The smaller C: progress in beating cancer

0:27The Economist Part of it is penny-pinching as costs of living rise. Part of it is a spreading resistance to ultra-processed junk. In a bid to survive, some firms of big food are getting smaller. And a curious thing happened on Tuesday evenings in Berlin. Members of the Bundestag swap their suits for sweats and play football. Sounds like utopia. But now politics has invaded the pitch, and players from the far right are banned from taking part.

1:02But first...

1:10It's a terrifying disease. It kills around 10 million people worldwide each year, a number that's only rising. Half of all men will be diagnosed with it, and one in three women. In some countries, including Australia, Britain and Japan, it's the most common cause of death. I'm talking about cancer. But even with that seemingly hopeless backdrop, this is largely a scientific success story. The good news is that cancer is becoming less deadly. Sloveya Cankova is our healthcare correspondent. And that's the result of better prevention and advancements in treatments. because there is a much better scientific understanding of how to prevent it and treatments are advancing at a fast pace too.

2:04The number of deaths from cancer is actually rising. So how does that square with the idea that treatments and prevention are improving? So it's really a function of demography because cancer is a disease primarily of old age. It takes decades to grow in our bodies. We have more people, the population is growing, but we also have more old people because we live longer. As we get more old people in the population, of course, we get more cancer. But if you look at the mortality rate within any given age group, it's been declining quite steadily in the last 30 years or so. And where are the biggest advancements?

2:45So the biggest gains have been made in prevention. A massive chunk out of this mortality reduction in rich countries at least, but also in some poorer countries has come from reductions in smoking. And that's because smoking causes around 80 to 90 percent of lung cancer. And lung cancer is the leading cancer in pretty much any country. And smoking still accounts for 20 percent of cancer deaths. So that's one big factor. In America, about half of the cancer deaths that have been prevented since the 70s are from reductions in smoking. The rest are split about equally between better screening with colonoscopies, mammograms, x-rays and so on, and advancements in treatments for people who develop cancer.

3:38Slavea, when I was growing up, we always talked about finding the cure for cancer. But it sounds like from what you're saying that actually it's about understanding cancers more and making them more manageable as we live with them. Is that right? Sort of. I mean, on one hand, treating cancer has become more successful for many types of cancers. There were cancers that once were just a death sentence. And now some of those are, you know, quite survivable. But really the biggest gains have been in prevention. And one really striking example is cervical cancer, which killed more American women than any other type of cancer in the early 20th century.

4:19Before it was discovered that there are certain changes in the cells on the cervix, which were visible. You know, a doctor could actually examine them without surgery that were leading to cervical cancer. And over time, it was discovered that almost every case of cervical cancer was caused by infection with the human papillomavirus. As a result, a vaccine was developed. And now we are at the stage where we can literally talk about eradicating completely that one cancer. But now, of course, cervical cancer and lung cancer turned out to be in many ways the easy cancers, is what experts have told me.

4:59There are so many types of cancers for which the causes, the risk factors are not really well known. For things like pancreatic cancer, brain cancer, these are often caught very late at a very advanced stage of disease. So those have been very, very challenging. But for cancer as a whole, about half of cases can be explained by things like obesity, smoking, even some inherited genetic variants that puts you at very high risk of cancer. such as faults in the BRCA1 and BRCA2 genes, and it leads to a big increase in the risk of breast cancer. But for about half of cases, the risk factors are not really known.

5:40So it's this big black box. And as a result, it's difficult to develop preventive interventions or to identify who are the people at risk. Cancer research appears to be a very rare, bright spot of unity in the world. people have put millions and millions into trying to eradicate cancers or to treat them better. What role have politics played? Politics is quite significant because the thing with cancer is because it's a disease that develops over such a long period of time, if you're testing anything that you think might work against it, you're looking at clinical trials that run for, you know, 10, 15 years.

6:24And politicians, if they invest in something, they may look for a very quick answer. which are not going to come in their tenure. So that's one kind of big challenge. The other thing is they can't point to a person and say, you know, I helped prevent your cancer from developing in the first place. But with treatments, you can easily say I treated that cancer. So much of the investment has been on the treatment side. And I think that's changing a little bit. But prevention is really where the biggest gains. can be made. And there is, of course, a little bit of anxiety about what's happening in America right now with the massive funding cuts happening at the National Institutes of Health, which is one of the biggest funders in the world of early research, particularly, which is the riskiest type of research that pharma companies tend not to do.

7:19So there are worries that cancer research is going to at least be slowed down by that. But there are still some advancements to come. So where should we be looking for the next great big breakthroughs? Yes, there is a lot going on right now that looks very, very promising. Cancer vaccines are one thing. So can you give a jab to someone that will prevent them from developing cancer in the first place? They're still in the very early stages of clinical trials, but the results are starting to look promising. Also, the better scientific understanding of those pre-cancerous changes in ourselves. And all of this research is really speeding up right now, partly because it's drawing on these massive biobanks that have been set up around the world.

8:1020 or 30 years ago, basically cohorts of half a million Europeans, half a million people in the UK for whom researchers collected blood samples and all sorts of data and then tracked them over time to see who develops cancer and who doesn't. And now there are technologies to examine those samples collected a long time ago for for proteins, metabolites, all sorts of things that could be signals for very, very early cancer development. And there are some results already emerging from that research that could give us these biomarkers. And it's really something that's happened in the last five years.

8:51There's also a much better ability to study how the immune system interacts with cancer. And that's what's actually led to the cancer vaccines, because researchers can now literally see in real time how single cells behave, and they can sequence them individually. And this is something that wasn't possible before. So there is so much going on that I'm really optimistic, you know, if you and I are sitting here 10 years from now, we'll have much, much more on the table than we have now. Slavea, it's amazing to have a good new story. Thank you so much. Thank you for having me.

9:47Mercifully for me, the bosses here have never made me earnestly tell you that I really like this mattress or that toothbrush or that boy my life was made easier by using stamps.com but they really do want me to tell you about our whizzy newly improved app so here goes you know what i just love about the economist's redesigned app there's no ads interrupting their podcasts and when a topic really grabs me i can click straight through to beautifully written pieces right there in the app. It is just great. You should subscribe too and enjoy it as much as I do.

10:31Back in 2015, the merger of food giants Kraft and Heinz brought under one roof some big global household names. I'm Janet Heinz. I can't be seen eating non-Hinz ketchup. Do we have any Heinz? there. Fill your potatoes, eggs, and pasta. Hello, creaminess. Philadelphia, a creamy touch of magic. Big food was just getting bigger in what we'll call a saucy deal. Times have changed, though, and that marriage going south is just one sign of massive changes in the food industry. Since Kraft and Heinz were combined, the stock has done incredibly badly. It's fallen by about three-fifths. And the business is doing terribly.

11:19Avantika Chilkoti is a global business correspondent for The Economist. The company expects profits to be down between 5 % and 10 % this year. And the latest bit of news is reports that they're considering splitting up again. So what's gone wrong for Kraft Heinz? Well, there's some things that are internal. So there was a huge amount of cost cutting at the business that seemed to have perhaps gone too far. But it's also just generally a bad time to be in big food. So if you look at the shares of the 12 American packaged food companies that are in the S &P 500, they're all down by an average of about 10 % altogether over the past year.

11:57There's various reasons for this. After the pandemic, they were kind of doing all right. You had a bit of what we called greedflation. Prices were going up. Surprisingly, consumers weren't cutting back on spending on food stuff so much. But now sales are actually flagging. And why is that in turn? So I mean, one thing to look at is just the broader trend in what people are eating. If you look at what Kraft Heinz produces, it'll be things that our listeners are very familiar with. Things like ketchup, packaged cheese, packaged meals and snacks. and aside from the fact that people are feeling hard up right now people are also shifting away from eating these sorts of ultra processed foods you're seeing a shift towards these upstart brands that claim to be premium or healthy the same time you have the US government leading this push to make America healthy again to cut chemicals and additives out of food and finally you have the rise of weight loss drugs, stuff like a Zempik, which are really spreading quite fast in the US at least and completely reduce the amount of cravings people have, how many times they go to the refrigerator, reach for a snack.

13:11So doesn't that speak to just changing the offerings that these big food companies have on store shelves, healthier stuff, cheaper stuff, I guess premium stuff too? So if you look at the majors like Kraft Heinz, they're sort of being squeezed in the middle. You're right. What's on the supermarket shelves is changing. But what they have is that on one side, they have a huge number of new upstart brands doing the premium products. The thing that always comes to my mind is those kind snack bars that you see, sort of like nut clusters and stuff. And on the other hand, for those people who are feeling hard up, who want something cheap, you have the own brand white label products that supermarkets create, like Walmart, Costco, Target, all of their own brand offerings that are cheaper.

13:55So yes, what's on the shelves altogether is shifting, but for the big food groups, they're being squeezed. They're neither benefiting from premiumization, nor are they benefiting from cost cutting. And so the best thing for Kraft Heinz to do, at least according to reports, is to break back up again. That's what they seem to be considering. So what the talk seems to be around is spinning off a bit of its grocery business, which includes ready meals and packaged meat, and creating a separate business that has the profitable stuff like sauces, spreads, condiments that are doing pretty well right now.

14:29And there's precedent to think that splitting up a business does well, particularly when the divvied up assets are then acquired by someone else. So if you remember Kellogg Split, You had W.K. Kellogg and Kelanova. Those were then acquired by Ferrero and Mars. Those deals are in the process right now. And the shares in those firms are now up basically 40 % since the carve-up. There's this idea that perhaps the way to turn a business around is to split it up, shrink it, and then basically allow it to grow as a result. Avantika, thanks very much for your time. Thanks for having me, Jason.

15:23Every Tuesday evening in Berlin, when the Bundestag is in session, a cross-party group of MPs discard their suits, clamber into a team bus and travel across the city, put on their football kits to play football together on an East Berlin pitch.

15:43Tom Nuttall is The Economist's Berlin bureau chief. FC Bundestag was founded in 1961 with the idea that MPs should put aside their political differences and play football together after work. And in doing so, raise a bit of money for good causes. But the team has run into a bit of a problem. FC Bundestag is struggling to keep politics off the playing field. Tom, before we get to the politics of football today, just tell me a bit about this team. So FC Bundestag, they're the kind of ambassadors of the German parliament. They traditionally have taken players from every party that's represented, male or female.

16:26There's some pretty big names in German politics who have donned the FC Bundestag kit over the years. There's Joschka Fischer, who was once foreign minister, and the late Wolfgang Schäuble, who was a famous German finance minister. And they play all comers from other amateur teams, business associations or lobby groups. They even play internationally against teams from other parliaments in Europe. And the team has always said that it is, quote, loyal to Germany's free and democratic constitutional order, celebrates cosmopolitan values and tolerance, denounces racism and xenophobic tendencies. And that is what has got the team into a little bit of bother lately.

17:07So what's going on now? So you probably heard of the AFD, the alternative for Germany, the hard right party that entered parliament nearly a decade ago. It is a party that harbours extremists in its ranks. It's been declared formally right-wing extremist by the domestic intelligence agency. No other party will work with it. But there were AFD players in the ranks of FC Bundestag. They basically joined as soon as the party entered parliament in 2017. But then in 2024, last year, the team decided that it would no longer welcome players from the AFD.

17:51So the AFD players challenged that decision. And a few months ago, they won a legal case in Berlin. A court said that banning players from a particular political party violated the statutes of the club. But in June, SC Bundestag rewrote its own statutes to put that AFD ban onto a firmer legal footing. They thought that that decision by the domestic intelligence agency, that the AFD could be described as right-wing extremist, gave them the legal backing that they needed in order to do that. But this is not over. The AFD, the players think that the ban is far too vague. They're going to challenge it again.

18:32A lawyer I spoke to says he thinks that the AFD's probably got a pretty strong case to overthrow that ban. So although we're in the summer break now, I think we can all expect this issue to rumble on for a little while longer yet. So how has the AFD reacted to this ban? Well, I think the AFD will try to take this back to court. This ruling by the intelligence agencies itself is subject to legal challenge. And in fact, it's actually been suspended pending that decision. so everything is sort of shrouded in legal limbo at the moment. They feel like they're being ganged up on. I spoke to an AFD MP called Jörn Koenig who was on the team.

19:11He said that when he first joined there was a good atmosphere with all of the players but that last year two parties of the left, the Social Democrats and the Greens, conspired to kick him and his AFD colleagues off the team. So it's difficult to imagine what the camaraderie in the changing room would be like even if the AFD is reinstated. Tom, so it sounds like what's happening in the football team is exactly what's happening in Germany at large. Yes, and that's why this story is a little bit more interesting than just a curiosity about a few middle-aged MPs puffing around a football pitch. In most European countries, far-right populist parties have secured some sort of foothold in government.

19:56They're in government and coalitions, or they support them from the backbenchers. Germany is one of a now pretty small minority of countries where that is not the case. The AfD is completely shut out from power by the mainstream parties at the federal level and also at the state level. They had their best ever election result in February. They won almost a quarter of the seats in the Bundestag. But nevertheless, all the other parties have blocked them from chairing committees in parliament or taking one of the vice presidencies in the Bundestag as parties would normally expect to be given. And so that firewall in politics remains very, very strong.

20:31But there are big questions over just how sustainable it is. The AFT had that very good election result in February. It's doing even better in opinion polls now. There are now calls from some parties, including the Social Democrats, to ban it outright. That's something that the German constitution allows for. I'm skeptical about whether that will ever happen. but the fact that it's even being debated seriously tells you where Germany has got to in its discussion about the AFD. So yeah, as it goes in football, so it may go in politics. All the other parties want nothing to do with the AFD, but the success of the AFD suggests that some of these strategies may not be entirely fit for purpose and they might need to update their game plan.

21:15Tom, thank you so much for talking to me. Thanks, Rosie.

21:36That's all for this episode of The Intelligence. We'll see you back here tomorrow.

21:52Thank you.