Oversight Hearing – National Institutes of Health

Okay, good morning everyone. We'll get started and we'll gavel in officially. Happy Saint Patrick's Day. Today we have the honor to welcome Dr. Bhattacharya, the director of the National Institutes of Health, known as the NIH, to this subcommittee. Dr. Bhattacharya was confirmed as the NIH director almost a year ago, and since that time has been very busy implementing the administration's priorities to advance NIH's mission of conducting basic research and applying these discoveries to the improved human health. Dr. Bhattacharya took the helm of the NIH at a very interesting time, inflection point. NIH-funded research has made the United States the world leader in biomedical scientific research. And over the decades, this research has resulted in breakthrough cures, treatments, and other advancements that have saved or have improved countless American lives. Unfortunately, however, the American public's trust in scientific institutions such as NIH was eroded significantly during the COVID pandemic. Restoring this trust has been a key goal under this administration and under Director Bhattacharya. Part of this is ensuring that Americans see the tangible benefits of the investments the federal government makes in the NIH-supported research, rather than research findings that just sit on a shelf somewhere, never to be seen or utilized. I look forward to hearing more about the NIH efforts to ensure that at the end of the day, NIH-funded research is leading to measurable improvements in Americans' health. Science can be incremental, but in keeping with NIH's distinguished record of biomedical advancements, our research investments must ultimately translate to better health outcomes, such as new treatments, therapies, and cures that improve the overall health. Another part of restoring that trust is establishing trust in the research itself. So it is encouraging that NIH has been exploring ways to encourage the scientific community to validate or replicate scientific findings. In line with this administration's goal of making America healthy again, NIH has also renewed its focus on addressing chronic illnesses that affects Americans. We all know someone affected by heart disease, cancer, diabetes, or Alzheimer's. These diseases are costly for our overall health system, and they take a tremendous toll on individuals as well as their families. Increasing our understanding of these illnesses and advancing these new treatments and preventive medicines and cures will have a profound effect on every American. As stewards of the American tax dollar, we have the responsibility to ensure the NIH funding supports rigorous science that produces meaningful research. In the FY 26 year of appropriations, Congress increased NIH budget by $415 million, including important areas of research such as cancer, diabetes, and Alzheimer's. We look forward to hearing from you, Dr. Bhattacharya, and working with NIH as it implements this funding in accordance with congressional intent. Dr. Bhattacharya, I look forward to continue to work with you personally and how we can, how you can work with us to productively advance our shared priorities that we have in an NIH investments that will lead ultimately to better health outcomes for all Americans. At this point, I'd like to yield to the ranking member, the gentlelady from Connecticut, for her opening remarks. So Congresswoman DeLauro.

Thank you so much, Mr. Chairman, and happy Saint Patrick's Day to everyone. I think I've done my part in green today. I think I wore everything in my closet that was green, so have a...

Love your glasses.

Well, thank you. Right, thank you. Thank you. Thank you. Well, I should have done the hair, you're right. Okay. That's what they said. I marched in the Saint Patrick's Day parade in New Haven, Connecticut, which is unbelievable, thousands and thousands of people. So I want to welcome you, Dr. Bhattacharya, to the first, your first House Appropriations Subcommittee hearing. I know you've testified before the Senate in the past. We appreciate you taking the time to be here and to answer our questions. I'm extraordinarily proud of the work that this committee was able to accomplish earlier this year, when we passed the full Labor, HHS, and Education funding bill for fiscal 2026. We were able to come together on a bipartisan basis. Democrats and Republicans, we forged an agreement that passed with an overwhelming majority in both chambers. In that bill, we provided $48.7 billion for the NIH. That's an increase of $415 million above last, above 2025. That includes $128 million more for cancer research, redoubling our efforts to treat, to prevent, and ultimately cure a class of diseases which claim the lives of over 1,600 Americans every single day, and which nearly took my life as well. As so many of you know here, I am a survivor of ovarian cancer. I was diagnosed at the beginning of my career in Washington, when I was chief of staff to Senator Christopher Dodd. It was a frightening moment, one that put my entire life into doubt. And I am alive today thanks to the grace of God and early detection and the kind of advanced biomedical research that this funding makes possible. Additionally, we were able to secure $100 million increase for research on Alzheimer's disease, Alzheimer's-related dementias, a $15 million increase for ALS research, and an additional $30 million above 2025 for the Office of Research on Women's Health. That is a 40 percent increase in funding. While we in Congress were able to come to an agreement on our priorities, and even include various provisions to strengthen our bills and ensure the money is spent in the manner that we prescribe, there still have been challenges. And over the last year, the Trump administration and Secretary Kennedy terminated hundreds of research grants simply because they related to racial health disparities or gender minorities or vaccine research. The administration seems to view these topics as dirty words and has sought to withdraw their funding, withdraw their funding, not because of the actual impact of the research, but because of their own ideology, their own willingness to score political points. The research, this research which you do is a public good. It must not be manipulated as a political weapon to serve a partisan goal. They fired thousands of NIH personnel, decimating our research capacity, interrupting, stalling, or completely derailing critical research into cures and treatments for deadly diseases. Shaken down universities, freezing billions of dollars in life-saving research, projects with the potential to uncover cures and develop treatments that would benefit millions of Americans in order to extract ideological concessions. In addition, this administration has sought to reshape grantmaking at the NIH by front-loading payment for multi-year research grants. The change in funding resulted in 2,000 fewer grants in 2025. If NIH continues to front-load payment for multi-year awards, the number of new research grants in 2026 and 2027 will continue to be thousands below historical levels, despite the increase of $415 million in the 2026 Labor-HHS bill. The drop in new research grants dramatically reduces the success rate for research who apply for NIH grants. Across the NIH, the success rate fell from 18.5 percent in 2024 to 13 percent in 2025, a drop of 5.5 percentage points or 30 percent in 2025. At the National Cancer Institute, less than 10 percent of research grants applications were funded in 2025. This research environment will force young scientists to abandon careers in research or move abroad to continue their important work. We can't allow those great minds to go elsewhere. We need those minds and their work to be done here and to deal with the discovery to cure. In my own district in Connecticut, Yale University has 8 percent fewer students pursuing postdoctoral research. This is a reflection both of the shrinking number of students choosing this line of work and will only be compounded in the future by the university's decision to admit fewer graduate students. It's a vicious circle that we are all the worse off for. Even as this administration has chosen to overhaul its grantmaking progress, they have pushed out more than a dozen NIH institute and center, IC, directors. The very people who are responsible for implementing these changes, removing qualified career officials and replacing them with quote acting directors. As we sit here today, there are 16 acting directors, meaning that more than half of the institutes are led by an acting director, and the combined annual budget of those institutes is nearly $24 billion. This is one more example of the chaos and disarray that comes from the Trump administration and from Secretary Kennedy. It does not inspire confidence that HHS is working on behalf of the American people. And lastly, NIH grant funding for fiscal year 2026 has dwindled to a trickle. NIH awards for this point in the fiscal year at a historic low. I have heard from researchers across the country that over the last six months, there has been a marked slowdown in awards going out. The pace has diminished substantially, and many researchers are left to wonder how they can plan for the future. Now, I understand that OMB finally approved NIH's apportionments last night. Yes, that is good news. I find it disconcerting that it took a congressional oversight hearing to prompt OMB to do what it should have done weeks ago. We are nearly halfway through the fiscal year and NIH's grantmaking is well behind schedule. I'm asking you here today, Dr. Bhattacharya, to commit to accelerating that pace. I know where your heart is on grantmaking at the NIH. You are a researcher, you are a scientist, you understand the value here, to reassure this committee that NIH grants will be awarded on scientific merit and not political ideology. And now, Dr. Bhattacharya, I recognize you are here today in your role as director of the NIH. But you're also director of the CDC. And I will be honest, I don't believe it's possible to do both of the jobs at the same time. NIH and CDC are too important for part-time leadership. CDC is essential to the health of our communities, childhood immunization, food safety, chronic disease prevention. CDC experts work with state and local officials to make our country healthier and safer. CDC has been hollowed out by Secretary Kennedy. He fired the last CDC director because she refused to rubber-stamp his ideological anti-vaccine agenda. And he placed hundreds of CDC personnel on administrative leave, including staff who work on tobacco prevention activities, as well as staff who lead public health programs for individuals with disabilities. I would just say with regard to vaccines, that I applaud the ruling by the court yesterday, and that we and that there is no authority to do what has been done and that we can turn it around. I do not doubt your work ethic. I do not doubt all that you believe in. You are working overtime every single day. But I think you know as we do that the CDC needs a permanent director whose sole priority is to restore the agency to being part of the crown jewels of research and medicine in this nation. And that's the NIH, and it's the CDC, and it is the FDA. And it's about public health in this country. And I thank you for what you do for public health in this country, your work now, but your past work as a scientist and researcher. We'll have questions as we get into the hearing, but thank you for being here today and thank you, Mr. Chairman, for convening this panel.

Thank you, Madam Ranking Member. Dr. Bhattacharya, we look forward to your testimony.

Well, thank you, Chairman Aderholt, Ranking Member DeLauro, members of the subcommittee. I've had the chance to meet with most of you. If I haven't, I'd love to let's get together. I want to thank you all for your continued support for biomedical research. The NIH's mission is straightforward. It's to turn scientific discovery into better health outcomes for the American people. Over the past year, the NIH has capitalized on past investments and discoveries leading to concrete advances for human health. And I thought I'd just spend a couple minutes talking about some of those big advances. In 2019, President Trump announced the Ending the HIV Epidemic initiative, where he predicted that we could essentially eliminate HIV from this country by 2030. I confess as a professor outside, I was skeptical about the timeline because I've been hearing promises for ending the HIV epidemic for 40 years. But what I found over the last year or two is that decades of HIV investments in basic sciences laid the groundwork for developing lenacapavir, a long-acting antiretroviral agent, a new one. A single injection of lenacapavir lasts six to 12 months and offers near total protection against getting HIV, even if you're exposed. With that plus the whole host of other widely used antiretroviral agents, we now have a real pathway to eradicating HIV from this country. Last year, 40,000 people got HIV. By 2030, that number should be zero. And we are it's the result of NIH-funded research and that's something I'm working on with across HHS to make that a reality. Gene-based therapies have never, second, let me go second example, gene-based therapies have never shown more promise than they do now. CRISPR-based gene editing has led to not just one but two treatments for sickle cell disease, a painful condition that's burdened families for generations, especially African American kids. NIH-funded researchers built upon this same gene editing technology to deliver a personalized treatment to a child with a rare previously fatal disease. You might have heard about Baby KJ. He has a disease that normally would have led to his death. And instead, he has the promise of a long healthy life thanks to NIH-funded research. This treatment was catalyzed by the NIH Common Fund's Somatic Cell Genome Editing program, and it was administered through an IV, edited the genes in Baby KJ's own liver to correct a lethal mutation. Technologies recently considered science fiction are leading to incredible advances. NIH-supported investigators developed computer systems that can convert electrical signals in the brain to audible speech in real time, providing real hope for stroke patients. Other groups have developed tiny electrodes implanted in the spinal cord following an injury to both restore movement and touch. In ophthalmology, digital models of retinal cells now allow researchers to test therapies to simulate age-related macular degeneration and to model conditions before vision is irretrievably lost. We have real hope for patients as a result of these investments. While novel cutting-edge research is exciting, the treatments are often costly for patients. One lever the NIH can use to develop more cost-effective treatments is drug repurposing. With existing FDA-approved medications found to have new therapeutic use, development timelines shorten and costs are reduced. That's the NIH way to address the drug price problem in the United States. Recent NIH-supported research suggests that a shingles vaccine, Zostavax, that I suspect many of you have already had, I had, is associated with a reduced incidence of dementia. Even a 20 percent reduction in the incidence of dementia can result in hundreds of billions of dollars of savings for this country. So you not only save patients, you also save the fiscal future of the country. Another example is terazosin, a long-standing treatment for benign prostatic hyperplasia with emerging evidence suggesting that it has a therapeutic potential for Parkinson's disease. By building on existing therapies, applying gold standard science, research can accelerate patient benefits while using resources efficiently. And these are just a few of the examples of what can happen with sustained NIH investments in basic and clinical science. While the promise of the NIH is strong, we must reflect upon policies and evolve with changing technology. And reform is already underway. A new office within the director will support rigorous analysis of the NIH portfolio to strengthen performance management, accountability, and promote reproducibility of our research because as Chairman Aderholt you said, it's vital that the research that we do is reproducible, that independent teams looking at the same result find the same answer. In concrete terms, I expect these efforts will lead to more value for every taxpayer dollar that the NIH is entrusted with. Another example is new human-based models and emerging technology that will improve the translatability of research into human health and responsibly reduce animal research where scientifically appropriate. One of my primary goals is to modernize how the NIH funds science to drive innovation. Under my leadership, the NIH has implemented a unified funding strategy to empower institute and center directors to make clearer, more consistent award decisions across our extramural funding portfolio. So many of my colleagues at the NIH, including in every single institute, have embraced this because it's empowered them to make scientific decisions to make the portfolio advance health for the American people rather than just produce papers that sit on the shelf. The new way of operating will reduce variability in funding practices and ensure that research investments are aligned with NIH-wide priorities and scientific opportunity meeting the urgent health needs of the country. We'll also develop strategies for greater geographic distribution of funding, which I hope to have a chance to talk about some of these ideas. I think I've talked with many of you already about them and I want to I'd love to work with you all to make them a reality because it's important for scientific the scientific vigor of the country. The strength of American biomedical research lies in its rigor, its openness, its ability to deliver research results that endure. The NIH's responsibility is to ensure that federal investments in biomedical research produce reliable knowledge, measurable health gains, and lasting public benefits. I and we at the NIH remain committed to scientific excellence and careful stewardship of the resources entrusted to us. Thank you all and I appreciate and looking forward to your questions.

Thank you, Dr. Bhattacharya. I'll begin. In January of this year, I was very personally pleased to see that NIH announced its new policy to end the funding of human fetal tissue from elective abortions in NIH-supported research. Instead, NIH will be shifting to supporting other promising research models. Can you talk about the potential of some of these cutting-edge research platforms that have been developing, such as the tissue chips and the computational models and helping us effectively model research about human disease?

Chairman Aderholt, that it's been so I should say when we made that decision to end fetal tissue research, we did a study of how many researchers were actually using the technology. And what we found is that it was actually declining very sharply. And the reason is exactly as you said, the availability of alternatives. The new organoid technology is absolutely it frankly it looks like science fiction to me. I went into a lab where they'd made a heart organoid that beats on its own. There was just a story about I don't know if any of you played the video game Doom. You probably haven't played the video game Doom. I used to play it. They made a brain organoid that can play the video game Doom. I played it a I confess I played it a long time ago, but I have not had I honestly I want to go beat the beat the beat the see if I could beat the organoid, but I'm old now, probably wouldn't be able to beat it anymore. But yeah, the point is that we have tremendous advances in biological technologies that can replace some of the older technology that were so ethically controversial. Instead of having a science that divides, we now have a science that unifies and also produces better outcomes for scientific advance and for the American people.

Good. Well, that's good to hear. Well, thanks for doing that. And you've commented before about how concentrated NIH research how it is and its a large share goes to relatively small group of research institutions. And of course, it's critical that we continue funding those researches that are meritorious. But we know that there are brilliant minds across the country at numerous research institutions. Can you talk a little bit about barriers in the existing system that prevent them from successfully competing for NIH funding and what opportunities you believe there are to expand access to NIH funding for those with proposals to conduct high-quality research?

The key issue is about half about a third of our portfolio of extramural research goes to about 20 institutions. Amazing institutions, including the institution I used to teach at. But the problem is that there are so many great scientists across the country with great ideas that have frankly less of a chance of getting their research funded. I've now been across the country. I've been to Oklahoma, I've been to Alabama, I've been to I've been to Iowa, I've been to Wisconsin, to Arizona. I've seen the promise of biomedical research across the country. And the reason this happens is the way that we support facilities facilities in this country. Right, so in order to get facility support, you know the indirect costs, you have to have great researchers at your institution that can win the grants. Then you get the facility support. But you can see the problem because in order to attract great researchers to your facility, you have to have great facilities. It's a catch-22 that guarantees that we're going to underinvest in research across the country. I can tell you from all of these these talks I've given across across the country in all these institutions, we have a country that is just poised to make the leap into the into the 21st century to stay the leading biomedical research community in the country research country in the world. But we have to make investments in those in those places in those places outside of the top 20. And just I'll tell you just a few like the the Parkinson's treatment I talked about, I found from a visit to Iowa. There's a researcher there that's been focused on using a existing cheap drug for that used for prostatic hyperplasia that potentially can prevent Parkinson's disease. Ideas that are just will fundamentally transform medicine. We need more than just a couple of biohubs in this country where all the all the activity happens. We need it across the country.

Very good. Well, I commend you for doing that and thanks for your work on that and paying attention to others across the country. In your testimony and in public comments, you've talked about the need to rebuild America's public confidence in public health and our scientific institutions, including NIH. I would argue that this is critical to maintain a broad lasting support for invaluable research supported by NIH. Can you elaborate a little bit about a little bit more about any of the agency's recent efforts to restore trust in NIH mission and the scientific research it conducts and supports through other institutions?

I think you mentioned a couple of things that I think really are directly online with this. First we why the that we have focused on reproducibility. Like to make sure that people everyone including scientists, doctors, clinicians understand that the the science we do actually is valid, that independent teams looking at it will find the same answer. But ultimately what will restore trust is if we deliver research results that translate over to better health for people. Because I saw during the pandemic the trust in science dropped, trust in public health dropped. It's because there was a sense that the science wasn't working for people. That was really the fundamental problem. The long-run solution is to restore trust is to deliver better treatments, better cures, better ways to prevent disease, to solve the chronic disease crisis. And and that to me is the main focus that I have at the NIH and also at the CDC while I've still acting director.

Thank you. Ranking Member DeLauro.

Thank you very, very much, Mr. Chairman, and thank you for your testimony, Doctor. I just would say in terms of building confidence and trust in the NIH, in your remarks you talked about HIV and where we are. We are on the cusp of eradicating. That is because of NIH and funded research. mRNA, the work that and the funding that we put in all of those years back allowed us to be able to move rapidly and quickly to deal with the pandemic. Immunotherapy, sickle cell, and you've probably got more to add to the list. That is trust, and the American people need to understand what you do and the remarkable, remarkable discoveries and cures you have that are there. They're there now. And that we shouldn't allow a view that we can't trust the NIH to prevail when the NIH is really saving lives and dealing with the therapies that are in front of us and being used to save to save lives. Let me just I did get the Shingrix shot. My arm was in desperate shape after after that, but but it's worth doing, guys. You know, I've heard from research institutions, as I said, about competitive grants as a trickle coming down. So you're a scientist. You have received NIH grant funding throughout your career. You know as well as anyone that researchers need confidence that funding is going to be there. Now that OMB has finally approved NIH's apportionments, can you commit to this committee that NIH is going to accelerate its grant making, and how long will it take for NIH to return to its normal level of grant making?

So we did this last year. The colleagues that I have at the NIH that that accomplished really a remarkable task of getting even despite all the disruptions, getting grants out the door, spending the entire allocation of the fiscal year 2025 money.

You did that.

That team has is is the world's best. I've been just honored to to work with them. And I as in direct answer to your question, yes, we will spend the allocation on excellent science this year. And scientists that are listening, don't pay attention to the hype. We are in the process of of identifying the excellent projects. The the grants are are already going out the door. I just got a an email from the the new NCI director, National Cancer Institute director, saying that they're they're actually on that they are that they are accelerating their grant approvals and that scientists need not worry. We will get the grants out the door this year.

Yes. Thank you. Thank you for that guarantee. Let me also have ask a question about CDC and staffing, if you will. And you heard my opening statement about the Secretary potentially hollowing out the CDC. Susan Monarez gone because she refused to rubber stamp an anti-vaccine agenda. What are you going to do to return CDC experts from administrative leave? What actions can you take to retain CDC staff so that the recently enacted 2026 appropriation can be implemented again according to congressional intent and that CDC does not become just a grant making agency?

So Congresswoman DeLauro, I've taken very seriously this this second hat that that the President asked me to take as acting director of CDC. I've spent a lot of time the last several weeks since I've been appointed in Atlanta trying to assess what's working well at CDC, what what isn't working well, including including revisiting potentially the hiring plan that that's there at the CDC to address some of the some of the gaps I think you're you're worried about. What I've found is that there's a tremendous amount of professionals at the CDC that care deeply about public health. I've sent this message to the CDC that I'm open to working with them. I was, you know, I was frankly very critical of the CDC as during during the COVID pandemic. And yet what I've found was that there was a real openness to discuss things where there are disagreements within public health. Again, a real sense of professionalism there. I have in the last several weeks, I started out in despair having to wear two hats, and you're right, we shouldn't have the same person wear for for all that long. But I've come out of it with an increased sense of hope. A concrete sort of signpost of this is the way that the CDC has responded to the measles outbreak in in South Carolina. Right? So I I gave a message to the folks in in South Carolina that it's really important to get their kids vaccinated for the measles vaccine. I've seen the the folks in South Carolina welcome CDC aid and support for an Epi-Aid that there, and it's been it's just been heartening to watch how the CDC when it's acting operating at full capacity can work. And so I'm committed to making sure that whoever the next director is has a CDC that's working well.

I have a quick question. I've got well, I don't have time, but I'm going to ask it. Dr. Bhattacharya, can you assure this committee that the decisions about how NIH research funding and awarding that funding will be based on scientific merit?

Only that alone. Scientific merit and the the potential to actually improve the health and well-being of the American people.

Thank you, and I yield back. Thank you, Mr. Chairman.

Dr. Harris.

Thanks very much. Good to see you, Jay. I'm just brief, just make one comment about CDC and vaccines. Look, the bottom line is the COVID epidemic destroyed Americans' acceptance of of vaccines because they were told things as absolute scientific truth that that weren't absolute scientific truth. That's all I can say. So you got to look back at the last group for that, not not the current leadership, but the last leadership, you know, with Anthony Fauci as the as the spokesperson for the NIH saying things that demonstrably were not true and sometimes contradicting things he said a few That's where it came from. Let me go to the NIH and, you know, one topic I've been talking about for 10 years and, you know, I was at Hopkins, you're at Stanford, you're at we're two of the institutions with the highest some of the highest indirect costs and some of the largest endowments. You the, you know, the announcement last year of the 15 percent level, you know, you and I disagree, I think it should be around 30, the median I think is 27 to 28 percent indirect costs. So if the median institution can do it with 27 to 28, everybody should be able to do it with that. And we have to develop, I think we have to develop techniques to get to that. As I've mentioned before, I chair the Agriculture Subcommittee, and the Agricultural Research Service, statutory limit of 30 percent. Obviously, there are plenty of grants, plenty of people, plenty of institutions who want to write a grant that can get 30 percent indirect costs. And as you all point out, the private foundations, including some of the largest ones like the Gates Foundation, for academic institutions, is 10 percent. And yet almost every academic institution loves to get those grants. So we have to solve the indirect costs because as what I've suggested, we should take those savings from those institutions and work with them. They've come visited me, they said, oh, we have some ideas at how we could decrease our Good. I hope they've visited with you. No, they took you to court instead. So, you know, Stanford, which, you know, claims they were going to lose $160 million going to the 15 percent, actually had a $6 billion, yes, with a B, increase in their endowment last year. Their solution to this was not to work with you. It was to go to court. Shame on them. Shame on them for that. Because we have to we could have taken all those dollars and channeled them into young and new young investigator grants, something I've been interested in for years. But we have to find a source for that because we can't just arbitrarily increase the NIH budget. We're at a $2 trillion deficit, $37 trillion debt. We have to get smarter at how we at how we muster our resources. So I hope we can work together, and I hope the institutions will work together so that we don't have to statutorily limit or put a limit on as again, similar to the limit that we have at the Agricultural Research Service. We talk a little about nutrition research because this is very important and and there's new data came out last week from the the Nurses' Health Study II, which showed a 45 percent higher risk of early colon cancer adenomas associated with process ultra with processed foods. That's pretty dramatic. And, you know, we've been scratching our heads saying, well, how come there's so much more early colon cancer that we're seeing, again, demographically, epidemiologically. And here's a study goes, oh, oh, by the way, if you're, you know, in that nurses' study, those are very good longitudinal studies, usually pretty good data, you know, these these are health professionals. They remember things pretty well. It's recall pretty well. 45 percent increase. And it's simple, they said it's sugary drinks, processed snacks, and fast food. Okay, let's have at it because the childhood obesity rate, which is now 20 percent, same list of bad things. What are we doing at the NIH? Because nutrition research, and as some people have said, it should be called the National Institute of Disease, not National Institute of Health, because we haven't done the research to promote health. And one of the ways we can promote health in this country, and thank goodness the USDA has taken a position on this with some the SNAP waivers in many states that actually limit these processed foods. What is the NIH doing to augment the or a plan or strategy for nutrition research to deal with these issues as soon as possible?

So I mean, that's personal to me. Actually, the Governor of of Arkansas when she applied for the SNAP waiver cited a paper I'd published in 2010 that I thought everyone had forgotten. The the what we're doing at the NIH is we have a common fund program on ultra-processed food to investigate nutrition. We have a office of nutrition research that's coordinating our investments across the the NIH. I mean, I think there's excellent science that still needs to be done on nutrition research doesn't have a great track record of reproducibility. But I agree with you entirely, Congressman Harris, the the idea that we should give our kids sugary foods and that I mean, it just doesn't as a parent, you know it doesn't make sense. As a doctor, you know it doesn't make sense. And, you know, I think science has backed that up. And I you know, at the NIH, we're fully committed to make sure that science is as high quality as possible.

Well, thank you very much, and I yield back.

Mr. Hoyer.

Thank you very much, Mr. Chairman, and Doctor, welcome to the committee. I've been on this committee a long time. And there was a time when we took a week or two to hear from NIH. It's my understanding the only person we're going to hear from is you, and therefore difficult to plumb each one of the directorates of which are now headed up by as I understand it by 16 acting directors as opposed to permanent directors. Is that undermining their ability to do their jobs in a way that we the American people would want?

No, sir. I mean, I have now worked closely with every single director at the NIH, including the acting directors, and they're world-class scientists each and every one of them. But I'll say this, I have put in a process to to as as rapidly as possible while still to have a scientist lead the way and identifying the next directors, a process to hire in each of those slots. We're you're going to start seeing people being hired you know, starting actually this month and moving moving forward. The key to me is making sure that that it's really scientific merit and leadership ability that determines who those directors are going to be. And so it's scientists, the institute directors themselves that are leading the charge. We have external groups, we heard from you all about the external groups being involved in in that process. And then the scientists at the Office of the Director and then finally me. The Secretary, of course, is is statutorily the one who appoints it, but the the recommendations I'm going to make are based on scientific leadership and scientific capacity for hiring each of those positions. You'll start to see, I promise, those are hired in. But I do want to say more for the

Those positions, political inclinations will have no part in that selection.

Not not on my not on my not not as far as I'm like the process I put in at all. I mean, for me, those institute directors are they're making their scientific judgment about what the research directions in their field for the country. It's too important to leave to politics.

Thank you, Mr. Secretary. Mr. Secretary, there's been a reduction of 22 percent in the complement of personnel at NIH. What adverse impact has that had on NIH and its abilities to protect the health of the American people?

Well, I'll just say like if you look last year where the the cuts were the biggest, the NIH identified an amazing portfolio of science. We we spent all the entire allocation of funds for 2025. We have a hiring plan to make sure that we are even you know, sort of we have all of the the holes we identified are filled this year and we're working as hard as we can to fill those fill them. I have to say, I it has been amazing to watch my colleagues at the NIH step up in very challenging times to do the work that they're that their mission in life is to do, which is to to identify

Is it your position that the NIH as you found it and have analyzed it was 22 percent overpopulated in terms of personnel?

I mean, I'd never been NIH director before last year, so it's it's been a learning experience for me. But I'll say I have found professionalism across the NIH to address this. The hiring plan that we have, I think whatever turbulence we had last year is designed to fill that so that we don't have the turbulence in the future.

Well, I agree with that. Thank you very much for trying to eliminate those catastrophic actions that happen in the federal government. NCI had a total of three opportunities this posted three opportunities this year, down 96 percent from the previous average. It has funded two grants so far, $2.6 million out of the $7.352 billion that this committee set aside for NCI research grants. What impact is that going to have?

Well, Congressman, I have to say that I talked with the NCI director just this morning, asking specifically because I'd heard about that, of course. And what he told me is that that first that that report is lagging. It's not true. Right now, there's I think he said there's 22 new grants that are out the door, 150 grants that are about to be out the door, a full portfolio of 1,100 continuing grants that are again about to be out the door. That he assured me that we are on track to spend all of the NCI budget. And that he expects that the success rate this year will be at least 10 percent on grants. It's unfortunate we can only fund...

My time is very limited. I apologize for that. The success rate. What is the average payline for the institutes at this point in time?

I mean, we fund roughly about 10 percent, eight to 10 percent of the grants that we receive.

When I was first on the committee, Doctor, it was somewhere in the neighborhood of 25 to 35 percent. And all the scientists that testified before our committee indicated that that was about the right pay level for good science, which you referred to in your...

But Congressman, can I say like the last year before I got in, actually the previous year, there were people that were putting in 60 grants, grant applications. The denominator...

I'm talking about the payline across all of the...

No, so what I'm saying, like the total number of applications includes a lot of like AI-generated content. We've taken action to try to address that. The paylines are of course a numerator and a denominator. So I think the 35 percent was in a different era for what the denominator looked like. It's it's a little harder now to say the payline determines exactly if we've got all the opportunities. I mean, are you what you're suggesting and it's true, that there's a lot of great ideas that that don't get funded. But it's not because by looking at the payline you determine that. It's by looking at grant application by grant application, doing the scientific review, which is what the what the professional staff of the NIH does.

My time is expired. Thank you, Doctor.

Thank you.

Mr. Moolenaar.

Thank you, Mr. Chairman. Doctor Bhattacharya, thank you for being with us this morning and I appreciated your comments about the scientific research leading to better health outcomes for the American people. And one thing I wanted to bring to your attention and that in 2023, dozens of patients across seven states contracted tuberculosis from infected cadaver bone grafts. And a constituent and a sister of one of my own staff members, Shandra Isenga, passed away as a result. And at the funeral, the family asked me to be sure this never happened again and that their family member's death wouldn't be in vain. And what I'm asking is, could the NIH research TB testing for cadavers? It appears that there's not a good test available and so when someone gets a bone graft, it could be contaminated with TB and it could be a dental treatment, it could be a back surgery in this case. And I don't think the American people are aware of this vulnerability and it appears there's not a good test.

Congressman, thank you for bringing that attention to my attention in our conversation yesterday. So first, we have a we have a great set of researchers who do work on TB. It's and I would love to offer to the the constituent that you have to to come talk with with us so that that they understand what the what the problem is. There are a lot of actually potentially viable tests that could be used, I think, again funded by NIH research to validate them. I'd be very, very happy to work with you to like make sure that we we do that. I just broadly, I think for it's really important that that NIAID, the National Institute of Allergy and Infectious Disease, work on diseases that the people actually have, that pose threats to Americans. And you're absolutely right that TB is not gone. It it still poses threats to Americans that and we're working very hard on you know antimicrobes, you know antimicrobial agents to address TB that that avoid the resistance problems. There's a whole host of suites of investments we've made. Delighted to work with you and your staff to to get these folks together.

Thank you very much. I appreciate that. Now just to shift gears a little bit. What has the NIH done to stop Chinese Communist Party-linked or the People's Liberation Army, the Chinese military-linked entities from benefiting from taxpayer-funded biomedical research?

So when I joined the NIH, I found a GAO report concerned very much about exactly this, that the NIH investments for foreign collaboration didn't have sufficient oversight. So we've implemented a system where that foreign where where foreign collaboration, not with countries of concern, but with other with other countries can still happen, but where the NIH has much more direct oversight and auditing responsibilities over the foreign entity. So if you're working with a UK researcher, that wherever the UK researcher is, their their institution has to have some we have to be have the capacity to work to like audit that institution. That's a new system that was a lot of brouhaha over at the beginning, but now we can have a much more secure foreign collaboration than we had before. As far as countries of concern, I don't think we should be funding research collaborations with countries of concern at all. And working with OSTP, you know at the at the White House to like make a make a formal policy. But the NIH we've we've reduced those investments substantially because I think if you can't trust and you can't do the auditing kind that that we are that we are able to do with domestic institutions, you shouldn't be funding those institutions at all, especially countries that are not particularly friendly to the United States.

Do you think that universities and research institutions should have to certify that they've in some way screened for ties to the PRC military or sanctioned entities before getting NIH funding?

I think that universities should have much stronger policies, absolutely. Whether certification exactly is the right way or or I'm happy to work with Congress and and the administration is really quite focused on this, as am I. So it's I think we're still working a process so that we can the I mean the the tradeoff is we want research to continue. We don't we don't want burdensome regulations to stop research. But we have to make sure that we don't fund research that's buttressing the capacities of our enemies.

And one of the other areas I wanted to ask you is the supply chains for our medicines. It seems that a lot of the medicines now have APIs from China, the starting materials from China and India. And there's a certain vulnerability there. And I know that China is also focusing a lot on their biomedical research and they're enhancing their capabilities. What can we do to stem this tide to make sure we aren't dependent on other countries as well as we continue to be the leader in biomedical research?

Well, the administration at large, this is a major, major focus to make sure that that American manufacturing in the for all those elements of the of the supply chain exist in the United States. What the NIH can do is we can support research to reduce the the technical cost of production of some of these elements. I'll give you one example. The cell-based therapies, including one that I talked about earlier for Baby KJ, a lot of that manufacturing happens in China. Right? So you have a cell that's taken out of a patient, that's shipped to China, the gene editing happens in China and then shipped back to the US. And Lord knows what the what the what the sort of like intellectual property protections are there. We're investing in research for reducing the manufacturing costs so that it's possible to do it in the United States and be competitive for this these cell therapies. The NIH's role in this is to invest in research to make that possible.

Thank you very much. And Mr. Chairman, I yield back.

Mr. Pocan.

Thank you very much, Mr. Chairman. And thank you, Doctor, for being with us. I just want to echo what Mr. Hoyer said when we had a event recently met a bunch of the institute heads. It was very interesting. They're all so excited about the research they're doing and have them come before the committee or some other venue would be awesome, I think, to do that. Thank you so much for coming to my office and coming by previously. I'm glad you're in the position you're at and I like you. If you need me to rescind those remarks, I will. But I mean them. I want you to know that. Because I think you're doing a very good job. And NIH is really important in my district with a big University of Wisconsin-Madison, a world-class research university. I want to share something this morning. I had a meeting, wasn't really related to NIH, and someone mentioned that their grandchild, seven years old, has a rare unidentified disease. They went to Madison, they went to the Philadelphia Children's Hospital and the NIH even had them come by. So I just want you to know, I'm getting feedback that wasn't even intended to be there about what the NIH is doing. So thank you for that. I ask this of every NIH director and if you don't have the answer, get back to me. But was there a single drug in the last year that was approved that did not have NIH support?

If there is one, it would stun the heck out of me. I mean, NIH research is at the basis of almost every single important biomedical advance in this in this century and much of the last century. You know, can I just talk about cystic fibrosis? There's a there's a treatment for cystic fibrosis now, an effective one. Again, based on NIH-funded research. Again, it looks like a it looks like science fiction to me because when I was a medical student, cystic fibrosis was a death sentence. You'd die in your of of respiratory disease at some point in your 20s. Now they're going to live long lives. We're going to start having to worry about aging cystic fibrosis patients. We turned it into a manageable disease. It's amazing.

No, that's awesome. Is there anything we can do to help you when OMB or DOGE after last week, I couldn't have been more upset watching the DOGE bros' videos online about how stupid how they did everything on cuts. The fact that they take this long, it does affect some folks back home when the money maybe isn't coming as quick or they don't know it's for sure coming. Anything we can do to help you? Some of us are on FSGG. Anything that because I'd rather have you in charge than those two idiots I saw on videos.

I mean, Congressman, I've I'm trying to stay out of politics as much as I possibly can because I I think science is what the NIH should be always about. I you know I think watching over the last year, Congress and and the and the administration, they you know you all together decide what the the investments in the NIH are. My job is to make sure that whatever the process ends up with is spent on good things for the American people.

We'll try to keep getting that message out to us vote. But anything I'd rather have you making these decisions and getting this taken care of. You talked about the really great progress with the new drug on HIV. However, I'm concerned because of shutting down USAID, we're not getting that around the world. And as much as this optimistic goal is to get rid of it by 2030, if we're not getting rid of it worldwide, there's going to be a problem. Is are you concerned at all about, you know what by leaving the World Health Organization, by getting rid of USAID, what does this mean about that 2030 deadline and maybe for our other pandemics as well?

Yeah, so let me just talk about the WHO because I with my CDC hat I've had some some invol- like started to have some involvement and learn about this. A lot of what the WHO does is actually what the CDC does. We have relationships with 60 different countries where we have teams on the ground managing epidemics in different countries. And so really it's the WHO relies on the CDC. I know the State Department, this is not something I've been involved with, I know but that they've been involved in developing more bilateral relationships with other countries. The WHO I think for we can talk get into this, but like I think for many reasons it makes it does it actually is healthy in many ways for the United States to say, look, we're going to build an alternative. Because I think it challenges the WHO to do better. Ultimately, I think the goal is a better world health public health system.

Sure. But to the specific question though, are you concerned though that without having USAID on the ground in these countries, the drugs aren't getting out there? Is 2030 still realistic? I mean, there's something good on the horizon, but not if you don't get it out there.

Yeah, so Congressman, I think first I've at the NIH I've been focused on the US because I think just 40,000 people had got HIV last year. That's too many, right? Which we should be zero.

But are you concerned that if we don't have something around the world that that could delay that timeline?

I think most of the transmission is domestic. It's not imported in the US. I do am concerned of course about HIV transmission outside the US as well. And I think there's been a lot of progress already made. I think my understanding is that that the State Department is still operating some of those programs for USAID. This is not my area. So and I think that there's still a desire to do that to make those countries but to have those countries more able to do this for themselves rather than relying just on the American American expertise. Americans will always help. We are responsible for the investments that led to lenacapavir, for instance. And I know there's lots of drug company that there's a lot of desire for drug by to make these drugs available. So it's hard it's hard to say 2030 for the world, but I think it's feasible in the United States and we should try to try to aim at that.

No, thank you so much. No, thank you so much and I yield back. Thank you.

Thank you so much. Best of luck. Thank you.

Thank you, Mr. Chairman and Ranking Member. And thank you, Dr. Bhattacharya, for being here today and also for your visit to Oklahoma. We had an incredible opportunity to spend the day together and you were able to see what's happening in Oklahoma at the at OU Health as well as the Oklahoma Medical Research Foundation. So thank you and your staff for taking the time to come out and see the great work that's happening. I wanted to first start by asking you about the current status of NIH grant awards. Are there any outgoing bottlenecks that you're seeing and if so, what are we doing to try to address that?

I mean, I I don't see a bottleneck now. I mean, I think we have our funding for the year. You all were very very generous actually with the NIH last year. And my my job is to make sure every single dollar goes out and it will go out by the end of the year on excellent science. A lot of the the concerns just seem like political noise to me. It's not it's not reality. The reality is my colleagues at the NIH, some of them are behind me, they're they're working very hard to make sure they identify excellent research and that we spend every dollar on research that will advance the health of the American people.

Speaking of excellent research, you and I have talked a lot about how those grants are actually given and that we wanted to try to look at funding projects that are not on the East and West Coast but are in the Midwest, in the middle part of the country. And so can you talk a little bit about the changes that you would like to see to grant funding from NIH and how it could impact states like Oklahoma?

Well, I first we want we want we want research funded no matter with good ideas no matter where they are. It's not right to to let great ideas wither on the vine just because they're in Oklahoma rather than in in Boston. Right? I want great ideas funded in Boston, I want great ideas funded in Oklahoma. The system as we currently have it essentially puts a thumb on the scale that hurts places like Oklahoma. Right? In order to get the facilities support to build the facilities, all the investments I saw at Oklahoma, they should be multiplied. But it's hard because you don't it's harder to get the NIH facility support unless you have scientists that win the grants. The facility support is tied to winning the grants. But in order to attract the the excellent scientists, you have to have great facilities. It's a catch-22 that guarantees a concentration of funding. The solution is competition for the facility support separately from the grant project ideas. Essentially introduce competition that would address Congressman Harris's concern about what the right level of of indirect funding should be. And by because you have competition, if Oklahoma can provide an excellent square foot of lab space more inexpensively than some other institution, they should have a leg up in getting it. And then fund the researchers so that and then essentially have like a portal where where institutions compete to get the researchers that have the grants. You would supercharge science around the country. Wherever the ideas are, we'd fund it and the and the facilities would compete for researchers. They'd be like NCAA athletes, you know, where where there'd be competition for scientists. You'd know the name of the scientists that are doing this, not just the name of the the football player not that you should know you should know the names of football players, they're pretty amazing. But but you should also know the name of the scientists as well.

I think we have our own concerns about NIL and the transfer portal, but we can talk about that in another meeting.

Yeah, I probably shouldn't get into sports economics. That's another thing.

Um, let me let me ask, what new initiatives does NIH have to address the greatest health challenges of the nation right now?

Well, I think the the biggest health challenges have to do with the chronic disease crisis. And so type two diabetes, obesity, a whole host of conditions that that Americans are all too familiar with. And so I I some of the research on ultra-processed foods, some of the research on on identifying putting nutrition research on a rigorous reproducible basis, a whole host of research on on like simple questions like a lot of so many Americans are now using GLP-1s. How do you how to use them appropriately? Do you is it is it possible to get off of them without regaining the weight? There's a whole host of nutrition-related questions, metabolic health-related questions I think are at the center of why Americans' life expectancy is flatlined. And we're investing in all of that.

Fantastic. And is there a plan or a timeline in place to begin filling the open director positions at NIH? I know you've been very busy trying to get around the country, visit our states, engage with us, but talk a little bit about the open positions you have currently.

I mean, I've been working really hard at that. So we've had two to four interviews of of so when the interviews reach my level, they've gone through this long process of scientific vetting. Normally that takes years. We've accelerated it. Scientists across the NIH, especially the leaders of the NIH have have identified the best candidates. They reach my level. I'm frankly the bottleneck because I can only interview two to four candidates a week. But we're going to you're going to start to see people appointed this month and you're going to start to see a steady flow of those. So hopefully the next time I come in front of you won't be 16 16 and and I'll tell you like many of the acting directors, I just want to speak up for them. They've done heroic things and they are amazing excellent scientists in their own right. And I and I think they're many of them will have a chance to apply and if they're the best candidate to to remove the acting from their role. I'm taking it very very seriously.

Thank you. And thank you, Mr. Chairman, with that I yield.

Ms. Frankel.

Thank you. Whoops. Get a little closer here. That box helping me. Thank you, Doctor. And I know we had a conversation. I wanted to not to ruin your reputation, you do sound thoughtful. Like a thoughtful scientist. I hope you don't prove me wrong. But a couple things I wanted to go over. We talked about Florida had 75 grants totaling $700 million canceled. It included grants because we have a very older we have an older population. But the grants Alzheimer's, dementia, fall prevention, that those were canceled, some of the vaccine prevention. I'm going to get back to you you gave me a list, just to let you know, I want to get back because I still don't understand why they were canceled. I'm going to go to the next question. That wasn't a question. But what we I understand this. You believe in vaccines. Your what you don't believe in, I guess, is mandates. And I think what you told me was that there were many countries around the world where there's very good vaccine rate, but they're not mandated. And so I did my own little research on that. And here's what I discovered, which is somewhat different than what's going on in this country, which was that vaccines are are free and offered in routine care. They're in given in convenient locations. You have reminder systems, reducing missed opportunities, and it's basically you have a healthcare system where people actually get coverage and can so that is I was just sort your comment on that.

I mean, I think the routine childhood vaccinations are tremendously important for childhood health. The U.S. has, of course, a very different sort of much a little more fragmented healthcare system. I think about half of our kids are on Medicaid. The CDC helps Medicaid systems to have access to the vaccines for for childhood vaccines. To me, the key thing is not I mean, those access problems, of course, are things that we ought to address. But the key reason why we're seeing drop in vaccination uptake by children is because of public trust, drop in public trust in public health. The reason why you see high vaccination rates in places without vaccine mandates outside the U.S. is because public trust in public health is just very very high. That's the thing we have to address in this country. Not and I believe mandates are a kind are counterproductive for that. It just I think you might work in the short run, but in the long run, ultimately, you build groups that say, I don't know why you're forcing me to do this instead of instead of reaching out to people and saying, look, this is good for your this this would be good for your health of your children.

Okay, I think one thing is confusing is that some doctors in high places seem to throw a doubt on actually the vaccines themselves. But let me move to something else. I hope that's something you can work on because I think our system of delivering healthcare is makes it and especially we're going to have going to see more Medicaid cuts, we've lost the Affordable Care Act tax credits. It's going to make it harder and harder. And we have crazy immigration policy that thousands of kids are not going into clinics. So it's making it very hard for kids to get vaccines. There has been a history in this country of underinvestment in women's health research. I'm a little concerned with this anti-DEI craziness and I just want to make sure that this isn't going to result in a loss of research for women's health.

I mean, I don't know how you make America healthy again unless you make American women healthy again. So and I just was at a great event at HHS event essentially reiterating the commitment that that the HHS has to women's health. And I'll tell you personally, it's it's absolutely vital that we that the NIH investments in women's I know you worked on, for instance, representation in trials. NIH is is making sure that every trial has women enrolled in it, prostate cancer aside, but you know, every single trial ought to have is is has women enrolled in it. That's not DEI, that's just how you ask answer basic biological questions to make women healthy. The the focus on on research on menopause, on on research on actually even diseases that are common to men and women, heart disease, right? Often manifest differently in women. NIH research has identified that, identified sort of ways to address that. I mean, I personally am deeply committed to women's health. I have a daughter, I have my wife, and I...

I have one more question. This is a women's problem and it probably a men's problem too. Any research on on sleep? How do people get to sleep?

We have a we have a the the yes, the answer is yes, we have a lot of a lot of research on sleep. I wish I could apply that to my own life, but that's another another matter.

Well, I think the rest of us would like that too. But is there anything promising?

I mean, I think there's there is. So like there's lots of advances in understanding sleep apnea and getting better answers to people about about sleep apnea, for instance. That's a major cause of of poor sleep. There's a whole host of sort of basic biological investments in understanding circadian rhythms, the the the biology underlying sleep disorders, basic science there. Huge amounts of investments across and as well as there's the something called the Brain Initiative at the NINDS that maps the human brain in detail that's again seems like science fiction to me that's going to lead to huge advances in our knowledge about about sleep.

All right, thank you. I yield back.

They are. How could they not be? Mr. Simpson.

Thank you, Mr. Chairman. I apologize for not being here for your opening statement. We've all got hearings going on. I'm chairing the Interior Appropriations Committee where we've got 100 tribes coming in and testifying today and tomorrow and stuff. And so but I stepped out for a few minutes because I did want to come up and talk to you for just a second. I've been a long-time supporter NIH and I always tell people that it's the nation's best kept secret. Over the years I've learned so much about the exciting and groundbreaking research NIH scientists are doing to improve the health and quality of life of all Americans. As you know, and we talked about this when you came into my office and thanks for coming into my office and having a discussion, the Institutional Development Award program and I apologize if you've already gone through this in your testimony or if someone's asked the question, was created to help build research capabilities in states that historically received lower levels of NIH funding and helps ensure that it is not limited to a handful of well-funded institutions on the coasts essentially. And I was excited about your comments on what we're doing to try to make sure that those institutions can build the research capabilities so that they can apply for these grants and spread it out across the country. Do you want to talk about that for just a minute?

Sure. First, the IDeA program is a fantastically important program for making sure that I think it's 23, 24 states get access to NIH money that traditionally it's been more difficult. But compared to the scale of the opportunities in those states, I think it's smaller than it ought to be. The key thing is fundamental structural reform so that we have competition across institutions in different states, essentially introduce a market for those facilities support separately from the grants, and then have the grants fund the researchers and the institutions then compete to bring the researchers to their institution to do the research. Essentially create a much more competition-friendly approach to where the research gets done. I've been across the country, I've talked to researchers in all across the country. There are great scientists everywhere and we just need to make sure we have a mechanism that they have a chance of having NIH support for their research ideas.

Thank you. Across the country and actually improve research by spreading it out across all of our institutions. You might guess that my second question has to do with something called fluoride, having been a dentist for like 23 years. The National Institute of Dental and Craniofacial Research pioneered the use of epidemiology and preventive approaches to demonstrate that dental cavities are an epidemic disease and community water fluoridation is a safe, effective, equitable, and economical way to prevent and reduce tooth decay. In your recent comments on a podcast episode you hosted with the acting director of the NIDCR, you highlighted balancing fluoride's proven caries prevention benefits with emerging data on exposure variability and potential risks. What specific research agenda has NIH established to objectively assess those exposures and which institutes are leading and coordinating that work?

Well, probably not surprise you it's NIDCR that's leading that work. The dentistry institute is a tremendously important part of the NIH. The key policy issue is fluoride is essential for oral health. But too high a level, there's been an NIH-funded meta-analysis that suggests that too high a level exposure can have impacts, neurological impacts and developmental impacts. So the key thing then is making sure the right dose is delivered in the right way. That's the key public health thing. But the NIH's equity in this is identifying what those too high doses are. It's a small part of the country, very, very small fraction of the country, but we want to make sure that that part of the country isn't overexposed, if you will.

And in some parts of the country, we have naturally fluoridated water that is too high.

Yeah. So it's got to be... we've got to reduce the fluoride in their water supply. Exactly. So let's bring the fluoride policy in line with what the data are starting to show. And the NIH's equity in this is not to pass legislation, but to make sure that whatever that we end up deciding is based on excellent science. What are the... what's too high a dose, what impacts are there, how do you mitigate them?

I look forward to working with you. I think you're going to do a great job there. And I agree with the previous speaker. If you can find a way that I could sleep more than two hours at a time, I'm on your side, man, whatever we do. Nice to meet you. I appreciate it very much. I'll do my best. Thank you.

Ms. Watson Coleman.

Thank you, Chairman. And thank you, Mr. Secretary. I appreciate your answers. I appreciated the discussion that we've had. Federal law requires that NIH to increase diversity in biomedical workforce. This includes increasing recruitment of women and other members of disadvantaged communities, underserved communities, for NIH training grants. Do you agree with Congress that diversity in the scientific workforce is essential to your mission?

I mean, I think it is absolutely essential our mission that we do research that improves the health and well-being of minority populations and minority scientists and female scientists are a fundamental part of that.

Thank you. Thank you so much. Do you have any concrete steps that you're employing now that would help to recruit more diverse scientists?

I mean, I think the key thing is empowering early career scientists with great ideas to have access to NIH funds so that they can do their work. A lot of those will happen to be...

Do you all have any kind of a program that's sort of identifying where the underserved are and trying to get them on board? That's really what I'm looking for.

Yeah. I mean, so like for instance, American Indian native communities, I think there's a big demand or desire for the native communities to be included in the research projects themselves. I mean, I think the key thing is we have to address the health needs of the country with the very best ideas wherever they come from.

Right. Thank you, sir. I just have so many questions because you do support healthcare, access to healthcare at every level to every community. And so what I'm concerned about is this whole issue of DEI. What is the NIH's definition of DEI and how exactly does it recognize this when you recognize at the same time that there's a diversity in need of workforce? I believe you would think that there's a diversity in need in clinicals, even though you talk to my colleague here about women. We do recognize, I believe, and you're a scientist, so you know better than I, that certain things don't work for certain different races the way you intended them to, so it's important that minorities of all kinds are included in clinicals and experimentation and things of that nature. So exactly how do you sort of reconcile this, what you believe is scientific and necessary, with this whole issue of DEI and the administration's disrespect for it, devaluing of it?

I mean, I guess that I want to make a distinction, right? So the NIH, if we don't do research that improves the health of minority populations, we're not accomplishing our mission. It is vital. We're not accomplishing our mission. We have to do research that improves the health of minority populations, right? So and I don't think there's anybody that disagrees with that. Research that is not rigorous, not as like overly politicized that doesn't actually have a chance of improving minority health, I don't want to fund it. I just want...

I don't want you to fund it. Because I don't think that that's the issue in folks like me who are concerned about diversity, equity, and inclusion. We're assuming that the entity that's coming before you or any other secretary has the value that the people who are bringing it have been educated and prepared. We don't understand why it's summarily dismissed in when we decide what we're going to award grants to and how do you reconcile that in your field in particular recognizing that diversity is essential to saving lives.

Congresswoman, I think the key thing is to me is I don't want to fund... the line. You want a line between DEI and not DEI. My line is research that has no chance, that's politicized, that has no chance of actually improving human health. I don't want to fund that.

I agree with that. So let me just ask you this question because this is very interesting response. Since you believe that, and I honest to God believe you believe it, how does that put you in good stead with this administration that doesn't understand what you are presenting as an issue of whether or not something is of value, that they are assuming that it isn't of value if it includes diversity, equity, and inclusion? So how does... are you welcome to the White House?

I am welcome. I mean, I've had nothing but... I mean, the President appointed me. I mean, he's not... let me put it this way. Not everybody's a scientist, not everybody understands these kinds of distinctions when it's applied to scientific projects. I've gotten tremendous amount of support and trust within the administration to make this distinction because I actually think science actually unites us. That's really the fundamental thing, right? Everybody wants research that improves everybody's health. We don't want to leave people behind on our in the research, right? So that and I found that on the Republican side, I found that on the Democratic side. It's the one thing that should unite us. A lot of the concern about DEI at the NIH has been over-politicized things that I don't think have a chance of improving health. So I've drawn the line in as best I can in a non-political way. Does the research have a chance of improving the health of people? If yes, then it has a chance of being funded.

I thank you for that because I believe what you're saying and I appreciate it. I also want to say one thing about the whole NIH, the whole HIV issue. I believe that we can eradicate HIV. I think that we're making a big mistake when we say to a country like Zambia, I give you the HIV medicine if you give me access to the minerals. Doctor, I don't think you can eradicate HIV unless we do it worldwide because people travel and they're exposed and don't even know it. So I just need to place that on the record how disgusting that even notion is. But I really appreciate having this time with you today and thank you, Mr. Chairman.

Ms. Dean.

Thank you, Mr. Chairman. I thank you, Chair Aderholt, I thank the Ranking Member DeLauro for convening this timely hearing. And I thank you, Dr. Bhattacharya, for being here today and for your work and for your... I can see many of your able team behind you. To begin, I am excited to see what progress our nation's scientists can make with a strong FY 26 appropriations bill passed earlier this year. That is something we need to do. As you have written in your testimony, one of the things you want to do is to restore trust in science at NIH. I'd like to talk to you specifically about restoring trust in regards to your other role at CDC. What I'm getting at is, unfortunately, OMB still has CDC on a short-term appointment that will expire literally Thursday. Are you working to release CDC's funding so that full activities can be initiated? What are you doing about that?

Yes, I've been at the CDC for about three weeks. So it's I've so it's been an education for me personally. I've gone I've gone down to the CDC in Atlanta a whole bunch of times to meet with CDC staff. As I said, tremendous amount of professionalism. We're working with with with folks to make sure that the CDC's activities are are continue without any interruption. I mean, I personally am committed to to making sure that happens.

I thank you for that. I'm worried about political interference in grant making and the agenda setting and some of the conversation here has touched on this. I want to focus on the role of the administration in NIH's decision-making process. I understand, we understand that OPM is revising performance management criteria to include elements like, quote, adherence to administration priorities, end quote. Job postings for roles at NIH are asking applicants to describe how they would, quote, help advance the president's executive orders and policy priorities. I don't know about you, but I'm pretty sure you swear an oath to the Constitution, not to any one president's executive orders, like the executive orders that came across January 25th of last year that would have shuttered PEPFAR, USAID, and all the rest and did shutter many, many things. Doesn't it worry you that those are becoming hiring criteria?

Well, I think the as far as I'm concerned, what the president has tasked me to do is make sure the United States is the single best country in the world in biomedical research.

I'm asking you about the criteria that people applying are reading. Doesn't that concern you that the chilling effect that that would have, the lawlessness that it would have? They anybody working in this government, we swear to the Constitution, not to any one man.

I mean, I agree with you. I'm not swearing to any man. I'm I'm telling you what the

Can you push back on that kind of language in application?

So so let me just tell you empirically what I've seen. I've seen a lot of great people apply to the NIH for the positions. They're not the the president's priorities are to make sure that and this is what he tasked me with, is to make sure that we have the very best

Literally it says his executive orders. Not just his priorities.

I don't I mean, we're implementing executive orders, but I don't think that that's inconsistent with excellent science. I mean, that's what I

Shuttering of USAID? I wish we could give you a third hat and maybe you'd go into State and you could reopen USAID. Yeah, we have that sleep study that we got to work on also. So I just hope you will push back on that. And I hope you will encourage this administration in this next go round to not only reopen USAID funding but to improve it and to increase it. I find it ironic that we started this conversation today around eradicating HIV here by 2030. Well, this is a global problem. It is not isolated to any single continent and the administration doesn't share your dreams.

I don't know if that's true actually. I mean, I just think that the idea of getting rid of HIV in this country, that's a that's a president the President Trump actually articulated 2019.

And that's America first. I want HIV eradicated around the world and we were well on our way to it. Let me move to something else. Last thing because this involves a dear friend of mine. Parkinson's disease, which I think some illustrates some of the broader disorganization happening across the agency. I have a friend with Parkinson's disease. His father suffered from Parkinson's disease and ultimately died of it. He was diagnosed in the last couple of years and we haven't really improved too many measures around research and cure and treatment of Parkinson's disease. In 20 and it affects 1.2 million Americans and their families. In 2024, Congress passed the National Parkinson's Protection Project. One element of this initiative is the Parkinson's Advisory Council. Its report to Congress was due January the 2nd. We've not received it. I'm particularly troubled by the fact that the Advisory Council hasn't even been announced yet. So, Dr. Bhattacharya, when can Congress expect the report and when will you announce members of the council?

Parkinson's disease is a major priority for the NIH and for me also. I mean, I think as I said earlier about terazosin, there's a whole host of of real opportunity scientific opportunities. I know the report's delayed. We're working on it. It should be sometime in the next couple of months, I think. I mean, I can't promise exact timeline, but it's a priority of mine to make sure that that that's I think that's a CDC report I think you're talking about though, not the NIH, right? So

I believe it is. Maybe maybe you could take a look at that and give us an actual timeline and how about announcing members of the council? When will you do that?

Yeah, we're we're I'm working on so this is one of those things where I just arrived at the CDC three weeks ago. I'm trying to figure out what the backlog is. So that's something I'm focused on.

All right. I pray for your health and your sleep. Thank you very much. I yield back.

Mr. Harder.

Thank you so much, Mr. Chair. And Director Bhattacharya, thank you so much for being here today. The NIH has long been the engine of American biomedical research driving discoveries that have saved millions of lives, affected all of our loved ones and I think what you've heard today is a bipartisan consensus that the work you are doing is incredibly important. I think that there's increasing threats to our dominance in biomedical research as we look internationally. We've seen China really rise in their scientific research over the last couple of years. They're now leading in more highly cited scientific publications than we are. Their leadership share in a lot of really exciting innovative areas is growing. And I think there's an opportunity to improve on some of the NIH processes to try to make sure that groundbreaking transformational research is happening in the United States first. I think about trying to make sure that we are moving beyond some of the constraints of the typical NIH process to do things like use large interdisciplinary teams, use ample funding to to really curate data sets and computational resources that are maybe greater than any one lab would be able to do and give sustained funding over a really long time horizon. I've worked on a bill that we've discussed on this topic called the Launching X-Labs for Breakthrough Science with Congressman Obernolte to do that, trying to give the NIH the ability to give long-term large grants to interdisciplinary teams advancing transformational research. I'd love to get your take on if you think there's a role for that and what we can do to try to make sure we're advancing priorities like this.

Congressman Harder, I mean, I really enjoyed our time to to talk about this because I think those are those kind of innovative ideas in accelerating the NIH's investments in early career researchers, in the the high-risk high-reward science, it's going to take a different way of doing things than we normally do things. And I'm delighted to work with you and your staff and and others who are similarly minded because as I've said to a lot of folks, the the opportunities are incredible. Like there are so many American scientists with great ideas, great training and I also agree with entirely with your characterization of the Chinese challenge, right? The Chinese biomedical research capacities have grown tremendously, in part because of American investments. So working on making sure that the United States remains at the forefront of biomedicine is going to take a lot of like new thinking. You know, I know you're working on X-Labs on on early career researchers. I'm very, very interested to work together on all of those opportunities.

Well, thank you. Appreciate your leadership on that. Another thing that I want to talk about is AI. There's enormous amount of fear on AI in many communities, data centers coming in that folks are concerned about, potential job losses. When you talk to a lot of the labs, sometimes the response you'll get is it's all going to be worth it because we're going to cure cancer. Whatever you think of the costs, I want to focus on how do we cure cancer? How do we actually make sure that we're getting the benefits from this AI revolution to try to make sure that we're harnessing it towards curing Alzheimer's and and cancer and all these other diseases? Talk a little bit about the state of AI research at NIH or using AI to further biomedical research at NIH and specifically whether or not an office coordinating those efforts would be important at NIH and what we can do to help further those coordination attempts.

I mean, if you go if you want to go be inspired and excited, go talk to some NIH scientists about AI. I mean, in every single aspect of the biomedical research process, you're see you're seeing AI investments that are just incredible. Everyone's heard about protein folding and AI, but then there's like gene annotation, drug discovery where you look for drug targets based on using AI predictions that are just accelerate accelerating the process of discovering and testing new drugs at scale. Clinical investments to make sure that, you know, when you go talk to your doctor, they're looking at you and not at the EHR because the AI is like doing the summary, helping the AI's to help radiologists do better better at diagnos at at you know interpreting images. All of these require research investments. Like how do you make sure that the AI is doing as well as you can? And the NIH is making research investments for a while on these on these. You're absolutely right, the coordination of them, that's the that's the hard part. Like we have investments all across the NIH and you can go I mean, I've been I've had this the great fun of going and talking to all these scientists tell me about their their investments. It's really it's like great geeky fun. It makes me want to like have a third hat as a AI scientist, but that's another thing. But

Would an office be helpful or what could be helpful?

I do I do I completely I think an office would be tremendously helpful. Like something to coordinate across. I've been looking at what DOE's doing in Project Genesis. It's inspiring actually. But a lot of that we actually have at the NIH. We just need to make sure that the scientists are talking to each other and that we're we're putting investments in the right place.

What could we do to make it go 10 times faster than it's going today? Knowing that it's already going quickly and there's lots of great efforts. How do we move faster?

I mean, I think working together on on how to get that coordination to work work well across the NIH, get scientists to talk to each other, get access to sort of high high capacity computing. We are again, we make a lot of investments in that already. But making sure that, you know, if a scientist is sitting there with a great idea, they have access to a computer a supercomputer so that they they don't have to like wait. I think that the things like that would be really really supercharge our investments.

Well, thank you. We'll be making requests for those for that office in the the the appropriations process and look forward to working with you and thank you for the work you do.

Thanks.

Okay, thank you. What we'll do is we're going to go a second round but we're going to limit to one question just so because I know it the hour's getting late. We're going on our second hour now. So I will go ahead and start but we'll just do one question and we'll go on down the line. So Dr. Bhattacharya, I want to ask about situation that I and I think a lot of my colleagues are also concerned about and it's in situations in the past in which Congress has provided increases in one institute for a specific initiative but NIH used only some of that new funding for the initiative and took the rest of the money for from budgets for from the budgets for other initiatives. Two examples of this are was with the implementing of Maternal Health and Pregnancy Outcomes Vision for Everyone, which is called the IMPROVE initiative, and the Undiagnosed Diseases Network under the National Institute of Neurological Disorders and Stroke. Cross-agency cross-agency collaboration is important. But this practice of using multiple institutes' budgets to meet the funding level provided to one institute for a specific activity is not what Congress actually intended. Can you commit to ensuring that NIH in the future carries out funding provided for specific activities based on both the letter and the spirit of the congressional direction?

That absolutely Congressman. But I will do ask a ask of you all also in that. So when there's a great scientific opportunity arising for that collaboration that we can work together to make sure that the whatever the language you have doesn't stop that from to encourage us that happen regardless. So I mean I am absolutely committed to following the directives of Congress because you all get to decide how what we spend. Like you're all elected not me. But but let's work together to make sure that that we don't miss any opportunities.

Yeah. Okay. Thank you for your commitment on that. Ms. DeLauro.

Thank you Mr. Chairman. Dr. Bhattacharya, the concern about the loss of new research 25, 26, 27 due to the decline in in research grants. The loss of young scientists and early stage investigation who see success rates of 13 percent are opportun- you know they're looking at how they change their careers or where they go with this. What's your concern about about that phenomenon? And let me just say this committee added a new general provision to limit the amount of funding that can be obligated through this front-loaded funding mechanism. Do you commit to abiding by the limitation that we've done? But your view as well as the it's real. The loss of young scientists and early stage investigations.

So let me start with the second. So yeah I'm committed to following exactly what you all tell me to do. So you know what whatever that limit is. For just very quickly on early career scientists and on on front-loading grants. Sometimes for early career scientists what you need is a front-loaded grant because they're building their lab and so they they want the they don't they can't wait till year two or three to get the money to build the lab. So it's scientifically justified to have it front-loaded. And I've been focused on when we're when we're front-loading to make sure that with those it has that scientific justification. I share your concern about early career scientists. Like I think I've been watching the data now for 20 years, 30 years. It's been going it's been harder and harder for early career scientists to get their grants funded. It once upon a time in the 1980s you were in your mid-30s when you got your first large R01, large first large grant. And now you're you have to be in your mid-40s. You have to do one, two, three postdocs. And I am thinking like of how to fix that as NIH because the NIH has undertaken lots of activities to try to fix that. It just hasn't worked. There's a few ideas I have and I'd love to talk with you and the rest the rest of the folks on the committee for how to do that. Because it's ultimately a science culture issue. Right? You have people unwilling to take risks on really promising ideas just because it's someone's an early career scientist. We have to change that. We have to say and I've done some things at the NIH already like this unified funding strategy that allows institute directors to say I don't need to make sure that every single grant produces a paper. I don't care if it produces a paper. But the portfolio as a whole has to advance health. And that means that they have to take risk scientific risks, intellectual risks, including on early career scientists in order to fulfill my sort of directive to them to like make a portfolio that can advance health.

I suspect we need to have the resources to do that as well which is what the purpose of this committee.

Yeah. I mean whatever I of course I'm very happy with the resources but the to me even even at whatever the resources are we have to have policies in place, incentives in place to solve this cultural cultural problem that's led to the position where early career scientists feel like they don't have a chance. It's vital to the future of this country that we do that.

Dr. Harris.

Thank you very much. Yeah let me and follow on a little bit along with that because I'm reminded by my staff that back in 2014 when I was on this committee for only a year I wrote an opinion piece in the New York Times called Young Brilliant and Underfunded.

I read that piece.

Well they're still young brilliant and underfunded. I know that's why I was I was younger then. It's 12 years later. So perhaps we need a new way to look at these things and you know again you know I was an NIH funded researcher. I know I know how it goes. So I'm going to particularly ask you you know the Howard Hughes research totally different. You fund the researcher. You don't fund the project. And in a rapidly advancing technology age that makes a lot of sense because the you know you'd spend months writing a grant and then it goes through review process might take a couple by then technology is totally different. So it what has there been any thought to go along that line to say look we're going to fund the researcher because and if you identify and I know I had them when when I was doing work you kind of know who the really smart young people are who if you just gave them a leash long enough and funded them they were going to they had the potential to be a Nobel Prize winner at some point. Are we stuck in this like you say you know average R01 age is 44 now. You know that's just to remind people that's the average age at which someone makes a Nobel Prize research discovery. We're not even funding them until that until that age. You got to start earlier if they're going to peak at age 44 and again and I've talked about this you know I'm a little older than 44. I don't have the these young younger folks have brilliant ideas. They don't have the blinders on you get and you know you've done research. You get blinders after a while like this is the way we're going to solve this problem and then a 25-year-old you know and next guy's name could be Steve Jobs comes along and says no no no there's a different way. And the NIH bureaucracy doesn't recognize that right now. So how do you get around it? Is it a method of funding a researcher instead of a institute and things like that?

I mean I think that's a really good idea. We have some mechanisms like that at the NIH like this MIRA MIRA grant. And I've talked to folks at Howard Hughes. Having that that idea where you fund an early career scientist and give them a like a open warrant to like follow their ideas. But then the flip side of that is if they didn't it didn't work out at the end of the five, seven years or whatever you then you have to go on to the next person. I'm looking at how we might be able to do more of that. The intramural program at the NIH has the capacity to do that and to some degree already does does that. The broader problem really is and I think the solution I'm sorry the broader solution to this problem is that we have to have a culture where intellectually risky projects are people feel like they can fund them. Can take a flyer on them because it tends as you say Congressman Harris the it's early career scientists that tend to have those challenging new ideas that don't look like they're going to work but my god if they do you cure type 2 diabetes. Right? And so I think if we start ident- giving the institutes a warrant and this is something I've done with this unified funding strategy a warrant to identify and fund high-risk high-reward ideas just as a matter of natural course we'll automatically get the early career scientists invested and and supported. Happy to work with you on on any of that. I remember reading that 2014 op-ed because I was I've written on science as science. I thought I was really delighted that there's folks in Congress that were focused on the issue. Now I see lots lots of folks are.

Well thank you.

Mr. Pocan.

Thank you Mr. Chair. Director Bhattacharya, I'm going to be the third person then to talk about young researchers because this is a big issue and certainly with university. We had a UW sophomore come to talk to my staff about the importance of biomedical education support for the NIH. And they said that they're considering changing their major because quote the STEM field is just not a stable career path right now. We also have a friend who does brain research gets NIH grants. She's thinking about getting out of the field completely. And this is all directed at what happened last year. I got my record number of calls 500 a day when DOJ and OMB were just stealing funds that Congress had approved. Wasn't NIH's fault but they were stealing funds and people have this opinion. So what can we do about the policy instability and funding uncertainty that's driving so many of these young researchers to reconsider a path in what they're doing?

Well I mean I've been going around the country again and everywhere I've gone I've told people and especially I've been talking to young researchers that this the United States is still and will remain into the 21st century the single best place to do biomedical research in the world. I think 85 percent of all public funding for biomedical research if you include all of the other countries and all the foundations is NIH funding. So if you want to try your ideas out your early career researcher and you have amazing ideas this country is still the single best place of to have any chance to try it out. And for folks and for young researchers who are listening there's no policy instability that's going to affect your career. You can hear in all the members of Congress you heard today a real commitment to make sure that we remain the leading nation in the world in biomedicine and for early career researchers you're going to have much more opportunities than you than you have had in the past.

I hope you can get on the field and talk about this more just because last year we did see funds being stolen and stopped and frozen and it had an impact on those researchers. So it's out there. I mean and that's only a couple stories I'm sharing. I wish you were the face instead of Russ Vought or some DOJ bro because that really has hurt us. But I yield back.

Thank you Chairman. And thank you for indulging a second round of questions. I want to go back to the notion of restoring trust. Trust in our institutions, trust in the things that you are leading. I want to note for the record that just yesterday a federal judge blocked Secretary Kennedy's cutting of a vaccines schedule recommended for every child. That he likely violated federal procedures in reducing vaccines whether it was flu, rotavirus, hepatitis A, hepatitis B, meningitis, RSV. I was glad to see the court's ruling. I assume it will be appealed. But what my constituents want and what I want as a grandmother to seven children is be able to be able to trust in our institutions. Right now we have to tell people go to your pediatrician because we are in such a shake up. So my question for you goes back to where we were talking before. Can you confirm that political ideology is not being used to screen or evaluate new institute and center directors that you are in the process of hiring?

Absolutely I can confirm that. For the NIH hiring process it is science first. So it's scientists at the institutes that are doing the first sort of level of of interviewing along with external groups. It's it's career scientists at the office of director that doing the second level screening and I'm doing the third level of screening. So the people I recommend my personal interview screen is are they scientifically capable? Are they demonstrated real leadership in their in their field and do they have a vision a passion for new ideas in their field? Those are the those are the three criteria I'm using.

And thank you for that commitment. I yield back.

All right before we close let me recognize Ms. DeLauro she wants to make her closing remarks.

Thank you so much Mr. Chairman. Several comments today about lack of confidence in the NIH or CDC. I just want to say very very clearly I have the utmost confidence in the NIH and CDC and I ticked off some of the areas in which you have led the way and then you added to that cystic fibrosis and I've had very close friends who lost two children to cystic fibrosis. So I have confidence in the scientists and the career staff at the NIH and the CDC. I thank you particularly for your commitment to this committee to accelerate the NIH grant making. This committee is going to be vigilant. And if you run into resistance in following the committee's guidance let us know. You need to let us know. This committee will be champions for NIH research but I'm also focused on NIH's new unified funding strategy. And I'm going to be following very closely to ensure that funding is awarded for the highest quality science and we repeated that over and over and over again today and is not awarded based on politics or political ideology. So thank you for your commitment in that effort. We expect the president's budget proposal will be released in about two weeks. My hope is that the president's budget does not repeat its proposal to cut NIH's budget by $19 billion. We've rejected that cut. The Congress did, this committee did. We will continue to reject cuts to NIH research because what you do is life saving. It is that lifeline to Americans and the world people have mentioned. We need more investment in NIH research and that would be you know my commitment and I think that we this committee has demonstrated and historically has demonstrated that. I can go back to John Porter of Illinois who chaired this committee whose goal was to double the funding for the NIH so that you can do that work. We all deal with a lot of things in my case it's you know infrastructure roads, bridges, helicopters, airplane engines but nothing that we do is more important than what you do in terms of saving lives. Thank you. Thank you Mr. Chairman.

Thank you Ms. DeLauro and and I want to thank you Director of coming before us today and I commend your efforts and the Trump administration to address long-standing issues that have been at the National Institute of Health. Limiting the use of animals in research, focus on building the research base across the nation's universities and replicating studies are not controversial and and reforms that are overdue. Bold actions under the Trump administrations are making necessary reforms to grow and to build on biomedical infrastructure. So thank you for your work. I think it's been a very good hearing today. I think your comments were very well received and we look forward to working with you to advance these efforts and moving forward. Thank you very much. We're dismissed.

Thank you.