Biomedical research. This means providing our scientists with what they need to conduct cutting edge to discover and develop treatments to help patients fighting disease. As i happen to be the granddaughter of an nih funded scientist, my grandparents raised me and i understand what an Important RoleBiomedical Research plays, not just in treating and curing disease, but also in bolstering our Economic Growth and ensuring that america is a Global Leader in innovation. We cannot afford to have nihs potential limited or even worse, have its legs cut out from under it yet. That is precisely what the House Republicans have proposed to do with their fiscal year 2024 budget caps in the bill that they passed last week. Cutting spending as they have proposed would mean slashing approximately 22 from programs next year that support a range of programs including supporting our veterans, keeping our communities safe and healthy and doing Vital Research to find cures for illnesses and diseases. It would mean a cut of over 10 billion in fiscal year, 2024 alone for life saving medical research at nih an extreme cut like that would mean nih could fund 5000 fewer grants and would shutter hundreds of labs across the country. It would stall training for the next generation of researchers and result in fewer drugs being developed for cancer. Alzheimers disease, diabetes, serious Mental Illness and other devastating conditions. This would slow progress to find treatments for disease and weaken americas competitiveness particularly against china and increase our reliance on Foreign Countries for Clinical Trials and drug development. Fortunately, here in the Senate Ranking member, capito and i are focused on writing a bipartisan labor hhs spending bill to move our country forward. We are committed to working together to find compromise. Our communities are depending on us to continue providing the support needed to combat the opioid epidemic, the Mental Health crisis and so many other challenges every day across wisconsin. Researchers at world class institutions like marquette university, the Medical College of wisconsin and the university of wisconsin system are working around the clock and making groundbreaking discoveries. Im pleased to say this subcommittee has a proven track record of recognizing the tremendous importance of supporting our nations Biomedical Research community, acting director tayback. Im pleased to see that the administrations budget request for nih would increase funding for the cancer moonshot and Mental Health research. And i look forward to learning about the agencys plans to develop, to deliver new cancer treatments with fewer side effects and develop a precision psychiatric initiative. But im disappointed to see programs that aim to address maternal mortality. The opioid epidemic, alzheimers disease and Health Disparities and develop a universal flu vaccine to name just a few that those programs remain flat or are actually cut in the proposal. I look forward to working with my colleagues to ensure nih has the resources it needs across its 27 institutes and centers to continue the progress of recent years. I have been glad to see nih working to examine barriers to diversity among its researchers and within its Clinical Trials and increase Career Opportunities for groups that are underrepresented in Biomedical Research. But there is still a long way to go. And in the meantime, these remain real problems with real consequences for research. Finally, before i turn it over to senator capito, i want to mention an article published last week in science revealing nihs failure to discipline an investigator with a known documented history of Sexual Harassment in march of 2022. After years of urging nih to take decisive action. This subcommittee wrote policy into law requiring institutions to inform nih of disciplinary actions taken against harassers to ensure accountability. Yet, following a far reaching investigation at Florida State university that resulted in a 131 page report detailing years of severe pervasive Sexual Harassment. Nih approved the transfer of an investigator from f s u to san diego Biomedical Research institute and awarded him a new 2. 5 million grant. Unsurprisingly, the abuse continued driving at least one trainee out of the institution. It is outrageous that nih is complicit in this case of past the harasser. And i want to know what youre doing to hold the researcher and institutions accountable and how you will prevent incidents like this from happening again in the future. So, acting director tayback, i look forward to your testimony and appreciate your being here today in a moment. I will turn it over to Ranking Member capito for her opening remarks following senator capito Opening Statement. We will hear from acting director tayback and after that, senators will each have five minutes for the first round of questions. Thank you madam chair. And its i agree with you. We, we need to do this together, work together. We have the vice chair here. Shes riding hard on all of us as, as she is with the chair. So we are hopeful that we have a successful result. Doctor, thank you for being here and for your role in performing the functions as nih director. Really appreciate this. Youve done this since december 2021 have helped your nih through, through some interesting times. Maybe youll write a book or something. Doctor volkoff. Thank you, doctor ho. Thank you, doctor gordon and doctor loy. Thank you for being here today to discuss some of the Biggest Health issues facing our nation. This is an important opportunity for us to hear about the nih Budget Proposal and better understand the priorities for fiscal year 2024. Ive mentioned before that our jobs will be more challenging this year given the debt ceiling and fiscal challenges that face our nation support and funding for Biomedical Research at nih has long been a bicameral bipartisan priority. The budget proposes 48. 8 billion in Discretionary Spending for n ih including 21st century cures and arpah. Nih funding has seen almost a 60 increase for the last eight years and these investments are good reasons are for good reasons. Since nih research affects every american in every way. As i look through the dice, i think of all the people that i know in my home state who are affected by your different disciplines. In West Virginia nih supports 952 jobs and 142 million in Economic Activity during 2022 alone, through the 49 million that were received in grants and contracts. This year, we need to prioritize areas of agreement such as funding to find cures and treatment for cancer, including Childhood Cancer and funding for our Academic Research institutions. For example, in the fiscal year 2023 omnibus, we reauthorized the Childhood Cancer star act which i led with senator jack reed and included in their 30 million to continue to implement it. The cancer star act directs the National Cancer institute to advance Childhood Cancer research, better understand and track the disease and enhance support for survivors and those affected by Childhood Cancer. Childhood cancers are different than adults and the Specialized Research is very important, West Virginia ranks above the national average, both in new cancer diagnosis and deaths. So im pleased that the budget devotes increases to the cancer moonshot and significant resources to the advanced Research Project agency for health or apa h to focus on finding cures and treatments for cancer. Another area i greatly support is for the nih Institutional Development award or the i dea program. There have been few programs as impactful to my state as the idea program and im disappointed that these awards are flat funded in the president s budget. West Virginia University is one of 17 Research Institutions nationwide to participate in an idea and eco program that was started in 2016. The collaboration between wvu establishes pediatric Clinical Trials throughout the entire state of West Virginia so that doctors and patients have access to the same treatments that are available at wus hospital in morgantown. Wvu is also a leader in nih covid research. Dr. Sally hotter with wvu is co leading an ied States Consortium initiative to better understand the long term effects of covid. The Research Capabilities at West Virginia university continue to prove that our Higher Education institutions can compete are are higher. Our West Virginia institutions can compete with any other institution in the in the country. Im disappointed in some of the overall funding levels in the nih proposed budget. First, there are no new resources specifically for Alzheimers Research in nih which doctor ho knows is a great passion of mine and in an estimated 6. 7 million people, 65 or older are currently living with alzheimers in our country. And the National Cost of caring for those alzheimers and other dementias is estimated to reach 345 billion. Not to mention the emotional costs on our families and caregivers. Theres a lot of Exciting Research going on in this area. Alzheimers and Dementia Related Research must remain a a a National Priority also Substance Abuse challenges or Substance Use challenges facing the nation basically are receiving Just Lip Service in this budget as the National Institute on drug abuse is receiving flat funding in 2021 fatal overdoses claimed nearly 107,000 americans. Doctor volkoff has visited my state and has seen first hand how we are in the crosshairs of the opioid addiction crisis. I know we are anxious to have you back in West Virginia. And frankly, id welcome all of you to visit West Virginia, not just to see and learn, but also to enjoy the state as well and meet the dedicated professionals. I know we are dealing with a tight budget year this year but investments in Biomedical Research are so important for the future of our country. Listen, i want to thank all of you for what you do. I should have started with that because youre in an exciting time for research, an exciting time for breakthroughs and we want to support you as well as we can. Thank you, senator capito. And i will now introduce our witnesses. Doctor lawrence tayback is the acting director of the National Institutes of health. Doctor Joshua Gordon is the director of the National Institute of Mental Health. Doctor richard hoti is the director of national, the National Institute on aging. Doctor douglas lowy is the Principal Deputy director of the National Cancer institute. And doctor nora volkov is the director of the National Institute on drug abuse. I want to thank you all for joining us and and underscore what senator capito just said, thank you for what you do and how you have devoted your careers. Acting director tayback, you may deliver your opening remarks. Thank you, chair baldwin, Ranking Member, capit and distinguished subCommittee Members. Im honored to be here today representing the National Institutes of health. Our mission at nih is to seek fundamental knowledge about the nature and behavior of Living Systems and to apply that knowledge to save lives and improve health. Fundamental translational and Clinical Research are critical components of the Biomedical Research enterprise. However, fundamental or basic research rarely makes headlines. Understanding how proteins fold or how gene activity is controlled, doesnt often improve human health immediately. But fundamental research is essential to making breakthrough discoveries that lead to treatments and cures. A paper published last friday in the journal of the American Medical Association indicated that nih funding contributed to the development of 354 out of 356 new drugs approved by the us u. S. Fda from 2010 to 2019. Nih supported the foundational evidence that pharmaceutical companies leveraged to develop life saving drugs and many thousands of patents. Ive spoken to the subcommittee previously about how fundamental research from nih supported scientists and collaborators positioned the United States to develop covid19 vaccines on an unprecedented timeline. But there are many other examples of how fundamental research has led to improvements in the health of americans. One such case is the breakthrough stroke treatment, tissue plasminogen activator or tpa that resulted from decades of work conducted across biological disciplines. Researchers first found the enzyme on cells that line blood vessels in 1946 3 decades later, certain cancer cells were found to secrete tpa in large quantities and once purified the purified enzyme dissolved clots in animal models. A decade after that, using Recombinant Dna Technology and nih supported Clinical Trials led to the approval of t p a to treat heart attacks. And then in the 19 nineties, tpa transformed the treatment of stroke allowing most patients who are treated within three hours to make a full recovery with far reduced health costs. Many of our most important advances have come when we were not even thinking about a direct application. Decades ago nih funded research on how bacteria protect themselves from viruses. No one involved could have predicted that this research would lead to tools that have revolutionized all of medicine because of research on recombinant dna. In the 1960s , it became possible to produce drugs like human insulin and tpa for widespread use. Starting in the 19 eighties. 1980s. Continued investments led to the transformative approaches for gene editing such as crispr. This highly Versatile Technology has revolutionized how basic research is conducted and how diseases may be treated, including such things as sickle cell and antibiotic resistant urinary tract infections. Discoveries build upon each other in ways that we cannot necessarily predict sustained addict. Sustained Public Investment addict. Sustained Public Investment and fundamental research is essential to the discovery and development of new medical treatments to foster the application of fundamental research. Nih continues to support Translational Research studies and collaborate with industry to advance crucial interventions for the public. As most of you know, naloxone is a life saving treatment that can quickly restore normal breathing when somebody overdoses on opioids. This drug is an essential tool in the fight against the Opioid Overdose Crisis which claims 188 lives in the us every day injectable naloxone was used for years, but an easier intervention was needed. In 2013, scientists from the National Institute on drug abuse created a stable formulation of concentrated naloxone for use in a nasal spray injector developed by an industry partner. Working together they conducted Clinical Trials to evaluate the nasal spray formulati