Specialists. Review the latest events any time at cspan. Org coronavirus. Now several directors from the National Institutes of health testified before a House Appropriations subcommittee on the president s 2021 budget request and the coronavirus outbreak. The subcommittee will come to order. Good morning, all. Dr. Collins welcome back to the labor hhs education appropriationless subcommittee. Let me also welcome all of you, the five institute and senate directors joining in this morning. Dr. Bianchi, director of the Eunice Kennedy sh rieber National Institute of child health and human development. Thats almost as long as the subcommittee on health, education, Human Services and related agencies here. So anyway. Dr. Anthony fauci director of the National Institute of allergy and infectious deceases. Dr. Gary gibbons director of the National Heart, lung and blood institute. Dr. Ned sharpless. Director of the National Cancer institute. And dr. Dara volkow director of the National Institute on drug abuse. Welcome, welcome to all of you. This is actually leader hoyer asked me this morning, he said do you have the nih coming . I said yes indeed and he says are you ultimately going to be able to get all the Institute Directors to come up and he said he will. And he said it is one of the most remarkable hearings that we have. And we thank you thank you for the great work you do and what a difference you make in saving lives of the people of in great country. At the start let me just touch on a matter of the coronavirus. I want to just say a thank you to the director, to all of the institutes. I want to say a particular thank you to you dr. Fauci. And i want to say that our Public Health experts deserve our praise for what is the excellent work that you are doing on what is clearly a matter of National Importance and National Urgency as you know in so many ways. Today we will be discussing the 2021 budget request for nih. And i want to note that i intend to invite an Additional Panel of institute and senate directors to testify in front of the subcommittee later this year. And i because i believe that we all learn a lot from all of you. And we did that happened with us last september as well. Before we get into the nihs 2021 budget, let me just if i can bring you up to date. I think you know that the committee has been working hard to develop an emergency supplemental to you know, to be able to fund the response of this outbreak. And there is still one or two issues that remain open. But with all speed and deliberation, the intent is that and the chairwoman can speak to that if she cares to. But were looking at trying to move as quickly as we can between today and hopefully tomorrow. But before the end of this week to get this finalized and voted on. So the a funding you know includes funding for the nih. The funding will support research on diagnostics therapeutics and vaccines for covid19 that will be critical to managing the outbreak, and again to save lives. I also might want to note that niaid is not starting at square one. Rather the years of building the research on coronaviruss and Vaccine Development and i just want to say to the subcommittee, colleagues on both sides of the aisle have invested sustained investments in Biomedical Research that the committee has made in recent years. And i am very, very proud that the congress has increased the nih funding by 11. 6 billion, 39 petros over the last five years. Last year alone the congress provided an additional 2. 6 billion increase over fichkle year 2019 level for the nih. And this was in a bipartisan bi camerale way this was done. And we are very, very proud of that. I know certainly the Ranking Member. And we worked closely together on this issue. I would just say to you that i you know, i think the president s budget would reverse this project. The budget proposes to cut nih funding by 3. 3 billion, 7. 9 below the 2020 level, resulting in nih making 1,800 fewer new grants to researchers, a reduction of 16 . This subcommittee will not be pursuing the cuts. We intend to move forward with continued increased investments in nih to build off the progress we made in recent years. And, again, that will be on a bipartisan basis. I know that, as i know anything about where we are going and what we are doing. I am especially proud the congress provided 25 million for research on firearm violence prevention including the 12. 5 million to the nih. I was glad to see that the nih budget request maintains funding for research on flu, including on the development of a universal flu vaccine. However, i believe we need to to continue to grow the research as we did in fiscal year 2020. And i look forward to hearing about what niaid will accomplish with the funds. I was disappointed to see a 559 misdemeanor cut to the National Cancer institute at a time of unprecedented promise in Cancer Research that has led to more and more promising researchers seeking nci research grants. I think cutting the funding for nci sends the wrong message. In fact, with only a few exceptions the proposed cuts to nih would touch every institute, almost every field of research. Last year in addition to new funding for several initiatives we were able to provide a 3. 3 increase to each nih institute and center. We need to keep up that momentum and not reverse it. I believe my friend, my colleague Ranking Member tom cole will concur. Biomedical research is one of the most important investments that a country can make because it gives the gift of life. Which we need to support. And promise you that we will. Thank you again for everything that you do. And i look forward to our conversation today. And let me turn this over to my good friend from oklahoma, the Ranking Member of the subcommittee, congressman tom cole. Thank you, madam chair and thank you all for being here. Before i get to prepared remarks i want you guys to know how deeply you are how you span the bipartisan divide we have here. I have actually made a statement and it was tweeted out by howard dean last night. So i thought was worthy of note. I very seldom get tweeted by governor dean. If im buying real estate in new york i listen to the president of the United States. If i talk about Infectious Diseases im listening to tony fauci. I want to commend all of you and thank you all for what youve been doing in the middle of a difficult national crisis, but more importantly what you do day in day out every single day and the amount of hope you give people around the world, certainly our fellow americans. I think you have been extraordinary custodians of the investment that this committee made month a bipartisan basis for multiple years. I know intends to make again if we can find any way to do it well do it. And i think we will find a way to do it. And i just the current challenge we have frankly is a reminder that you need to do these things and need to do them on a regular basis. You cant just show up game day and think youre going to be able to deal with something. You have to make the commitments and investments over a long period of time to have the infrastructure to do it. Im proud of this committee and the counterparts and the United States senate because we have done it. And im proud of congress for in quite frankly. And this is no disrespect to anybody. But this committee consistently the last five years gone beyond what any president of either party asked it to do. It did that because when congress. We doubled the nih budget many years ago that was a Congressional Initiative if you recall. I think congress because its close to the people has a very keen sense of awareness of how much your fellow americans value the endeavors going on at the nih ill go to the formal rarjs after five years of staentd innocences im pleased to welcome to the hearing director francis kocollins. Once against i want to comment commend you dr. Collins on the long distinguished career in federal service. You left a legacy of excellence its an horp to work with you. You i said you got to be the best politician to get appointed by barack obama and donald trump. I think it says something about the bipartisan nature of what you do and the National Commitment there. Ive made no secret of the fact that increasing funding for the nih is one of the proudest bipartisan accomplishments of this subcommittee. A sustained steady commitment to increase nih funding is critical to ensuring our nations future as the leader in Biomedical Research and unlocking cures to so many of the diseases burdening our Strained Health care system. The hard work and innovation this funding fosters is the part of the sustaining force of the United States economic growth. Leaders in the house and senate, democrats and republicans, have unified behind the increases over the past five years and i ardently hope the trend continues for years to come. While i appreciate and sympathize with the fiscal restraint in the president s budget, i dont think the reduction proposed for nih is in the best interests of the American People. To reduce the nih funding at this juncture would erode the progress we made as the chairwoman mentioned over the past five years. Signal to the Research Community instability and quite possibly delay by years or perhaps decades advances in modern medicine, including curing diseases finding better treatments for cancer and unlocking the power of precision medicine. I also want to caution against president budget requests proposed changes to the negotiation for indirect cost our funds included as part of the grant to cover facilities and administration. In critical funding serves as a foundational element for research and i support the enacted bill language. I hope madam chair we continue that restraint. This is a false economy that our friends at in some quarters have pointed out. And its one that will hurt research not provide additional dollars. We simply, you know, need to protect the institutions that weve been investing in. This past year we had the opportunity to sit down with a Nobel Prize Winner dr. Jim alisyn. His work on immunotherapy for Cancer Treatment promises to chart a course for a new direction for treatment for our deadliest cancers. The noninvasive nature and rapid time between treatment and resuming normal daily life is nothing short of remarkable. More over the treatments are coming to market faster than therapies of the past and could take a decade before Standard Health insurance reimbursement. New applications for research in this area are overwhelming available federal funding. Its something i hope we look at carefully going forward. Companies have noticed the promise of such methods and are beginning to invest their own resources as well. Ten years from now we may have thousands of cancer survivor that is under todays treatment protocols would not have been helped. Its stories like this that remind me that support for the nih has a real life impact on life and that every dollar investment is a direct downpayment to a Better Future for millions of americans and tense of millions of others around the world. I also want to highlight the progress we made in alzheimers disease research. The deadly disease is creating an enormous strain on the health care system, families and the federal budget. Its a rising cause of death and impacting more and more americans each year. Total spending on alzheimers will exceed 1 trillion by 2050 if it raemt remains on the current trajectory. We must make progress, frankly fiscally there is no other option. Im pleased to learn an International Team of researchers partly funded by nih has made more progress in explaining the again et he can component of alzheimers. They are now assemble data from 35,000 individual was the late on set of alzheimers has identified variance in five genes that put people at greater risk of the disease. In order to tack the physical, emotional and financial toll of the disease is having on families we must have a better understanding of the underlying again etics. I dont want to take up additional time recognizing all of the distinguished Institute Directors before us today, madam chairman. Quite frankly like you i would rather here from them about the Exciting Research that theyre all involved in. However, i do want to thank you each of you and your colleagues and those institute and Center Leaders who are not with us for your passion, dedication and hard work. Inl the work at the nih has and will change the course of the disease direction and treatment for many generations to come. And i Hope Congress continues to be a supportive partner in these efforts. Thank you, madam chairman for holding this important hearing. Thank you very much. Its now my pleasure to yield to the chairwoman of the full Appropriations Committee and bun someone who has had just a major role in making sure that we respond in kind and with lackrighty request. Thank you for holding this hearing. Welcome once again our very distinguished guesting. I dont know how you are awake dr. Fauci. Its all those exercise routines. Thank you. But thank everyone, because i know its a team effort. Let me say at the outset, president trumps disastrous budget is filled with deep cuts that tear at the fabric of our nation. Instead of building on the historic investments in last years appropriations bills, the president doubled down on partisan talking points. To propose investing 2 billion for the wall and cutting 3. 3 billion from the National Institute of health really does expose the Trump Administration priorities for what they are, political rhetoric over Public Health. But as you know, this committee is on your team. And at a time with surging cases and costs associated with Heart Disease, cancer, amaze heimers and related dementias, a vaping epidemic and now the novel coronavirus, this panels commitment to nih will remain as strong as ever. I would be remiss not to mention that with my retirement this will likely be my last nih budget hearing. Ill have to come and be in the audience. And when i think about it, we have come so far since i joined the subcommittee in 1993. I was a kid then. When nih was funded at about 10. 3 billion. We committed to doubling the nih budget. Then more than tripled it. Together with the great leadership of this subcommittee in the past five years we have increased increases of 11. 6 billion for a total funding level of 41. 7 billion. And frankly every penny was worth it. And we are so appreciative for all of you, for your talents, hard work, commitment. Its really been an honor for me to serve on this committee. I do remember touring a lab with a young dr. Francis collins who had a plan to map the human genome. I remember that first map. There was nothing in it. The advances in combatting Breast Cancer have revolutionized survivor rates, as immunotherapy has given life to people who would have had a death sentence a decade ago. We know more about Childhood Development and the human brain. And we are witnessing amazing strides in precision medicine. And if you recall, we now even have some female lab rats, those who werent part of the humor at the time, we were convinced all the lab rats were male. Im delighted to know that you have female lab rats. Your work has filled me and millions of americans with hope. Never in all of Human History has medicine had more to offer. And yet with all these great achievements we have so much more to do. I recently came across my questions from an nih hearing in 1999 when i asked why women are more likely than men to have alzheimers. We still dont have the answer. In fact, we dont have many answers to amaze heimers. I was on a panel, lord knows why they asked me to be on a panel. It was about 35 of us sitting around a table with one person who knew what he was talking about, a scientist from columbia. And everyone was kind of quiet. And i said, dr. Gibson, from columbia, so what are you recommending . For many people around that table, there were experts, people who had been working on this for years and years. And he sat up. He said diet and exercise. Dr. Fauci knows that, right. Weve had conversations about that. Actually so many of you. But after all the investments thats really all were offering most people when it comes to amaze heimers. We still dont know the answer. And we still dont have a method for Early Detection of certain cancers. We still dont know why treatments work for some patients but not others. And we still dont know why rates of autism are rising, and why there are higher rates among boys than girls. By the way, if you have answers to any of these questions today, feel free to share them with us. In may be up to date. I thought as of this morning. But if you have some answers to these questions wed love to hear them. So there is so much we need to achieve. And i can think of know better people to do it than the people sitting in front of us today. Yo