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You can't find any teddy bears at CureSearch for Children's Cancer, which is aiming to become a national center of research. CEO John Lehr says there's a direct connection between financial leverage and breakthrough research. His organization is one of the main funders of the Children's Oncology Group, a coalition of 210 hospitals that coordinate research and have the ability to run large clinical trials on, say, acute lymphoblastic leukemia, the most common childhood cancer. "They have been at the forefront of all the clinical breakthroughs that have occurred over the last several decades," says Lehr.
The throw-weight argument is also made by Susan G. Komen for the Cure. Komen is the largest funder of breast-cancer research after the government-run National Cancer Institute. Komen has $300 million in grants outstanding, but in the past couple of years it has focused on giving what it calls Promise Grants — those that have the best chance of producing tangible results within a decade.
Elizabeth Thompson, Komen's president, says the recession has forced some rethinking within the sector. "We have been approached by other organizations during the worst of the economic times about consolidating. [But] organizations are almost always founded by someone who had a particular or specific vision. The idea of giving that up is difficult."
One of the major reasons that charities underperform is that they aren't held accountable. "We don't have high-functioning markets the way we do in the for-profit deal," says Professor Allen Grossman of Harvard Business School, who has pushed reform by developing analytical tools for nonprofits. "In the for-profit world, if you don't serve your customers, they go away."
That lack of market discipline is being challenged by a new type of charity largely run by venture philanthropists operating in a venture-capital mode. Using tools like those being developed by Grossman and FasterCures, they can measure output — how has a charity advanced the science, for instance. By demonstrating effectiveness, this new breed is outcompeting traditional charities in the race for available funds, especially from philanthropists and big foundations.
The stars of the venture-charity model include MMRF and ABC2 (Accelerate Brain Cancer Cure), started by AOL founder Steve Case and his family, which posits that a "nimble, focused and entrepreneurial model" will make advances against a cancer that has a poor long-term survival rate. The Melanoma Research Alliance, started by Wall Street mogul Leon Black and his wife Debra, is now the largest nongovernment funder of melanoma research. According to FasterCures, no other group was spending as much as $1 million on research.
Critically, FasterCures has sought to link these evolving groups through a program it calls TRAIN, an acronym for the Research Acceleration and Innovation Network. It's trying to spread best practices across a host of health care groups, a break from the past in which researchers and organizations shielded their work to protect their grant money and intellectual property. "Those that are willing to change want to learn from other groups," says Margaret Anderson, executive director of FasterCures. "They believe in 'Let's make it as efficient as possible.'"
Many traditional cancer nonprofits aren't going to measure up in this entrepreneurially driven, results-oriented world. And more to the point, they are going to be unmasked as better information comes into the marketplace. The one thing that isn't likely to change is our generosity. People will spend lots of time and money trying to snuff out a leading cause of death. But they will have to eliminate some organizations to achieve the best results. That may be harsh. So is cancer.