Being late. The days take on a life of their own. So, but i wanted to say good morning. Good morning, dr. Collins, welcome back to labor hhs to the appropriations subcommittee. Let me just say a thank you on behalf of the 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 met with the researchers who were working to cure Sickle Cell Disease, to develop treatments for major depression, the shrinkage of cancer tumors in children. We heard from participants whose lives have been changed by Clinical Trials. So it was a moving and an informative, but a very moving experience, as well. Let me welcome our witnesses including the five institute and Center Directors who join us today, and in addition, and always a great addition dr. Francis collins who has joined us many times, director of the National Institutes of health. Today joined by dr. Bruce tromberg, by the institute of biomedical imaging and bioengineering and dr. Helene, with the center of complimentary and integrated health and dr. Eliseo perez, director of the National Institute on Minority Health and disparities. Dr. Patricia flatly brennan, rn and ph. D director, National Library of medicine, and dr. Christopher austin, director of the National Center for advancing translational sciences. Your work, all of the 27 institutes and centers leads to treatments and cures for diseases and conditions that affect people around the globe. Its transform tiff aative and the greatest good that we can do in government. They hold a Budget Hearing to hear from the nih director as well as directors of five or six of the institutes of the center, but todays hearing is an opportunity for the subcommittee members to hear more and to hear from directors of an additional five institutes and centers which is very, very important to all of us. When i joined the subcommittee about 25 years ago, we used to invite every director to testify. Its been a long time since we have heard from many of them. In fact, theyre plain spoken about this and my Ranking Member, congressman cole knows about this. I wanted to include the National Institute of nursing and i wanted to include the fogh erty National Center and the Eye Institute as well this morning. Unfortunately, the administration denied our request on the grounds that we did not provide twoweek notice. Im disappointed, but nevertheless, we will find another opportunity to hear from other directors. Let me again, i think we ought to be inviting every director, at least every two or three years, to be able to listen to what you are doing and how we can assist in that process. Its critical for the subcommittee to get a picture, a full picture of the nihs portfolio as well as the research landscape. So youve heard me say before, with each scientific discovery and each medical break through, the nih, advances Human Knowledge and above all, it saves lives. I am so proud that the congress has 4 million and i will note that the subcommittee did this on a bipartisan basis. In in fact, for 2020, the house passed appropriations with increased funding consistent with significant annual increases over the last four years. The house bill increases funding for each of the institutes by at least 5 . Our funding bill is a statement of our values and a reflection of our commitment to investing basic, Biomedical Research at the nih. It is not overstating the case to say that the nih has prolonged or improved the life of every american. Because of nih research we have childhood decreased cancer mortality, 50 in 35 years. We have a vaccine to present cervical cancer. We have a drug that prevents hiv transmission with 99 effectiveness. In fact, a recent study in the proceedings of the National Academy of sciences in february found that nihfunded research contributed directly or indirectly to every single one of the 210 drugs approved by the fda between 2010 and 2016. That is your impact and it is amazing. So to our guest, we say a thank you for everything that you do. We look forward to our conversation today and now let me turn this over to my colleague from oklahoma, the Ranking Member of the subcommittee. Mr. Cole. Thank you very much, madam chairwoman. A couple of housekeeping things. Its wonderful to have our friend here. Weve not had her back for a while. She has the most excused absence of all time, but its great to have her back. Thank you. Just to let our witnesses know, ive been told to share this, at some point i have to get up to go to a Leadership Meeting and it has nothing to do with your testimony. I have to get away and i want to thank the chair for bringing this together and you guys actually do that and its wonderful to see you and to see the chair and 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 and inviting some of the institutes and centers. We do not get to hear from as often as we should and i associate myself with the remarks she made about that. I look forward to learning more about the research being done and learning about the promising cures in the future. However, i would be remiss if did i not recognize dr. Francis collins. I want to congratulate dr. Collins on reaching an amazing accomplishment on the director and hes clearly the best politician in washington, d. C. , if he can get appointed by both barack obama and President Trump. Thats Pretty Amazing span of appreciation for the manner in which hes led the nih and a great deal of national confidence, obviously, in his ability and the Wonderful Team that hes assembled there and has been there for many, many years. Obviously, dr. Collins and iss groundbreaking research and supported by nih funding and again, ive said it here and the four years of sustained funding increased which was as the chair said very bipartisan and owes a great deal to frankly, our confidence in dr. Collins as the leader of this institute, as well and hes made the case up here for a lot of years as to why this is an important investment in this committee and a bipartisan fashion has listened to that. I want to highlight some of the of the work being done in local universities and my district through the support of the nih. Somehow they always seem to miss that when they announce new cures and it never says funded by the nih or awarded and we need to work on that and maybe require them when they get grants and working with the university of oklahoma, and researchers at the Oklahoma Medical Research foundationdation are using a novel, threedimensional model and to study the respiratory, and its the interstitial virus i wont try it twice, thank you a virus that affects the lungs. This virus is the leading cause of pneumonia worldwide. It can take a particularly heavy toll on children infecting half of their first half of life and nearly 100 by age 2. The virus is highly contagious and for those with weakened immune systems with conditions like asthma, it can be dangerous and even deadly. These researchers hope to reveal what predisposes infants to severe infection and to create a launching pad for therapies down the line. This lung in a petrie dish model could prove to be valuable for studying other lung infects like flu, allergy and asthma. Another medical Research Foundation is lupus. It infects a million and a half women and its particularly bad on after can americans and hispanics and its a chronic and auto iks mun disease that causes inmraming a tut your bo are body. Your bodys own immune system is responsiblet and the breakdown. It can affect various tissues in the body, including ones skin, blood and internal organs. It can cause ooh on its a op ten cause of death, afric africanamerican and miss pan earn, and to condition duck large scale genetic announcement and the focus on 25 genes and it is disproportionately burden africanamericans with lupus. The medical Research Foundation has done in the lupus space including discovery by one of its own researchers, dr. Judith james an antimalaerial medication. These medications are now part of the standard treatment of care for many lupus patients. There are countless stories like this of Ground Breaking research taking part in the United States as a direct result of nih funding. Nih fosters such ingenuity. Simple idea from one lone researcher that can open an entirely new field of medicine in Biomedical Research. All americans benefit from this research. Future generations will benefit from the untold promises from the research being done today. Despite some of the controversy that can surround this bill, support for research at nih has been broad, bipartisan and been supported by leadership in the house and senate alike. I do not want to take up any additional time recognizing all of the Institute Directors before us today because, quite frankly, i would rather hear from them about their exciting research, but i do want to thank each of you and your colleagues and the leaders not with us for their work and i believe the work will change the work and treatment for generations to come. I Hope Congress continues to be a supportive partner in these efforts. Thank you, madam chair, for holding this hearing. I yield back my time. Thank you very much, congressman cole. Im not going to go into what they do, but i am so proud that the yale school of medicine has one of the awards. We are a hub and it is amazing work that gets done that, as well and we thank you for that and with that, let me yield to the chairman of the appropriations committee. My colleague, congresswoman nita lowey. I thank the chair of this Extraordinary Committee for this hear coming is so very, very important, and i think im sorry youre leaving, but i thank my good friend mr. Cole for holding this hearing. Theres no question that whether its chairman cole or not chairman cole, there is bipartisan support for the outstanding work youre doing and i really thank my good friend the chairwoman delaura for holding this hearing and i welcome dr. Tromberg, dr. Perez, dr. Lantern, dr. Austin, dr. Brennan and of course, dr. Collins. Ive been reading you with a big smile for many, many years, and i really appreciate all that you and your team are doing. Earlier in the year, however, the Trump Administration submitted a budget that would cut the nih by almost 5 billion. Its Crystal Clear that President Trump doesnt really understand the nature of this committee and how bipartisan it is, and no regard for the National Institutes of health and the cuttingedge work you do to save lives, advance cures and improve the health of americans. Despite the president s heartless and misinformed efforts to cut 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 passed fiscal year 2020, labor health any related agencies would provide their 2 billion more including increase for the institutes and centers. This would allow the nnih to petter respend to make brick troous, but thaw such as those of us pd. They are leading innovation and theres so much going on, dr. L collins, i dont know if you threw the numbers in a hat to try and pick which ones are here today, but i really look forward to hearing your remarks. Not only will we hear about the encouraging advances achieved to date, but also the exciting innovations that are just over the horizon. Were talking about lifesaving achievements that with our continued commitment and investment could soon be on our doorstep thanks to the nihs extraordinary work. So rest assured, the administrations attempt to slash your budget will not stand. We remain committed to ensuring that you have the tools and the 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. Thank you. We will now proceed to Opening Statements from the nih panel. We have six witnesses today. So what we have done is to ask you to please offer three minutes of opening remarks. Im sorry. They curtailed the five minutes and we wanted them to get in the opportunity to testify. You know the drill today. The full testimony will be entered into the issuihearing r. You are recognized for three minutes. Good morning chairwoman delauro, and yes, im Francis Collins and director now for over ten years of the National Institutes of health. On behalf of nih, i want to thank the committee for your work on the fy20 hhs funding bill that passed the house in june. We were grateful for your bipartisan support and we were table to host a visit to some of you last week. Let me start by introducing dr. Christopher austin, director of the trains lagztranslational subjects and leak you theyre translated into new ways of combatting disease. Today weve identified the molecular causes from more than 6500 diseases, yet treatments exist for 5 hun. So addressing that gap requires Translational Research and one of my first initiatives upon becoming nih director was to ask congress to create end cats and you did and here is the director . Mix up is next to me on my left, your it is focussed on one way it does this is to have a database that provides access to more than 5 million articles from biomedical ujournals and te other is the online catalog of public and private Clinical Trials which, by the way, is a great resource to share with your constituents looking to take part in medical research and thats where you can find the trials and now meet the director of the National Center for complimentary and Integrative Health which this very week celebrated their 20th anniversary. In pack, it was you, should Sub Committee that established this center in 1999, citing the need for more Scientific Evidence on Complimentary Health practices and that need remains great today. Let, let me introduce dr. Eliseo perez, and director of Minority Health and Health Disparities. I think it is wrong for, and how is the krill cal issue of distension wished, and im yo other investigators push the innovation knowie envelope to create smart, faster and less expensive medical technologies and i thank you for the opportunity and it help explain why i am so excited to lead all of nihs institutes and centers working together to encourage this next generation of researchers. I can assure you you will speed the path from discovery to health. My colleagues and i will be happy to entertain your questions. Thank you very, very much, dr. Collins and for being so succinct. Its unusual for me, i know. Please, now let me just recognize dr. Tromberg. Thank you again. Your full testimony will be earned interest the hearing record. You are rb oized for three minutes. Thank you. Madam chairwoman and members of the subcommittee. Its an honor to be at your hearing with thousands of physical scientists across the country who are developing Innovative New technologies to improve human health and ive only been director for five months and ive spent years pioneering the optics and photoprojectsed bksz sksz become are bu and we build strong partnerships with industry, academia, federal agencies and every nih institute and center. Our programs lead to better, faster and less costly ways to advance technologies from blackboard to bench top to bedside. And mibib supports 1,000 grants each year in four major technical areas and computation and Artificial Intelligence, engineered biology and sensing and imaging and advanced therapeutics. One of the innovative and sensible platforms has been the widespread problem of foodal lerjs for billions of pub look io have you had a point of Care Technology. Its small foufr check on on a key chain in less than ten minutes. Small personal Sensor Technologies are helping drive the development of new personalized imaging platforms to help address the Breast Cancer detection painlessly and without xrays and contrast agents. Researchers are using invisible laser light pulses that are one billion of a second in duration to create ultra sonic vi vibrations. 3d images of breast tissue are formed for diagnosis and guiding therapies. In the same way that advanced Imaging Technologies it eliminated the once common practice of exploratory surgery. New technologies are revolutionizing brain surgery so it can be done without scalpels. The approach uses special ultrasounds placed around the head that are controlled to target structures deep in