The University of Hawaii recently released a report on the UH Cancer Center (UHCC) prepared by an independent UH faculty committee.

We thank the reviewers for their work and the UH administration for releasing the report publicly. This document confirms that the center has been poorly managed and has declined over the last six years from being a highly respected, self-sufficient research operation to being a relatively weak unit with a $10 million annual deficit.

This decline was allowed to reach catastrophic proportions despite early and persistent warnings to decision-makers by faculty members.

With the report out, it is time to discuss how to turn around the center and preserve its most highly successful programs.

However, it appears that the UHCC is now stuck in a tug-of-war between the UH administration and the state Legislature. Put in simple terms, UH wants the Legislature to come up with additional public funds, and the Legislature wants the UH administration to improve its management prior to further investment.

We do not want the importance of UHCC’s mission and its many accomplishments to be lost in the shuffle.

At the heart of UHCC is a group of faculty and staff who have worked relentlessly for decades to prevent and treat cancer in Hawaii. Without effort to maintain the center, it is likely that its important work on understanding why some cancers are common in Native Hawaiians and Asian-Americans will be discontinued. That would be a tremendous setback for our community.

UHCC studies have provided a wealth of critical information on ethnic/racial disparities in chronic disease occurrence and survival, as well as on risk factors and screening practices, in Hawaii.

These studies conducted in our multiethnic population have been essential in establishing that most common cancers are caused by unhealthy lifestyles and are, thus, highly preventable. This message and our specific findings have contributed to public health recommendations made all over the world.

It is completely misguided to compare UHCC with mainland cancer centers that have endowments or major revenues from patient care. UHCC is a small center that mostly focuses on laboratory and population studies, benefited by a multidisciplinary environment.

UHCC certainly needs to go back to a management model based on accountability, fiscal responsibility, transparency, faculty governance and extramural grant funding to conduct innovative and relevant research.

UH is a public research university and research is part of its mission. Indeed, the UHCC has brought much research funding — about $120 million in the past five years — and recognition to UH in its 30-plus years.

The Cancer Center faces many challenges, most of which can be overcome. Although ill-conceived decisions led to the construc- tion of a building with a hefty debt service, which UH does not have the resources to cover, UHCC should be able to cover its operational costs. Downsizing the center’s administration that has ballooned in the past five years would achieve substantial savings.

More could be achieved with faculty involvement to understand where cuts could occur without endangering UHCC’s mission.

Although it is widely accepted that moving UHCC under the UH Medical School would not reduce expenses substantially, closer interactions would benefit both institutions.

Crucially, control of the UHCC budget and faculty positions should remain with the center director, since this is a requirement for National Cancer Institute designation.

The debate must move to explaining the value of the center to the community, to decide whether it wants a cancer research center as part of its research university.

Expectations should be realistic about what kind of clinical research should be developed in Hawaii.

The center needs to go back to focusing on the niche it occupies in the national cancer research agenda, one that relies on its exceptional environment and multiethnic population to best serve our geographically isolated population and the nation.