As the year 2016 came to a close, so did the de facto functioning of , an organization launched 18 years earlier by its founding honorary co-chairs, former and his wife Barbara Bush as the -- an effort to foster discussion and collaboration about cancer-related issues among the public, private, and non-profit sectors.
The group's current leadership, including the former president, say its mission has been fulfilled and that it was time to pull the plug -- to direct its remaining resources where they might be more useful rather than depleted through inertial existence.
Although the closing had been planned for several months, the official public announcement was to have been made in late January by Mrs. Bush and C-Change honorary co-chair , Duke University's men's basketball coach, in a co-authored op-ed appearing simultaneously in several major newspapers about decisions facing non-profit boards.
And on Wednesday, the Bushes were to be honored for their support of the cancer community and C-Change at the George H.W. Bush Presidential Library in College Station, Texas, "where it all began."
But the Bushes' recent hospitalization and the proximity to President Trump's inauguration led to the event's cancellation and postponement of the op-ed's publication, according to C-Change officials.
C-Change's board of directors decided to fold the entity and transfer all remaining assets to its cousin organization, (CEORTC), which agreed to keep C-Change's special reports and historical information on its website for up to 3 years, according to , C-Change President and CEO.
There had been concern among those involved in the decision about how the Bushes would react, but President Bush told 番茄社区 via email that he backed the move.
"My chief of staff, , who is on the [C-Change] board, had a conversation with Liz Thompson about some of the options going forward for C-Change. Barbara and I both were immediately supportive of closing our doors. I was proud of the C-Change team for realizing that might be the best path forward. I might add that when we founded C-Change, we never thought it would be a 'forever' organization. In fact, I think we lasted longer than we originally thought," Bush wrote.
C-Change's Founding
Former National Cancer Institute Director and FDA Commissioner Andrew von Eschenbach, MD, told 番茄社区 that, when he was still at Houston's MD Anderson Cancer Center prior to his government appointments, he had started an integrated prostate cancer program there in the 1990s that brought together a high-level external advisory committee with people interested in cancer but not involved in the field, including the elder President Bush, who was active with MD Anderson's Board of Visitors.
Von Eschenbach described an evolving relationship with the former president, who had lost his daughter Robin to leukemia when she was 3 years old and had a longtime interest in cancer.
The former NCI director said that he considered cancer to be a societal problem, as well as a medical, scientific, economic, and cultural problem, and wanted to bring together a coalition of leaders from government, industry, and the academic and non-profit worlds to define a comprehensive strategy to address cancer.
He also noted that he thought the issue to be bigger than his program or MD Anderson and spoke with Bush, whom he called "the greatest coalition leader in the world" (based on his role in the 1991 Persian Gulf War) about convening the initiative. He added that it was critical to get CEOs involved who could actually execute a plan.
Bush noted in his email that the seeds of Dialogue were planted when "some heavy hitters in the cancer community came to have lunch with us [himself and Barbara] to discuss their concerns about some of the things going on in the cancer community. One of the top concerns was lack of communication. There was a lot of duplication of efforts in research, fundraising, etc. There also was concern about an uneven playing field."
At that time Von Eschenbach was in line to become the American Cancer Society's president, and so he spoke with its then-CEO John Seffrin, PhD, about possibly bringing leaders together in a forum for dialogue led by Bush.
Von Eschenbach also stressed Bush's interest in keeping the effort truly bipartisan, which was reflected by his inviting Sen. Diane Feinstein (D-Calif.) to serve as honorary co-chair at its inception. A year after the Bushes retired from C-Change's board in 2010, Krzyzewski joined Feinstein in the co-honorary leadership role, with the senator becoming less actively involved over time.
Seffrin, who retired as the ACS's chief executive in 2015, said that he brought the initiative to the ACS board, which agreed to provide what would be the seed money to launch the National Dialogue on Cancer in 1998. The society continued its commitment to funding Dialogue and later C-Change until Seffrin's retirement.
Allen S. Lichter, MD, former CEO of the and a member of C-Change's board, told 番茄社区 that he thought that the loss of future support from ACS and some others may have contributed to C-Change's eventual demise.
Fostering Communication
Seffrin said that it was necessary to find ways to partner, collaborate, assist, cooperate, and complement other cancer organizations so that all investments are more impactful.
Bush remembered that the Dialogue's first meeting was somewhat contentious. "It was at my [at Texas A&M University in College Station] and at least one person walked out. That meeting was proof how much a dialogue was needed." Subsequent meetings were often held at the library or at the Bush family home in Kennebunkport, Maine.
In 2004, the Dialogue was renamed C-Change: Collaborating to Conquer Cancer, in an effort "to be more aspirational and be perceived as doing something," said Kinga Bartoszek, VP for finance and operations, who joined the organization in 2003. More leaders representing industry, government, academia, advocacy, and other non-profit groups were brought in over the years.
A number of those interviewed said that the larger meetings often revealed a clash between the cultures of those from the corporate and non-profit sectors, with some industry CEOs eventually sending representatives instead of attending themselves.
Bartoszek recalled that Bush would always ask participants to check their egos at the door and encouraged open dialogue among the sectors that may not have had the opportunity to interact before.
In 2001, Bush, who wanted to do something "bold," asked , then-CEO of what was then Glaxo Wellcome, "to convene and chair a separate, complementary organization, comprised of action-oriented chief executives, and challenged them to do something more about cancer prevention, diagnosis, and treatment with your own family as well as within your corporate family."
This was the birth of the CEORTC, which was part of C-Change until it was separately chartered in 2005, and Bush told 番茄社区 that the new organization emerged from "great enthusiasm from Bob Ingram and to focus on CEOs, so I had no problem with this spin-off. The goal was the same: To fight cancer. I didn't care how we got there. They have done great work."
The former president also said that he and his wife tried to attend annual meetings of both C-Change and CEORTC over the years, and would often host fundraisers in Kennebunkport. Seffrin fondly remembered the former first lady knitting during the sessions.
"But you have to understand," Bush continued, "Our role was that of the 'convener.' The discussions were typically way over our heads. We were cheerleaders."
Final Days
Charles Hugh-Jones, MD, former chief medical officer for Sanofi North America, became C-Change's board chair in December 2015 and presided over discussions related to its future.
He said during a phone interview that he had not previously been a member of C-Change but had served on an oncology open data sharing committee with the CEO Roundtable.
"I came in [and] my role was to pull together an excellent board and to ask them what the direction was and to make effective decisions about what the organization should do next."
He said that the organization had completed its mission, that other organizations had arisen over the years that were now implementing many of the initiatives that C-Change had originally started, and that everyone involved felt that the closing made sense at this time.
When asked if C-Change had met his expectations, Bush wrote: "The answer is yes, yes, yes it met our expectations. This might be hard to explain, but the fact we are closing our doors is proof of that."
He also said, "I also remember coming away from every single meeting inspired by the knowledge in that room, the dedication, the creativity. There was such a great feeling of hope. I knew we could and would win this battle. And we will."