Iain Foulkes, our executive director of research at Cancer Research UK

Iain Foulkes is our executive director of research and innovation.

Another day, another set of gloomy statistics. Today’s new figures from the UK’s National Cancer Research Institute project a devastating 24% drop in the UK’s overall cancer research spending this year, driven by a 46% fall in charity sector funding.

With a near constant stream of statistics, it can be tempting to let them blur together or to shut them out completely. But when it comes these latest figures, we can’t afford to do that: they’re a warning light for the health and future of UK research.

That’s because unlike other countries, where government and industry funding dominate, the UK is unique in its prominent, well-integrated charity-funded research sector. For example, charities provide 66% of UK public investment into cancer and cardiovascular research. Sadly, this strength has become a vulnerability in a global pandemic, with the public’s ability to fundraise for causes that matter to them severely impacted.

But while sobering, this drop doesn’t come as a surprise for us at Cancer Research UK. We know first-hand that the country’s vibrant charity-funded research sector has been heavily hit.

The urgent case for government support becomes clearer by the day. To risk disrupting the UK’s intricate network of universities, charities and small and large companies would be incredibly short-sighted. It has an outstanding track record of developing innovations that prevent, diagnose, and treat cancer around the world. In the UK, survival has doubled since the seventies, and now half of people survive their disease for a decade or more.

As just one example of the UK punching above its weight, consider the drug olaparib.

A legacy of innovation

In the 1990s, Professor Steve Jackson’s charity-funded research at the University of Cambridge revealed new insights into how cells repair their DNA, which led to an experimental cancer therapy – the first of its kind. He then formed the spin-out company Kudos pharmaceuticals, which drove this research forward, and was later acquired by AstraZenca, who led international trials proving its effectiveness.

Olaparib is now licenced to treat people with several types of cancer, including ovarian and prostate cancers. Last year, tens of thousands of patients around the world were able to access the drug, all thanks to a discovery made in a UK university, funded by a charity. And to complete the virtuous circle, a share of the revenues from sales of olaparib is returned to Cancer Research UK, to reinvest in the breakthroughs of tomorrow.

This innovation is a hallmark of the UK research ecosystem, with charities taking on risks to supply opportunities to a broad community of investors. If one funder pulls out due to high risk, others step in, excited by the potential of high reward.

But this stream of scientific ideas relies on a highly skilled workforce. UK charities support more than 17,000 medical researchers’ salaries – a number at risk of dramatic decline. We’ve estimated that without government intervention, 1,500 of Cancer Research UK’s scientific roles could be at risk.

Opportunities beyond cancer drugs

So, clearly, the UK’s substantial track record in drug development must be protected. But this issue goes beyond pharmaceuticals, and there are still areas where there’s so much more to do and understand – none more so than detecting cancer earlier.

The Government, via the NHS Long Term Plan, has a bold ambition that, by 2028, 3 in 4 cancers are diagnosed at an early stage. Getting there will mean two main things: more health service capacity, including through addressing workforce shortages, and an improved research environment to develop and adopt new early detection and diagnosis technologies.

Developing these technologies will, in turn, require partnerships like our international Alliance for Cancer Early Detection, bringing together researchers at leading UK and US universities, and making the UK attractive to leading companies such as Grail. We need more of such partnerships if we are to realise the Government’s ambitions in early diagnosis.

So clearly, there is an untapped potential for the UK to be a global leader in this field. Not only would patients benefit, but interest from the global private sector provides an economic benefit too. Progress in early cancer detection could also be transformative for other diseases, and lead to a future focused on the maintenance of health, rather than purely tackling symptomatic disease. But this opportunity could be squandered if the UK ecosystem is disrupted.

Working across borders

Beyond early detection, there are other opportunities that may be missed. Globally, cancer is the second leading cause of death and growing all the time. In 2018, it claimed 9.6 million lives, accounting for 1 in 6 deaths worldwide. We need to make bigger breakthroughs and faster. And that requires us to work together.

Last month we announced a partnership with the National Cancer Institute (NCI) in the US, to allow global and multidisciplinary collaboration at increased scale. But to realise the benefits of this collaboration, we need the UK’s research ecosystem to be healthy as well as wealthy. The upcoming publication of the Government’s R&D Road Map – setting out how the government will put science at the heart of the economy – is encouraging, especially as we try to rebuild an economy shattered by COVID-19. But it will not achieve its aim of boosting UK R&D to 2.4% of GDP if we let our charity sector flounder.

As we continue to deal with a global pandemic, science’s pivotal role in solving worldwide health challenges has been pulled into the sharpest possible focus. The public already greatly value medical research, with 7 million people donating to the cause in 2018. And the events of 2020 have only increased public awareness of the essential role research plays in our society.

Yet despite their role in tackling disease, today’s figures show how our medical research charities are facing a substantial funding gap due to COVID-19. We’ve written before about how medical research charities form a vital part of the country’s scientific ecosystem.

Urgent action from the Government is needed to provide a temporary bridge – or progress that is still much needed in cancer, and other diseases, is at risk.

Iain Foulkes is the executive director of research and innovation at Cancer Research UK

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