On the Lege

The Cervical Wars Part I: Perry, HPV, and the Politics of Cancer

Our long-suffering governor
Our long-suffering governor

With all the yelping from Republicans this week, you would have thought their man Rick Perry had threatened to poison their wells with fluoride and seize their daughters, too. As most of you know, just days before his State of the State address Tuesday, the governor quietly issued an executive order requiring preadolescent girls to receive a vaccine against a sexually transmitted disease that causes cervical cancer. In signing the mandate last Friday, Perry touched off a weekend wave of sexual hysteria among his most faithful supporters in his conservative base. What's next, they asked, embryonic stem cell research?

As well, Republican leaders were miffed that the governor bypassed them and the Legislature, where two related Democratic bills were pending, their futures uncertain. For Perry, the order puts Texas on the map (and his name and hair in klieg lights) as the first state to take a bold, progressive stand against a disease that kills hundreds of Texas women each year. Perry's surprise maneuver was much in contrast to his 2006 campaign's rebuke of a proposed mandatory vaccine against the cancer-causing human papillomavirus, which Democratic nominee Chris Bell laid out in his gubernatorial campaign.

Two legal experts have questioned the constitutional legality of Perry's executive order. In a Statesman opinion piece Wednesday, former Travis Co. District Judge Scott McCown said the state constitution authorizes the governor to administer the law, not make the law. "This principle is textbook civics," he wrote. "Making law is for the Legislature." McCown is now executive director of the Center for Public Policy Priorities. Similarly, Tuesday's Quorum Report quoted Austin attorney Buck Wood stating flatly: "There is no such thing as an executive order. It's made up."

On the financial front, Perry's flip-flop on the HPV vaccine effectively gets the ball rolling for Merck – currently the only drug company with FDA approval for the vaccine. The pharma giant's lobbyists and shareholders have been waiting to cash in on Merck's biggest blockbuster drug since … Vioxx. You remember Vioxx. It's the anti-inflammatory drug that the company took off the market in 2004, after years of denying it carried serious heart risks.

As it did with Vioxx, Merck is heavily hyping its pricey HPV vaccine, sold under the name Gardasil. This time, the ad campaign is targeting girls and young women even as the company is still conducting clinical trials to determine if the drug adversely affects pregnant women and nursing mothers or if it throws the whole reproductive system out of whack.

Perry's surprise order was supposed to fit in neatly with the overall health-care plank in his State of the State address, but the politico-sexual furor that followed overshadowed his more praiseworthy and inclusive proposal to invest $3 billion in cancer research. That plan has enough bipartisan support to wend its way through the legislative process without an executive order. Five lawmakers will carry the bill – Republicans Jane Nelson, Florence Shapiro, and Democrat Kirk Watson in the Senate and Republican Jim Keffer and Democrat Patrick Rose in the House. Even so, the HPV vaccination could turn out to be the fly in the ointment. Perry defended his decision in his State of the State address Tuesday (see "Perry Speaks"), but Nelson and Keffer have already stated opposition to the HPV vaccine plan.

The cancer dustup at the Lege brings us, in a roundabout way, to Molly Ivins, the comedic political writer who died of breast cancer Jan. 31. The Legislature and "Gov. Goodhair" were two of her favorite targets; she would have had a field day with this particular sticky wicket. Even before the HPV uproar, Ivins probably could have gotten her digs in on the cancer-research idea alone. "We lose her right at the beginning of the session, when the Legislature is getting ready to take up a bill that will hopefully create research that will find a cure for the disease that killed her," Watson mused the other day. "Somebody like Molly might find some wry humor in that. We ought to be reminded of the way she continued to kick us in the butt and tell us not to forget those who don't have access to early, frequent, and effective health care." The former Austin mayor, a cancer survivor who lost both his parents to cancer, says he was fortunate to have quality medical care. "Molly would spur us to recognize that a lot of us have had access to health care that made our lives complete. But we need to recognize that a lot of people with cancer are having difficulty in finding access to fight that beast."

Ironically, the Perry-led cancer-research initiative was the brainchild of two Democrats and friends of Gov. Ann Richards, who died of esophageal cancer in September. As Richards was nearing the end of her battle, Cathy Bonner, a longtime friend and former chief of the state commerce department, argued that Texas should mount a "Marshall Plan" to cure cancer. She asked John Sharp, the former comptroller, to help figure out how to do it. Sharp personally hired his former analysts at the comptroller's office to research the issue and draw up a rough draft of legislation. Selling the idea to medical researchers was a cinch. The original idea called for a statewide bond election to fund the initiative, but Perry switched gears Tuesday, proposing instead selling the Texas Lottery and sinking $3 billion of the proceeds into a trust fund for cancer research. During the early brainstorming process, Bonner immediately brought bicycling champion Lance Armstrong in on the plan while Sharp took the proposal to Perry and set about recruiting potential sponsors. The governor got some great press out of the deal. It's uncertain how the proposed lottery tie-in will fly with other supporters of the plan.

The only thing missing from the research discussion are the words "human embryonic stem cell research." Perry has said he opposes such research and the state's leading cancer researchers appear willing to accept that limitation, even though it might put Texas behind California and other states in the race to beat cancer. "My personal view is that we shouldn't be limiting research," Watson said. "When we say that we are for life, we should be focusing on the way that we save and preserve life. But," he added, "what the researchers tell us is that there are so many different kinds of research, limiting [stem cell research] would not ultimately make that big a difference."

Ivins famously joked that George W. Bush "thinks stem cell research is the same as taking human lives, but that 40,000 dead Iraqi civilians are progress toward democracy." At the same time, Ivins acknowledged her own lack of expertise on the subject. As she wrote in 2005, "I don't know enough about stem cell research to tell you that it will produce miracle cures for Alzheimer's, Parkinson's and other diseases, as some scientists claim. But it's not only worth a shot, it would be criminal not to do it. The people who are ill are here, now, human beings in terrible suffering."

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cancer, Rick Perry, cervical cancer, human papillomavirus, Merck, Gardasil, HPV, Jane Nelson, Florence Shapiro, Kirk Watson, Jim Keffer, Patrick Rose, Molly Ivins, Ann Richards, Cathy Bonner, Scott McCown, Buck Wood

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