Subcommittee hearing is two hours and 15 minutes. It is my pleasure to welcome you to the subcommittee on health and Human Services and education to discuss the fiscal year 2017 National Institutes of Health Budget request. We are looking forward to hearing the testimony of dr. Whoins and his colleagues will be brought in for questions along the way. I would like to publicly thank dr. Collins and the staff at the nih for hosting me and other subcommittee members for a briefing at a tour at the nih campus a few weeks ago. I hope it will become an annual trek. Withinleft nih appreciation of the exciting work your staff to every day to find ways to save lives. I am proud than last year this congress was able to increase nih funding by 2 billion a night in confident that through these efforts one day we will find cures for diseases like cancer and alzheimers. Fore disappointed is the proposed budget cut to the. Ih this year the proposal to divert one billion dollars of Biomedical Research funding to the mandatory set a budget ledger and rely on new and possibly unlikely authorizations to continue the advances that we have made in increasing your Research Funding is sort. I do not plan to let the 1 billion cut stand. We need to ensure sufficient basic Biomedical Research bases that are sustained to pave the way for these longterm advancements. Propose new onetime mandatory spending that may never materialize is not the path to do this. Look forward to discussing the effects of the president s proposed discretionary budget cuts on your research this morning. I also want to stress how important it is to ensure that we continue to focus on the next generation of investigators to clean out on the takes for a new drug to make it from the lab to the patients and without a pipeline of young researchers committed to following the process, we will not be on a find a cure. I will be asking some questions this morning about a variety of issues like Institutional Development awards, alzheimers disease, the cancer moonshot are a hope to learn more this morning on the how and how the increases we provide to the nh this you are being used to move us forward to more to cure is is that these diseases that caused some are suffering in our nations with a much for i want to welcome dr. Francis collins, the nh director, the subcommittee, dr. Collins is accompanied by four directors who can assist in answering questions. The dr. Anthony faucher. Dr. Richard hodgins. Dr. Doug lloyd. Nora valco. As a reminder to the subcommittee and ever witnesses, we will abide by the fiveminute rule. Joined by both the big chairman as we like to call him in our Ranking Member. I will defer first to the chairman for any remarks he would like to make. The fiveminute clot is not apply to you. Clock does not apply to you. Welcome. You have exhibited the highest level of professionalism and dedication during a time of so much groundbreaking research. Protection. Cancer, nih has the right man at the helm to me the challenges that we face. The emergence of the zika virus throughout the western hemisphere, one of those challenges that you are undertaking, underscores the mission, tof nihs gain and apply knowledge to enhance health and reduce illness and disability. Since most of its recent , zika hasin brazil spread to dozens of countries. Although cdc does not anticipate anyone spread outbreak in the we have had 190 three travelassociated cases reported. The chairman and i and others just returned from a visit to south america. Leaders, health officials, talking about the virus. We are interested in hearing your thoughts on the role that into our plane to develop vaccines and therapeutics based on existing and future research. To 11 american exposure Going Forward. With various officials on that trip, particularly in brazil. And explored what they are doing to try to stamp out the exposure. And others in the region. Importance of nih wererch, i am proud and we able to work in a bipartisan fashion to increase your budget and fiscal 2016 2 billion to fund more groundbreaking medical research. This year, the nih budget request prioritizes basic foundational research, Precision Medicine, applying big data to improve health outcomes. In addition to the Public Health benefits that accompany your ofk, the Economic Impact medical research should not be underestimated. Nih Research Dollars not only Impact Research facilities and researchers, but they also help get new drugs to the marketplace. Through this funding, we have established a strong and theship between nih National Cancer institute. They continue to perform Transformative Research benefiting the entire country. We look forward to continuing our Work Together to bring an end to these devastating diseases. That being said, funding toward that goal must come through regular discretionary channels. That allow us to respond to needs as they arise. Disappointed to see the request cuts nih discretionary , includingbillion 57 million from the national abuse. Tes on drug the hole witheels over 1. 8 billion in mandatory money. However, i look forward to meeting your requirements for the regular appropriations process. We do not like mandatory spending. It has grown out of control. We have adequate Discretionary Spending for five years by almost 200 billion. In the meantime the mandatory entitlement side of the budget is soaring out of control. I came to congress, we are appropriate or two there is a federal spending. Now it is one third. Now there were two thirds in growing in this deal with it, we cannot even pay the interest on the debt. With discretionary funding. So, that is why we are so dead set against mandatory increases. We need to keep control of the spending that takes place which is the only accountable and to with theora volcow spirit she has been a champion for events and assigns drug abuse and addiction as a director of the National Institute of drug abuse for 13 years now. Be on her personal expertise in imaging, shebrain has been with us since the beginning of our battle against drug abuse and southern and eastern kentucky. I am anxious to hear about your recent efforts regarding the abuse of prescription medications. As you know, this epidemic runs rampant across the nation. I hope you will update the committee on your work with pharmaceutical companies to evaluate the risk associated with longterm use of opioids and what nih is doing to Research Abuse deterrent medications and opioid alternatives. I am also pleased that you have once again committed to sharing these insights of National Prescription summit in atlanta. We are excited about you being here for this one. That others on the subcommittee will be able to make that summit as well. I look forward to hearing from you today about your pursuit of the adolescent Brain Cognitive Development study. Collecting extensive data on the effects of marijuana and other drugs, a Young Persons brain will help us finally appreciate the harm these substances can do overtime. Law is clear, if states continue to rush to decriminalize over legalize marijuana, despite the lack of sufficient scientific that saids use it help close the cap and hopefully shift Public Perception back to reality. Steamedciate this very panel being with us today. We look forward to working with you during the year to make sure that you are doing what the country expects of us. Thank you. Moving next to our Ranking Member, the distinguished lady from new york, miss lloyd. Thank you for holding this very important hearing. It is a pleasure to be with you. This is one of the most exciting hearings i attended every appropriation session. Theuld like to welcome doctors. I would also like to thank each of you for your service and it is because of your vision and to provide aon Bright Future for millions of americans suffering from illness and disease. Im very pleased you are here to discuss important investments in Biomedical Research and the health of our nations. Thank you. I must say was thrilled as i always am to meet with many of you at the nih two weeks ago. During our meetings, i saw firsthand the lifesaving breakthroughs, including gene therapy to treat patients, torahigh field mri machines look at the brink, allowing for advances in alzheimers and other brain diseases, and clinical studies that are improving Mental Health and reducing suicide and so much more. These breakthroughs in the need is whyitional research this committee thought to increase funding for the nih by 2 billion in fiscal year 2016 omnibus spending bill. Nih has the worlds best physicians, researchers, technology. I worry that even a 2 billion investment will not go far enough to ensure that the nih can compete against Foreign Research initiatives. It does not serve our National Interest if there are not enough brands to support young researchers over if researchers are lured away Foreign Countries to develop medical breakthroughs abroad. That is why last year, although i was pleased with the 2 billion increase, i called on this committee to once again commit to doubling funding for the nih. I was here when that bipartisan and i do, myde colleagues on both sides of the aisle to double the funding for the nih puritan we cannot afford to let some of these brilliant researchers not get the support they need. Your fiscal 2017 budget request would be a positive step toward that end up your budget includes target investment such as the cancer moon shot, increases imprecision that is, the great initiative, in addition, it would result in 600 Additional Research project these investments not only fund research, they were greatly reduce the cost associated with treatment and down the line. By the way, i must say i had the watson, theto visit ibm Research Center in my district just last week. In fact, i am not sure i understood everything they were explaining to me, but what i paid particular attention to was a coordinated effort between watson and other Research Facilities in your precision it is sotive amazing to me that Precision Medicine and the research that is being done at the nih is coordinating with many facilities and i understand my followup, watson is the only place. So, dr. Collins, i would love if you would touch on that as well, the coordination that is going on. The amazing work to think could get her cancer analyzed at the nih and other facilities out there and in the same that could certainly help lead us to new discoveries and new cures. Let me say, however, while representing a net increase of 825 million, your budget will result in a one milley one billion dollar cut it discretionary funding for nih and i assure you, that this chair and Ranking Member in the chair iin the big will just not let that happen. Funding is of concern. Finally, in addition if you can get it, good luck to you that would really be great. Finally, in addition to your budget request, the nih is also awaiting congressional action on the emergency supplemental to combat zika. The world is looking to the United States to lead and i and concern that delaying consideration of the emergency supplemental is leaving the american public, particularly women who are pregnant or could soon be pregnant, at severe risk. And i know you are doing Additional Research. I am still not satisfied that only pregnant women can suffer from zika, i know we have touched on that in our discussions. But the bottom line is, we are already behind. We must act. I urged committee and congress to meet this need without delay. Thank you, mr. Chairman. We now go to the gentlelady from connecticut. Thank you. In this any yankee fans audience, you will know the term a murderers row. I want to look at this group this morning as survivors wrote. You are, indeed, allowing people to survive. As i have said in the past, you give the gift of life and we are so honored to have you here this anding and to listen to you have the opportunity to have a discussion. Mr. Chairman, i want to welcome ,veryone and as we discussed the nih is the leading Biomedical Research entity in the world. With each scientific discovery, asian medical breakthrough, its Research Advances human knowledge, improves the quality of our life in saving lives. Funding this research has the power to do more for more people than anything else within the purview of our government. Who has to we were able to provide a significant increase of 2 billion dollars for the nih. I want to say thank you to the chairman and all the members of theirbcommittee for bipartisan work to support nih. The additional funding is helping nih accelerate research to find cures for cancer, alzheimers, and help them move forward with exciting new the Precision Medicine initiative in the Brain Initiative. However, i was disappointed to learn that funding for hivaids research is not increasing in fiscal 2016. In his 2006 in budget request, and age propose an additional 100 million for hivaids research in order to advance his work on universal vaccines to prevent hiv infection. I think it is mistake to change nihse and i hope to see support their research this year and it is something i will advocate for. In plays an integral role responding to emergency Public Health threats. , nih as ebola raged accelerated its work to create any bowl of vaccine are recently, nih has been working to develop a vaccine to address crisis whichika poses an urgent and serious threat that my colleagues to take a look at yesterdays New York Times. Pregnancy is shattered by fear of zika. Of womenn the minds particularly. I look forward to hearing from the doctor about the current status of ebola vaccine candidates as well as progress zika vaccine two Clinical Trial. Some of my colors have expressed the desire to shift unobligated funding the congress provided for ebola to respond to zika. I strongly oppose that idea. I would be anxious to know what activities we would have to forgo if we shift funding away from ebola to zika appeared we need to be able to respond to multiple Public Health threats at the same time. Congress in in this the last congress i proposed funding a Public HealthEmergency Fund that mirrors a Disaster Relief fund which would enable the federal government to immediately respond to Public Health threats. I would also urge the nih to use its Statutory Authority to respond to the rising cost of Prescription Drugs. As you know, when taxpayerfunded Research Results and age maytent, require the Patent Holder to license the resulting intellectual property to a third party. The resulting in competition that drives down drug prices. It is outrageous that drugs invented under tax payer funded sicks can cost the americans hundreds of thousands of dollars over the course of a year. The public pays while nah is funded at 32. 1 billion, that funding has not kept pace with the rising cost of Biomedical Research. Fy2016 funding level 2003ins 7. 5 billion below level adjusted for by medical inflation. Funded one innih three research grants. Today, it has fallen to one and five. The slight improvement over recent years but still low for historical standards. We are missing opportunities to work towards cures for life altering diseases affecting far too many people. That brings us to todays topic, the 2017 budget request. I applaud the ambitious proposal to include Cancer Research in 2017. As a 30 year survivor of ovarian cancer, you have heard me say it before, im alive because of the grace of god and Biomedical Research. Im pleased to see proposed increases at 100 million and 45 million for the Precision Medicine initiative and the Brain Initiative. These initiatives have the potential to revolutionize our understanding of the disease as well as our understanding of longterm physical and Mental Health. I think we can do better. We need to continue to develop consequencesr risk of antibiotic resistant bacteria for our Public Health. I want to note my concern over mandatory funding for nih. It is the responsibility of this committee to fund the nih. An increase for this subcommittees allocation is thi the responsible way to support Research Rather than relying on mandatory funding that will not materialize. We should continue to uphold the longstanding tradition of scientific independence and set ting federal