Collins and other and i age leaders testify before House Appropriations subcommittee on funding and research efforts. This is about 21 2 hours. The subcommittee will come to order. Thank you very much and apologize for being late. They take on a life of their own. I wanted to say good morning, welcome back to labor hhs, appropriations subcommittee. Let me say thank you on behalf of of the subcommittee for hosting members of the subcommittee for the site visit at the nih campus last week. We had a wonderful opportunity to learn more about nihs work, we learned about researchers working to develop treatments for major depression, shrinkage free cancer tumors in children, we heard from participants whose lives have been changed by Clinical Trials so it was a moving and informative experience. Let me welcome our witnesses including the five Institute Center directors who joined us today and in addition, always a great addition doctor Francis Collins, director of the National Institute of health. Today joined by the director of the National Institute of biomedical imaging and bioengineering. The director of come from entry and integrative health, pocan Helene Langevin. Doctor eiliseo perezstable of Mental Health and disparity. Patricia flatley brennan, phd director, National Library of medicine. Doctor Christopher Austin director of the National Center for advancing translational science. Your work, all the 27 institutes and centers leads to treatment and cures for diseases and conditions that affect people around the globe. It is transformative and some of the greatest good that we can do in government. Each year the Sub Committee holds a Budget Hearing to hear from the nih director as well as directors of 5 or 6 of the institutes of the center but todays hearing is an opportunity for subcommittee members to hear more and to hear from directors of an additional five institutes and centers which was very important to all of us. I joined the subcommittee 25 years ago. We used to invite every director to testify. It has been a long time since we heard from many of them. I have been plainspoken about this as my Ranking Member i wanted to include the National Institute of nursing, i wanted to include the fogarty interNational Center. Unfortunately, the administration denied our request on the grounds that we did not provide two weeks notice. I am disappointed but nevertheless we will find another opportunity to hear from other directors. I think we ought to be inviting every director every 2 or 3 years depending on what you are doing and how we can assist in that process. It is critical for the subcommittee to get a full picture of the nihs portfolio and the research landscape. You heard me say before we need scientific discovery of each medical breakthrough. Nih advances human knowledge, improved our quality of life and above all saves lives. Im proud of the increased nih finding of 9 billion, 30 over the past four years and i will note the subcommittee did this on a bipartisan basis. For 2020, house passed appropriations include increased funding consistent with significant annual increases over the last four years. The hospital increases funding for each of the institutes by 5 . It is a statement of our commitment to invest in basic Biomedical Research at the nih. The nih has prolonged life of every american and because of nih research we had childhood decreased answer mortality, 50 in 35 years. We have a vaccine, a drug that prevents hiv transmission with 99 effectiveness. A recent study in proceedings of the National Academy of sciences in february found nih funded research contributed directly or indirectly to every single one of the 210 drugs approved by the fda between 20102016. That is your impact and it is amazing. Thank you for everything you do. We look forward to our conversation today and let me turn this over to my colleague from oklahoma, the Ranking Member of the subcommittee. A couple housekeeping things. I want to say it is wonderful to have miss herrerabeutler back here, she has the most excused absences of all time but its great to have her back. I have already told to share this, i have to go to the Republican Leadership meeting. I will be coming back, has nothing to do with your testimony. I have been called away and i congratulate our chair for scheduling a perfectly timed hearing because we need something to bring us together and you guys do that. It is wonderful to see you and the chair of the full committee. Today we have our second Budget Hearing on the National Institute of health and i want to thank the chair for having this hearing, inviting the institutes and centers we do not get to hear from as often as we could and i associate myself with the remarks you made about that. I look forward to research being done in the promising cures of the future but it would be remiss if i did not recognize doctor Francis Collins on reaching an amazing accomplishment leading the nih for ten years as director. He is clearly the best politician in washington dc to be appointed by both barack obama and donald trump. Pretty amazing span of appreciation for the manner in which he led the nih and National Confidence in his ability in the team he has assembled and has been there for many years. Doctor collins is an advocate for groundbreaking research at the nih and supported by nih funding. Four years of sustained funding increase which as the chair said was very bipartisan and owes a great deal to our confidence in doctor collins as the leader of this institute and he made the case for a lot of years why this is an important investment. I want to highlight the work being done in my district through the support of the nih. They seem to miss that when they announce it never says funded by the nih. We need to work on fat. May be required it when we get grants but working at the university of oklahoma science centers, researchers at the obama medical Research Foundation are using divisional model made of human tissue to study the now respiratory i will get this wrong i wont try it twice. Virus that affects the lungs. This virus is a leading cause of pneumonia worldwide. It can take a heavy toll on children affecting half of the first year of life, 100 by age 2. The virus is highly contagious and for those with weakened immune system, it can be dangerous or deadly. Researchers hope to reveal what happens to create launching pad for therapies down the line. This lungs in a petri dish model could prove to be valuable for studying other lung infections like food, allergies and asthma. Another area of focus is lupus which affects 1,000,0001 2 americans but it exactly particularly heavy toll on african demands, hispanics and native americans. Lucas debate lupus is a chronic autoimmune disease that causes inflammation throughout your body. Autoimmune disease is a condition in which your bodys own immune system is responsible for the inflammation and breakdown of its own cells. Inflammation seen in lupus can affect organs and tissues in the body including ones joints, skin, blood and internal organs, the disease can be severe, potentially lifethreatening, cause permanent organ damage. There is no known cure for lupus. Lupus remains a top 10 cause of death in African American and Hispanic Women between the ages of 15, and 45. To understand more about it scientists are conducting largescale analysis of thousands of lupus patients from thousands of healthy volunteers, the focus on 25 jeans previously linked to the disease, the goal is to identify the genetic culprits the disproportionately burden africanamericans with lupus. The study builds on groundbreaking work of the medical Research Foundation in lupus space including discovery by one of its own researchers, doctor judith james, antimalarial medication, relieve and delay the symptoms of lupus. Because of this discovery these medications withstand treatment of care for many lupus patients. Countless stories like these, groundbreaking research taking part across the United States as a direct result of nih funding. Nih fosters such ingenuity. A simple idea from one loan researcher can open an entirely new field of medicine and Biomedical Research. Allamericans benefit from this research. Future generations will benefit, from the untold promises from research being done today. Despite some of the controversy that comes around this bill support for research at nih has been broad, bipartisan and supported by leadership in house and senate alike. I wont take additional time recognizing all the Institute Directors because i would rather hear from them about their Exciting Research but i want to thank each of you and your colleagues and those institute and Center Leaders who are not with us for their passion, dedication and hard work. I believe the work of the nih has will change the course of Disease Detection and treatment for generations to come. I Hope Congress continues to be a supportive partner in these efforts. Thank you for holding this hearing and i yield back my time. Thank you very much. Im not going to go into what they do but i am proud yale school of medicine has translational science awards. We are a hub and this amazing work gets done there as well. Thank you for that and with that, let me yields to the chairman of the appropriations committee. I think the chair of this Extraordinary Committee which is so very important. And i thank my good friend, mister cole, for holding this hearing, no question that whether it is chairman a or not chairman cole, there is bipartisan support for the outstanding work you are doing and i really thank chairwoman delauro for holding this panel. I think doctor Helene Langevin, Patricia Flatley brennan, doctor collins, i have been reading it with a big smile for many years and i appreciate all that you and your team are doing. Earlier in the year the Trump Administration submitted a budget that would cut the nih by almost 5 billion. It is Crystal Clear that donald trump doesnt really understand the nature of this committee and how bipartisan it is and now regard to the National Institute of health and the cuttingedge work that you do to save lives, advance cures and improve the health of americans. Despite the president s heartless and misinformed efforts to get the nih, we have responded resoundingly. Unlike the president my colleagues and i prioritize the health of all americans. We are on track to invest billions more than the president would for our worldclass National Institutes of health. Our house past fiscal year 2020, health and Human Services education and related agency bill, would provide 2 billion more for the nih including a critical across the board increase for all the nih institutes and centers. This would allow the nih to better respond to scientific breakthroughs that result from astonishing foundational Research Done at the institute such as those with us today. We have the distinct pleasure to hear from several Institute Directors who are leading innovation in their respective fields and there is so much innovation going on. Doctor collins, i dont know if you put the numbers of the institutes in a hat to pick which ones are here today, but i look forward to hearing your remarks. Not only will we hear about the encouraging advances achieved to date but also the exciting innovations over the horizon. We are talking about lifesaving achievements that with our continued commitment and investment will soon be on our doorstep thanks to the nihs extraordinary work. Rest assured the administrations attempt to cut your budget will not stand. We remain committed to ensuring that you have the tools and resources you need to deliver for the american people. So i really do want to thank you and i look forward to our discussion. Thank you all for everything you do just to improve lives. Thank you. We will proceed to Opening Statements from the nih, we have 6 Witnesses Today but what we have done is ask you to offer 3 minutes of opening remarks. Sorry to curtail the five minutes but we want to get it in and the opportunity to ask questions. Doctor collins, welcome, thank you for being here today and you know the drill, full testimony will be entered into the hearing record, you are recognized for 15 minutes. Good morning, chairwoman delauro, distinguished subcommittee members. I am Francis Collins, director for slightly over 10 years of the National Institutes of health. On behalf of nih i want to thank the committee for your work on the fy 20 labor hhs funding bill that passed the house in june as we are grateful for your ongoing and bipartisan support and we were pleased to host visits by some of you last week. Today i am joined by the leaders of five of the nihs 27 institutes and centers. Let me start by introducing doctor Christopher Austin of the center for advancing translational sciences. Like you im always impatient for basic Research Discoveries to be translated into new ways of combating disease. We have identified the molecular causes for more than 6500 diseases yet treatment exists for only 500. Addressing that gap requires Translational Research. One of my first initiatives on becoming nih director was to ask congress to create in cats to speed this process and you did and heres the director. Next up, Patricia Flatley brennan who is next to me, director of the National Library of medicine. Like everything at nih, activities are focused on innovation that advances Biomedical Research. One way to do this is through a database that provides access to more than 5 million articles from by a medical journals. Another is through Clinical Trials. Gov, the online catalog, public and private political trials which by the way is a great resource to share with any of your constituents looking to take part in medical research. Now meet Helene Langevin from the National Center for complimentary and medical help which this very week celebrated their 20th anniversary. It with you, the subcommittee that established the center in 1999 citing the need for more Scientific Evidence on Complementary Health practices. That needs remains great today. Next to let me introduce eiliseo perezstable of the institute on Minority Health and Health Disparities. It is important for you to meet him for many reasons including at your april hearing many of you asked about Health Disparity in the Critical Issues of Maternal Mortality. Also in todays testing list lineup, on my right, your left, the director of the National Institute of biomedical imaging and bioengineering, his instituting gauges, engineers and other types of investigators to push the innovation envelope to create smaller, faster and less expensive medical technology, bruce tromberg. Thank you for holding this committee, and im excited to lead all of nihs institutes and centers. Working to encourage this next generation of researchers to be sure we will speed the path from discovery to health, my colleagues and i will be happy to entertain your questions. Thank you for being so succinct. It is unusual for me, i know. Let me recognize bruce tromberg, your full testimony will be entered into the hearing record, your recognize for three minutes. Reporter members of the subcommittee, it is an honor to represent the thousands of talented engineers and physical sciences across the country for developing Innovative New technologies to improve human health. I have only been director for nine months but i spent 30 years pioneering new optics info tonics technology and training students as professor of Biomedical Engineering and surgery at the university of california. The mission is to transform through engineering the understanding of disease and its prevention, detection, diagnosis and treatment. We support cuttingedge research connected to by m