They did. For our complete American History tv schedule, go to cspan. Org. Announcer the director of the National Institutes of health testified at a Senate Hearing about nih funding. Senator roy blunt chairs the twohour subcommittee hearing. Sen. Blunt committee will come to order. The appropriations subcommittee on labor, health and Human Services, education, and related agencies will come to order. Related agencies will come to order. Before my opening statement, i the personognize that we had a chance to meet and talk about her cancer fight, and the success she has made. We are glad you are here. I was just told the youngest of your six children just got their drivers license. Good luck with that. [laughter] chance toad to have a meet with her. We are glad to have dr. Collins and the other Institute Directors here today. The budget, of course, proposes assured theu rest committee will find unacceptable. The 7. 5 billion cut from nih was, according to analysts, would cost nearly 90,000 jobs nationwide, result in 15 point 3 billion of lost economic activity. In my home state of missouri, that equates to a loss of nearly 1700 jobs and 292 million in economic activity. The cut is one you can rest assure the committee will not take. I fundamentally disagree with the proposed funding reduction. However, this isnt the first president to propose a reduction. President obama proposed a 1 billion cut in his budget last year. We went 3 billion beyond his proposal. Im not sure we can do anything like that this year. I also mentioned that when his budget was submitted to the senate, 98 senators voted against it and one senator voted it. We have a long history of the congress asserting itself on issues of how to allocate money. I believe this committee will do the same thing this year. In the last two years, with significant encouragement from the whole committee, and particularly from senator murray, senator allen ender, senator durbin, and the whole committee, recently i think it was the Biggest Senate delegation to go to nih. We spent most of the afternoon there. I hope you, dr. Collins, and your institute of directors, know how much your work is appreciated. In the last two years, we have increased nih funding by little more than 13 . We will be listening carefully to your presentations today. Before that, i would like to go to senator murray for her opening comments. Senator murray thank you to all your team for being here today. We appreciate all that you do to champion the critical work of nih. And i really appreciate your leadership. I look forward to having a discussion today about the devastating impact of President Trumps budget on nih. He has proposed cutting nih by 22 , most of it by arbitrarily resultingdirect costs and lowest funding for Biomedical Research since 2002. Three month after releasing the proposal, we still do not have a sick information from the imminent basic information from the administration about how they would implement a 7. 5 billion reduction without severe consequences for thousands of research facilities, and tens of thousands of scientists that rely on it to supply their work. Facilities like an institute in my home state of washington where scientists have pioneered bone marrow transplants, and they are searching for cancer and hiv vaccines, but because of this proposal could be forced to dramatically scale back their efforts to develop cures for patients. These cuts are deeply concerning, which is why i said repeatedly, i really hope both parties will once again reinvent reject President Trumps budget the puzzle and content proposal and carry out the vital work that gives hope to those living with tonic and lifethreatening disease, and bolster Economic Growth and competitiveness. Before this discussion can have to note that todays hearing takes place in the midst of a very Pivotal Moment for our Health Care System as a whole. As we have heard all week, our republican colleagues appear to be dead set on jamming their version of trumpcare throughout the senate in a matter of days. This is subject to no hearings, no public debate, and no expert testimony. It is a bill so secretly , that apparently until just moments ago, Many Republican senators were telling press that they could not say what was in the bill. Even President Trumps Top Health Care advisor, secretary of human and health services, told us last week that he didnt know what was in it. It has been so secret and closely guarded that not even the 13 male senators who made up the socalled working group could comment with certainty on what was in that or when it would be brought up, or by what procedure. In fact, it is so secret that even the White House Press could notfirmed confirm whether President Trump or anyone in the white house has seen the bill. Which vexed the question, what our republican leader so ashamed of . It is becoming clear that those who wrote the Trumpcare Bill knew they would not be able to go back and defend it, because based on what we are now learning, this bill is going to be the same kind of Trumpcare Bill that went in the house, and it will have tremendous i impact on patients and families, higher costs for families, especially seniors and people preexisting conditions. Insurance companies will no longer be required to cover basic Health Care LikeMaternity Care and Mental Health services. Women would lose access to their doctors and the care they need at planned parenthood. Parents of millions of people across the country would see their medicaid coverage taken away. That means people nationwide who are finally getting treatment for Substance Use disorders like opioid addiction or Mental Health care or access to primary care doctor under medicaid are going to lose that access. As many of my democratic colleagues have said, this is not a Health Care Bill, it is a attack on families, health, and financial security. I want to reiterate my message to Republican Leadership. It is not too late to dump this Trumpcare Bill. It is not too late to make the right choices and work with us as democrats to fix the Health Care System. As the chairman and others on the committee should know by now democrats stand ready, as leo is as weWork Together, always have, to Work Together to make health care more affordable for patients and families across the country, but we cannot begin the conversation until Republican Leadership reverses course. Lastly, i do have to say that after hearing this week about so many of my republican feeling frustrated about the bills process, who were angered about being shut out of the process, or are receiving conflicting information, or who may be shocked at the text just released, well, you have the power to do something about it, not just complain. You can insist on hearings , open debate, increased transparency. Lets be clear. People across the country are really worried about the approach being taken. They are watching and paying close attention. We need to get this right. With that mr. Chairman, i turn it back to you. Sen. Blunt thank you. We are pleased to have the chairman of the full committee and Ranking Member of the full committee with us today. I think senator leahy has a statement. Senator leahy i ask that the statement be put in the record. Blend you german chairman blunt, im glad to be here, and senator murray. I completely agree with her statement. I think this is an important meeting. On a personal note, my mother, she she was still with us, was italianamerican, and she saw that dr. Collins would be here, she am worried about the budget. This affects all of us. You have tohe fact support the middle growth middleclass and support the most foldable. Has been a shining example, but sequestration has had devastating effects. I think those consequences will last for generations. My children and grandchildren. This budget makes it even worse. Deep budget cuts, those have drawn the most bipartisan opposition. Said. Ard what sen. Blunt the most bipartisan criticism has been reductions for the National Institutes of health. Blunt to commend chairman and Ranking Member murray in their efforts to bolster the nih budget in recent years. This budget we have been given by the white house turns the progress upside down, it slashes and ih resources nih resources wanted 1 . 21 . ,ou know better than i do medical research, you cannot just turn it off or a few years, wese studies and trials, will come back in five years and pick them back up again. You cannot do it. You dont hit pause on studies. You cannot have ups and downs based on the whims. Based on whims. The cap on research is being done around the nation, universities and other entities. Im not being parochial, but i mentioned the university of vermont, they receive grants every year. It is unlikely they could continue their research on this budget. They have been doing cuttingedge research and cancer, among other things. A full copy of their letter to be placed on the record. Without objection. Sen. Leahy this is where we can lead the world. Not only that, we can make life so much better for our own people. And people around the world. Toill fight for every dollar be gained back that i can. And you very much, mr. Chairman. Thank you, sir. Dr. Collins, we are pleased you are here. We look forward to your opening statements, and when you are through, we will go to opening will go to questions. Dr. Collins to my right, dr. And thenodes, gordon, andoshua you have already recognized dr. Fauci feared on the far nearsighted, gary gibbons. We brought the 18 today. A team today. It is a great honor to be with you today. I am privileged to continue in this role as nih director geared i want to thank all of you for your sustained commitment to nih, a commitment that ensures that we remain a leader in Biomedical Research. I would like to highlight several areas of exceptional scientific opportunity. I would like to introduce you to a few patients and also talk about some young researchers who are working hard to make these dreams come true. I will show a few images over on the screen. Lets start with an opportunity that shows the transformational power of investing in nih basic science. Imagine you could determine the precise molecular structures of proteins like you see here. Interactactly how they with each drug. This is starting to happen things to a new technology. This image shows the structure of a protein channel, indicated in a great mesh, it regulates salt and water balance in the lungs. Folded misfolded in Cystic Fibrosis. Give mutation that causes Cystic Fibrosis was discovered in my own Research Years ago. Only now, are we able to design better drugs to help cystic abilynns, like little feud she is doing pretty well now. That this ago, she probably would not have made it the on her teens. Havenger, aired today, we no longer. Drugs that help cf. Among the early stage investigators tackling this fromenges is a scientist alabama. He plans to transform in fundamental ways the way we design and deliver drugs for all kinds of conditions. We need that. Treatments only exist today for about 500 of the 7000 diseases for which a molecular cause is now known. Among those in desperate need of a breakthrough is sickle cell disease, a disorder in which red blood cells clog. Today, the only way it can be cured is from a bone mero transport. Transplant beard it can work well for some people, like chris shown here. He is now essentially cured. Most that dont have a well matched most do not have a well matched bone marrow. What if we could correct the sickle cell in a patients blood cells . Once, i wouldve said it is unlikely. That is changing. There is a new gene editing system. The goal is to fix the underlying genetic defect and make the patients own cells healthy. If courtney and other scientists can get this to work for sickle cell, think what they might be able to do for thousands of others. Are 86 billion neurons in the brain. Brain disorders are taking and a normas toll on and a normas toll on our economy. Enormous toll on our economy. Lets imagine that using tools and technologies created by the Brain Initiative, you could easily identify someone at risk for alzheimers and apply effective ways of defending the disease that has touched effective ways of correcting the disease that has touched so many. Investigator from Massachusetts General Hospital is among those taking on this challenge. Her work is focused on the largest known group of people in the world with inherited alzheimers. A Family Living in the mountains of columbia. Using pet scans to compare the brains of family members who have the alzheimers gene with those who do not. Curing alzheimers will not be easy, but they have the talent and drive to make it happen. You all are part of that. Your emphasis on alzheimers and related Dementia Research in fiscal 2016 and 2017 is enabling progress toward our mutual goal toward effectively treating these devastating conditions. All of us are motivated today by a sense of urgency to help haitians in need of breakthroughs. The next generation of innovative and passionate researchers will be the critical part of that bright future. Nih announced the next generation researchers and initiative to bolster support to early and mid career investigators like a three you see here. Our Nations Health and wellbeing depend on your strong support for them. Thank you, mr. Chairman, my colleagues and i welcome your questions. We are glad you are here. I was pleased with the president s decision to continue your leadership at nih. Many of us have advocated for that and we are pleased to see it happen. Your team and what your team does is inspiring to all of us. We will have a fiveminute round of questions. I think there are a lot of competing things going on today so we will try to keep that as close to five minutes as we can, starting with me. Want to askareas i ask specifically about in the president s proposal, one was to eliminate the Fogarty International center. I think particularly with the zika process we are going through, that center was pretty actively involved. Be about whatmay the center does as opposed to commenting on it necessarily the president s view of this. I appreciate the question, im going to let dr. Comment onndeered that. Center is the fogarty critical to what we do. Nationally and internationally. Know nous diseases borders. Some cogent examples of how the fogarty training of International Scientific colleagues has benefited the United States of america, and the two in most recent memory are the Ebola Outbreak and the zika outbreak, not to mention the longstanding commitment trials inids, and subsaharan africa. These trials are almost all led by International Scientists trained by fogarty grants. Mightegard to ebola, you recall that in africa, they had 11,000 deaths. If that had gone beyond those aliders to places like m or nigeria, it couldve been a bigger catastrophe. Went toted individuals mali or nigeria, it did not make much press because it was a success, but the investigators were able to isolate and stop it in those countries before it , particularly in nigeria, the most populous country in africa. Each of those individuals were people who were trained at the Fogarty International center. We look upon them as our true colleagues. I refer to them, and i mean it sincerely, as our brothers and sisters in the battle against infectious diseases. If this were a metaphor of a military thing, they would be our closest allies. They may be where a different uniform, but they are our allies. The impact of the folk training has been extraordinary. We really need to continue. Cinderblock senator blunt the agency for Health Care Research and equality would be consolidated into, i believe a proposed a new institute in your organization youd if you want to comment about that generally come and if that was not going to happen, all their are there alternative ways to do that without creating a new institute . Dr. Ankford the 8 the agency is focused on Health Safety and quality. How to prevent Health Problems such as hospital readmissions, infections from intravenous catheters for example. Withve close connections them and we regularly look at our portfolios to make sure we are being complementary and not duplicative. If it were the case that ahrq was moved into nih, we would there out how we could make best of that circumstance in order to keep that Important Research going forward. Your other question is, would there be other models to achieve this other than a new institute . Certainly, we could consider other models such as having the q distributedahr among the existing institutes that do Similar Research and incorporating the staff into the nih staff