because of loss of focus. Fears of bioterrorism will inevitably result in funding increases for infectious disease research and the development of new vaccines and treatment for potential biological warfare agents. Consider the potential costs of vaccinating every American against anthrax and smallpox, two diseases that have had zero health impact in this century in this country. Other sources of cancer research funding could also be impacted. There will certainly be huge increases in military and defense spending. That could lead to pressure on the Department of Defense to lessen its investments in medical research. While defense department dollars do not represent a big percentage of cancer funding, they have been a welcome source of investment for new ideas and innovative programs. Our country has waged war in the past. We have faced times of crisis and of economic downturn and depression. We have lived through hours, days, and eras that have changed our perception of the world and ourselves. For the most part, we have met all these challenges with resilience and reaffirmation of the spirit and strength of our nation. These are anxious and edgy times. We all live with the knowledge that what we do in the near future will have a great impact not only on our lives, but also on those of future generations. So many of us came away from September 11 with a deeply renewed understanding of what is real and important in our lives. If that awareness is carried forward, then Americans are far more likely to continue giving to the causes that have the potential to assure a more positive and healthy future for us all. Through their elected representatives they will also urge that our government do the same. Cancer is one of those causes. Our task is to keep the need clearly visible and our message powerful. If we do that, then the resources to continue our quest for the control of cancer will be forthcoming. I'd bet a red, white, and blue dollar on it. Related Information Page 16: Several cancer nonprofit organizations were surveyed on how they are coping with the aftermath of the Sept. 11 attacks. Page 38: Dr. Young talks about his new role as President of the American Cancer Society.