▶ 0:12:43Chair Collins: The committee will come to order. Good morning. As this is the first full committee hearing of the senate appropriations committee and the 119th congress I would like to first take a moment to welcome back our returning members and also welcome the new members of the committee.
▶ 0:13:07Chair Collins: I am very pleased to be joined once again at the helm of this committee by the senior senator from washington, vice chair murray. The topic for our first full committee hearing -- "biomedical
▶ 0:13:29Research: Keeping america's edge in innovation" is significant. It speaks to the high priority this committee places on biomedical research. There is no investment that pays greater dividends to american families than our investment in this research which can lead to lifesaving and life enhancing discoveries.
▶ 0:13:59Research: For more than 75 years the united states has been the world's leader in scientific research and technological innovation. We earned this position to the hard work of countless researchers and scientists and their staff, many of whom trusted their careers to the culture of science built by the american people.
▶ 0:14:27Research: At the heart of that culture is a strategy coordinating grand based research and university and private labs funded through the national science foundation, the national institutes of health, the department of defense, the department of energy, and many other federal agencies. This strategy has been an enormous success.
▶ 0:14:56Research: In the years following world war ii the U.S. emerged as the global leader in science and technology, accounting for 69% of global r&d across all fields by the year 1960. In biomedical research the U.S. dominated the second half of the 20th century.
▶ 0:15:22Research: During this period our scientists faced in the united states published 70% of the papers in the top cited journals, secure the majority of the worlds biomedical patents and won more than half of the nobel prizes awarded in medicine.
▶ 0:15:44Research: Stability is a key aspect of the american formula because it allows scientists to focus their work knowing they will have the support they need to pursue and test their ideas from start to finish.
▶ 0:16:05Research: The freedom to explore and collaborate is also crucial, especially to younger scientists who are eager to get into the lab and work on what inspires them. This combination has made the united states a "irresistible magnet" for researchers everywhere as one of our witnesses put it so well, drawing the best and the brightest from around the world.
▶ 0:16:42Research: Their work demonstrates the value of the american system, leading to breakthroughs that save lives and restore health for so many. Over the past 20 years the fda has approved more than 600 new cancer treatments, including standard chemotherapy, targeted therapies, and immune therapies.
▶ 0:17:07Research: All made possible by decades of the national cancer institute investment into basic research. Another example relates to alzheimer's and dementia research because of studies financed by the national institute of aging, researchers now have an array of biomarker tests for dementia, including a new blood test allowing for
▶ 0:17:39Research: Earlier diagnosis of this devastating disease. The continued success of this system and america's leadership cannot be taken for granted. Since the turn-of-the-century china's investment in biomedical research has grown more than 50 fold. China has now caught up with the U.S.
▶ 0:18:05Research: In biomedical patents filed and papers published up proposed funding cuts, the firing of essential federal scientists, and policy uncertainties threatened to undermine the foundation for our nation's global leadership.
▶ 0:18:28Research: One such recent development has been the unilateral imposition of an arbitrary 15% indirect cost cap on nih ants in february, followed by more recent caps on grants from doe and other federal agencies.
▶ 0:18:55Research: While some reform of the facilities and administrative system may be merited, this one-size-fits-all cap would be extremely harmful to many institutions and the people who benefit from their work. They are also directly contrary to language approved by this committee year after year after year and incorporated into appropriations law.
▶ 0:19:26Research: Also very troubling are the administrations of abrupt cancellation of grants, proposals to slash federal funding, and laying off scientists and technical experts with apparently little or no justification. These actions put our leadership in biomedical innovation at real risk and must be reversed.
▶ 0:19:55Research: America's edge in biomedical innovation is also of immense economic value to the nation, generating $2.5 for each dollar invested through nih, supporting 400,000 jobs and driving global health standards.
▶ 0:20:19Research: In may nih grants and contracts support 1468 jobs and $286 million in economic activity. We must not lose sight of what is truly at stake.
▶ 0:20:41Research: This debate is not just about scientists and researchers and economic activity. If clinical trials are halted, research is stopped and laboratories are closed, effective treatments and cures for diseases like alzheimer's, type one diabetes, childhood cancers, and muscular dystrophy
▶ 0:21:11Research: Will be delayed or not discovered at all. We must preserve and strengthen america's leadership for the sake of families all across this country. I am now happy to turn to vice chair murray for her opening statement.
▶ 0:21:36Vice Chair Murray: Thank you and let me start by congratulating you on your first meeting as chair. We managed to do a lot of bipartisan work over the past years and I hope we can build on that record. I appreciate this important hearing on biomedical research. It is an issue with long-standing bipartisan support.
▶ 0:22:01Vice Chair Murray: We have worked together many times over the years along with our colleagues to invest in advancing medical breakthroughs and those investments have paid off in so many ways, not just billions in economic activity, hundreds of thousands of jobs and a medical research enterprise that is the envy of the world. They have also paid off with genuine miracles. Cures once impossible. Treatments that were once unthinkable.
▶ 0:22:31Vice Chair Murray: These give patients hope for the future, they give them back a life derailed by disease, they give people precious time with loved ones, which is why I am so deeply alarmed president trump has taken a wrecking ball to our biomedical research enterprise. He and elon musk have been tossing tomorrow's groundbreaking cures into a shredder. From day one doge has been cutting critical research without rhyme or reason or any regard for who gets hurt.
▶ 0:23:02Vice Chair Murray: Trump has already asked over $1 billion in research for hiv prevention, breast cancer, diabetes, alzheimer's, and more. They've also blocked $2 billion in grant funding from universities and research institutions across our country and they slapped a one dollar limit on nih researchers payment cards, meeting our labs cannot get gloves or pipes for the basic things you need to do to
▶ 0:23:32Vice Chair Murray: Get research. If trump and musk have their way they will not just grind medical research to a halt, they will send it backwards. Trump apparently wants to/$21 billion from nih -- to slash $21 billion from nih, the biggest cut in aig history. He out -- in nih history.
▶ 0:24:01Vice Chair Murray: He also wants to defy a bipartisan law this committee past. If trump succeeds a lot of world-class research institutions like the fred hutch cancer at the university of washington will face massive shortfalls. The fact that trump and musk are pushing such a painful policy underscores how they do not know whether their policies hurt people.
▶ 0:24:28Vice Chair Murray: If you needed more evidence there is no real strategy, just consider the women's health initiative. It was coordinated by the fred hutch cancer center in my home state of washington and led to major investments in our understanding of women's health issues, especially in older women. It has paved the way for a generation of researchers focused on women's health. That is something we never had before.
▶ 0:24:55Vice Chair Murray: Trump was going to axe it, presumably because he thinks it is "woke" to care about women's health. Then 24 hours later he claims to have reversed course. Yet the fred hutch cancer research has not heard from nih directly about if that funding will be restored.
▶ 0:25:19Vice Chair Murray: Trump's 360 goes to show you these cuts are not about some big strategy, just chaos and extortion. We have seen trump freeze billions of research dollars for purely political reasons, putting his own petty grievances ahead of curing cancer and saving lives. None of us should stand for that, not for a minute. Just as slashing nih is not about a strategy for our country , it is not about efficiency.
▶ 0:25:50Vice Chair Murray: Nih has an incredibly high return on investment. While medical research accounts for less than 1% of the federal budget nih has contributed to 99% of drugs approved by the fda in recent years. While we are talking about government efficiency let's not talk about the fda, which families trust to keep them safe. The nih breakthrough will not do much good if fda does not have the staff and resources they need to approve new drugs.
▶ 0:26:23Vice Chair Murray: Trump cannot got fda, push out 4000 workers come and expect to maintain that standard that keeps food and drug safe and gives our nation a competitive edge. Nih cuts are not just cutting off promising future research, but undermining studies we are right in the middle of right now.
▶ 0:26:43Vice Chair Murray: One nih lab that analyzes blood samples for 200 trial studying cancer treatments, organ transplants and more lost half its staff during trump and elon's layoffs. In this country patients and critical trials are played -- are praying for breakthrough. They are seeing their best hope cut off by the richest people in the world.
▶ 0:27:10Vice Chair Murray: Worse than undermining anyone study, trump and musk are cutting the beating heart out of our medical research enterprise by pushing talented researchers out of the door. Trump has pushed out nearly 5000 people at nih and counting. China is trying to seize the moment and recruit some of the brightest talent and the same for europe. Instead of supporting new talent trump is slashing france for our early career scientists.
▶ 0:27:42Vice Chair Murray: I heard about this firsthand a few weeks ago -- trump is slashing grants for our early career scientists. Bright young people who want to do their medical research are suddenly worried. Why start that phd if their funding will get yanked away? Why study new vaccines of rfk junior will meddle in their work? Why come to the U.S. for promising research if trump might try to deport them for jaywalking?
▶ 0:28:14Vice Chair Murray: United states is the world leader in medical research. Creating that was not an accident and maintaining it is not inevitable. It is a choice we make through our investments, one that is paid off on a scale that cannot be measured. How do you measure the miracle of eliminating a disease? Of funding a cure? A new vaccine? How do you measure giving someone the chance to become a parent were see their grandkids?
▶ 0:28:45Vice Chair Murray: You cannot. This leads me to the question I hope we focus on. Why would we let trump slash that to ribbons? Why would we give up on alzheimer's research or heart disease or cancer? I am not giving up on patients or cures. I suspect many others feel the same.
▶ 0:29:09Vice Chair Murray: I hope this discussion helps us focus on that common ground and that working together we can push back on these devastating cuts and push forward the research that is so important to folks that come.
▶ 0:29:20Chair Collins: Thank you vice chair murray. We will now turn to our distinguished witnesses. Our first witness today is Dr. sue dilip parikh -- Dr. sudlip parikh.
▶ 0:29:48Chair Collins: He is the chief executive officer and executive publisher of "science," the premier weekly in the field and also serves as the ceo for the american association for the advancement of science. Dr. parikh began his career at nih but I want to point out that he also spent time as a professional staff member on this committee.
▶ 0:30:17Chair Collins: He has an unusual blend of knowledge that is particularly helpful to this committee. Next I am pleased to say we will hear from Dr. hermann haller, the president of mdi biological lab in bar harbor, maine. Dr.
▶ 0:30:38Chair Collins: Holler will describe the innovative research done at mdi lab and tell us about his personal journey from his native germany where he earned his medical degree for studying science at yale university and what that teaches us about the attractiveness of america's model to scientists around the globe.
▶ 0:31:05Chair Collins: Our next witness will be dear esham -- cartier esham, the director for the alliance for a stronger fda. Prior to serving in her current role she was the chief scientific officer and executive vice president of the biotechnology innovation organization.
▶ 0:31:32Chair Collins: I will now turn to senator britt to introduce our witness from the state of alabama.
▶ 0:31:37Sen. Britt: Thank you, chair collins, and congratulations on your first hearing. Thank you to chair collins, ranking member murray, and fellow members of the committee to introduce our witness. It is a distinct honor to introduce Dr. barry sleckman, a leading voice in cancer research and patient care and a true asset to the state of alabama and our nation. Dr.
▶ 0:32:03Sen. Britt: Sleckman serves as director of the uab comprehensive cancer center in birmingham, alabama. It is alabama's only national cancer institute designated comprehensive cancer center. Thanks to his leadership uab's o'neill comprehensive cancer center has continued to fulfill its mission, bringing hope to families and communities with the altman hope of a life without cancer for patients across alabama and the southeast.
▶ 0:32:35Sen. Britt: We are blessed to have him his expertise and his commitment in alabama and I'm grateful he is here with us to share his insights. It is my distinct honor to introduce Dr. barry sleckman before the appropriations committee today.
▶ 0:32:49Chair Collins: Thank you, senator britt. I will now turn to vice chair murray for her introduction of our witness from the state of washington.
▶ 0:32:59Vice Chair Murray: I am always pleased to welcome voices from washington state to share their personal stories. Today we will hear from emily stenson, she is a mom, a patient advocate, and cofounder of the stenson foundation which raises funds for promising pediatric research. When her daughter charlie was three years old they received heartbreaking news, stage four cancer diagnosis.
▶ 0:33:29Vice Chair Murray: Fortunately they were also able to receive world-class help. Charlie participated in clinical trials at seattle children's hospital with -- which drastically improved her quality of life and she has been cancer free since december 2024. I'm especially pleased to say charlie is here with us as well. Thank you for being here and bringing your mom and congratulations.
▶ 0:33:54Vice Chair Murray: During this journey emily and her husband saw firsthand how invaluable medical research can be to families and how hard it can be to get research funding for rare conditions like pediatric cancer. That is why she founded the stenson foundation to raise funds for pediatric research and help patients like her daughter.
▶ 0:34:18Vice Chair Murray: Thank you for sharing your story and speaking about the power of innovative research in saving young lives in the crucial role of federal funding for these programs. We look forward to your testimony.
▶ 0:34:29Chair Collins: I am now going to call at our first witness, Dr. parikh. Please begin.
▶ 0:34:40Dr. Parikh: Thank you to members of the committee. I want to start by taking stock. We live in an extraordinary world. A world where a child who is born with cystic fibrosis has every chance of becoming a grandparent were just a few years ago they might've died in their teens. We live in a world where the most common type of childhood leukemia has gone from a death sentence to 95% survival rate.
▶ 0:35:06Dr. Parikh: We live in a world where a mother with sickle cell anemia is not needed a blood transfusion in more than five years. Five years without debilitating pain. We also live in a world where the economic benefits of those advances have grown the U.S. gdp and help create jobs and additional investment. Senator murray use the word miracles. As scientists we shy away from the word miracles. I grew up in north carolina and I would hear people say that you can see the grace of god.
▶ 0:35:41Dr. Parikh: I think there are moments you can see the hand of god working through advocacy by patients and scientists. I think that is very true. Our U.S. ecosystem is why that is possible. It is a miracle made by our ecosystem.
▶ 0:35:59Dr. Parikh: Our ecosystem includes a vibrant biotech and pharmaceutical industry, it includes effective philanthropy, multiple government funding agencies, regulatory agencies, passionate patient advocates, and diverse sources of capital from across this country and talent from everywhere. Each and every one of you all has been champions on behalf of biomedical research for as long as I can remember.
▶ 0:36:28Dr. Parikh: That fission is what has propelled us to those miracles that happen -- that vision is wh at has propelled us for those miracles. I am an advocate for the r&d tax credit. I am an advocate for ensuring our regulation is optimized. It all starts with federal funding for biomedical research. That is the light and the heat for this ecosystem. Many of the achievements have humble beginnings.
▶ 0:36:56Dr. Parikh: In the early 1990's scientists were studying dna and bacteria and they discovered that parts of that dna repeated over and over and they thought that was curious. That was interesting. By 2012 scientists realized this biological oddity was actually a possibility for editing genes and could cure disease and today after intense investment by the nih and other agencies, by
▶ 0:37:27Dr. Parikh: Investments by industry and capital and venture capital we have a cure for sickle cell anemia in the hands of patients. That is remarkable. It is not by accident. If you ask those scientists in the 1990's why they were studying those bacteria they might've said out of curiosity or to make better yogurt. That was the only thing that was close at hand. The real answer is we do not know but someday it could be important.
▶ 0:37:56Dr. Parikh: You've been following all of this because you care about patients and your families and the biomedical research that gives them hope. I have watched you all lead in certain aspects of science and health. I want you to know that the miracles and economic growth I noted at the beginning of my statement would not have been possible without your leadership. Thank you for that. Despite our successes there are many tragedies that remain. Cancer, drug addiction, suicide.
▶ 0:38:26Dr. Parikh: One of the things everyone agrees on is we have to make sure our ecosystem works for all americans. There is grave risk ahead and I want to talk about two things. The possibility of impoundment or rescission of fy 2025 funds. Here is where I will geek out on appropriations. We are not obligating those funds that you appropriated at a rate that will ensure they get obligated by the end of 2025.
▶ 0:38:54Dr. Parikh: That means we could end up with impoundment by default because we did not spend the money. It is not because there are not ideas. You will hear about the wonderful ideas still out there for science. It is not because they're not ideas. It is because we have lost the machinery to make that pure review and make the grant administration happened. We cannot let that be a passive way of cutting biomedical research. Second, there is the possibility of catastrophic cuts in 2026.
▶ 0:39:26Dr. Parikh: You have seen the leaked budget. I hope it is not real. If those dollar numbers come anywhere from 20% to 45% are real, I want to be clear we are no longer in a race with china, we will have lost that race. Those numbers do not enable us to compete. Investments in science are not the only thing you need. You need people.
▶ 0:39:53Dr. Parikh: The national science foundation has cut by over one half the number of graduate research fellowships they will provide the students. These are the best students in our country. The cream of the crop and we have cut 55%. That sends a horrible message to the scientists working on behalf of patients. It is the wrong message. I'm determined to find common ground about how we can protect and strengthen the scientific enterprise.
▶ 0:40:20Dr. Parikh: If an effective treatment for alzheimer's disease or parkinson's or cancer comes from birmingham or billingham or baton rouge or beijing or brussels, we will all be thankful for it and we will use it it will plot those who contributed to it. As an american, I want the benefits from that cure, from that advance to come here to the united states of america. We are the ones at the cusp of these discoveries and these cures.
▶ 0:40:50Dr. Parikh: That is what I have come to work with you on. We have to be the protagonist of our own story. We cannot let passive things happen like the idea we not obligate funds you already appropriated and destroy something we have built over 80 years. If we allowed to break we cannot just put it back together again next year. It took generations to build it and it will take generations to rebuild it. Frankly that is not the way to go. I am optimistic we can find a way forward together.
▶ 0:41:18Chair Collins: Thank you very much. Dr. haller?
▶ 0:41:25Dr. Haller: Distinguished members of the senate appropriations committee, thank you for the honor of appearing before you today. My name is Dr. hermann haller and I am president of the laboratory and independent research institution in northeastern maine. I am a kidney doctor. I've directed major clinical research centers and founded biotech companies and I trained hundreds of students.
▶ 0:41:53Dr. Haller: For nearly a century united states has led the world in biomedical innovation and american science has shaped the modern world. These innovations were no accident. They were driven by farsighted federal investment and gifted thinkers, bold ideas, and the infrastructure that allows science to thrive. That commitment has made the U.S.
▶ 0:42:21Dr. Haller: -- and this has also been mentioned before -- an irresistible magnate -- an irresistible magnet for researchers like me. I came to the U.S. from germany as a postdoctoral researcher in 1987, attracted by america's commitment to high-quality science and the freedom to explore new ideas.
▶ 0:42:48Dr. Haller: No institution has shaped my scientific vision more than the mount desert island biological laboratory. We focus on fundamental questions. Can damaged tissue regenerate and how we may slow aging? These questions do not yield quick answers but they form the bedrock of tomorrow's life-saving therapy.
▶ 0:43:20Dr. Haller: We are also working to make this journey from discovery to treatment faster and more efficient. We innovate by using unconventional models like fish and salamanders to study chronic disease and regeneration to test new therapeutic compounds. This high risk, high reward science offers unique insights into human biology that leads to breakthroughs.
▶ 0:43:50Dr. Haller: Sustained and sought for federal support is a lifeline for our work. My message to you today is simple. Federal funding for biomedical research is not just a cost, it is a national investment. It drives innovation and fuels the economy and it protects americans' health.
▶ 0:44:14Dr. Haller: Program like the nih development award have transformed rural states like ours into small powerhouses of scientific progress, allowing us to recruit and retain more than 50 scientists statewide and trained more than 3000 undergraduate students. That is good for science, that is good for health, and that is good for the economy. As was mentioned before we must go further.
▶ 0:44:44Dr. Haller: Chronic diseases, from kidney failure, which is been my life's work, to alzheimer's disease impact millions of americans and cost hundreds of billions of dollars annually. With strategic investment in desert we can halt these diseases before they become chronic. We also need more public support for drug development and for drug repurpose and. Finding new uses for existing medication.
▶ 0:45:14Dr. Haller: This is also cost-effective. To ensure america remains the global leader of biomedical innovation I respectfully urge you to support a forward thinking strategy that includes support for high-risk, high reward research, providing coordinating sustained funding from early discovery to clinical applications feeding the innovation pipeline.
▶ 0:45:45Dr. Haller: Second, investment in research capacity, workforce training, the next generation, mentor ship, particularly for rural and underserved areas. Third, renewed focus on treating and preventing chronic disease targeting our visit -- our biggest health burden and funding for novel initiatives such as drug repurpose and,
▶ 0:46:18Dr. Haller: Accelerating safe and effective treatments. These are proven economical actions grounded in public service. The lives we save tomorrow depend on the decisions we make today. Thank you for your leadership and for your support of american science.
▶ 0:46:38Chair Collins: Thank you. Dr. esham?
▶ 0:46:45Dr. Esham: Good morning and thank you for the opportunity to testify before you today. The alliance for a stronger fda is a group of more than 150 stakeholders including health professional societies and trade associations all united about the vital role the fda plays in safeguarding health and maintaining the united states global leadership position.
▶ 0:47:09Dr. Esham: Today's focus is biomedical research, I would like to convey the importance of the role the fda serves in ensuring the safety of our nations food and cosmetic supply included working to prevent foodborne illnesses. It also regulates innovations that improve the health of 100 billion companion animals.
▶ 0:47:27Dr. Esham: The biomedical research is compelled by support for foundational research that advances our understanding of the underlying causes of diseases to help inform how we treat them as well as an fda that works to regulatory -- that works to regulate the environment and keep pace with scientific advancements and provide approvals of medical advancements based on a gold standard of safety. Support for these biomedical innovation pillars are drivers in private investment.
▶ 0:47:58Dr. Esham: Fda not open to innovation or unable to manage its future workloads will negatively impact continued investment in next-generation medical interventions. The U.S. biopharmaceutical industry supports over 4 million jobs. In 2020 for the U.S. accounted for 35% of all global clinical trial starts. China 30%, europe 2020 -- europe 20%.
▶ 0:48:24Dr. Esham: This is a particular important statistic when you consider these companies continue to raise funds for clinical develop in programs is heavily influenced on whether there is a regulatory agency with the expertise to review novel medicines. There is been a 38% increase in active trials since 2014. Cell and gene therapy trials have tripled.
▶ 0:48:53Dr. Esham: Right now there are 3000 clinical trials focused on neurodegenerative and psychiatric disorders including alzheimer's and parkinson's. These increases indicate strong innovation and the potential to improve the lives of millions of patients and their families but they require an fda open to innovation. Most of the medicines approved in 2024 continue to be launched in the U.S.. The U.S.
▶ 0:49:22Dr. Esham: Second and china third, showing a 47% increase. The strength of the fda is an important influencing factor. The outcomes matter. Last year we saw the approval of the first new type of treatment for schizophrenia in decades, disease that affects 3.7 million americans. We saw the first treatment for now and alcoholic hepatitis as well as a new cell therapy treatment for solid cancers and several new treatments for rare diseases.
▶ 0:49:52Dr. Esham: Med tech is responsible for 2 million jobs in the united states and is expected to reach $800 billion in revenue for wearable tech services. Approximately 82% of device companies are also small companies and depend on a strong fda to advance their innovations.
▶ 0:50:11Dr. Esham: The center for devices and radiological help manages 240 8000 devices including pacemakers, hearing aids, and lasers and the number of innovative medical devices authorize has increased five times since 2009. The overall number of devices launching in the U.S. has been increasing from 55% in 2022 to 65% in 2024 and it is no coincidence these trends align with positive steps to improve the regulatory environment.
▶ 0:50:40Dr. Esham: Over the past years the fda has authorized exciting new med tech including an over-the-counter glucose monitor, and a spine simulator that the stores -- that restores function for patients with spinal cord injuries. We are also seeing artificial intelligence and machine learning takeoff. The amount of applications has increased 12 fold in only 1000 ai devices has been authorized.
▶ 0:51:07Dr. Esham: An fda with this expertise is critical to having these devices realized by the american public. I cannot overstate how critical the role of the fda is for safeguarding help -- for safeguarding health. The agency highly skilled scientists allow medical breakthroughs to reach patients safely and efficiently.
▶ 0:51:28Dr. Esham: We look forward to working with you and the administration as we all share a common goal and understanding they strong and well-functioning in a properly resourced fda that embraces innovation is essential for the well-being of millions of americans and ensuring america's biomedical leadership and we at the alliance are here to help.
▶ 0:51:47Chair Collins: Thank you very much. Dr. sleckman?
▶ 0:51:53Dr. Sleckman: Eric collins, vice chair murray, senator britt, thank you for allowing me to be here to share how biomedical research conducted in the united states impacts the health of american citizens. I will focus all of my comments on cancer research and cancer care.
▶ 0:52:14Dr. Sleckman: I want to emphasize the advances in virtually all other chronic and acute illnesses have been equally remarkable and all because of federal investments in biomedical research. I am barry sleckman, I am the director of the comprehensive cancer center at the university of alabama at birmingham. I have spent the past 27 years as a faculty member conducting cancer research.
▶ 0:52:41Dr. Sleckman: My research, along with that of thousands of other scientists in this country is supported by the federal government, primarily through the national institutes of health, nih, and for cancer, the national cancer institute. On behalf of these scientists and myself I would like to thank you for decades of unwavering bipartisan support for U.S. biomedical research.
▶ 0:53:11Dr. Sleckman: In 1990, when I was a medical resident, I took care of several patients with metastatic melanoma whose life expectancy was measured in months. I would not have dared to have dreamed that in my lifetime there would be a treatment for metastatic melanoma.
▶ 0:53:30Dr. Sleckman: Yet here we are today with 43% of patients with metastatic melanoma living 10 years or more due to new treatments we referred to as cancer immunotherapy. These treatments were pioneered by a federally funded american scientist who for this work was awarded the nobel prize for physiology or medicine in 2018.
▶ 0:53:58Dr. Sleckman: The impact of federal support does not stop at these important new scientific discoveries. The nih and nci also provide support for clinical trials designed to test the safety and efficacy of novel treatments based on new scientific discoveries. As the sophistication and innovation of our research increases, so does the success rates of these trials.
▶ 0:54:24Dr. Sleckman: As a result, there are thousands of americans who are alive today and cancer free due to new treatments they received as part of a cancer clinical trial. The cancer center's program now includes 73 cancer centers that span rural and urban areas in 37 states and the district of columbia.
▶ 0:54:51Dr. Sleckman: These centers form a critical network that accelerates breakthrough cancer research and lifesaving cancer clinical trials. At any given time thousands of research studies are underway at these nci designated cancer centers, many of which are collaborations between the cancer centers and the community and industry.
▶ 0:55:15Dr. Sleckman: Rightfully so, the american taxpayers want to know whether they are getting a good health return on investment for the substantial federal funds that have been put into biomedical research in this country. For cancer, consider this. The mortality from cancer has declined 34% in the last 30 years. In the U.S.
▶ 0:55:41Dr. Sleckman: In 2000 there were 8 million cancer survivors. In 2022, 18 million. The number in 2040 is projected to reach 26 million cancer survivors.
▶ 0:56:06Dr. Sleckman: A number of cancer survivors that is greater than the combined populations of the states of washington, maine, alabama, kentucky, and connecticut. In 2000 the average survival of a patient with metastatic melanoma was six and a half months. Today it is six years. There are 39,000 people in this country living with metastatic melanoma.
▶ 0:56:40Dr. Sleckman: Senators, due to basic biomedical research fueled by federal investments, these individuals together will enjoy an additional 215,000 years -- 215,000 years -- of life. Impactful biomedical research that lessens the burden of disease does not take a village, it takes a country.
▶ 0:57:10Dr. Sleckman: Until recently this country has been undeniably the united states. For generations the U.S. has had an unwavering commitment to biomedical research, training the next generation of scientists and accelerating the pace of disease during discoveries. I have barely scratched the surface of the impact of this commitment in my testimony today. I would like to close with a photo that I keep on my desk as a reminder of the importance of what we do.
▶ 0:57:42Dr. Sleckman: Each year the o'neill comprehensive cancer center honors nine cancer patients at the o'neill iron strong award ceremony. Nine patients who had otherwise fatal cancers before entering a clinical trial. Nine patients alive today thanks to new experimental treatments they received on those trials. Take a good look at them. They are young and they are old.
▶ 0:58:13Dr. Sleckman: They are men and their women. They are black and they are white. They are all healthy, happy, and cancer free. Some for more than a decade. Patients like this is why we do what we do and what we do would not be possible without federal government support through the nih and nci.
▶ 0:58:39Dr. Sleckman: I would like to thank you for the opportunity to speak today and on behalf of these patients and the thousands of biomedical researchers in this country whose tireless efforts have given them life. Thank you.
▶ 0:58:53Chair Collins: Thank you very much. Mrs. stenson?
▶ 0:59:01Mrs. Stenson: Good morning. My name is emily stenson and I am here today with my five-year-old daughter charlie to share our family story and to speak to the critical importance of pediatric medical research. I sit before you not only as a mother but as a witness to what federally supported research can make possible and what it would mean to lose it.
▶ 0:59:25Mrs. Stenson: Charlie was diagnosed with stage four cancer in november 2022 when she was just three years old. After more than a year of unexplained symptoms, doctors discovered a five inch tumor in her belly that had already spread to her liver. Our life changed overnight. We started treatment at a local hospital but soon transferred to seattle children's for specialized care.
▶ 0:59:52Mrs. Stenson: There charlie received high-dose chemotherapy and stem cell transplants, some of the most advanced pediatric cancer care available. In march 2024 we heard the words we have prayed so hard for, that charlie was cancer free. Just months later scans showed a relapse. Her baby brother was only two months old when we learned the cancer had returned. Relapse treatment was the hardest stretch yet. Charlie lost weight, she needed a feeding tube, and she battled brutal side effects.
▶ 1:00:24Mrs. Stenson: Through it all she never lost her smile. Today I am proud to say charlie is again cancer free. She started preschool in february it is back to the joyful chaos of five-year-old life. She loves coloring and chasing her siblings. These moments are not guaranteed for any child but for us they are possible because congress chooses to invest in research. This road has not been easy.
▶ 1:00:57Mrs. Stenson: We faced a nationwide chemotherapy shortage and move to seattle for her safety and at one point we were told charlie might have to require a full hysterectomy or live with a bag throughout her life, possibilities that were devastating. Thankfully neither became a reality. Charlie has fought through a very scary reaction to a medication, a failed excubation after liver surgery and painful post surgery complications.
▶ 1:01:27Mrs. Stenson: These were not just medical setbacks, there were moments of deep fear at survivable only through expert care and charlie's in a bravery. Seattle children's leadership and clinical trials gave charlie access to treatments that preserved her hearing, provided fertility preservation methods, and gave her a fighting chance. She received expert care from a leading cancer specialist because of the infrastructure and innovation that only research can provide.
▶ 1:01:59Mrs. Stenson: Every option we had was built on the courage of families before us, families who participated in studies and fought for funding. Because of their efforts we had hope, we had choices, and we had a path forward. I know parents who sent home on diagnosis day told simply to make memories. That is a devastating reality and only one that federally funded research can change.
▶ 1:02:29Mrs. Stenson: Real-time advances continue to matter. Charlie's tumor went undetected for so long because she is in the 10% of patients whose tumors do not show up on standard blood tests but researchers are developing a groundbreaking test using mrna to detect early. That could be lifesaving for kids like mine. There is nothing that makes my family more deserving of hope than yours. We are not any different.
▶ 1:03:01Mrs. Stenson: If you were in my shoes you would want to know that everything possible is being done to save your child and grandchild. Can we say our nation is doing all it can for our kids? We cannot afford to slow down, not now, not when semi lives hang in the balance. Cuts to medical research are not just numbers on a spreadsheet. They are stolen chances, unfinished stories, and futures left unrealized.
▶ 1:03:29Mrs. Stenson: Progress in pediatric research is not a luxury, is a lifeline, and for families like mine it is deeply personal. That is why I am asking you to please continue to fund and prioritize pediatric medical research. Every investment you make saves lives, protect futures, and gives children like charlie a fighting chance to grow up and thrive. Thank you for the opportunity to share our story and for the commitment to saving the lives of our nations children.
▶ 1:03:59Mrs. Stenson: [laughter] -- [applause]
▶ 1:04:07Chair Collins: Mrs. stenson, thank you so much for putting a human face on this story and the need for this research and for bringing charlie with you. Thank you. We have talked a lot and will talk a lot about nih.
▶ 1:04:30Chair Collins: We often overlook the fact that there are other agencies such as the national science foundation that are deeply involved in supporting the basic research that lays the groundwork for critical developments to promote human health. Dr.
▶ 1:04:51Chair Collins: Parikh, I would like to start with you and ask you to describe some of the contributions to biomedical research and innovation that have derived from nsf supported basic research.
▶ 1:05:09Dr. Parikh: Thank you for that and for realizing that. The national science foundation is an extra ordinary funding agency and that it funds basic research. It is one of the only parts of the federal government that funds just basic research. Some of the things that have come out of that, I told you the story about jean editing. -- about gene editing.
▶ 1:05:37Dr. Parikh: When scientists find these bacteria in hot springs, that is funded out of curiosity driven research. That curiosity driven research leads to cures and it has multiple times. It has also led to the developing of things like the technologies we use for imaging. Basic research is coming from the national science foundation. Engineering is coming from the national science foundation. The national science foundation also creates the people. I told you about graduate research fellowships.
▶ 1:06:08Dr. Parikh: That does not say money will go to some institution. It chooses the best students in america and says here is funding for you. Go where you think you can make a difference. That is worth so much and has driven discovery for decades.
▶ 1:06:24Chair Collins: Thank you. Dr. haller, we talked a lot about the arbitrary 15% cap that usually is negotiated between nih and the grant receiving institution. In this case the administration has proposed an across-the-board cap of 15%.
▶ 1:06:55Chair Collins: Could you tell us how this proposed cap on indirect costs, also known as facilities and administrative costs would ef fect mdi biological laboratory?
▶ 1:07:11Dr. Haller: Yes I can. Thank you very much for the question. To understand what the cap means, we have to look at the funding system. Very briefly, you know all of that. You apply for a grant and the grants are highly competitive and they are given on the basis of scientific excellence.
▶ 1:07:38Dr. Haller: Before a scientist can start doing this research and using the grant money, they have to be provided with lab space, sophisticated laboratory space, with the services and the supplies needed to be able to carry out the research. The costs, the indirect costs are real costs.
▶ 1:08:03Dr. Haller: They provide the basis for hr in our institution, for the federal regulation that will fulfill the requirements for that, for microscopes used across the institution. This is all what we need the indirect costs for.
▶ 1:08:30Dr. Haller: In research institutions like mine, without a large endowment and without revenues from tuition, we arereimbursement beo other means to cover them. There is always room for improvement. We are open for discussions.
▶ 1:08:54Dr. Haller: The proposed 15% cap endangers our work and the work of all of the other independent research institutions. We will not be able to participate in what we have heard in lifesaving research and biomedical breakthroughs.
▶ 1:09:15Chair Collins: Thank you. Vice chair murray?
▶ 1:09:20Vice Chair Murray: Thank you for being here to share your story and charlie story and your experience at seattle children's. I cannot imagine what you've gone through to make sure charlie got the right care and treatment and I would like to know that thanks to the national cancer clinical trial she is now cancer free. We know that lifesaving cancer clinical trials are on the chopping block in less than 100 days the trump administration has terminated 55 and ih cancer research grants.
▶ 1:09:52Vice Chair Murray: That is more than $137 million that has been ripped away from researchers in 18 states and on top of that the leaked budget from this administration shows they plan to cut nih funding in half. Emily, if half of the cancer clinical trials were suddenly canceled, what would that mean for patients like charlie and the people you know on the cancer board at seattle children's?
▶ 1:10:17Mrs. Stenson: It would be devastating. There is no other option often than he clinical trial. How can you look at these families and say we are taking away the only option to save your child? There is no funding. It feels like the government does not care about families like ours if they take that away. It will be futures left in the balance.
▶ 1:10:41Vice Chair Murray: Thank you for being here. Dr. parikh, for the last three months nih has awarded billions of dollars of lesson funding over the same period from previous years. For a 10 day stretch in february nih did not award a single grant.
▶ 1:11:03Vice Chair Murray: That is unprecedented for an organization that typically award 60,000 grants a year and meanwhile president trump has pushed out nearly 5000 nih employees, including grant administrators whose job it is to get that funding out the door. I wanted to ask you, do you think nih will be able to spend the $47 billion congress passed and president trump signed into law?
▶ 1:11:26Dr. Parikh: If the will is there they can because I know the program folks are still there and they will work harder than anybody to get those dollars out because those dollars are not just about getting money out the door, it is about finding the ideas proposed and there are plenty of good ideas. The of good ideas. We don't fund enough good the pay lines are already at 10% and 20%. We need to make sure to get the dollars out.
▶ 1:11:54Dr. Parikh: >> know they peer review panels and they are firing staff. Can they get the funding out effectively?
▶ 1:12:01Dr. Parikh: Only if it becomes priority. We have to make sure it can go out. I am confident it can be if they make it priority. The say the nih leaders and the department of health we have to start awarding the grant at the rate required to get to the fully appropriated amount you are approved at the end of the last fiscal quarter. Several merry to your knowledge, has that been done?
▶ 1:12:36Dr. Parikh: After 34 years the trump administration announced it would stop the women's health initiative, a long-term first of kind project launched first in 1991 to study cancer, heart disease, and osteoporosis in postmenopausal women and 120 6000 cases of breast cancer and 76,000 cases of heart disease were prevented over a decade.
▶ 1:13:04Dr. Parikh: The fret hutch cancer center research in my state is the clinical coordinating center and one of the four regional centers. I was told last year its funding was being terminated. The annual funding for these centers costs about $10 million. That is less than 50% on what taxpayers spend on president trump's golf trips over the last three months. $10 million.
▶ 1:13:34Dr. Parikh: How important is sex in the diagnosis of the treatment of cancer and you think now is the time to be cutting breast cancer research?
▶ 1:13:42Dr. Steckman: Thank you for that question, senator. Let me first comment about the women's health study. These types of studies are essential for cancer and understanding the basis of cancer. This is a very long term study, not a five-year grant. Something where they have been following women for decades and using the information to understand about cancer risk and make informed decisions.
▶ 1:14:14Dr. Steckman: These types of studies can only be funded through a large organized way through the federal government, the nih, and nci. Getting back to your question, I think it is extremely important to study the biological differences between men and women when it comes to cancer risk, cancer progression, and cancer treatment.
▶ 1:14:37Dr. Steckman: There are large groups and pretty much all nci cancer centers that either take that into account when designing a trial or are studying it specifically. Absolutely important. Thank you for that question. >> senator kennedy.
▶ 1:14:55Sen. Kennedy: Dr. parikh, do you know anybody who is against biomedical research?
▶ 1:15:05Dr. Parikh: I do not.
▶ 1:15:10Sen. Kennedy: That is like being against children, isn't it?
▶ 1:15:13Dr. Parikh: It is.
▶ 1:15:17Sen. Kennedy: It is like being against world peace isn't it?
▶ 1:15:21Dr. Parikh: It is.
▶ 1:15:26Sen. Kennedy: It is like being against golden retriever's, isn't it?
▶ 1:15:28Dr. Parikh: There are some people that argue there.
▶ 1:15:33Sen. Kennedy: Let's get that out of the way. I want to ask you about nih. I love nih. I think they do extraordinary work. But, isn't it a fact, if nih assigns way too much money for overhead, that that money comes out of basic research? Isn't that the case?
▶ 1:16:04Dr. Parikh: Senator, both those things are providing funds for research. I agree that we need to make the administrative burden and cost associated with it as low as possible.
▶ 1:16:16Sen. Kennedy: Why can't nih live with 15% overhead?
▶ 1:16:19Dr. Parikh: We have had a partnership going on for 75 years in the country.
▶ 1:16:25Sen. Kennedy: Why can't nih live with 15% overhead?
▶ 1:16:28Dr. Parikh: At this point that would turn institutions like the one we have heard about here to where they are laying off researchers.
▶ 1:16:39Sen. Kennedy: Well, the gates foundation, when they make grants they limit overhead to 10%.
▶ 1:16:43Dr. Parikh: They do. That is apples to oranges. They count different things.
▶ 1:16:50Sen. Kennedy: The robert woods johnson foundation limits overhead to 12%.
▶ 1:16:53Dr. Parikh: They count differently.
▶ 1:16:57Sen. Kennedy: Isn't it a fact that the universities who receive the most money from nih also have the biggest endowments?
▶ 1:17:03Dr. Parikh: I have not checked. That's probably true. I agree there are challenges we need to work on.
▶ 1:17:10Sen. Kennedy: Let's take art. $.69 out of every dollar from nih given to harvard goes to overhead.
▶ 1:17:21Dr. Parikh: No, sir, 69 cents out of every dollar 69. It's on top of, not within.
▶ 1:17:32Sen. Kennedy: Let me ask you about one of the worst abuses I have ever seen. It was at stanford. Stanford was spending 74% of grants from nih on overhead. Remember that?
▶ 1:17:52Dr. Parikh: I do. Though, I was in high school at the time.
▶ 1:17:57Sen. Kennedy: I was not. They audited stanford.
▶ 1:18:02Dr. Parikh: Yes, sir. They bought a sailboat.
▶ 1:18:07Sen. Kennedy: They found stanford was spending some of that money to pay the salaries of the employees at a stanford owned shopping center, didn't they?
▶ 1:18:17Dr. Parikh: I don't remember that part.
▶ 1:18:23Sen. Kennedy: They found stanford was spending some of the money that was supposed to go to research, ladies and gentlemen, to renovate the president's home, didn't they?
▶ 1:18:32Dr. Parikh: I believe so, senator.
▶ 1:18:38Sen. Kennedy: And to renovate the vice provost home?
▶ 1:18:40Dr. Parikh: I believe you when you say that.
▶ 1:18:45Sen. Kennedy: Stanford took nih research money to help children and applied the depreciation on the stanford yacht, didn't they?
▶ 1:18:53Dr. Parikh: Yes, sir, when I was in high school, sir.
▶ 1:18:58Sen. Kennedy: Does nih audit every year at the way the grants are being spent?
▶ 1:19:03Dr. Parikh: I don't audit every year.
▶ 1:19:08Sen. Kennedy: They just trust universities?
▶ 1:19:09Dr. Parikh: No. Negotiation takes place.
▶ 1:19:15Sen. Kennedy: If it is a five-year grant and they agree on indirect costs that they don't audit it every year. What if universities lied to them?
▶ 1:19:22Dr. Parikh: That's absolutely a possibility.
▶ 1:19:28Sen. Kennedy: What is fungible mean?
▶ 1:19:29Dr. Parikh: That you can move money from one place to another.
▶ 1:19:33Sen. Kennedy: And money is fungible.
▶ 1:19:34Dr. Parikh: Money is fungible.
▶ 1:19:37Sen. Kennedy: I am readied to have a productive discussion. I have to go to another committee. I have heard the implication is anybody against asking hard questions about the overhead and spending is against biomedical research.
▶ 1:19:52Dr. Parikh: I would not say that, sir.
▶ 1:19:56Sen. Kennedy: I don't agree with that.
▶ 1:19:57Dr. Parikh: I don't either.
▶ 1:20:02Sen. Kennedy: Every penny we spend on overhead that is not being audited, you know as much as I do, doc, that some of it is being abused. It is money taken away from research. That is just a fact. If you care about this child here -- and I know you do. We all do.
▶ 1:20:25Sen. Kennedy: Then any money spent illegitimately on overhead to pay the salary of a professor in the humanities department at a university is coming out of her research. It is not wrong to ask questions.
▶ 1:20:36Dr. Parikh: It is not.
▶ 1:20:39Sen. Kennedy: Dr. parikh: know it's not. Not at all. It is important to ask those questions.
▶ 1:20:45Sen. Kennedy: I don't understand why universities can't live on 15% overhead when the gates foundation limits it to 10% and the johnson foundation limits them to 12%. I don't understand it. All of a sudden if they do not get 35 percent overhead, civilization will melt.
▶ 1:21:06Dr. Parikh: It is important --.
▶ 1:21:11Sen. Kennedy: My mama did not raise a full and if she did, it was one of my brothers.
▶ 1:21:14Dr. Parikh: Senator, it's worth the conversation. >> thank you, the time has expired.
▶ 1:21:21Sen. Kennedy: I went way over. Thank you, madam chair.
▶ 1:21:28Sen. Collins: A vote has started on the senate floor. Senator o has -- two chairs the subcommittee with jurisdiction over this issue will take over as the chair. We will be trying to keep the hearing going in the meantime. Thank you, senator.
▶ 1:21:56Sen. Crapo: -- Sen. reed: thank you chair collins and senator murray for convening this hearing and thank you to the witnesses for your extraordinarily effective and timely testimony. Let's agree from the beginning, everybody loves biomedical research. But, some people don't want funded adequately.
▶ 1:22:21Sen. Crapo: And they are -- don't want to fund it adequately, and they are in the administration and that is why we are here today, frankly clear I want to thank you for coming in testifying. It must be difficult to come talk about that. Let me point out the obvious. Charlie is the best behaved person in this room, including all of us.
▶ 1:22:43Dr. Steckman: The trump administration is slashing funds for research and now they have raised the issue of indirect cost. They are not central. But, that terminology doesn't really capture what these costs are for. They help keep patients safe while they are in treatment.
▶ 1:23:09Dr. Steckman: They help to provide the sanitary situation in a hospital research. They also are used, in many cases to subsidize young professionals that eventually will become the real researchers , several years from now. Can you talk about how this will impact of the university of alabama, your facilities, if this is cut to 15%?
▶ 1:23:41Dr. Steckman: As was discussed earlier, the costs we call indirect costs are used to support all the infrastructure required to do the research. To put it simply, if I was making automobiles and I considered how much it costs for parts on -- and labor on the assembly line, those would be direct costs to make the automobile.
▶ 1:24:08Dr. Steckman: The cost for the accountants, the salespeople, the depreciation of buildings and security guards, those would be the indirect costs of making the automobile. I getting industry, has direct costs that go directly into the work product, the science, and indirect costs, into things that support the science. A concrete example of a reduction of indirect cost for us was brought up earlier.
▶ 1:24:37Dr. Steckman: If indirect cost drops, we will no longer be able to support the level of staff needed to safely open and run clinical trials. So when we get money for a clinical trial, the money goes directly to paying the cost of administering the new drug and taking care of the patient.
▶ 1:24:55Dr. Steckman: It does not cover any of the cost of the oversight groups like the institutional review board, the legal group that are required to open those trials, monitor them, and make sure they are being run safely.
▶ 1:25:12Sen. Reed: Dr. parikh:
▶ 1:25:16Sen. Reed: Dr. parikh, you mentioned aids foundation grants and other foundation grants. Don't those essentially utilize this indirect course will their contribution can be much less?
▶ 1:25:26Dr. Parikh: They certainly pool together and in addition they allow certain costs that we would call indirect costs for the federal government to be considered in the direct cost. That means it is an apples to oranges comparison.
▶ 1:25:44Sen. Reed: That's important to know. Emily, thank you for being here again. I have had the great fortune of working with my colleagues on the star at the first legislation that focused nih on pediatric cancer research. We are very proud. We have worked together. Very capably. We got it through.
▶ 1:26:07Sen. Reed: We have been nih focused now intensely on pediatric cancer research. One reason we do that as we know it affects the whole family. It is not an adult that can go to work and keep up with that. It is the whole family. One of the aspects of our research with the star act is the fact we required long-term studies of the effects of cancer on children, not just the child come of a family.
▶ 1:26:39Sen. Reed: -- the child. The family. Brothers and sisters. Is there anything you would like to add?
▶ 1:26:47Mrs. Stenson: I just want to thank you for putting forth that act. Charlie is followed by two clinical trials to measure her survivorship and help other kids yet to come.
▶ 1:27:02Sen. Reed: Thank you, madam chair. Go charlie.
▶ 1:27:08Sen. Capito: Senator britt.
▶ 1:27:16Sen. Britt: Thank you, madam chair. And thank you for being here. Thank you for your opening testimony. Charlie, you are the best. I want to welcome everybody here. We have a number of alabama men's.
▶ 1:27:30Sen. Britt: -- alabamians and one I got to meet this morning, jerry cuneo yes -- jerry cornelius to say thank you to the o'neill cancer center for saving his life and everybody knows a story like gary's, either hours personally, I loved ones, a family member, a neighbor, a coworker.
▶ 1:27:53Sen. Britt: We understand a smart investment and continued research is essential to make sure we can save lives and change lives moving forward. We have heard a lot about the progress we have made over the last several years and decades and we want to thank you for that.
▶ 1:28:07Dr. Sleckman: What are some of the initiatives currently at uab that you are doing and investing in that will change lives ultimately in the future?
▶ 1:28:18Dr. Sleckman: Thank you, senator britt for that question and I want to answer in behalf of the dedicated researchers and clinical care professionals who really do the work at the o'neill comprehensive cancer center. It is hard for me to answer that question. People always ask, what is the most exciting thing going on? I say, everything is exciting. I could not have said that in 1990, but I can today.
▶ 1:28:50Dr. Sleckman: Next week, next month, we will find we will turn the corner on a major clinical trial that has now given us insider hope for treatment for an otherwise untreatable cancer. Those things are most exciting to me. But then again, I'm a basic scientist.
▶ 1:29:10Dr. Sleckman: At heart what I love more than anything is someone who comes into my office and says we just had an amazing new finding and loud we think will shed important insight into a disease, a cancer, or potentially a new treatment for a cancer or a treatment of a resistant cancer.
▶ 1:29:30Dr. Sleckman: Those are the things going on at the o'neill comprehensive cancer center and those are the things going on at all 72 other nci designated cancer centers in this country thanks to the support of that program. Thank you for that question.
▶ 1:29:46Sen. Britt: And you mentioned in your opening testimony that back when you were a young physician just starting out researching that type of thing, there were types of cancers that you could not have imagined would be something that somebody could live the way they do now. What was it, metastatic melanoma? You said it was six months and now six years. Over 43% of people are living 10 years past that.
▶ 1:30:17Sen. Britt: That progress is tremendous. We see across the country that incidents of cancer overall are on the rise. What is attributable to that? And a subset of that, what about the fact we feel like with the younger population we have seen an increase in canter there as well? -- cancer there as well?
▶ 1:30:37Dr. Sleckman: The incidence of cancer are definitely rising in this country and I think they will probably continue to rise. A lot of people have used that to discuss whether or not we are investing enough in prevention and doing a good enough job with prevention. I would say we are probably not investing enough and probably not doing a good enough job.
▶ 1:31:01Dr. Sleckman: There are a lot of people in this country who smoke and an obesity epidemic in several states including our own and those are risk factors for cancer. But the number one risk factor for cancer is age. So, the major reason the cancer rate is increasing, are you ready? It is because we are having such great success with research in approaching other diseases. Cardiovascular diseases.
▶ 1:31:31Dr. Sleckman: Pulmonary diseases, renal diseases, neurologic diseases, infectious diseases, all things which would have killed citizens in this country before they got cancer, they are now living with to a much older age where they increase the risk of getting cancer. Then, you asked me about a new thing that has cropped up over the last couple years where younger groups of people, some in their 20's, for example, are developing colon cancer. This is a serious problem.
▶ 1:32:02Dr. Sleckman: It has not reached epidemic levels yet, but it is disturbing. There are new grants to begin to study this. At this point, nobody really has a good idea why that is but we all know we need to figure that out quickly.
▶ 1:32:22Sen. Britt: Can you tell the committee why federal funding is unique in cancer prevention research?
▶ 1:32:29Dr. Eshman: I -- Dr. sleckman: in part because there aren't a lot of other revenue streams for cancer prevention. It's not a high priority for industry on pharma. So, federal funding to understand how to develop cancer prevention approaches is critical.
▶ 1:32:49Dr. Sleckman: Thank you. I appreciate it.
▶ 1:32:53Chair Capito: Senator baldwin.
▶ 1:32:57Sen. Baldwin: I want to thank our chair and vice chair for this hearing and the opportunity to discuss the importance of biomedical research and what the trump administration's actions will mean for scientists, research institutions, and most important, patients. The trump administration eliminated 222 active training grants stripping away more than 180 million dollars from research institutions in 37 states.
▶ 1:33:26Sen. Baldwin: The programs to train undergraduate researchers, masters students, postdoctoral scholars, and early career scientists as they transition to faculty positions. In total, the administration has canceled $5 million in grants for the medical college of wisconsin. I want to request a statement by the medical college of wisconsin be submitted for the record.
▶ 1:33:51Chair Capito: Without objection.
▶ 1:33:55Sen. Baldwin: The administration canceled more than $10 million in grants to the university of wisconsin meaning fewer jobs for wisconsinites, fewer young scientists launching their careers at a time when the average age for receiving a first research project grant is already in the mid-40's. It means delaying research into lifesaving cures and treatment. I want to ask Dr. parikh and Dr.
▶ 1:34:22Sleckman: What are the long-term implications of these actions on the next generation of scientists, on research institutions, and on america's leadership in biomedical innovation?
▶ 1:34:36Dr. Parikh: Senator baldwin, thank you for that question. This worries me the most. As I have traveled across the country in the last few weeks talking to institutions and of the concern and angst among our early career scientists, even pre-graduate school, undergraduates, it's enormous. It's the biggest worry I have because they are considering things I have never heard before. Some are saying, perhaps I should choose something outside the scientists.
▶ 1:35:09Dr. Parikh: Those with their goals set on curing cancer or alzheimer's they have started looking elsewhere. Not just for nationals, americans born in this country. There are examples of them being recruited from around the world. There is a recruitment from a university in france. I can't say that I am because I can't speak french but there are real numbers. 400 people applied at 136 of them or so are american citizens. We will lose talent in a way we have never seen before and the industry needs that talent.
▶ 1:35:39Dr. Parikh: It's not just about academics. It is about industry, gdp, and jobs.
▶ 1:35:41Dr. Sleckman: Thank you, senator. I would agree with that wholeheartedly. Even before this, there has been a trail off of young trainees being interested in science. But, what we have seen over the last several months has accelerated that in a way that is kind of creating a perfect storm where multiple factors have come together to lead to significant losses.
▶ 1:36:13Dr. Sleckman: Many universities and medical schools in this country have elected to, for example, cut the number of graduate students having their first class by 50%, some even 75%. Those are people that want to enter graduate school this year and therefore, it will not enter the scientific workforce in 10 years.
▶ 1:36:38Dr. Sleckman: And I also want to give an example that I find particularly disheartening and I think really emphasizes the situation we are in now. I have a very good colleague, a friend of mine that is a researcher at the nti. He works in my field. -- nci. He works in my field. He's brilliant. He is a member of the national academy of sciences and the national academy of medicine.
▶ 1:37:04Dr. Sleckman: He has been doing research on dna damage response and genome stability for 30 years. He is now looking at positions in europe and canada. Is this what we want? Is this what we want for the next generation of researchers and for our current generation?
▶ 1:37:30Sen. Baldwin: Thank you. Mrs. stenson we sell reports last week that alzheimer's disease patients may lose access to clinical trials thanks to the trump administration decision to halt funding to alzheimer's disease research centers. About a dozen of the centers are running out of funding today. The trump administration is withholding 47 million dollars from nine cancer centers across the country. The funding was approved months ago.
▶ 1:38:01Sen. Baldwin: This is not wasteful government spending. The trump administration is putting real people's lives at risk. Meanwhile, they fired more than 5000 staff at the national institutes for health, which is delaying promising research on cancer immunotherapy treatments like charlie received. Mrs. stenson what would delays for promising cancer treatments mean for families like yours?
▶ 1:38:27Mrs. Stenson: It would mean that we don't have other options to help our kids. I know plenty of families waiting for new trials to come out. They are just sitting and waiting. It's so miserable and devastating that they are waiting for more. If the existing ones are getting cut, what will we do instead?
▶ 1:38:55Sen. Baldwin: Thank you. Senator hyde-smith.
▶ 1:38:58Sen. Hyde-Smith: Thank you all for being here today. It is tremendously important and very insightful. I certainly have faith we will be in a better position soon. The university of mississippi's medical center is in the office right now. I just met with them and had to run out to get the questions in. But they are our only academic medical center and they are currently working towards achieving the national cancer institute designation.
▶ 1:39:27Sen. Hyde-Smith: They are working on that really hard. Today there has been no nci designated centers in mississippi, louisiana, or arkansas. This situation requires mississippians to travel distances for advanced cancer care running nci status requires significant research. We know that is important and there is a reason for that in critical areas like cancer biology, immunology, and genetics.
▶ 1:39:56So I Will Ask Dr. Sleckman: , asa researcher at an nci designated center, how could cancer research funding cuts affect institutions in their efforts to achieve this status and how can we improve this?
▶ 1:40:15Dr. Sleckman: Thank you for that question, senator. As your neighbor, I understand the cancer burdens your state experiences very, very well. I suspect as they start to make cuts like this they will look at programs. These larger programs to absorb some of those cuts.
▶ 1:40:40Dr. Sleckman: Though I don't have a crystal ball, I would imagine the rate of new cancer center designations which, over the last five years, has been about one or so per year, will lessen. There are many cancer centers including the one in your own state that are kind of in a holding pattern, waiting for the control tower to let them know it's time to land.
▶ 1:41:08Dr. Sleckman: Those will have to stay holding for a longer period of time.
▶ 1:41:14Sen. Baldwin: And aust -- Sen.
▶ 1:41:17Hyde-Smith: We also do long-standing research studies. The jackson hard to study, are you familiar with that? It studies the cardiovascular health and other things which address risk factors for prevention of dementia, which was discussed earlier. Both of these studies were funded by nih for over 25 years. Understanding these complex conditions and how to address this best is not a fast process.
▶ 1:41:48Hyde-Smith: It requires years of study and investment. Dr. parikh, can you speak to that, please?
▶ 1:41:53Dr. Parikh: I can. I had the privilege of visiting jackson when this study was the starting and I have seen it grow and produce results. To follow those populations for 25 years and the next 25 years, how will we enter the access and the treatments and cures available in jackson are also available in the delta? That is the only way that will happen. If the jackson heart study and others feel at risk which, surprisingly, they do.
▶ 1:42:24Dr. Parikh: I am always surprised by that. But they feel at risk now, as do many other studies across the country. We have to put forth a vision that says, this is what we will do. This is our priority. Thank you for showing it as a priority to the committee.
▶ 1:42:40Sen. Hyde-Smith: Thank you for what you have done in mississippi. Dr. haller your testimony highlighted the nih institutional development award or ideal program and recommended nih expanded the program. The idea program has had a profound impact in my home state of mississippi. It has helped corrected the historic imbalance in federal research funding that has been concentrated at a small number of legacy institutions.
▶ 1:43:07Sen. Hyde-Smith: Idea has helped unlock innovations at schools across my state where the cutting edge research is being conducted and I am currently working on protecting and continuing the program with my idea reauthorization act. How has research funding fostered innovation that might have otherwise gone untapped?
▶ 1:43:29Dr. Haller: Thank you for the question. As I mentioned, in my testimonial, the program has changed. We were one of the first states where the program started in 2003. Over the years we have trained and first hired faculty. We have to do more.
▶ 1:44:02Dr. Haller: We are training. But now we are training the workforce. We have talked a lot about clinical studies. Now the next step is also translational research. What is a very important is an initiative we are thinking out -- about, about clinical studies throughout the state. At the moment we have only a few clinical centers.
▶ 1:44:27Dr. Haller: There is an untapped possibility of mainers participating in the study which helps overall public health and diagnosis. So, the idea program should grow.
▶ 1:44:43Dr. Haller: The idea program, besides what we are already doing, educating the younger generation, and hopefully, not losing our generation of talented young people, we should work on translational research. And, we should associate our efforts with what is happening in the biomedical and biotech industry.
▶ 1:45:10Sen. Hyde-Smith: Thank you all for participating.
▶ 1:45:12Chair Capito: Senator van hollen.
▶ 1:45:16Sen. Van Hollen: Thank you, madam chair. Can I ask that six statements from well respected organizations expressing their support for nih be submitted for the record?
▶ 1:45:25Chair Capito: Without objection.
▶ 1:45:29Sen. Van Hollen: Thank you, senator britt thank you chair collins, senator murray, and especially all of you, the witnesses, for your powerful testimony today. I have been listening on c-span and I want to thank all of you for being witnesses. As to why the work done at nih, the fda, and other places is so important to kids like charlie and our country.
▶ 1:45:57Sen. Van Hollen: I am a proud that my state of maryland is home to nih and fda. And I am especially proud of the work they do on behalf of americans and american families every day. What we have witnessed in this first 100 days of the trump administration is a direct attack on nih and medical research. And what that means, and you have all boiled it down, is it puts more americans in harm's way.
▶ 1:46:30Sen. Van Hollen: It means less research into lifesaving treatments, lifesaving cures and treatments. And of course, at the global level, it simply opens the door to our adversaries like china. Who has been working very hard to emulate the american model. So whether it is a threat to U.S.
▶ 1:46:55Sen. Van Hollen: Innovation in the area of medical innovation, or, whether it is the direct harm done to american families, what we have been witnessing is a danger to all of us. Ms. stinson, I am glad to hear that your daughter, charlie, very cute, is cancer free. And that she is back enjoying the simple joys of being a kid.
▶ 1:47:25Sen. Van Hollen: Earlier today you did talk about how these moments aren't guaranteed for many families impacted by pediatric cancer diagnoses. But they are made possible by lifesaving research. Congress and this committee has invested in that in the past.
▶ 1:47:44Sen. Van Hollen: As somebody whose family has been so personally impacted as well as your support for others battling pediatric cancer, can you talk about what progress in medical research and access to clinical trials has meant to you and other families.
▶ 1:48:02Mrs. Stenson: Thank you for the question and kind words. Access to clinical trials is huge in our communities. Many families move across state lines to receive treatment and save their children. Rolling back access would be devastating and we simply cannot do it. We need to be expanding access and increasing cures for children. There are far too many families that don't realize a cure.
▶ 1:48:33Mrs. Stenson: It's not lost on me that we got to because of nih funding and clinical trials, but there is so much more needed.
▶ 1:48:41Sen. Van Hollen: Thank you again for bearing personal witness to the great benefits of medical research and also the dangers of cutting this area.
▶ 1:48:52Dr. Sleckman: It was heartening to see the photo you held up as a reminder of the importance of this work. Like others on the community I -- on the committee I am very worried about how we will completely dis-incentivize younger researchers from engaging in this life saving activity.
▶ 1:49:20Dr. Sleckman: And, the impact, of course, that we are talking about in clinical trials. Can you speak broadly to the dangers we will all face if we continue to cut these areas and discourage young researchers from entering this important field?
▶ 1:49:37Dr. Sleckman: Thank you for that question. We touched on some of that today. To crystallize that, clinical trials, running clinical trials is challenging for the researchers to do it. There is an awful lot of regulatory and administrative activities that go into that.
▶ 1:50:03Dr. Sleckman: I would say they do it primarily driven by their love and passion for being able to provide their patients, who otherwise might have untreatable cancers, with a possible cure. 30 years ago when we put patients on cancer trials, there really was no upfront feeling that the patient themselves would benefit from that.
▶ 1:50:28Dr. Sleckman: They were doing it to help us learn about treatments of the future. As I said in my presentation, there are thousands and thousands of patients and people walking around today alive because they had a good outcome from a treatment they got on a trial. The medical professionals at my cancer center and others are committed to doing that. But there a limit to the commitment.
▶ 1:50:58Dr. Sleckman: If the challenges are made unsurmountable, they will not be able to do it. If money is removed that supports the services that help them open the trial now makes it more difficult for them to open the trial, eventually they will say I have to take care of patients, including I don't have time to do this. It's critical we keep things in place the way they are now.
▶ 1:51:24Sen. Van Hollen: Thank you. Thank you all.
▶ 1:51:27Chair Capito: Senator moran. Simple moran german collins, thank you to -- the chairman collins and thank you very much and thank you to our witnesses. The couple questions I was going to ask have been asked and answered.
▶ 1:51:48Chair Capito: But I want to take the time I have to make certain that, from my perspective, on behalf of many and most kansans, that we express our gratitude to those working every day to find a cure for the disease is my constituents at home in kansas and people around the country and around the world, they and their families are facing.
▶ 1:52:12Chair Capito: I was thinking as you all were speaking, there is not one american, not one who does not benefit from a the research that takes place in the search for that cure or treatment for disease and affliction. I cannot think of other expenditures. It may be, our national defense. Every american benefit by protecting our country's from our adversaries.
▶ 1:52:37Chair Capito: But many things we appropriate money for our narrow towards a specific cause or specific organization, a task that government has been given. This task of finding the cure for diseases is there is nobody that loses. There is nobody that has not benefited even if they, or their families, people they know have not experienced the diseases we are trying to find a cure for.
▶ 1:53:09Chair Capito: Medical research provides hope. Mrs. stenson, you indicated that every family would have the capability of having the right kind of research to meet the needs of your circumstances. But all of us have hope if we learned something about a family member or ourselves, what we can gain from medical research is the hope that either today or tomorrow or the next day there will be a discovery that makes a
▶ 1:53:40Chair Capito: Difference in a person's life. And I just want to speak in support of this kind of research. We can prioritize and certainly look for ways to be more efficient. We can find ways, perhaps, to eliminate things that make no sense at all. But, those kinds of things should not be the reason to criticize medical research in general, or, medical research totally. Criticize the mistakes we make.
▶ 1:54:13Chair Capito: Make certain it does not spill over into destroying an asset the company has that is so valuable to us. Very few things in life provide -- I happen to think there is anything that provides hope in this world but very few things we do in congress provides the hope nih provides for people across our country.
▶ 1:54:38Chair Capito: Let's do our jobs and be certain we make the right kind of choices and decisions that prioritize and eliminate things which need to be eliminated. But don't fall into the trap of saying that what happens at nih does not matter. It matters, as I have been talking at least about individuals, families, and people.
▶ 1:55:01Chair Capito: I want to make certain there is no child, no person that we did not support nih for that loses out on a trial or treatment or something that was discovered. On the other hand, I want to make sure we don't miss some young person whose dream it is in life to be a researcher to find a cure for a disease. We have to do our jobs well and do them right.
▶ 1:55:31Chair Capito: This is not just the so-called throwing money at something to solve a problem. This is making certain no researcher misses the opportunity of pursuing their dream of research and solutions to life's problems. And no patient or potential patient loses the chance to live another day, another year, or live a lifetime. We all want to have the benefit of long life and time with family and enjoyable things.
▶ 1:56:01Chair Capito: I look forward to working with my colleagues on this committee to make certain we don't destroy the dream of a family or destroy the dream of a young person who will solve a problem. We focused a lot of our attention on cancer and alzheimer's and down syndrome. I just think that the potential is so great that we have a lot to be optimistic about and we ought to take the chance whenever things come our way that actually work, congress ought to take advantage and be supportive. Thank you very much.
▶ 1:56:34Sen. Coons: Thank you chair collins and vice chair murray for convening this hearing. I want to thank each of the researchers who have dedicated your life to science, medicine, and progress for your testimony today. Emily, thank you. I am enraged and struggling with this hearing.
▶ 1:57:01Sen. Coons: Listening to you talk about the value of hope to you and your daughter with cancer, and the very measured and reasonable way in which we have all discussed what has happened makes me crazy because doge in my view is a horde of locusts that has been unleashed on the federal government. They have torn up things we have built over decades.
▶ 1:57:32Sen. Coons: Let me briefly review. At nih, 1200 probationary researchers were laid off and another 1300 were fired. That's a 25 hundred dedicated researchers. At fda, 3500 staff. At nih, doge canceled 800 grants valued at over $1 billion. We were told to grants focused on d.e.I.. In fact, they focused on diabetes, alzheimer's, mrna, and cancer.
▶ 1:58:04Sen. Coons: My father died of cancer. My father in law died of cancer. My stepfather died of cancer. Your daughter, charlie, is with us today because of the incredible and dedicated research and is a groundbreaking work of people we have talked so calmly about today.
▶ 1:58:22Dr. Sleckman: , I have a personal friend, a combat veteran, a marine corps colonel that came to me diagnosed with stage four medela -- metastatic melanoma whose life was saved by the research you described. I have a personal friend of decades, nikki who came to me when he was diagnosed with brain cancer. His son is close friends with my son.
▶ 1:58:53Dr. Sleckman: His wife is close with my wife and he went to nih month after month, year after year. Sometimes clinical trials don't benefit the individuals, but it benefited nick and his family. It gave him hope and kept him alive. I don't understand how a single member of this congress can look you in the eyes as a mother and say we should cut these programs.
▶ 1:59:21Dr. Sleckman: Sure, we can talk about overhead rates. Sure, we can talk about measured, thoughtful reasonable ways to trim a little here or cut a little there but that is not what is happening. What is happening is the whole scale abandonment of billions of dollars of research. I was just at the university of delaware last week, at the national institute for innovation in manufacturing biopharmaceuticals. Do you know what I was told?
▶ 1:59:49Dr. Sleckman: That at the university of delaware, 55 million dollars in health research has been delayed, pause, or withheld, research on hiv, alzheimer's, and the characterization of cancer cells. If that is happening in my little state, all across our country, we are devastating the next generation of researchers. We are harming our nation and given china the opening of a lifetime to recruit the best and brightest from around the world.
▶ 2:00:19Dr. Sleckman: A buddy, we are taking away from families like yours all over our nation hope. Emily, can you tell me how important hope is for you and charlie? How important is it that we keep investing in research?
▶ 2:00:35Mrs. Stenson: Thank you for the question. Hope gets you through the hardest days. I explained in our story some of the hard days we had. Hope kept my husband and I going. With trying to save our daughter. There is no value you can put on hope. We need to be providing it to all families like ours.
▶ 2:01:06Sen. Coons: Yesterday I caught up with the delaware area and who has been living with als for years and a close friend of mine who confided a recent diagnosis with als and senator murkowski and I worked to get signed into law a bill to invest in als research. How will the cuts to the fda impact your agency's ability to characterize and bring new treatments to provide hope to those living with this horrific disease?
▶ 2:01:36Dr. Eshman: I believe you are probably aware the alliance sent letters to this committee expressing our concern about the volume of departures and potential impact on the fda to be effective and continue to evaluate the safety and efficacy of next-generation medical interventions. I did have the privilege of meeting with the commissioner monday. I was happy to hear he doesn't have any major plans for major reorganization.
▶ 2:02:06Dr. Eshman: While they are looking at efficiencies, potential consolidations and things like travel and I.t. And potential efficiencies brought about by regulatory innovation, I was happy to see they are looking hard at examining what functions need to be brought back to the agency to ensure they are able to optimally manage their workload and continue to review and approve next-generation medicines. If they continue transparency in communication about this, engagement will be important moving forward.
▶ 2:02:36Dr. Eshman: Certainly, the alliance will be examining the proposed budget updates about staffing, including information about what positions are funded by user fees and how we can work together to make sure in total up the fda has the resources it has to have to not just to prove what is before them now, but continue to drive investment in the U.S. into next-generation medicines.
▶ 2:02:57Dr. Eshman: We don't have -- if we don't have a functioning fda it has a severe impact on the ability to raise funds for next-generation medicines.
▶ 2:03:12Sen. Coons: The fda and nih and national cancer institute give hope to those facing cancer, the challenge of new diagnoses and the need for a path forward that is positive but thank you for what you do. >> thank you, madam chairman for this important hearing. I wish I had been able to spend the full morning here.
▶ 2:03:36Sen. Coons: Just the few minutes I have been here with colleagues, listening to the comments and concerns, just know that I feel like everybody is speaking to me and my family situation. I hope senator moran, when he mentioned that the hopes and dreams of young researchers being dashed, he is talking about my nephew. I called him yesterday because it is his birthday. He is a junior at marquette.
▶ 2:04:06Sen. Coons: He said, I'm floored by what we are seeing. All I want to do is find the cure. Senator coons, he wants to find a cure for als, because of how that has touched our family. When we talk about hope and what happens when you don't have hope, I can tell you, because the als community reaches out to me as one of their advocates here, as I know they do with you, senator coons.
▶ 2:04:33Sen. Coons: They said, when they see news about what is happening, the lack of hope pushes them into the point where, unfortunately, many are thinking about further shortening their time. Without hope, how do you get through each day knowing you are incrementally on the decline?
▶ 2:05:01Sen. Coons: So, the significance of what we are talking about, the contributions we see through nih, through our federal entities, those who are getting up every single morning to focus on hard things, to make that incremental difference. And then those who backed them. I see some in the audience today giving their time and their treasure for advocacy in alzheimer's, in als.
▶ 2:05:34Sen. Coons: I guess I want to ask a specific question here. We are dealing with unprecedented, unprecedented hits to the nih into -- and to those who have given their all to be there for others.
▶ 2:05:56Sen. Coons: We do a good job, I think, of taking the opportunities in other research areas to better gain leverage with the advancements we make.
▶ 2:06:16Sen. Coons: How can we do more, particularly, at this really difficult time to ensure that the coordination we have between complementary research efforts? And I see this with als. Where nih is focusing on understanding the biology and dod is looking at the early stage drug development, the fda is doing clinical trials. So you have a lot going on that comes together.
▶ 2:06:46Sen. Coons: What more can and should we be doing? And with the funding constraints we are looking at, how will these collaboration efforts be compromised?
▶ 2:07:07Dr. Parikh: That coordination is vital when approaching something like als that has many different facets. But at this moment I want to put a real face on this. We will keep stiff upper lives here. But the scientific community is in paralysis now. It is in paralysis across the country.
▶ 2:07:29Dr. Parikh: In every state there are graduate students and scientists and senior scientists that, instead of thinking about the problems you are talking about our thinking about the next grant, the next six weeks. If I can add urgency for this committee, it is not about the fy 26 appropriations process, that will be very important. It is about the obligation of funding right now. And making sure we actually see stability.
▶ 2:07:58Dr. Parikh: That word, stability, madam chair, that you used is so important. There is paralysis that does not allow us to spend time thinking about the very good question you Dr. haller.
▶ 2:08:14Dr. Haller: Research is about stability and continuity. An example. We have recruited a wonderful, brilliant young researcher, emily spalding. She is working on als and on how transporting molecules across neurons is important. As a young researcher, she is driven by curiosity.
▶ 2:08:45Dr. Haller: She is driven by a desire to understand knowledge and make contributions, for understanding als and the disease. But at certain points of her career she needs federal support. She needs continuity. When you start as a young student, you need federal funding.
▶ 2:09:07Dr. Haller: When you embark on a postdoctoral research, or, in her case, now waiting for the last seven months that the grant she has written, which is excellent, and which will be reviewed and has been -- it has not been reviewed. This stability is what we need at the moment. Then later on when she becomes an accomplished scientist and she is pursuing bold ideas, federal support is needed again.
▶ 2:09:37Dr. Haller: And as was already mentioned, young people, we train them. They discussed what to do with their lives and whether they want to pursue a career in biomedical science. This message of uncertainty is deleterious.
▶ 2:09:58Sen. Murkowski: Thank you, madam chair. >> thank you. Senator ossoff.
▶ 2:10:07Sen. Ossoff: Thank you, madam chair for convening the hearing today. It is a tragedy that we have to hold it. Evidence of the catastrophic incompetence of the trump administration that the U.S. is reduced to holding hearings to affirm that, yes, clinical research into childhood cancer is worth the investment.
▶ 2:10:35Sen. Ossoff: A young woman came into my office Mrs. stenson, just a few weeks ago and explained that she had stage four colorectal cancer. Three children. And the clinical trial in which she had been enrolled was paused. So, those three little kids might now lose their mother. For what? Why?
▶ 2:11:05Sen. Ossoff: What is the constituency for this? Who in the american public is sitting at home demanding we shut down cancer research and alzheimer's research? We will pay for this not just in lives and in children's lives now, but for a century. Irreversible damage has already been done and it is an outrage. I hope this hearing demonstrates there is bipartisan rejection of these policies in the U.S. senate.
▶ 2:11:35Sen. Ossoff: I hope that we follow-up this hearing with real action. I have a three and a half-year-old little girl at home. Thank god that your little girl is alive. Every parent can understand when you hold your precious, innocent, kind child and you fear the most intense fear that something could happen to them.
▶ 2:12:01Sen. Ossoff: To think that american parents of children who have cancer now do not know whether they can enroll that child in a trial because maybe there is a way to save that life? That's devastating. Thank you for being here and bringing your sweet little girl. Thank you for sharing your testimony with us. I have here a statement for the record from emory university in georgia that includes the following statements.
▶ 2:12:32Sen. Ossoff: "this research has contributed to significant advancements in treating diseases like cancer, alzheimer's, infectious diseases and cardiovascular diseases. Cuts or stagnation in research funding jeopardizes these efforts and could have far-reachingonsequences for patients and communities. Even a short interruption of research funding could set back scientific progress decades.
▶ 2:12:55Sen. Ossoff: We urge congress to continue prioritizing bipartisan investment in biomedical research." Mrs. stenson, my understanding is that charlie's participation in clinical trials save your daughter's life. Is that right?
▶ 2:13:11Mrs. Stenson: Yes.
▶ 2:13:15Sen. Ossoff: And because of what you have experienced and been through in your advocacy, I would imagine you have come into contact with other families similarly situated, whose children are only alive thanks to clinical trials.
▶ 2:13:28Mrs. Stenson: Yes.
▶ 2:13:32Sen. Ossoff: I want to ask, the multi-decade potential impact of this war on medical research. Talk about the long run.
▶ 2:13:51Dr. Parikh: In the next few months, we are at a moment of extreme opportunity. You have heard from all of the scientists at the table about what has been accomplished and could be accomplished. And there is another pass -- path of the leaked budget that says a 44% cut to nih funding.
▶ 2:14:20Dr. Parikh: That means we aren't in the race anymore. There might be cures for disease and investment made in china and elsewhere that could lead to things we want. We want to set the standards. We won't have the ability to catch up because benefits will accrue to some other place.
▶ 2:14:58Dr. Parikh: These early career scientists that are really in moments of panic now, they will be determinative of whether or not we have a generation of scientists to replace the ones we have today. It's not just a five-year problem. It's a 10 year, 20 year, 30 year problem that becomes not a virtuous cycle, but the opposite, a cycle to a downward slip we can't pull out of. In germany 100 years ago if you wanted to do chemistry you spoke german and in the U.S.
▶ 2:15:27Dr. Parikh: You spoke german. 20 years from now what will be the language of science? Will it be english? I don't know what this moment. We are at a crossroads to figure that out. It's a historical moment.
▶ 2:15:42Sen. Ossoff: Well put. And it is urgent free to think you are. Thank you madam chair. >> senator durbin. Sorry. Senator shaheen. You were first. I apologize.
▶ 2:15:56Sen. Shaheen: Thank, chair collins for holding the hearing and thank you to all our witnesses for your very eloquent, powerful, and compelling testimony this morning. I'm sure -- sorry senator kennedy left of the hearing because I thought he was effective in pointing out that all of us support biomedical research and think it is important.
▶ 2:16:25Sen. Shaheen: But what he missed is we all also oppose waste, fraud, and abuse in these programs will -- programs. We all think that the example he used from stanford is one we believe should be cracked down on and that should not happen in these programs. But let's not be distracted by that. That's a red herring.
▶ 2:16:50Sen. Shaheen: I wish we were as concerned about auditing the department of defense as we are about auditing these research grants. You would probably be saving more money. What we are talking about in terms of this research does not save money. It costs money in the long run, as you all have pointed out so well.
▶ 2:17:21Dr. Parikh: You made a compelling case about our ability to compete with china. Other agencies like usaid, the cdc, our foreign assistance programs have also helped form the foundation for global disease surveillance for public health preparedness and being able to address the kinds of diseases and cures we want to talk about.
▶ 2:17:54Dr. Parikh: Can you speak to how the cuts to U.S. foreign assistance particularly in the global disease surveillance arena undermine not just our ability to develop biomedical innovations, but our national security, given the risk of drug resistant diseases and undetected outbreaks that have, in the past, evolved into global threats?
▶ 2:18:17Dr. Parikh: Infectious disease does not know international boundaries. Something happening half the world away can be here in 12 hours. We have to have the ability to understand what is circulating around the world. It's a technological thing. It is a sociological thing. It's a relationship based thing. You have to build relationships around the world.
▶ 2:18:45Dr. Parikh: You end up with an ability where there are laboratories in south africa that can help you identify something so that before it gets here we have some idea of how to prepare. That is an extraordinary thing. It is not theoretical. It has happened in the past and will happen again. It also has an element of soft power and relationship building. There is nothing wrong with the idea that we will protect human beings from disease. In fact, I think that is one thing we all share in common.
▶ 2:19:15Dr. Parikh: When we, as a country, project that ability. When we increase that capacity around the world, we make a difference today in terms of relationships and tomorrow in terms of ensuring we don't have epidemics that become problematic in this country.
▶ 2:19:34Sen. Shaheen: I agree. Sadly, we have seen pullback in arm -- our foreign assistance programs in countries around the world and now we are seeing china move in taking over those programs in ways that not only affect our ability to get that information but our national security.
▶ 2:19:54Sen. Shaheen: I often think if you cannot get people to do something for the right reason, because it is the moral thing to do, sometimes you can get somebody to do something because it is cost-effective effective to do that. Dr. eshman, in new hampshire we are developing a real biomedical industry. In our state it is important to local economies throughout the state.
▶ 2:20:23Sen. Shaheen: These are jobs that fuel our small towns and cities. They are partnering with institutions like dartmouth and the university of new hampshire on breakthroughs. I thought that you were very effective talking about the role of the fda.
▶ 2:20:41Sen. Shaheen: Can you talk about what stability at the fda and nih means as we are looking at getting private investors to invest in growth around the country, certainly, in our small towns in new hampshire where private investments have been critical as we looked at how to build this industry?
▶ 2:21:04Dr. Eshman: Thank you for that question and congratulations for I have long been a supporter of the proliferation of biosciences and biotechnologies across the country and it is exciting to see what is going on in her state. They are great jobs and a great community. It is in the title. It's the biomedical research ecosystem. You have foundational research that helps us understand the underlying foundational causes of disease.
▶ 2:21:32Dr. Eshman: It leads us to understand about new targets, new endpoints, new ways to look at diseases and think about patient driven medicines. That information and knowledge is transferred into a clinical trial system where the biopharmaceutical company -- and again, a lot are small companies that you talk about in your state, taking that doing cutting-edge research. They are often pre-revenue to. They don't have any money. They aren't making anything on the market.
▶ 2:22:01Dr. Eshman: They are on the edge of discovery of next-generation medical interventions. What they need is an ability to understand that the regulatory agency is capable, has the expertise required to evaluate on a scientifically-based foundation how to evaluate the safety and efficacy's of these medicines and they need to understand they have the capacity to move forward in a timely manner. Even if the answer is no. That's better than a long limo period.
▶ 2:22:33Dr. Eshman: That has profound impact on the private investment community and money is global. We have to be realistic about that. The stronger the fda is in the U.S., the more we can keep building biotech hubs like in your state.
▶ 2:22:49Sen. Shaheen: Thank you all very much. I hope you have all heard a lot of bipartisan support on this committee for the work you are doing.
▶ 2:22:59Sen. Durbin: Thank you for this historic hearing. There are those of us that are concerned about this issue. You used your authority as chair of the appropriations committee to draw us together and help this story to a larger audience. Thank you for that. Mrs. stenson, your daughter is amazing. She gets a special congressional medal for putting up with so many political speeches.
▶ 2:23:31Sen. Durbin: If you have ever been a parent sitting in a doctor's office with a baby on your lap and heard those words that were earth changing diagnoses, you knew your life would never be the same. The questions you would ask -- and I have been there. The questions are obvious. Is there a medicine? Is there a surgery? Is there a procedure?
▶ 2:24:01Sen. Durbin: Is there a clinical trial? We all ask the same questions faced with this terrible challenge, praying to god that one of the answers is yes and this is what the hearing is all about, making sure that one of the is yes. It really makes all of the difference in the world. I will tell you that 10 years ago I went out to the nih and met with francis collins, who we consider a modern-day saint.
▶ 2:24:31Sen. Durbin: I said to him, I appreciate this, Dr. per week. I can remember the time when a handful of legislators doubled in the nih budget. I sent to Dr. collins, I do not think I can do that again. What can I do? He said give us 5% real growth a year and the researchers will account that the next year it will be good too and they will stick to the research and good things will happen. So I set out to do that.
▶ 2:25:00Sen. Durbin: The first person I visited was a volunteer and roy blunt, a republican senator from missouri who chaired the committee and lamar alexander, and other from tennessee. We achieved not perfect 5% growth each year, but we went from a $30 billion budget to a budget of $49.8 billion today. 60% increase. 60%.
▶ 2:25:34Sen. Durbin: The suggested change from the trump administration in nih will wipe out all that. 10 years. One decade of work. Bipartisan work to increase medical research across the U.S.. That is what is at stake here. I look at it and think, I want to mention the number of drugs that have been approved by the fda in the last 2010-20 19. 300 56 new drugs.
▶ 2:26:03Sen. Durbin: You see them on television all the time. 350 six new drugs. How many came out of nih research? 354 of 356. You have to make sure research leads to medicine that makes a difference. That is what we are fighting to make sure continues.
▶ 2:26:24Sen. Durbin: And I want to put in the record, but I'm sure a statement from the defense and health research consortium that talked about the department of defense medical research. It is focused primarily on veterans and members of the military, but has many applications beyond that with traumatic brain injury and research that also affects epilepsy. There are many ways these things can work together.
▶ 2:26:49Chair Collins: Without objection.
▶ 2:26:57Sen. Durbin: If you want to make america great again, don't run away from the child sitting at that table. Stick with the research at nih that gives her hope. We can work together. I think that this hearing is the beginning and there is strong bipartisan support for nih.
▶ 2:27:17Chair Collins: Senator peters.
▶ 2:27:19Sen. Peters: Dr. eshman, I do not think anybody in the room has forgotten about the infant formula crisis of 2021 after the fda inspection found some infant formula products at abbott's jewel, michigan plant had been -- sturgis, michigan plant had been contaminated.
▶ 2:27:42Sen. Peters: This crisis alerted us to a glaring issue, that the fda doesn't currently have the authority to inspect infant formula until after the product has left the manufacturer's control, which makes no sense. I have been working on legislation to provide the is -- this authority recently and introduced a bill that would require infant formula manufacturers to test for contaminants before releasing their product, which seems to make common sense.
▶ 2:28:09Sen. Peters: Last year I asked the former fda commissioner about the long-term effects of this legislation, should it go into effect and its ability to test products early and he supported that effort. Given the terminations of scientists at the fda food safety labs, and the more recent decision to rehire several specialists on food related illnesses, what value do these scientists bring to ensuring the safety of products, including infant formula?
▶ 2:28:37Dr. Eshman: Thank you for that question. The short answer is, it is very important. Our members have raised concerns about recent cuts and the impact it might have on the ability of labs to manage, operate, response functions, direct safety and quality. Some staff are being brought to these labs, in particular, in chicago, responsible for the grade a milk program and in san francisco which does important work on avian flu testing and dairy products.
▶ 2:29:07Dr. Eshman: My members have conveyed there have been -- there continues to be a need for support. And resources to meet the food safety modernization act requirement. That will be a important managing things like the infant formula issue. I'm happy to facilitate conversations with our members who are experts on that, but hopefully it gives you a picture of the importance.
▶ 2:29:38Sen. Peters: I am troubled by the firing and sudden rehiring of scientists and inspectors at fda medical products laboratories including a lab in the city of detroit. These labs don't just inspect food and medicines. They make sure that this applies in the strategic national stockpile are ready at a moments notice if they are needed. My question for you is, what impact are these reckless personnel actions having on the health of americans and our national security?
▶ 2:30:07Dr. Eshman: Thank you for that question. I will repeat some things I said earlier. It is certainly the case that the inspectors office has long been stretched. In recent times we were getting close to I think getting a state where they could better manage to keep up with the workloads of domestic and foreign inspections.
▶ 2:30:33Dr. Eshman: What we do think there are ways to think about how we can use innovative technologies to streamline and lessen the burden of inspections both here and around the world, that is certainly of concern. Again in the letter we sent to this committee we expressed concerns about the volumes of layoff. And we had in the office of the inspector in mind.
▶ 2:30:56Dr. Eshman: As I said, we were heartened to hear during our conversations with the commissioner monday that they are carefully looking across all the recent employment decisions to determine what functions are critical to be brought back. I will presume that is on that list.
▶ 2:31:13Dr. Eshman: We hope to continue to work with you and the commissioner to ensure that the fda has the resources it needs to protect its ability to conduct a timely, important inspections.
▶ 2:31:34Sen. Peters: I recently spoke with the university of michigan president and vice president for research to learn about changes to the federal health enterprise and I remain concerned about the future of innovation at our country's leading research universities. Like its counterparts nationwide, the university of michigan is being forced to adapt to major policy changes all at once, putting significant stress on the research enterprise, focused on innovation as well as bettering patients lives.
▶ 2:32:03Sen. Peters: My team recently met with a group of graduate students from the university of michigan as well as michigan state that were participating in the aaa catalyzing science and engineering advocacy workshop. During the meeting the students stressed these major policy changes are diminishing opportunities for the next generation of scientists and researchers that we will count on to provide the innovation and help that they can deliver.
▶ 2:32:33Sen. Peters: Dr., do you echoed these concerns and can you elaborate?
▶ 2:32:39Chair Collins: Excuse me, time has expired. For the vote on the floor. I will ask the witness to respond for the record. I apologize. Although, you got your full amount of time. We have to close out the hearing. Because, the floor is calling for all of us to come and vote. But, I wanted to thank everyone for being here.
▶ 2:33:11Chair Collins: Particularly, and incredibly patient and well-behaved charlie. Who has not made a peep through the whole hearing. [applause] I was struck listening to the exchanges today. This is a matter of such passion for all of us.
▶ 2:33:34Chair Collins: The reason is, each and every one of us has had a loved one or experience personally of an illness or a condition that biomedical research is helping to find a means of prevention for, or more effective treatments or one day, in the case of alzheimer's, for example, a cure. That is why it is so important.
▶ 2:34:05Chair Collins: The debate over funding for scientific research is ultimately a debate about lives that will be saved and enhanced by the cures and therapies discovered in america's labs and universities.
▶ 2:34:25Chair Collins: That is why it is so important we preserve and strengthen our system of scientific research and innovation and why it is such a high priority. There were many issues raised today that we will follow up with with our witnesses and all of the advocacy groups that are out there. The record will remain open until friday, may 9. At 6:00 p.m.
▶ 2:34:52Chair Collins: For senators who wish to submit any questions for the record. In addition, the committee has received a number of letters and kristin -- written testimony for the record. All those will be included in the record without objection. Any members who wish to submit additional materials can do so up to that deadline. Again, thank you all for being here.
▶ 2:35:23Chair Collins: I do want to turn to the vice chair for her closing remarks as well.
▶ 2:35:28Sen. Murray: Thank you, chair collins. I have approximately three dozen statements from outsider organizations in support of nih I want to submit to the record.
▶ 2:35:37Chair Collins: Without objection.
▶ 2:35:40Sen. Murray: Thank you for this critical hearing. I appreciate the opportunity for us all to talk about these critical federal investments in medical research and how it pays off for our economy and global competitiveness and for our children and families and all of the patients and providers out there. I really look forward to our next conversation and I hope we can bring in trump officials to our , so we can share our grave concerns with them.
▶ 2:36:07Sen. Murray: It is important to say there is a reason that nih is referred to as one of our nation's crown jewels. Who it is a source not just of great value, but national right hand nope. No moon is a word we have heard continuously -- but our national hope. Hope is a word we have heard throughout this committee.
▶ 2:36:31Sen. Murray: We will work to make sure that we don't lose that hope for many families and I echo support for charlie for being the most patient five-year-old I have ever met.
▶ 2:36:40Chair Collins: Thank you. This hearing is now adjourned.