VI. How do we dismantle the cancer-industrial complex?
“The master’s tools will never dismantle the master’s house.” — Audre Lorde
If anything, all these words so far have made it clear that the current strategies in the War on Cancer are not working for the benefit of the patients, but rather for the benefit of corporations, who, legally deemed as persons, do not bear the physical burden of this disease or the consequences. One can even argue, that the War on Cancer, an inherently capitalist idea borrowed from imperialist notions of conquest and exploitation, is actually advancing as expected. The end goal of any capitalist machinery is to maximize profit, and this often comes at the cost of human lives, as history has shown time and again.
Experts have offered many options to steer the tide towards the people- improving clinical trial designs and providing better palliative care on the clinical side, imposing compulsory government revenue on drugs developed by public-private collaborations and using those funds to subsidize public health initiatives, initiating preventive measures in low-income populations to reduce cancer incidence, regulating drug prices like other developed countries, and reducing implicit bias and racism in healthcare by focusing the “center at the margins”. However, these initiatives can only act as band-aids on a festering wound that is the capitalist framework under which public policies are designed. As MN Oliver states, “class exploitation and racial discrimination are distinct social processes, that, nevertheless, reinforce and reproduce one another in contemporary societies”, racial disparities in healthcare cannot be ended using the genome-based approach that NIH director Francis Collins advocated for.
“The relationship between scientific knowledge and state power has been dialectical”, writes sociologist Catherine Bliss in describing how health justice is defined in the post-genomic era. Public policies shaped from the genomic knowledge collection, such as the Precision Medicine Initiative, have little to offer the public; given their capitalist framework, they are likely to be hijacked for private interest (e.g.- Patrick Soon-Shiong, billionaire cancer scientist, co-opting Joe Biden’s Cancer Moonshot initiative). In her essay, Bliss outlines how the well-intentioned belief that genomics in healthcare would end racial disparities have fallen short of its promises, as it doesn’t take into account the overall environment an individual resides in.
There is no need for a “battlespace vision” to fight against cancer. What we do need is a radical revision of how we understand cancer — not as an enemy, but rather, an anomaly; a redefinition of what is “normal” and what is “pathological” (for those interested — Georges Canguilhem is a must-read). This requires a “paradigm shift” as actually described by Thomas Kuhn (a fundamental change in the basic concepts and experimental practices of a scientific discipline), and not as ubiquitously abused in the current scientific literature. For this to happen, we need to move away from a capitalist framework of reductionist science and more towards a dialectical view of biology that focuses on the interactions between organisms and their environments rather than focusing on the organism or the environment exclusively.
This also requires Science to be re-instated as a public good, and “scientific capital” be redistributed among scientists and not maintained in a hierarchial fashion that is typical in today’s scientific community, as shown by the work of the eminent sociologist Robert Merton. This is tied with, again, an individualistic system of recognition, and leads to elitism, as Levins & Lewontin explain — “ elitism perhaps contributes to the belief in the notion of hierarchical organization and to the search for the controlling factor that fits into the reductionist worldview, which retards the study of the reciprocal interpenetration of parts in favor of a chain-of-command model of genetics, society, and even ecosystems.”
The 47 year long war on cancer under a capitalist framework has given us disparate results at the cost of public sacrifice, all the while benefiting corporations, a trend seen across other such wars against crime (the prison-industrial complex) and terror (the military-industrial complex). Therefore, effective change in cancer outcomes for all races/ethnicities cannot happen without dismantling the current oppressive capitalist system, more suitably termed as “carceral capitalism.” Whether or not cancer is capitalism manifest, or the other way around, it is undeniable that the fate of the two are inextricably linked. The “war on cancer” can only be won when the war on capitalism ends in victory for the people.
