A Pacifist"s Guide to the War on Cancer review – bold musical demystifies the disease

A musical about cancer? I see no reason why not. For much of its length this show, co-presented with Complicite Associates and written by Bryony Kimmings and Brian Lobel with a score by Tom Parkinson, offers a robust demystification of it subject. Only in its later stages does it turn from a piece of theatre into a dubious form of group therapy.

The premise is simple. Emily, a single mum, takes baby Owen into hospital for a series of scans. We share her helpless anxiety as her son is taken from her and she follows the stories of a group of cancer patients. They include a radical feminist, a pregnant 18-year-old, a woman seeking a miracle cure for a terminal condition, a defiant working-class smoker and a young man with a testicular problem who is accompanied everywhere by his mother. They are a representative bunch, all, we later discover, based on real-life cases.

Clearly the point of the show is to sabotage cliche responses to cancer: not just the vocabulary of “struggle” that surrounds it but also, as one character says, the “aggressive sorrow” and special “cancer face”, assumed by friends. The advantage of the music is that it gives each patient his or her moment in the spotlight while showing collective attitudes. Purloining a phrase from Susan Sontag, Kingdom of the Sick is a jaunty choral number capturing the sense that cancer patients are part of a large, ever-growing club. But we are also reminded that each case is different: Mark, the heavy smoker pining for his estranged daughter, sings a Willie Nelson-type cowboy song while Laura, destined for a hospice because of ovarian cancer, rips off her clothes to launch into a shake-it-all-about 70s rock routine.

Battering at an open door … A Pacifist’s Guide to the War on Cancer. Photograph: Tristram Kenton for the Guardian

But, as the show proceeded, my reservations started to mount. It increasingly seems to be battering at an open door. Far from being reticent in speaking about illness or death, I would say we have never been more open about it: I am at an age when any social occasion is prefaced by what a friend calls “the organ recital” and, when I was diagnosed with a kidney tumour three years ago, I saw no need to hide the fact. Although I welcome the show’s candour about cancer, it also lapses at the end into an extraordinary form of self-display: as cast and audience are invited to shout aloud the names of patients they know, I felt I was attending a secular revivalist meeting.

Kimmings herself directs with great verve and there are good performances from Amanda Hadingue as the distressed single mum, Golda Rosheuvel as the miracle-seeking Laura, Rose Shalloo as the teenager facing genetic issues and Naana Agyei-Ampadu as a tough American who wisecracks her way through trouble. The show is bold in confronting cancer with ebullient music rather than hushed reverence but when Kimmings, in a climactic voiceover, endorses the point, it comes dangerously close to self-congratulation.

• At the Dorfman theatre, London, until 29 November. Box office: 020-7452 3000.

A Pacifist"s Guide to the War on Cancer review – bold musical demystifies the disease

Cure all diseases? The Chan Zuckerberg plan is brilliantly bold | Ian Sample

There is ambition and there is Silicon Valley ambition. For where else on a map could a pin be placed when asked to guess where billionaire philanthropists had declared their intention to cure, prevent or manage all human disease before the end of the century?

It was clear from the start that the announcement from Priscilla Chan and her husband, Mark Zuckerberg, nudged at the boundaries of belief. Writing in praise in the US journal, Science, David Baltimore, a Nobel laureate at California Institute of Technology concedes the goal “may raise eyebrows”. Even Cori Bargmann, the renowned neurobiologist who will lead the charge, is aware how it might be perceived. It is “ambitious”, she says, “but not completely ridiculous”.

It is tempting to dismiss the Chan Zuckerberg Initiative as hubris. But the best part of a century is a long time in medicine. Most babies born in 1900 did not live to see the age of 50. Medicine has not been the only reason for the dramatic rise in life expectancy since, but it was a crucial factor. “By 2100 we’ll be shocked by how much we’ve achieved, and we’ll be more shocked with initiatives like this,” says Jim Smith, chief of strategy at the UK’s Medical Research Council.

If not hubris, then what about one-upmanship? Bill Gates wants to eradicate malaria in a generation. Elon Musk wants a Mars colony in a decade. Yuri Milner has set his sights on sending a spacecraft to a star at one-fifth the speed of light. How better to leave your mark higher on the wall than to make every human disease obsolete within your child’s lifetime? Or at least find a way to manage awful conditions, so they no longer mar people’s lives?

But audacious goals are precisely what are needed. “We have to be bold about the scale of the challenge we face in improving human health,” says Steve Craddick, professor of chemical biology at University College London and director of innovation at the Wellcome Trust, the world’s largest biomedical research charity. “What is truly important about this kind of approach is that it creates the hope you need to go from exploratory science to making the world a better place.” He goes on: “Aspiration is essential. This idea that if we put our minds to it, almost anything is possible – that is what can sustain people through the peaks and troughs of decades of research.”

Chan and Zuckerberg will stump up at least $ 3bn (£2.3bn) for the effort over the next 10 years. That is not a vast sum for the task ahead. The new Francis Crick Institute in London, now filling with 1,400 scientists, could be built and run for 10 years on that. The Wellcome Trust itself will spend £5bn on biomedical research in the next five years alone. But part of Chan and Zuckerberg’s hope is to grow a movement to fund science: where they have led, they want other wealthy individuals to follow. An audacious, long-term goal backed by world-class scientists is the way to make that happen.

As Chan and Zuckerberg state, four types of diseases cause most of the deaths in the world: heart disease, cancer, neurological diseases and infectious diseases. The research kicked off by the initiative will focus on the basic science underlying them. The rationale is sound: it takes fundamental breakthroughs to make a real difference in medicine.

The first step is a $ 600m “Biohub” that will draw scientists and engineers from the Bay Area’s leading institutions: Stanford, the University of California, San Francisco and the University of California, Berkeley. The hub has two major projects lined up already. The Human Cell Atlas will map out the internal workings of every cell type in the body, a mammoth task that is bound to open up new avenues in medicine. The Infectious Disease Initiative aims to bring fresh thinking to drug design, diagnostic tests and vaccines. According to Tom Solomon, a neurologist and director of the Institute of Infection and Global Health at Liverpool University, such radical new approaches could be as important as the money itself.

And yet in Silicon Valley, it seems the only solutions are hi-tech solutions. This is one area where Chan and Zuckerberg may fall short in their aim to leave the world a better place for children. Only 10% of health research funds are spent in developing countries, where 90% of preventable deaths occur. The Chan Zuckerberg Initiative will apparently direct three-quarters of its efforts towards heart disease, cancer and neurological disease, the chronic conditions of the west. That may leave too little emphasis on infectious diseases.

A recent report from the World Health Organisation made clear that unless developing countries have the means to gather and study their own medical data, public health is unlikely to improve. It is the old adage about teaching a man to fish. Childbirth still kills hundreds of thousands of mothers and babies in low-income countries. To prevent those deaths does not require a scientific breakthrough. It takes know-how and facilities.

“It is not as sexy as saying you are going to develop a drug or a vaccine, but what is needed is research capacity development,” says Trudie Lang, director of the global health network at Oxford University. “Nurses, midwives and community health workers need to be trained and supported. It’s hard to get funding for it, because you can’t show how many lives you have saved, but it is absolutely vital,” she says. “It’s a slow win, but it’s what they should be doing.”

Cure all diseases? The Chan Zuckerberg plan is brilliantly bold | Ian Sample