Cancer was cured decades ago. It is only because of the insidious activities of Big Pharma that these wonder drugs are not publicly available. Or at least, this is what a significant portion of people actually believe.

In truth, cancer is remarkably complex. The human body is both incredibly fault tolerant and very diligent when it comes to eradicating badly functioning cells. In order for a major cellular mistake to form and continue to multiply unchecked, the genetic aberration has to be extremely well-positioned. While modern medicine is impressive, it is still largely groping in the dark. It is not by greed’s hand that we have no cure for cancer; it is by the hand of complexity.

Furthermore, as is the case with most addle-minded conspiracies theories that pin the world’s ills on the activities of capitalism, this argument falls apart for a simpler reason: science is a team effort. It is highly unlikely that only one person would know of such a silver bullet. The set of people who make a career of medical research only to make money is dwarfed by the set of people who make a career of medical research to help the sick. In order for curative treatments to be mothballed in the name of profit, both the unbelievably greedy and the commonly compassionate would have to be convinced to keep quiet. What compensation would be required to silence both sets of people? Many of these researchers have dedicated their lives to demolishing specific diseases. It is highly unlikely that once doing so, they would take a massive payoff while sacrificing those whose lives they were hoping to save.

One common and valid argument in favor of non-profit research projects and against Big Pharma concerns profit incentives. Pharmaceutical companies do have a greater incentive to find treatments that require long-term (or permanent) reliance on their products than they do in finding curative drugs. It takes a monumental amount of money to search, select, develop, and bring a new drug to market. In order for a drug to be viable from an economic perspective, there must be a sizable market to offset these costs. It follows that treatments that are more likely to be approved while showing some efficacy — such as chemotherapeutic agents — would represent their more rational choice when allocating research and development budgets. Most Chemotherapeutic agents exploit small differences in the tolerance for damage between healthy and unhealthy cells. This requires the relative simplicity of observing rates of cell death after exposure to chemicals. Highly targeted molecular agents require a far greater understanding of the cell, accounting for pathways rife with feedback and cascading signals. It is far easier to design a carpet bomb than it is to design a cruise missile.

However, this does not mean that large government research efforts are the solution to the problem of this incentive structure. For one, they too have a similar incentive to pluck the apparently low hanging fruits represented by crude but simpler treatments. While their funding is not tethered to the democracy of market mechanisms, they are (almost as) accountable for results or lack-there-of. A highly-risky, speculative research project — one that has the potential to greatly advance the field of medicine — is judged only by its outcome. If a risky project fails to yield any useable knowledge or therapies, those who worked, approved, and funded the project will be judged harshly. Consequently, it often makes sense for decision makers to fund less risky projects (under the banner of “good science”). They can claim that were not expecting a miracle, only incremental advances. They fail to recognize (or state explicitly) that these minor incremental advances may be climbing a local minimum in the search space for therapies — the payoff may never come.

Assuming that both the for-profit and government inspired research projects are biased towards projects that, from the perspective of those afflicted with a disease, are suboptimal, a third source of research endeavors emerges — the non-profit sector. Researchers who want funding for projects that lie outside the comfort region of traditional sources of project funding would likely find the non-profit sector to be a strong ally. There is a general willingness — if not insistence — of cancer survivors to be part of any movement that marches towards cures and more humane treatments. If presented with projects that promise the possibility — however remote — of significant advances most cancer survivors are willing to contribute financially. While there is a risk of exploitation by quackish actors soliciting funds for poorly formed or entirely fraudulent projects, lightweight organizations acting as intermediaries between the researchers and donors would greatly reduce this threat. These organizations, being numerous, would increase the diversity of the portfolio for medical research.

While methodical, incremental research represents the bedrock of science, it is important to recognize that it is the large leaps resulting from the exploration of entirely new areas that often causes true progress. Large pharmaceutical companies and government research initiatives underweight the value of riskier projects for organizational reasons that are unlikely to change. Consequently, the burden of funding these projects falls to those more willing to take on risk — those affected by the diseases.