Mesothelioma does not respect the color of your collar, your rank, or your title. It doesn’t care where you live, how fit you are, how much money you have, or whether you’ve done good deeds.

When I met Congressman Bruce Vento four years ago, the tumors had already taken his lung, pleura and diaphragm, and he was undergoing chemotherapy. His body was failing, but his will to help others remained strong. He knew that the power players—the government, the pharmaceuticals, the medical community, the trial lawyers and former asbestos companies—collectively had acquired great knowledge about mesothelioma over the last 50 years. So four years ago, Congressman Vento delivered a speech, an impassioned plea to the players to unite against the cancer which ultimately took his life.

Rather than fixing blame, Congressman Vento said we should try fixing the problem—the underlying public health problem. Admiral Elmo Zumwalt, another great American taken by mesothelioma, was known for using "Z-grams" to inspire his sailors. This morning, I’m going to relay some "V-grams" from Congressman Vento with the hope that you too will be inspired to help eradicate mesothelioma.

Let’s put these numbers into perspective {Slide 6}. In 2003, the most recent date for which data is readily available, far and away the largest slice of the NCI pie has gone into breast cancer ($564 million), prostate cancer ($311 million) and colorectal cancer ($267 million). On the intuitive premise that there is a positive relationship between the mortality statistics, the dollars budget and overarching public health priorities, I did some rough calculations. First, I found a cancer whose mortality data parallels mesothelioma: cervical cancer, which afflicts about 4,100 Americans yearly. I found that while we spent $17,340 per cervical cancer case, we invested only about $933 per mesothelioma case -- and that’s assuming 3,000 deaths a year for the latter, a number which we can’t really cite reliably since we do not have in this country a mesothelioma disease registry.

Now, we all know that every dollar spent on curing any cancer is a dollar well spent. That mesothelioma research has been historically under-funded comes as no surprise, but what’s astonishing is the dramatic vastness of that disparity.

One can argue that the government has a duty to fund mesothelioma research. A whopping 32% of all mesothelioma patients diagnosed in America served in the U.S. Navy or worked in U.S. Navy shipyards. 32%! Go back in time. Historically, millions of Americans have served in the Navy or worked in Navy shipyards since WWII. In 1980, the American Insurance Association in an unpublished risk analysis report studied the number of deaths due to mesothelioma and other asbestos diseases. They focused on shipyard workers only. They estimated that from 1941 to 1945 (during WWII), about 4.5 million U.S. workers were exposed to asbestos. Assuming a 30-40 year latency period, the insurance companies projected that a total of 410,000 of those exposed shipyard workers were expected to die from lung cancer or mesothelioma.

To put that number in perspective, during WW II, the number of U.S. soldiers who died in combat was 292,131. {Slide 10} For Navy sailors and shipyard workers, clearly the war didn’t end on V-Day.

The Department of Veterans Affairs (DVA) has medical treatment programs for veterans exposed to Agent Orange, Gulf War toxins and radiation-induced cancers from nuclear bomb testing. It has a medical program for POWs. But neither the DVA, nor the Department of Defense (DOD), has any program for the detection, treatment or cure of mesothelioma. We can and we must do better.

Does Congress mandate medical research programs for any cancer? Yes. Surprisingly, Congress for years has tagged on to DOD appropriations bills a number of Congressionally Directed Medical Research Programs. We generally don’t think of breast cancer or prostate cancer as service-connected injuries or illnesses, but through 2003, Congress has directly mandated and funded programs for these cancers to the tune of $1.17 billion and $341 million, respectively. President Bush recently signed into law the FY 2005 Defense Appropriation Act, which continued to fund breast, prostate and ovarian cancer research, among others ($150M, $85M and $10M, respectively). Through the years, unfortunately, Congress has yet to specifically allocate any funding for mesothelioma.

For Navy vets who put their lives on the line to protect this country, the government’s apathy is a bitter pill to swallow. I’m reminded of a career Navy officer, Don Thorp, who served under Admiral Zumwalt during the Vietnam War. A few years after he had life-sustaining surgery at UCLA, Don’s tumors came back. When his doctor prescribed Interferon, which had been shown to effectively retard tumor growth for other MM patients, Don asked his local VA in Idaho for help. They refused to fill the order. Shortly thereafter, Don Thorp, who had railed against his government for "not solving the asbestos-cancer menace," which in his words, had "already taken too many good men and women down," himself joined the legions of Navy heroes taken by "this damn tumor." {Slide 12}

Navy veterans, like all mesothelioma patients, don’t want lip service. They don't want sanctimonious sympathy or flag-waving speeches. They want what they gave: commitment, action, security, respect and results.

Before setting out to cure a disease, one must first acknowledge it exists. In 2003, a Congressman from Pennsylvania proposed a "National Mesothelioma Awareness Day." (H.Con.Res. 317). The resolution was intended to make the public aware of a number of disturbing facts about the scale and scope of the epidemic. The recitals included statements we all know to be true, such as: one month of exposure can cause mesothelioma 30 years later; asbestos was used in "virtually all" homes and schools built before 1975; treatments were inadequate, the survival rates were intolerably grim; and the rescue workers at Ground Zero were at an increased risk. Non-partisan, fairly undisputable facts. A slam dunk? No. The bill has been bottled up in committee for the past 11 months.

You may ask: Why would a congressman from Pennsylvania push this tragically obscure agenda? The answer is MARF. In particular, two ladies on MARF’s Family Advocacy Board, both of whom lost their husbands to this disease. MARFites Nancy Buszinski and Alice Steigerwald recently persuaded the City of Pittsburgh to declare a Mesothelioma Awareness Day. This is the first time in U.S. history any government at any level has recognized Mesothelioma as a public health priority. Soon after, the Governor of Pennsylvania issued a resolution recognizing Mesothelioma Awareness Day. This is how revolutions are won, one city at a time.

V-Gram No. 2 to Asbestos Litigation Defendants: "Now it's time to clean up the mess."

At the end of the estimated 5 to 6 years it takes for an asbestos debtor to emerge from the Chapter 11 liability acid wash, what will be left for the claimants? Again, I didn’t look at the estimated value of all 40 Chapter 11 debtors. But if you add up the projected value of the respective asbestos victims’ settlement trust funds, you’re looking at around $20 billion. {Slide 17} David Austern of the Manville Personal Injury Settlement Trust recently forecasted the aggregate present value of all pending reorganizations at $65 billion.

As things stand now, the debtors have no plans to set aside a dime of the trust money for medical research to detect, prevent, treat or cure mesothelioma.

Now that’s sad on many fronts, but what hurts most is the knowledge that OCF could easily pay their debt to MARF. OCF’s business continues to be strong, so strong that they can afford to sponsor a NASCAR race car, which costs between $6 million and $18 million a season. {Slide 18}

Aside from the projected billions and billions that will be available when the 40 asbestos debtors walk away from the Chapter 11 courts, it comes as no surprise that the solvent defendants remaining have a good deal of money. The RAND think tank estimates that over 6,000 companies have been sued in asbestos litigation. If you look at the numbers for only 12 of the current corporate defendants, the combined stockholder’s equity is $278 billion and the market capitalization is $666 billion. {Slide 19} Like Sam Rayburn used to say, "A billion here, a billion there, and pretty soon we’re talking about real money."

We all know that industry has always had the wallet, now it’s simply a question of whether they have the will, and the heart.

V-Gram No. 3 to Trial and Defense lawyers: Your client’s "first priority is life." {Slide 20}

Bruce Vento was an advocate in the truest sense. An advocate is one who defends, comforts, and pleads the cause of another. Congressman Vento’s constituents’ priorities became his priorities. When he was stricken with mesothelioma, Bruce Vento asked trial lawyers to take up the chief priority of cancer patients as their own: more and better life.

Have we? Have trial lawyers added "getting client more life" to our traditionally narrow role as zealous compensation-getters? Have defense lawyers urged their corporate clients to fess up, do the right thing, put people over profits and clean up their mess? Has anyone really tried to use the tort system to make a mesothelioma patient "whole"—that is, terminal cancer free? Or make the parties who opened the asbestos Pandora’s Box accountable for all of the social costs? Let’s take a look.

First, just how well have the lawyers done? Using the Connecticut Valley Claims model, again assuming that $70 billion has changed hands, through 2003 defense lawyers have gobbled up about $26 billion in fees and costs. Plaintiffs’ lawyers took home about $17 billion. The grand total was roughly $42.8 billion. That’s a whole lot of billable hours and contingency fees, with no guarantees that any of it will actually wind up preventing or treating the disease. Looking forward, RAND and others project another $100 billion "wealth transfer" by 2015. That means another $64 billion in lawyer fees and costs.

MARF’s fundraising mantra is that stakeholders should consider donating at a level commensurate with their knowledge of the epidemic, their compassion for the injured, and their wealth. Since 2000, 40% of MARF’s coffers have come from trial lawyers, 31% from mesothelioma patients, 21% from family and friends, and 6% from the corporate defendants. The defense lawyers have yet to step up with a single donation. Not a penny. I don’t think anyone will disagree that we can all do much, much better. We can and we must.

Since we posted a slide on the wealth of the top 12 corporate defendants, I’ll do the same for the top asbestos trial lawyers. Lawyers aren’t obligated to report their wealth publicly, so we’ll have to rely on the accuracy of the scribes over at Forbes Magazine. {Slide 22} These numbers were reported in 2001, well before Mr. Joe Rice and Mr. Ron Motley earned their billion-dollar fees from the big tobacco settlement. Of all those big shooters, only one has donated to MARF. Of the 11 top corporate defendants, five (5) have donated to MARF (to be sure, in amounts which represent a tiny fraction of their wealth).

To put these numbers in perspective, one of MARF’s original donors, Barbara Hoffacker, who lost her husband in 2001 to mesothelioma, pledged her entire six-figure settlement to MARF. She was not a wealthy widow. But she is giving every penny.

SLIDE 23 (Click Here for larger image)

V-Gram No. 4 to Drug Companies: "Solving Meso's mysteries can help cure other cancers."

Vento knew that few drug companies would be willing to invest millions of dollars in a drug for a cancer that afflicts "only" 3,000 to 4,000 Americans yearly. {Slide 23} However, Bruce was also a high school science teacher, and he understood that his tumor was a microcosm of other solid tumors. He knew that if we could find the Achilles heel for mesothelioma, that discovery could lead to cures and treatments for other cancers.

Was Vento right? Look at Eli Lilly’s experience with Alimta, the new chemotherapy recently approved by the FDA as a frontline therapy for non-resectable mesothelioma patients. Since 1983, Lilly invested about $1 billion in bringing Alimta to market—a drug which extends the median survival to 30% over conventional cancer drugs {which translates into about three more months’ survival on average}. {Slide 24} Did Lilly invest the $1 billion to target a cancer that strikes around 3,000 Americans yearly? Probably not, as just recently the FDA approved Alimta as a second-line therapy for Non Small Cell Lung Cancer, which afflicts over 100,000 every year. And now Lilly is seeking approval for pancreatic, colon and breast cancer. Lilly is forecasting $1 billion in sales per year over the next few years, and more to come, which I’m sure makes a lot of their stockholders happy.

Fighting and winning wars is something we expect our government to do. Most surveys show that Americans put fear of cancer over fear of terrorism. Nevertheless, our country is today spending about $6.5 billion a month to wage war in Iraq, which is almost $2 billion more than we allocate to the NCI to research all forms of cancer for an entire year (i.e., $4.7 billion).

Whether the drug companies will invest in preventive drugs or vaccines for mesothelioma remains an open question. It takes about 15 years and a war chest of about a billion dollars to bring a drug to market. I’ll leave it to the experts to answer the question whether any drug companies will attempt to get FDA approval for Cox II inhibitors, like Celebrex, or statin drugs, like Lipitor and Lovastatin, as "mesothelioma-prevention drugs." 

Third, Congress must consider a cancer tax on the sale of asbestos-containing products (ACPs). In 2002, 6,805 metric tons of asbestos in various products were sold in the U.S., mainly roofing, friction and gasket materials (down from 9,000 metric tons in 1995). All of the asbestos was exported from our neighbor to the North, Canada. Senator Murray’s office estimates that the value of all ACPs sold in the U.S. approaches $290 million. MARF believes that all asbestos products should be banned, but absent a ban, we should at the very least impose a 25% asbestos-cancer tax (just as it does for cigarettes). An asbestos-cancer tax would yield revenues of about $72.5 million a year, all of which should be used to fund a medical program. {Slide 28}

Fourth, if Congress ever does approve a Federal asbestos compensation trust fund, it must contain funding for a mesothelioma medical program. The value of any such trust will of course be hotly debated. I don’t think any party, however, would seriously object to MARF’s $140 million proposal. In the words of a lawyer in Senator Hatch’s office, "$140 million in a 140 billion dollar bill is nothing."

Fifth, the NCI needs to fund mesothelioma research proportionate to research programs for other cancers. The NCI has funded research for cervical cancer the last several years for on average about $67 million per year. In the same period, it’s funded mesothelioma research on average about $2 million per year. Both cancers have similar mortality statistics (about 4,000 deaths per year). Moreover, we urge the appointment of a Mesothelioma Czar who can set the roadmap initiatives, recruit the best talent, and target the most promising therapies.

As one mesothelioma patient put it—a doctor from North Carolina who has undergone an EPP— "I’m sure the stress levels of the lawyers are high, but we victims do the overwhelming majority of the suffering."

In 2001, the manufacturers and insurance carriers reportedly paid out $1.7 billion in litigation costs and compensation. A 2% surcharge on that amount would yield revenue of $34 million, all of which can be deposited in a mesothelioma medical research and relief trust fund, managed by a Mesothelioma Czar. With yearly revenues of $30 to $35 million from the manufacturers and their insurers, the government would not have to foot the bill, even though it certainly should contribute its share. By the way, I nominate Dr. Harvey Pass to be our first Czar (he’d look great in a Russian crown and ermine cape).

Seventh, we must continue to press everyone with a financial, medical or personal interest to donate to research commensurate with their knowledge of the epidemic, their compassion and their wealth. Thanks to the generosity of a fellowship of plaintiffs; a good number of trial lawyers; an army of friends and families; and a handful of responsible manufacturers, MARF has funded $1.3 million in treatment-oriented medical research. This year we have 31 grants under review.

Roger G. Worthington

Founding Director
Mesothelioma Applied Research Foundation, Inc.
Email: rworthington@rgw-pc.com
October 14, 2004