▶ 0:15:04>> good morning, I want to welcome everyone to our hearing. I will give an abbreviated statement and I will be adding more into the record. I want to thank Dr. jay and all of his colleagues for joining us this morning. It is an important opportunity to look at the nih budget from last year to see how we can understand priorities for 2027. I think all of us care a lot about biomedical research.
▶ 0:15:34It has long been a bicameral and bipartisan priority and I'm proud of the work we did last year where we secured an additional $215 million for nih funding. Areas of concern for me and those at the dais know this, are things for ground zero of the opioid epidemic in west virginia. Communities where we have some of the highest rates of overdose deaths. We are making positive strides, as we are across the country.
▶ 0:16:02The cdc data shows a decrease. I want to thank Dr. volkow for coming to west virginia, for visiting. We are really pleased because of what is going on at the rockefeller neuroscience institute. I think he was pretty loud to see what -- pretty wowed to see what wv is doing.
▶ 0:16:31As the parent of two dutch as the child of two parents who had alzheimer's I want to find a way to cure it. I think that's what nih is all about. One area of interest for me is the childhood cancer star act that I did with senator reed. Dr. letai thank you for coming to my office and I look forward to hearing about how you will grow our clinical trials in that area. With that I will turn to senator baldwin for her opening statement.
▶ 0:17:02Sen. Baldwin: Thank you, chair capito. I want to welcome Dr. bhattacharya here today. I also want to note that the director of the national institute of was was slated to testify but stepped down from his position.
▶ 0:17:22Sen. Baldwin: Other top officials at -- has been forced out of their positions. Across our health agencies, this is of great concern.
▶ 0:17:43Sen. Baldwin: That of course is in addition to the unprecedented termination and forcing out of thousands of career scientists across the nih as part of this administration's anti-science and, frankly, anti-vaccine bent. Over the past 16 months the trump administration has waged war on science. I'm not talking about isolated policy disputes or partisan disagreements.
▶ 0:18:11Sen. Baldwin: I'm talking about the systematic dismantling of long-standing research programs and the deliberate erosion of research institutions that make america the global leader in biomedical innovation. Across the country researchers, universities, cancer centers, children's hospitals, and patients are experiencing disruptions because this administration has thrown nih into chaos.
▶ 0:18:40Sen. Baldwin: They have terminated over 5000 nih grants. Slashed nearly a quarter of nih workforce. And cut the number of new research grants by more than 2000, or 22%.
▶ 0:18:57Sen. Baldwin: That cut was largely due to a policy that omb -- deal omb director cooked up that requires nih to expand multi-year funding, forcing the entire cost of multi-year grants to be paid in advance. This was not based on science or boosting the discovery of new treatments and cures. This was a political decision.
▶ 0:19:21Sen. Baldwin: As a result, nih spent 2.5 billion dollars more on multi-year funded grants in fiscal year 2025 than it did the year before, an unprecedented amount. What that means is $2.5 billion was locked away in bank accounts for future years' expenditures that cannot be spent today.
▶ 0:19:50Sen. Baldwin: $2.5 billion that could have funded over 2000 more research grants. Each one a shot we didn't take at discovering the next medical breakthrough. There is simply no reason to do this. All it does is dramatically reduced the number of nih grants funded. Take cancer research.
▶ 0:20:14Sen. Baldwin: Last year, the national cancer institute funded 334 or 21% fewer new research grants. That is 334 fewer opportunities to discover new cancer treatments and cures. An untold number of patients and families that won't benefit from this research. This was the case across the nih .
▶ 0:20:46Sen. Baldwin: The national institute on aging the primary funder of alzheimer's research funded 33% fewer grants last year. That is not creating stability for researchers. It is kicking the chair out from under them. I worked hard to limit funding. Although we included a provision that prevented the administration from doing even worse damage I was disappointed we weren't able to do more to stop it. The chaos has ramifications across the country.
▶ 0:21:17Sen. Baldwin: Hiring freezes are hollowing out research labs and forcing institutions to rescind job offers to young scientists. Clinical trials are being canceled or postponed. For decades, nih funding decisions were guided by scientific expertise and independent peer review, as they should be. Now, political appointees and ideological screening decide which grants get funded.
▶ 0:21:46Sen. Baldwin: Researchers are spending more time trying to decipher shifting political priorities than finding treatments and cures. Groundbreaking research is being stifled. Notices of funding opportunities that nih uses to solicit research on specific topics are down by 90%.
▶ 0:22:05Sen. Baldwin: These specialized funding calls are necessary for type one diabetes research, expanded access for als and cancer and hiv research. Even after this committee provided 415 million dollars in increased funds for nih in this fiscal year, the white house delayed getting that money out the door and left nih unable to fund research for 40 days.
▶ 0:22:35Sen. Baldwin: I can't comprehend why this administration is so hell-bent on sabotaging the life-saving research nih supports, but they are doing so at every turn. What concerns me most is that this damage will take years, if not decades, to undo. Because the cost is so much higher than lab closures, canceled clinical trials, or young investigators leaving science.
▶ 0:23:01Sen. Baldwin: The cost will be fewer treatments and cures, lost loved ones, and in an entire generation of scientists gone. Congress should do more to stop this administration, what they are doing to our biomedical research enterprise. I have certainly been pushing to do that. Congress also needs to get serious again about running a budget and appropriations process that truly allows us to prioritize biomedical research.
▶ 0:23:32Sen. Baldwin: From 2017-20 23, we provided meaningful increases for nih, and nih awarded more grants each of those years. But that progress has stalled. Republicans' insistence on squeezing and cutting nondefense funding meant nih funding has not kept up with rising research costs.
▶ 0:23:55Sen. Baldwin: This, combined with misguided administration policies like multi-your funding, will mean nih will award fewer research grants this year than any year since 2017. Meanwhile, the president is asking for $1.5 trillion, an increase of $450 billion or 42%, for defense spending. If we can find additional funding for bombs we should be able to find additional funding for cancer research.
▶ 0:24:25Sen. Baldwin: We need meaningful increases in non-defense funding to do that. That is what I will be pushing for during the fiscal year 2027 appropriations process so that scientists can discover the next breakthrough and families can have hope for new treatments and cures.
▶ 0:24:44Chair Capito: Thank you. Welcome, Dr. bhattacharya, we welcome you for your opening statement before we get the questions.
▶ 0:24:54Dr. Bhattacharya: Chair capito, ranking number bald one, members of the subcommittee, it's an honor to appear before you to discuss the work being done at the national institute of health. The nih mission is to cover scientific discovery to better health outcomes and longer life or the american people central to the make america healthy again initiative.
▶ 0:25:18Dr. Bhattacharya: The nih plays a leading role in confronting the disease crisis, advancing rigorous nutrition science, prioritizing prevention , and so much more. Chronic disease remains the leading cause of death and disability in the united states driving most health-care costs and affecting millions of americans. Nih is intensifying research that identifies the root cause of these conditions and enables interventions including integrating genetics, behavior, environment, and diet.
▶ 0:25:46Dr. Bhattacharya: Diet is a major driver of chronic disease risks, yet critical gaps remain in understanding how specific foods affect health. Ultra processed foods count for 60% of daily caloric intake with growing links with obesity and metabolic conditions. To address this the you nih is supporting multidisciplined research advancing targeted interventions to address chronic disease at its source so we can make america healthy again.
▶ 0:26:11Dr. Bhattacharya: The nih continues to deliver measurable progress by building on decades of foundational science. Our sustained investment in basic research has resulted in transformative clinical advances across multiple areas of medicine. In 2019, president trump announced at the ending the hiv epidemic initiative preventing we could eliminate hiv in the united states by 20 30.
▶ 0:26:37Dr. Bhattacharya: Basic science laid the groundwork for drugs, like a long-acting antiviral agent. A single injection lasting six-12 months offers near total protection against hiv acquisition. Together with other antiviral supported by nih research, this provides a critical pathway to ending the hiv transmission in the united states in coming years. Gene therapies have never show more promise.
▶ 0:27:04Dr. Bhattacharya: Crisper based gene editing has led to two treatments that can cure sickle cell anemia. A disease long thought untreatable. Researchers built on this same platform to deliver personalized therapy to an infant with a rare untreatable condition. This treatment edited genes directly in the liver to correct a lethal mutation so the baby will live a long, healthy life.
▶ 0:27:35Dr. Bhattacharya: Nih is harnessing advances in artificial intelligence and data science. Nih supported researchers recently developed ai tools to match patients to clinical trials more efficiently reducing the barriers to participation and accelerating access to potentially life-saving therapies. Nih's is advancing partnerships to advance the frontiers of biomedical science proud to work with nasa on the artemis ii mission for the avatar project we uses sales from astronauts to create organ on a chip biosystems.
▶ 0:28:03Dr. Bhattacharya: I think that my colleagues brought an example to show around. To show how deep space radiation and microgravity affect human biology. You may ask how this helps the average american. Microgravity reveals changes, and this work informs treatment for chronic diseases on earth. Innovation is critical, affordability remains essential.
▶ 0:28:30Dr. Bhattacharya: Drug repurposing is a powerful lever to reduce the cost and accelerate access to new technology. Testing fda approved drugs for new medications can happen faster with less risk than for new drugs. Nih supported study suggests that a single's vaccine may reduce dementia at the national institute of aging are organizing a roundtable on this. There is potential in parkinson's disease. More research is needed.
▶ 0:29:01Dr. Bhattacharya: The approach allows interventions to be delivered more cost-effectively while maintaining scientific rigor. Improving how science is conducted and funded, nih is advancing a coordinated agency-wide effort to improve rigor, replication, and reproduce-ability including the reputation initiative and investments into $100 million to validate key findings. I'm grateful to congress for making that possible. These efforts ensure that nih-supported sciences are ready to afford critical clear.
▶ 0:29:30Dr. Bhattacharya: Fosters innovation by supporting the balanced research portfolio three unified funding strategy. The nih is strengthening its ability to cure portfolios, it that span the full spectrum of scientific approaches, and align with the national -- national priorities. Working to broaden the geographic scope of funding, research capacity, and institutions across the country while expanding the use of human-based research models to improve translate ability reducing animal use when appropriate. Let me finish with this bit.
▶ 0:30:01Dr. Bhattacharya: The strength of the american biomedical research rigor, transparency, and early stage investigators deliver durable results. Our role as careful stewards of researchers entrusted to us and ensure every taxpayer dollar produces reliable knowledge is, measurable health, and lasting public benefit. We remain committed to scientific excellence and improving health of all americans. Thank you, look for to your questions.
▶ 0:30:26Chair Capito: Thank you, very much. I will now turn to the chair of the full committee, senator collins, for several minutes for a statement, questions, or whatever -- she can have whatever she wants. [laughter] I like that.
▶ 0:30:44Chair Capito: Remember I'm the one who said it. Chair collins thank you, madam chair. Let me welcome all of you this morning. I worked so closely with many of the members of this panel. And I admire your dedication to improving the health of the american people.
▶ 0:31:07Chair Capito: There are, however, budget issues that I find to be inexplicable in some ways, and I do want to discuss some of those with you today. In fiscal year 2025 the nih awarded more than 100 $20 million to grants and contracts to entities in my home state of maine.
▶ 0:31:33Chair Capito: This funding directly supported 1003 at 78 jobs and more than $280 million in economic activity. I mention that because there is an economic impact to the research we are doing as well as an impact on the health and well-being of americans.
▶ 0:31:59Chair Capito: This funding has also led to very exciting developments, such as a clinical trial for a new lyme disease vaccine and another clinical trial investigating how glp-1 drugs could be used to treat long covid. Really exciting developments. Breakthroughs like these can only be sustained if research institutions are able to cover this cost.
▶ 0:32:32Chair Capito: Yet the administration's budget request once again proposes a 15% arbitrary across the board cap for indirect research costs after congress specifically blocked a similar proposal last year.
▶ 0:32:51Chair Capito: Such a cap would negatively affect cutting-edge research happening at universities, nonprofit laboratories, medical centers around the country, and undermine the foundation of our nation's global leadership in biomedical research and technological innovation.
▶ 0:33:15Chair Capito: Doctor, we discussed other alternatives last year to have more accountability, increased transparency on indirect costs funded with taxpayer dollars.
▶ 0:33:30Chair Capito: I would like to ask you whether you have a specific proposal for improving the current indirect cost system without adopting this one size fits all, arbitrary, very harmful cap across the board?
▶ 0:33:49Dr. Bhattacharya: Senator, we remain committed to making sure the research institutions of this country receive the support they need to have the success you described. I'm grateful that you started with the examples of a potential vaccine for lyme disease. Glp-1's for so many different uses. So much more. I'm sure that you could have gone on for a long time.
▶ 0:34:17Dr. Bhattacharya: The key thing I would love to have happen, and I will convene a committee of my advisory committee directors to discuss this openly, is a proposal to de-link -- to allow competition, free and open competition for these facilities, the money nih has for institutions.
▶ 0:34:42Dr. Bhattacharya: The key idea is right now in order for may and at other places to win the facility support you have to have excellent scientists who when the grants and a link to that is the facility's money. To have people when the grants in the first place -- win the grants in the first place you have to attract the great scientists. You have to have great facilities. Investments and institutions will be concentrated.
▶ 0:35:09Dr. Bhattacharya: 20% of institutions get about one third of our support. I would love to work with you and we had great conversations about this. The de-link this connection and allow there to be more open competition for the facilities money by places like maine, kansas -- I have visited so many of these great institutions across the country where there are so many great scientists. We need to make it easier to build up facilities.
▶ 0:35:37Dr. Bhattacharya: Nih is like seed money for these places. When we invest to get investing as well. I went to work with you to launch essentially a renaissance of biomedical research across the country, where we don't have a couple of super biomedical hubs, but everywhere across the country where there are amazing scientific ideas people should be able to get support for it.
▶ 0:36:05Chair Collins: Dr. rodgers, it's great to see you again, although I don't think this hearing will be quite as moving and inspiring as the children's congress hearing at which you testified last summer.
▶ 0:36:23Chair Collins: Seeing all of those with type one diabetes across the country, including six-year-old carolyn from the state of maine, who traveled to share her story, was truly moving. Recent type one diabetes research funded by nih has led to some exciting developments.
▶ 0:36:46Chair Collins: Clinical trial data resulting from nih funding, clinical transplantation, has contributed to the first ever stem cell treatment for type one diabetes.
▶ 0:37:06Chair Collins: And I realize the clinical trials have been small so far, but it is so exciting that after receiving this treatment 10 out of 12 patients in clinical trials no longer needed insulin. That is extraordinary.
▶ 0:37:23Chair Collins: Therefore for the life of me I cannot understand why the budget would propose a $167 million cut for your institute, the national institute of diabetes, digestive, and kidney diseases. By contrast, we have increased funding for the special diabetes program. This is the last point at which we should be cutting funding for biomedical research, period.
▶ 0:37:56Chair Collins: Your institute, given that we are finally seeing real progress. Could you please comment on this?
▶ 0:38:04Dr. Rodgers: Sure, senator collins. Thank you for your ongoing support for the special diabetes program. Yours and your colleagues'. This has led to major breakthroughs in the way that people in this country with type one diabetes have enjoyed long and their quality of life has changed dramatically.
▶ 0:38:30Dr. Rodgers: We mentioned the first fda approved stem cell treatment, transplantation, but also the first drug under your watch that can delay the onset of type one diabetes by at least three or more years. Also, it was support that was responsible for five of the six commercially available artificial pancreas technologies. These are now being applied in many other areas.
▶ 0:39:00Dr. Rodgers: A reduction in funding will have consequences, of course. We have to either delay or postpone many of our efforts, including the vehicle which led to this approval, ultimately, of the first drug to delay the onset.
▶ 0:39:21Dr. Rodgers: We are right on the cusp of understanding what the environmental determinants of diabetes in youth are, the so-called teddy study. We are at the point where we are in the intense data analysis phase. That could delay that to some extent. We are thankful for what we get and we will make the appropriate adjustments as necessary to ensure that all of our funding goes out as required by the law.
▶ 0:39:53Dr. Rodgers: Thank you.
▶ 0:39:53Chair Collins: Thank you, madam chair. I know of gone over my time. I will submit for the record questions on alzheimer's disease, which is also one of our top priorities, and women health care grants.
▶ 0:40:07Chair Capito: Senator baldwin.
▶ 0:40:10Sen. Baldwin: The current ebola outbreak highlights the potential use of mrna technology to respond rapidly to viral threats, especially ones we don't have vaccines or treatments for, like the bolo strain that is emerging in central africa -- the ebola strain that is emerging in central africa.
▶ 0:40:35Sen. Baldwin: Last year 500 million dollars in contracts were terminated for cutting-edge mrna development and redirected that funding to 80-year-old vaccine technology. Experts have expressed serious concerns that this technology is outdated and inferior. The way that the funding was awarded circumvented the scientific review process. Dr.
▶ 0:41:03Sen. Baldwin: Bhattacharya will you commit to providing this subcommittee with the contracts that awarded that funding?
▶ 0:41:07Dr. Bhattacharya: Senator, first, I should say that the ebola virus that is now in the drc, we don't have a vaccine for it --
▶ 0:41:23Sen. Baldwin: I'm raising the issue there were 500 million dollars in contracts for mrna vaccine development that was cut off and redirected. What I asked was will you provide this committee with the contracts that awarded that?
▶ 0:41:44Dr. Bhattacharya: Those are not nih contracts. Nih contracts, we are an open book.
▶ 0:41:52Sen. Baldwin: Was there an open, fair, transparent call for proposals for this funding?
▶ 0:41:57Dr. Bhattacharya: For the funding for the universal flu vaccine?
▶ 0:42:02Sen. Baldwin: For the funding that was taken from the mrna contracts and redirected?
▶ 0:42:09Dr. Bhattacharya: The universal flu vaccine that the nih is investing in for research for research purposes followed our normal processes for identifying intramural research opportunities. The answer is yes.
▶ 0:42:24Sen. Baldwin: Was there a peer review of that process?
▶ 0:42:26Dr. Bhattacharya: It is the same standard process we use for all of our intramural research is. It's very promising. The idea that we could get a single vaccine --
▶ 0:42:37Sen. Baldwin: So you bypass the peer review competitive process to award 100 million dollars internally to two nih researchers, one of whom is your deputy director --
▶ 0:42:50Dr. Bhattacharya: That's not accurate. It followed the normal process for determining how intramural -- nih has a tremendous number of amazing scientists, some of whom you see at the table with me. There is a normal process for deciding which get funding.
▶ 0:43:06Sen. Baldwin: $500 million in contracts were terminated, 100 million redirected to 80-year-old technology, without competition. And the researcher, one of them is best known for being a covid vaccine skeptic. I had his lab's annual operating budget increased by more than 50 times.
▶ 0:43:34Sen. Baldwin: Did secretary kennedy, his special assistance, direct nih to award funding to these two investigators?
▶ 0:43:42Dr. Bhattacharya: The project you are talking about is a tremendously promising project.
▶ 0:43:48Sen. Baldwin: Did secretary kennedy direct nih?
▶ 0:43:54Dr. Bhattacharya: Nih followed normal processes to decide if to invest in the universal flu platform. If the project works out and tremendously early results look promising, we could have a single injection so you don't have to get annual flu --
▶ 0:44:09Sen. Baldwin: I'm concerned about the lack of contest and peer review. The funding was appropriated in the american rescue plan. Congress agreed and our fiscal year 20 26 labor hhs appropriations bill to rescind that funding. The bill was made public on january 20. Nih obligated this funding on january 31, well after the bill was public the three days before it was enacted into law and would have been rescinded.
▶ 0:44:41Sen. Baldwin: In late january, did anyone at nih discussed needing to award this funding before congress rescinded it?
▶ 0:44:46Dr. Bhattacharya: We follow the law on allocating funding. We allocated to a very promising project that promises to end the need for annual flu vaccines with a single injection that can protect people from the flu forever.
▶ 0:44:59Sen. Baldwin: My understanding is those discussions did happen. The trump administration rushed out american rescue plan funding before congress could resend it as we try to do in our bill. Secretary kennedy has his own narrative about the effectiveness, or lack thereof, of mrna vaccine technology and hiding studies to show their effectiveness is something I'm deeply disturbed about.
▶ 0:45:27Sen. Baldwin: Meanwhile, nih is bypassing its actual gold standard scientific review process to unilaterally award more than 100 million dollars to two nih researchers, one of whom is best known for being a covid vaccine skeptic and the other who reportedly just stepped down as the niad director without explanation.
▶ 0:45:50Dr. Bhattacharya: They are among the two most important flu vaccine researchers in the world. They had a tremendous track record of success in particularly flu vaccination research. They are nih funded researchers who have been here for decades among the world's leaders in flu vaccine research.
▶ 0:46:09Sen. Baldwin: We will expect to see those contracts. Thank you.
▶ 0:46:13Chair Capito: I was going to start my question with Dr. letai but I have to respond. Senator baldwin and I get along well, but the insinuation from the remark, sitting in front of six incredible scientists for our country who are trying to solve some of the most deepest, devastating problems, it is being done on the lamb or being done illegally or being done suspiciously is very offensive to me.
▶ 0:46:41Chair Capito: So, I just wanted to say that before I asked -- he knows what I'm going to ask him, I think. I am from a rural state and I'm interested in the nci cancer center designations. I've seen several projects where it talks about the concentration of cancers in rural areas, such as mine -- such as many of our states here.
▶ 0:47:10Chair Capito: The states that they are the highest cancer mortality rates remained largely without access to nci designated care where it is proved the care is better, more successful, and has better rates of cure. We have the idea program that has great success. To get some of that biomedical research out to our rural areas.
▶ 0:47:35Chair Capito: What I would like to see is the nci cancer designation branch an alternative designation pathways, or something, so the structural barriers that are preventing our eligible institutes in states such as mine -- and I know mine is working towards this end were working with them and I appreciate that -- will you continue to keep looking at this comprehensive review of cancer center support?
▶ 0:48:00Chair Capito: Maybe you can give us a 3 how 0 seconds?
▶ 0:48:14Dr. Letai: Thank you, senator. First, I would like to say I think the undercurrent of your question is that it's no good to have major advances in cancer research unless we can reach all americans? The I in nci wholeheartedly agree with you. We are working closely with Dr. jenkins to make sure that when an application is submitted it will be a successful application.
▶ 0:48:38Dr. Letai: Nci designated cancer centers are specifically designated because of their devotion to research as well as clinical and basic research if they are a comprehensive cancer center. I think that that is a laudable goal and I agree that our cancer centers, not only providing clinical care but advancing the standard of care, nci designated cancer centers have been essential to that function, and we look forward to a cancer centers from rural states joining that group.
▶ 0:49:08Dr. Letai: I want to make the point that nci designated cancer centers aren't the only way that we bring top-quality care to more rural areas of america. We have nctn sites throughout the country where people can enroll in nci-supported cancer clinical trials, and that is a way of getting cutting-edge research to people whether they are in rural environments or urban environments.
▶ 0:49:36Dr. Letai: We look forward to continuing that.
▶ 0:49:39Chair Capito: Thank you very much. Dr. volkow, you visited west virginia and in your many years of working in the area of expertise, we have big problems. We are having breakthroughs in your area. Some exciting opioid research results from the intramural research team. I will say Dr.
▶ 0:50:00Chair Capito: Mike and his team identified a novel, highly potent will that shows potential therapy for pain and opioid use disorder.
▶ 0:50:12Dr. Volkow: Thank you for the question. The overdose crisis was born out of lack of treatment for people suffering from chronic pain. That led to the use of opioids. A priority for our institute in partnership with others is to develop safer treatments for people with severe pain. The one that you are reporting by Dr. mike actually is an opioid itself. You can go to mechanisms that don't have opioid in the system or those that do.
▶ 0:50:41Dr. Volkow: Most of the most powerful drugs we have actually activate the opioid system. What he has been able to document in animals is that this molecule activates the opioid receptor in a different way, such that the signaling inside of the cell results -- does not result in the addictiveness of typical opioid drugs.
▶ 0:51:07Dr. Volkow: In that respect it's a breakthrough because you are manipulating chemistry to create the confirmation that can lead you to it but it is safer. We need to bring this into humans.
▶ 0:51:18Chair Capito: Basically, what you are saying is, an opioid that is nonaddictive that can address the pain element that opioids are really good at, nothing the pain, but have the side effects of addictiveness?
▶ 0:51:35Dr. Volkow: Exactly. But we need to test it in humans.
▶ 0:51:39Chair Capito: Senator moran.
▶ 0:51:45Sen. Moran: Are you sure that I am next?
▶ 0:51:49Chair Capito: You are right. I hate saying that to you. [laughter] senator durbin.
▶ 0:51:57Sen. Durbin: Thank you, senator moran and madam chair. I was a sophomore in high school, 14 years old. My father had lung cancer and he died at age 53. I stood by his hospital bed and felt helpless and destroyed as a kid. I never forgot that experience and I never will. So, when it came to congress I decided to take on big tobacco.
▶ 0:52:29Sen. Durbin: 36 years ago I introduced an amendment that banned smoking on airplanes. That amendment triggered a reaction I didn't anticipate. It was a tipping point. The time that we pass the limit to ban smoking on airplanes, 27% of high school students were smoking tobacco products. 27%. Today it is 2%. Our kids are not safe from another product of big tobacco called vaping.
▶ 0:53:01Sen. Durbin: Are you familiar with vaping? I'm sure you are as medical doctors. Dr. volkow, is vaping dangerous to children?
▶ 0:53:08Dr. Volkow: Yes. Vaping is by itself, but even more so if it has nicotine. It can produce addiction and particularly in children this can escalate. Yes.
▶ 0:53:22Sen. Durbin: Do you hear statistics about the percent of kids in high school and junior high that are vaping today?
▶ 0:53:28Dr. Volkow: We monitor it very carefully. Fortunately we have seen significant reductions in vaping among teenagers over the past three to four years. Yes. Fortunately. The levels were very high. It went up to 23% of 12th graders. Now, we are much lower than that.
▶ 0:53:50Sen. Durbin: Big tobacco is no longer peddling tobacco to kids, they are peddling vaping with the same addictive qualities of nicotine and the same danger to these kids. The question is what is this administration doing about vaping?
▶ 0:54:07Dr. Bhattacharya: You heard Dr. volkow talk about our research programs. I agree that it's dangerous for kids. I think for the nih our role is to document the ways that vaping and other things affected the health of children. As well as other people.
▶ 0:54:28Sen. Durbin: Do you see connection between fruit-flavored vaping and children being attracted to it?
▶ 0:54:34Dr. Bhattacharya: I would have to do research, but absolutely I think that's probably inappropriate for children to be using fruit-flavored vapes.
▶ 0:54:43Sen. Durbin: The policy within the next two weeks will make it easier for these countries to pedal fruit monster vaping, candy cane vaping, raspberry slushy vaping to our children and junior high and high school now?
▶ 0:54:58Dr. Bhattacharya: I think the vaping for kids is a dangerous thing. I think it is the role of the nih is not to set policy, is to do research to document the way to address these health problems.
▶ 0:55:11Sen. Durbin: They are peddling flavors that attract children. Children who don't have the maturity to make the decision and they become addicted to a product that is dangerous to them according to Dr. volkow. I couldn't agree more. How can we in good conscience say that this administration has the best interests of children at heart when they are exposing them to this deadly product?
▶ 0:55:34Dr. Bhattacharya: All I can say is about the nih' is commitment that we study this issue as fairly and evenly and objectively as possible in a rigorous way.
▶ 0:55:43Sen. Durbin: We don't need a study, we need action, we need to stop this. The previous administration was better, to be honest with you. I was critical of them as well. To think that these companies, many from china, will peddle some product to our kids that they will vaped in the steamy concoction of chemicals, chromium and god only knows what else is in it, and we will look the other way.
▶ 0:56:10Sen. Durbin: As this administration says, let's have more fruit flavors on hand for kids to dabble in and try to make a decision. Does this make sense to you?
▶ 0:56:17Dr. Bhattacharya: Senator, having kids have more access to vaping does not make sense to me.
▶ 0:56:23Sen. Durbin: Is there anyone on the panel of six doctors who thinks that this is a sensible decision by the trump administration to make it easier to pedal fruit-flavored vaping to the kids in high school and junior high school? Anyone among you who thinks it's a good idea? Thank goodness you are honest in your response.
▶ 0:56:46Sen. Durbin: There is a disclosure today and I don't know the source, but a $5 million donation from big tobacco proceeding the vaping decision. A check for $5 million and the president switched his position on this. This is ghastly we are allowing this to occur. 36 years after passing banning smoking on airplanes, seeing us introducing a new product, a new variation to addict children.
▶ 0:57:15Sen. Durbin: For gods sake, is there one person in the administration besides those who have already resigned who will stand up and say enough, this violates my conscience? I yield.
▶ 0:57:24Chair Capito: Before I go to senator moran, thank you for correcting me, I would like to recognize two youth volunteers from west virginia in the audience. Nicole and brendan, can you stand? Thank you for what you're doing. Senator moran. Several moran, thank you very much. I appreciated the opportunity to welcome you to candace -- the kansas. I appreciated your visit.
▶ 0:57:55Chair Capito: I invited Dr. rutter to come home to kansas. Dr. hodes volunteered on his own volition. Dr. letai you are the only cancer director that hasn't been with me in kansas to see what we are doing and I would extend the opportunity and welcome the chance to showcase, but more importantly the visits I hope affect how you look at research decisions that you make.
▶ 0:58:26Chair Capito: Perhaps the most value is for us to figure out how we can do our jobs better to meet the needs of this country and world in solving the problems related to diseases and afflictions. I'm very appreciative of your presence today and appreciate the relationship that we have developed with the ball in the past and look forward to that continuing -- with you all in the past and look forward to that continuing. I want to raise the topic -- and I don't know that I've asked about parkinson's disease in any of these hearings before.
▶ 0:58:57Chair Capito: Certainly, I'm becoming more aware of the challenges people face in regard to this disease. Fy 26 we were successful in adding a $5 million amounts of money for implementation of the national plan to end alzheimer's. Dr. bhattacharya or Dr. hodes, tell me what that means, what's going to happen as a result of that?
▶ 0:59:17Dr. Bhattacharya: I will let my colleague.
▶ 0:59:20Sen. Moran: Dr. hodes.
▶ 0:59:23Dr. Hodes: The national plan for parkinson's disease will be taking a major lead following the pattern for alzheimer's disease. A national advisory council has been established with scientific experts, advocates from the private and public sector to work together in an unusual committee structure to survey and make recommendations for progress in research, care, and long-term services.
▶ 0:59:53Dr. Hodes: I think the parkinson's initiative is intended to model after this very effective and all-encompassing approach to an important neurodegenerative disease.
▶ 1:00:04Sen. Moran: I was involved in the initiations in the world of alzheimer's and I'm pleased that it's seen as a role model for other things we hope to address as we are doing alzheimer's now. I want to ask a question perhaps to all of you. I think every institute may have something to do with this topic. I would like to discuss nih research on cmv.
▶ 1:00:34Sen. Moran: It is not a thing that's well known. It is a common generally harmless virus that can be contracted at any age. Cmv is the most common congenital viral infection affecting newborns. One and 200 children born with congenital cmv each year is transmitted to a child during pregnancy. The viruses often without symptoms but in some cases can lead to developmental disabilities in children.
▶ 1:01:04Sen. Moran: I'm telling you something that you know but I want my colleagues and I to understand what I'm talking about. There are treatments available to children born with congenital cmv and display symptoms like hearing loss if treatment is administered to the child shortly after birth. But there is a current patchwork approach across our state for screening, testing, treatment. In virginia you have a hearing test on the birth of a child and in kansas you do not.
▶ 1:01:32Sen. Moran: My question is, nih has funded cmv research for decades and in recent fiscal years there have been dozens of grants awarded to the study. Would you speak to the developments in the issue that I've raised?
▶ 1:01:46Dr. Bhattacharya: Thank you for bringing to the attention of the country this problem. The virus you are talking about can absolutely end affecting children because some of the conditions you talked about, including hearing loss. We have a program to evaluate universal cmv screening policies to see how it can prevent exactly the outcomes you are talking about.
▶ 1:02:13Dr. Bhattacharya: It is not as well-known as people might hear about hiv your other viruses, but -- hiv or other viruses, but it is something where potential early intervention can make a big difference in the life of a child and we are committed to studying it and figuring out ways to better prevent it so that children don't have to suffer for it.
▶ 1:02:31Sen. Moran: Are there any other directors who have comments on this topic? My time has expired.
▶ 1:02:41Chair Capito: Senator shaheen.
▶ 1:02:43Sen. Shaheen: Thank you for being here this morning. I will ask a question. I understand senator collins has asked this question but as the other cochair of the diabetes caucus it's worth following up. I will direct this to you, Dr. rodgers and Dr. bhattacharya.
▶ 1:03:05Sen. Shaheen: As we know, the federally funded research through niddk through the special diabetes program has made a difference in advancing diabetes treatments, which is not only smart from a personal perspective to help those people who have type one and type two who require insulin, but it makes policy since because it saves money in the long run.
▶ 1:03:30Sen. Shaheen: Unfortunately what we have seen in the president's budget is that it cuts both of those programs. Can both of you share why diabetes research funding is so critical and what is going to happen -- what would happen if we were to cut all of that research funding, Dr. rodgers?
▶ 1:03:48Dr. Rodgers: Thank you for the question and thanks for your long-term support on not only the special diabetes program but other forms of diabetes, which is extremely important. On the type one diabetes front we have made a lot of major findings and accelerated the course so that the care and
▶ 1:04:18Dr. Rodgers: Quality of life has really changed vastly over time. There are some discoveries that were on the cusp of having a second level of impact. We know people who have type one diabetes, for example, are potentially genetically prone. Something in the environment is a trigger that turns on their immune system.
▶ 1:04:45Dr. Rodgers: We have screened a large number of people, followed 8000 kids from birth to the age of 15, and concluded the data collection on the last patient about a year ago. We are now in the phase in which we are analyzing the data using artificial intelligence and machine learning. Should there be a cut this may be delayed in answering this question.
▶ 1:05:14Dr. Rodgers: If it turns out to be something in the diet and dietary modifications would be in order, it's viral --it is likely multiple -- but those are the things we are on the cusp of learning. In terms of a cure for the disease, we have developed ways to expand stem cells derived from patients.
▶ 1:05:38Dr. Rodgers: Now we are trying to figure out how to get the stem cells in large volumes in a patient to restore it.
▶ 1:05:45Sen. Shaheen: I am familiar with that. Vertex has a new partnership in new hampshire working on that. We've seen some really amazing results, I think, from that. I will stop there because I'm about to run out of time. I will go to Dr.
▶ 1:06:01Sen. Shaheen: Volkow because you have been so helpful over the years from your research addressing substance misuse and the challenges we've had in new hampshire. I appreciate that following up on senator capito's question on where are we. I would like to you to give us an update on the new research to address substance misuse.
▶ 1:06:29Sen. Shaheen: I would also like to register, Dr. bhattacharya, my concern about merging nida with the national institute on alcohol abuse and alcoholism and cutting the funding at the same time I 165 million dollars I think at a time when the country still recovering from the opioid epidemic. It is not the time to do that. Can you update us on new research?
▶ 1:06:56Dr. Volkow: Thank you for the question and we have done significant progress in the reduction in overdoses from opioids across the country. The numbers are still very high and we cannot forget about it. The other issue that is relevant is there are certain states where that's not happening. In particular, the reduction in overdose deaths is not as apparent in rural areas. Some states are still seeing increases in overdoses.
▶ 1:07:25Dr. Volkow: It has become more complex because it is not only opioids but also stimulants. There is some extremely exciting areas that look transformative, particularly I am interested in an comment related to repurchasing your glp-1 drugs, the medications for obesity and diabetes, are leading to the patients to spontaneously stop taking them and that is exciting
▶ 1:07:58Dr. Volkow: Research. In parallel, we understand as the brain works and tools to model, we now have new ways of treating substance abuse disorder. Two, we are getting into the space with drugs to be able to optimize the way that we can help the brain recover itself from harm through neural plasticity. This is a time of enormous amounts of discovery, trying to translate them.
▶ 1:08:25Chair Capito: Senator hyde-smith.
▶ 1:08:29Sen. Hyde-Smith: Thank you, madam chair, and appreciate the panel for being here today. You are all truly outstanding. We have some from mississippi here. It takes a long time to get here but folks who are interested in these health care issues traveled. Ashley parker is here, who survived cancer. Will you stand up? She is fiercely helping others, other people going through this. Certainly appreciate her.
▶ 1:08:58Sen. Hyde-Smith: What we are dealing with in mississippi is the university of mississippi medical center working towards the national cancer institute designation. Our local legislature in mississippi, they have given $100 million to start this. We expect to break ground this fall. This is one of the most exciting things that we have going in mississippi in health care.
▶ 1:09:26Sen. Hyde-Smith: We have made a lot of progress in recruiting professionals and scientists, top, who are wanting to come help us, and we couldn't be more excited about this cancer center and research institute. We know that obtaining the nci designation, although it is a top priority for me and obviously the legislature in mississippi, we know that that can be a tall hill to climb. Dr.
▶ 1:09:56Sen. Hyde-Smith: Letai, I will direct this to you and ask about your commitment in maintaining open communication with the university medical center in jackson and my staff during the process, including meeting with ummc leadership to identify ways to support this very important project in mississippi.
▶ 1:10:20Dr. Letai: That is an extremely easy commitment to make. We very much like to hear from centers, especially in states that don't already have an nci-designated cancer center. We love to hear from senators who want to take the next step to designation. I love what I'm hearing about three legs of the stool. Institutional commitment, infrastructure support -- and I love what I'm hearing about what the state of mississippi is doing towards that.
▶ 1:10:52Dr. Letai: The third leg of the stool is research. It's a very important part of the nci designation. That there is a commitment to research. I'm already familiar with some very high quality research from the university of mississippi. They are doing excellent work. I look forward to continue to help them. I know excellent research is taking place in mississippi.
▶ 1:11:20Dr. Letai: It's easy for me to say that with our office of cancer centers we look forward to working with the staff at the university of mississippi to make this a successful application.
▶ 1:11:30Sen. Hyde-Smith: Thank you very much for that encouraging answer for sure. Dr. letai, I appreciate knowing we have your support and commitment. I would like to follow up on some things that senator capito made comments about. Addressing her questions about the challenges some states face towards nci designation.
▶ 1:11:56Sen. Hyde-Smith: We both represent very rural states and have so many areas that don't have access to good health care. There are under resourced states that don't have the same long-standing biomedical research infrastructure for various reasons. The funding of those pipelines and institutional capacity, heavily-funded states, yet our need is immense.
▶ 1:12:24Sen. Hyde-Smith: That is where we find some of our sickest patients in these rural areas. Dr. bhattacharya, I would like you to come in as well, about the commitment to supporting rural and historically under resourced areas and academic medical centers pursuing nci designation and sustainable cancer research that we are putting our best foot forward in mississippi trying to address.
▶ 1:12:51Dr. Bhattacharya: We are committed to that. A very easy asked. At nih we have many programs. I am looking for more. The ideal program to make sure states like mississippi and institutions have a chance to get nih funding. The care for funding to make sure patients have access to the best clinical trials.
▶ 1:13:18Dr. Bhattacharya: We want to make sure that americans, no matter where they are, benefit from the fruits of biomedical research. Scientists, no matter where they are, if their ideas are good they have a chance to get nih funding.
▶ 1:13:30Sen. Hyde-Smith: You do an excellent job and I'm impressed with all of you. The things that are to come, your interest, commitment, dedication, motivation to address these is very applauding. Thank you very much.
▶ 1:13:43Chair Capito: Senator schatz.
▶ 1:13:49Sen. Schatz: Thank you to the panel and everyone who does this important work. Dr. bhattacharya, this subcommittee's investment in nih has helped hawaii to recruit top-tier talent and a shot at a grant to grow our workforce focused on ai and cancer research but it has been sitting in administrative review at hhs for six months. Do I have your commitment to unstick this decision as soon as possible?
▶ 1:14:18Dr. Bhattacharya: I will have to look into it, senator. I have a deep commitment to make sure hawaii, the native populations, tribal populations and other places have the support from the nih to do research that can only be done in those places.
▶ 1:14:35Sen. Schatz: On the native hawaiian and pacific islander research office, native hawaiians and pacific islanders have less access to care compared to other americans and suffer worse health outcomes. Which is why three years ago we launched the first nih native hawaiian and pacific islander health research office. Last year it was funded at $5 million. Do you commit to staffing this?
▶ 1:15:04Sen. Schatz: Last week, we talked about health disparities research. Do you agree there are fundamental to biological differences that are worthy of scientific inquiry and that is not d.e.I.? Some examples of biological differences are the disease rates in ashkenazi jews, americans with sickle cell disease, women and osteoporosis, asian-americans and some cancers.
▶ 1:15:32Sen. Schatz: Do you agree we should start studying these disparities?
▶ 1:15:35Dr. Bhattacharya: Absolutely. We make sure the nih studies the health problems of everyone in the country. We have to take into account the biological realities. Anything we find has to be accurate. It has to be rigorous. It has to be in scope. That is not d.e.I. Research. That addresses fundamental health.
▶ 1:16:00Sen. Schatz: We saw a 73% drop in the awards for the study of health disparities. You just issued seven competitive awards, a total of $6 million. I want to make a point that every time I talk to you I am reassured, but every time I see the amount of money spent on disparities research, I am not reassured.
▶ 1:16:24Sen. Schatz: There seems to be a disagreement between the scientific community and president donald trump, and someone else somewhere else in the administration, who is alleging that this kind of scientific inquiry, that this kind of health disparity research, somehow has a liberal bent. It is preposterous.
▶ 1:16:46Sen. Schatz: I don't want to get you in trouble, ok, but this is ridiculous, and I think you know it is ridiculous, and I think all of us on this committee should be able to wall off our disagreements about diversity, equity, and inclusion and the extent to which the biden administration and progressives over the last decade may have done things that republicans are concerned with and disagree with, and letting it spill over into basic biological questions that we really want to know the
▶ 1:17:16Sen. Schatz: Answers to.
▶ 1:17:18Dr. Bhattacharya: The nimh d is committed to spending the funding that congress has given this year as well as last year. The acting director is an amazing scientist, and I have full confidence that they will be able to identify great research that improves health and well-being.
▶ 1:17:41Sen. Schatz: Finally, chronic pain mentions hypertension and diabetes is the most prevalent, costly, and debilitating disease in the united states. My stop pain act was enacted nine years ago, and since then, the nih has fondled hunt -- funneled hundreds of millions of dollars of payments. We have seen good progress, but there is still more to do to work on safe, effective treatments. We need to re-commit to funding studies.
▶ 1:18:11Sen. Schatz: Instead, we have limited pain research, and I am wondering why.
▶ 1:18:17Dr. Volkow: I am not aware there is any limitation on pain research. In fact, we are very grateful to congress for giving us a first time allocation of 250 million dollars to study pain. That has accelerated discoveries.
▶ 1:18:33Sen. Schatz: That is great to hear. The office of policy and planning, there is no proposed line for fiscal year 2027. Millions of grants were terminated, cutting key initiatives. If this is a misunderstanding, it is the best misunderstanding I have encountered in many, many months.
▶ 1:18:57Dr. Bhattacharya: It is such an important program for addressing addiction in this country. The leader has been a champion of it and I fully support it.
▶ 1:19:09Sen. Schatz: I'm going to assume I am wrong and be happy with that. Thank you.
▶ 1:19:15Chair Capito: Senator boozman?
▶ 1:19:19Sen. Boozman: Thank you, and thank all of you for being here. I have had the opportunity to have almost all of you in my office on occasion. These meetings have been productive as any I have. I also understand that you are talented people and could do a lot better financially doing something else with your time. So we appreciate your service.
▶ 1:19:51Sen. Boozman: Dr. bhattacharya, the idea program has played a critical role in expanding support of research to states like arkansas ,. Many of these states face some of the highest rates of chronic disease and adverse health outcomes.
▶ 1:20:13Sen. Boozman: Can you discuss the impact the program has had on strengthening research capacity, improving health outcomes, and how nih will continue to ensure the benefits of innovation and economic growth reach communities?
▶ 1:20:32Dr. Bhattacharya: The idea program is such an important program for exactly the reasons you state. I think it is 23 states that have had difficulty getting nih funding. A third of our per folio goes to about 20 institutions, and that is a mistake because it means we are under investing in the research capacities of the whole rest of the country, where there are so many great ideas, and people who need access to the kind of research products that
▶ 1:21:02Dr. Bhattacharya: We have. I am absolutely committed not just to the ideas program, but to other mechanisms for addressing that problem, including reform of her wheat fund facilities, so that every facility in the country has a chance of getting nih funding in a way that does not disadvantage you just because you are not in the top 20.
▶ 1:21:23Senator Boozman: That is excellent. One of the things we are seeing is the trend of the rising incidence of cancer among younger adults who would otherwise be considered healthy and low risk. Can you tell us a little bit? I know you all are working on this project. Can you tell me what the nih is doing to better understand the factors driving this and what research initiatives are underway about causes?
▶ 1:21:54Senator Boozman: And how we can help with that? >> it is a problem many of us in the cancer community are aware of. I would say although there are several cancers with increasing incidence in young people, the one most captures my attention is clearly a rectal cancer, because we have seen an increase in cancer mortality in young people, not just cancer diagnosis. We have several avenues.
▶ 1:22:25Senator Boozman: One is in our population science efforts. We are trying to identify are there any tags, any features of people getting this, that are different than other people. So far, it has been a puzzling problem and it is difficult to assign a single cause. It is probably not connected to obesity. We do know that colorectal cancer notoriously has environmental cues, so there are environmental cues, but we have not identified them.
▶ 1:22:55Senator Boozman: Among these cues is the rectal biome. There is research indicating there might be particular microorganisms that contribute to this, particularly in young people. This is very early research. We need to, I would say, solidify that. But the thing about the micro-biome is that if we do find the bacteria in the gut are contributing in some cases. We duked ways to manipulate the micro biome.
▶ 1:23:26Senator Boozman: That is another promising area of research. I assure you this has captured our interest with a very interesting theory.
▶ 1:23:37Sen. Boozman: Very good. Thank you. Although we are making positive strides which we have discussed, substance disorders in places like arkansas is still a critical issue. Recently, a powerful new synthetic opioid reportedly even stronger than fentanyl.
▶ 1:24:02Sen. Boozman: These synthetic drugs are being designed to look like legitimate prescription medications, which makes them incredibly difficult for experts to track. Can you share how nih ensures that federal resources continue to help our states tackle these things? The other thing very quickly -- well, go ahead.
▶ 1:24:33Sen. Boozman: >> we have a multipronged approach. The problem of synthetic drugs is not new. It is getting worse and it is here to stay. We look at how addictive that drug can be. And there is competition with others in the market. We are, number one, assessing the emergence of why drugs are appearing across the country.
▶ 1:24:58Sen. Boozman: The second one is analyzing the characteristics of these drugs, and then communicating and implementing interventions for people that are overdosing, how to treat them. We are trying to also develop the guidelines while working with other agencies so that we can have a concerted effort, because this is not just us in isolation.
▶ 1:25:20Sen. Boozman: It is working with the cdc, working with the dea, and working with the fda, so we can come in, they can use this knowledge to generate policies on what should be forbidden or not.
▶ 1:25:35Chair Capito: We are joined by the cochair of the full committee, senator murray. Thank you for coming.
▶ 1:25:43Sen. Murray: The nih funding level is not just a number on a page. It really determines how much we can find opportunities to discover the next life-saving cures, whether it is for cancer, alzheimer's, diabetes, and so much more. That is why so many of us have fought so hard to boost nih funding.
▶ 1:26:04Sen. Murray: Between 2017 and 2023, we were able to increase nih funding to support more than 6000 additional grants for research on childhood cancer, on dementia, and on many other terrible diseases. And that was only possible because our overall nondefense budget was growing.
▶ 1:26:27Sen. Murray: But now, with what we have in front of us, the congressional republicans have for years held that domestic budget flat, and that meant that nih funding has been essentially flat for three years, resulting in fewer grants and fewer cures.
▶ 1:26:43Sen. Murray: The budget we have now been presented -- you are literally asking congress to cut nih's budget by $6 billion in order to provide room to give trump's 1.5 trillion dollar war budget. Dr. bhattacharya, how do you justify cutting nih research by billions to send a half trillion more to the pentagon? Do you personally support that?
▶ 1:27:10Dr. Bhattacharya: Senator, the budget is obviously a major problem for this country. Nih, my job is to make sure that my colleagues have the resources they need to find the best biomedical research in this country. I am grateful to work with congress and the administration to make sure that is possible.
▶ 1:27:32Sen. Murray: You did not really answer the question, and I know why. For all of us to understand, we are being asked to cut nih by $6 billion in order to provide a huge increase on the defense side. According to one estimate, it would take not even 2% of trump's war budget to compare candidate vaccines against active viral diseases. I hope this committee rejects that request and works to make sure we have a better opportunity for americans when it comes to biomedical research.
▶ 1:28:04Sen. Murray: We are now dealing with the junta virus outbreak and a deeply concerning emerging ebola outbreak. I am concerned because there is a void of public health leadership from this administration, especially as you know work to balance roles, two full-time jobs. With less funding and fewer staff and stalled research, can you credibly tell us that we are better prepared for public health threats than we were a year ago?
▶ 1:28:33Dr. Bhattacharya: As the acting director of the cdc the last three months, when I have just encountered is absolute professionalism, ac/dc public health staff who has devoted their lives to protecting this country and frankly the world from the kind of infectious diseases that you have seen.
▶ 1:28:53Dr. Bhattacharya: The junta virus outbreak, for instance, which the cdc has played such an important role in addressing, is largely contained, in part because of the professionalism of cdc employees.
▶ 1:29:07Sen. Murray: I don't doubt the professionalism and I greatly admire anybody doing this hard work. The reality is, we are behind. I just heard that at least eight of the top 10 officials at ni a I.d. Are no longer in the roles, and that includes the institute 's director, its top immunology scientist of 30 years, and the microbiology and infectious disease director. We need these people on the job right now. This is I think deeply concerning to all of us as we look at that.
▶ 1:29:39Sen. Murray: And this administration has also terminated over a thousand infectious disease research grants, terminated $500 million in promising vaccine contracts, our best bet for rapidly developing vaccines countering junta virus and ebola.
▶ 1:29:59Sen. Murray: I am really concerned that you have terminated niaid funding for a group studying the exact type of hantavirus that because the deadly outbreak we are dealing with right now. We have lost 4000 excellent staff. I know you are scrambling to rehire. It just seems like we have dismantled our infectious disease research and pipeline, and we will pay the price.
▶ 1:30:25Dr. Bhattacharya: Niaid is such an important part of the nih, and for years it has had civilian bio defense. We have shifted the folks at niaid to address diseases people have including the hantavirus, including ebola and so much else. We also have shifted the priorities to prioritize allergy and immunology. That shift means that we need leadership.
▶ 1:30:55Dr. Bhattacharya: The folks who are talking about are still there at places they can help with the change message of the niaid to focus on infectious diseases and on allergy and immunology.
▶ 1:31:10Sen. Murray: I would say we need both and I am very worried.
▶ 1:31:12Dr. Bhattacharya: Niaid should play a leading role. We are a civilian agency and we should be focused on the threats to health that americans actually face. Like when we had the hiv epidemic. We need implementation science. Scientists are excellent at implementation, so we have the tools we need, the technological tools. We just need to understand how to use them.
▶ 1:31:41Dr. Bhattacharya: That means using the scientists and expertise. We have to have that. I want to use the niaid for addressing the health needs of the country.
▶ 1:31:54Sen. Murray: I hate to interrupt you, but we are watching this. It is deeply concerning. You are trying to justify it. At a time when we are seeing these outbreaks, it is disconcerting to all of us to see the public health side, cdc, nih, lose a lot of their experts. Let me ask you one other question. I want to ask about the pediatric trial network, which funds studies into safeties of medication for children.
▶ 1:32:20Sen. Murray: Are you aware that last year's nih pediatric network received less funding?
▶ 1:32:29Dr. Bhattacharya: There are contracting issues. We are making sure there are opportunities for children across the country to participate.
▶ 1:32:38Sen. Murray: It received $11 million, 7 million less dollars than in 2020 four. Researchers were told by nih that this year's funding is going to be even less. Researchers at seattle children's hospital are going to have to stop their work investigating how pain medications can be safely used to help some of our sickest children as they face surgery and hospitalization, and this funding was cut because of an arbitrary nonsense rule made by omb director vote that capped spending on contracts.
▶ 1:33:12Sen. Murray: Children from 29 different states are currently enrolled in active trials, including one in the state of washington. Do you know what will happen to all that data and infrastructure that was built to conduct these pediatric trials?
▶ 1:33:26Dr. Bhattacharya: We want to make sure we have the data from those trials.
▶ 1:33:31Sen. Murray: It is hundreds of samples have been wasted. That is what I am being pulled. Blood samples from more than 400 children, and other tissue that was given selflessly. Labs are closed and scientists across the country are really looking at what is being lost here. The worst part is we have kids who are not able to receive evidence-based treatment. I am watching this and I am deeply concerned.
▶ 1:33:58Dr. Bhattacharya: Senator, we have invested in a new pediatric intensive care unit and clinical center at the nih campus so that we can expand our research.
▶ 1:34:10Sen. Murray: I appreciate what you are saying there. I'm telling you I'm seeing the reality on the ground at seattle children's and it is deeply concerning.
▶ 1:34:18Dr. Bhattacharya: We will make sure we can address that.
▶ 1:34:22Sen. Britt: Thank you so much for the commitment to ensuring that life-changing research continues and is seen through to fruition. I know this entire group is responsible for that. You are giving hope and giving people an opportunity to live another day, I want to tell you how grateful I am for that and what an honor it is to stand alongside you. I want to pick up on something we heard earlier from my colleague from hawaii. Dr.
▶ 1:34:52Sen. Britt: Volcow, I appreciate your leadership. When we are looking at different abuses, your research has really been groundbreaking. One of your areas of study is actually gambling addiction. We are seeing that run rampant.
▶ 1:35:17Sen. Britt: You can ask any 15 through 30-year-old about people gambling and the prevalence of that addiction amongst their peers, and you will be startled by what you hear. Can you talk to me a little bit about what we know about gambling disorder and what characteristics make some groups uniquely vulnerable to this addiction?
▶ 1:35:42Dr. Volkow: Thanks very much for that question and I think this is an important issue that deserves attention. To your specific question into who are the highest risk -- it is teenagers. The transition from teenagers to adults. What we are seeing is a significant rise in gambling, whether it is through sports or other means, among young populations.
▶ 1:36:07Dr. Volkow: If we look at it from our understanding, from the biology, we know that the sequence evolved with addictive behaviors with drugs overlaps with behaviors like gambling. We are also very interested into terminating -- determining if interventions we are using for addictive drugs have effects for gambling addiction. That is another area.
▶ 1:36:34Dr. Volkow: I do think it is crucial that we educate the public about interventions that can protect children and adolescents.
▶ 1:36:47Sen. Britt: You are saying younger people. I have found that it seems to be younger men. It is even more prevalent. This bit addictive behavior can occur with any young person. They are susceptible and they get into a pattern that they cannot get out. If they start this earlier, and my right that that prevalence continuing through their life is significant? You just mentioned prevention.
▶ 1:37:16Sen. Britt: Senator blumenthal and I dropped the game act this week. It bans digital marketing to teenagers, to underage individuals. Right now, we are seeing that not be the case. We think that could make a significant difference, if they are not being delivered the marketing.
▶ 1:37:40Dr. Volkow: I agree. That could prevent them from getting exposed.
▶ 1:37:44Sen. Britt: We have to do something. It is the next generation and we continue to hear the stories and see the data. Congress continues to be feckless when it comes to dealing with what is happening with our young people, with social media, with putting up proper guard rails and protecting them from these types of advertisements. The truth is when you look at things like gaming or pornography, when we all grew up, if that is something somebody engaged in, you had to go somewhere, go call a bookie.
▶ 1:38:13Sen. Britt: You had to do these things to make that happen. All of that is now in the palm of her child's hand. They are being delivered advertisements to gamble. They are being delivered pornography daily. The fact that we are doing nothing about it is absurd. I hope that people will take a look at your research and that we will do our job and protect the most vulnerable, which is our children. Thank you so much.
▶ 1:38:42Sen. Britt: Please continue to do that research and I look forward to working with you. Dr. bhattacharya, you have been prioritizing early career researchers. I don't have much time. I have one more question. I wanted to ask about early stage investigators and how you are making sure they are able to compete with more well-established investigators to ensure we have the best research and you are creating a pipeline where america continues to dominate. I also wanted to have a quick question about rural health care. We talked about clinical trials.
▶ 1:39:13Sen. Britt: It is important that those occur and it is important that those are accessible to every single individual regardless of their zip code. I would like to know what nih is doing to make that more attainable in places that are sometimes unreached.
▶ 1:39:27Dr. Bhattacharya: On health care investigators, we have a unified funding strategy that allows directors to identify projects at the cutting edge and prioritize them for funding. We're also going to continue the training grants and investments we make, and double down on those, because I completely agree. Our health investigators -- it is vital for the future.
▶ 1:40:00Dr. Bhattacharya: Dr. rutter, would you mind talking about investments in rural health?
▶ 1:40:03Dr. Rutter: Thank you for your question. I would agree with the idea that we are supporting in our clinical science and public works program more early training development programs. We are excited about that. In terms of rural research, senator, I am also from a small western town, in kansas.
▶ 1:40:29Dr. Rutter: With a large clinical and transitional science awards program, we work with the idea of programs, and we work with other hubs and spokes that also award. Through that, we have developed a rural health network. What they do is they are funding rural pilots. They are funding workforce models that they can share across what they are learning and doing. They are solving common barriers that exist to those activities.
▶ 1:41:02Dr. Rutter: In a way, this is a program, even though it is not necessarily in rural environments, it is partnering with those who are and helping to disseminate the research findings for things like digital health and telemedicine more broadly.
▶ 1:41:19Sen. Britt: I would love to continue on that. Thank you.
▶ 1:41:23Sen. Reed: Thank you, madam chairman. We are looking at an ebola outbreak in the and ghana, which w.h.o. Has declared a world emergency.
▶ 1:41:41Sen. Reed: At the same time, you are proposing to eliminate the center at the nih named after congressman tom fogarty, who is iconic to me and rhode islanders. Its mission is to train workers and researchers, particularly in developing countries.
▶ 1:42:03Sen. Reed: That does not seem to make sense when we are seeing an ebola outbreak, and you are taking away one of the means that we try to deal with international problems that could come quickly to the united states. It is more than ironic. I think we are feeling in a major area.
▶ 1:42:24Dr. Bhattacharya: The fogarty center serves an important role that absolutely will continue at nih. We are making foreign collaborations easier and safer. Those are important for research. As far as the ebola response, just this morning, I spoke with the minister of health of the democratic republic of congo. Again, I emphasize the professionalism of the cdc staff working on the ebola outbreak.
▶ 1:42:55Dr. Bhattacharya: We have been collaborating closely with the ministry of both. We have a country office with 30 different professionals, epidemiologists, a host of expertise to address this outbreak. I can assure you, senator, that they are well equipped to help the drc. The drc ebola outbreaks -- cdc has led the way in helping undress each and every one of them.
▶ 1:43:32Sen. Reed: Are any of those congolese officials graduates of the fogarty center? I would request -- I think it would be surprised. Many people in key positions had some experience of the fogarty center. One of my most memorable moments was cosponsoring come up with the chairwoman -- we funded it at $30 million.
▶ 1:43:59Sen. Reed: I would hope that you will continue the funding and get the commitment to do so. We have been trying to do that, both house and senate. Can you commit to the $30 million level of funding at least?
▶ 1:44:17Dr. Bhattacharya: The support for the research that comes from it -- as far as particular funding levels, I am grateful to work with congress and the administration to make sure that those initiatives which are really vital -- I share your commitment to that -- continue, and expand if we possibly can.
▶ 1:44:38Sen. Reed: We are today talking about the budget, but we also have to think about second and third order consequences of what you are proposing. M.I.t. Indicated that the research budget has shrunk by 10%, and there enrollment has shrunk by 20%.
▶ 1:45:04Sen. Reed: With respect to the funding and also claiming the funds by doge and other operations, and the immigration laws which are frankly scary. We are surrendering our leadership on research, and your budget would reinforce that. Do you think about these consequences?
▶ 1:45:27Dr. Bhattacharya: We were grateful last year to receive the funding we received from congress. There are a lot of accusations that we were not going to spend the money that congress had allocated, and we did. We spent the money for the work of my colleagues here and the other directors to identify excellent science and make sure that every dollar you allocate to us goes to improving the health and well-being of people.
▶ 1:45:55Dr. Bhattacharya: We will continue that, absolutely.
▶ 1:45:58Sen. Reed: How do you explain the fact that over senior research university has many people can verify -- Dr., are you saying effects at the harvard medical school on research? If you can speak objectively.
▶ 1:46:16Sen. Reed: Clips with respect to cancer funding, I think it is important to recognize that in 2025, despite what was a turbulent year, the nci gave out more in extramural dollars than we ever had in the past. And in 2026, we will be exceeding the amount we gave to the community in 2025.
▶ 1:46:43Sen. Reed: Are you noticing a decrease in overall research at universities, and a lack of students? Again, we talk about dominating the world health research. Are you doing that in this budget? >> I completely aligned with the priority of the united states biomedical research community maintaining its dominant role. There are several ways to do that.
▶ 1:47:12Sen. Reed: I have not seen any decrease in cancer research over the last year. What I see as an important part of my job is that we maintain our leadership in cancer research.
▶ 1:47:25Sen. Reed: There are indications that our leadership is slipping and the chinese are funding aggressively. This budget is heading us in exactly the wrong direction. Thank you.
▶ 1:47:40Chair Capito: That will end our hearing today. I would like to thank my fellow committee members for a thoughtful conversation, and particularly think the director and your colleagues for joining us today. For any senators who wish to ask additional questions for the record, they are due may 28. The hearing record will remain open until then for members wish to submit additional materials for the record. The subcommittee know will stand in recess. Thank you very much.