Proposed FY 2027 Budget Estimates for National Institutes of Health

Well, uh, good morning, and I wanna welcome everyone to our hearing. I'm going to give an abbreviated statement and I will, uh, be, uh, adding more and, uh, into the record. I wanna thank, uh, Doctor, uh, Bocera and all of the, uh, his colleagues for joining us this morning. This is really an important opportunity, uh, after to look at the NIH budget. from last year uh to see how we can uh understand priorities for twenty twenty seven. I think all of us care a lot about biomedical research. It's long been a bicameral and bipartisan priority. And I'm proud of the work that we did last year where we secured an additional four hundred and fifteen million dollars uh for NIH funding. Um, areas of concern for me and those at the dais know this, uh are things were ground zero for the opioid epidemic uh in West Virginia communities. We still have some of the highest rates of uh overdose deaths. Uh, but we're making positive strides as we are across the country. Some of the CDC uh data shows a decrease. And uh I wanna thank Doctor Volkov for coming to West Virginia, and coming back maybe to West Virginia, um for visiting. We just had Doctor Hodis there as well uh and we're um we're really pleased because of what's uh what's going on at the Rockefeller Neuroscience Institute I think he was pretty wowed at to see what WB is doing in the innovative and groundbreaking work that we're doing there as a child of two parents who had Alzheimer's. Uh, I I don't wanna just find uh ways to keep people uh in a steady state, I wanna find ways to cure, and I think that's what the NIH is all about. So, uh, one area other area of uh interest for me is the Childhood Cancer Star Act. I did that with uh Senator Reid. So, Doctor Letai, thank you for coming to my office and and looking forward to hearing about how you're gonna clinical trials in that area. So with that, I'm gonna go ahead and turn to uh Senator Baldwin uh for her opening statement.

Thank you uh Chair Capito and I wanna welcome uh Doctor Bhattacharya and the Institute and Center Directors here today. Um I also want to note that the Director of the National Institute of Allergy and Infectious Diseases was slated to testify but uh stepped down from his position. Other top officials at NIAID have also reportedly been reassigned and forced out of their positions. In the midst of an emerging Ebola outbreak, we have a leadership vacuum at the world's premier infectious disease institute and across our health agencies. Uh, this is of great concern. And that, of course, is in addition to the unprecedented termination and forcing out of thousands career scientists across the NIH as part of this administration's anti- uh science and frankly anti-vaccine uh bent. Um over the past sixteen months the Trump administration has waged war on science. And I'm not talking about isolated policy disputes or partisan disagreements. I'm talking about systemic uh systematic dismantling of long-standing research programs and the deliberate erosion of research institutions that make America the global leader in biomedical innovation. Across the country, researchers, universities, cancer centers, children's hospitals and patients are experiencing disruptions because this administration has thrown NIH into chaos. They have terminated over five thousand NIH grants, slashed nearly a quarter of NIH uh the NIH workforce and cut the number of new research grants by more than two thousand or twenty-two percent. That cut was largely due to a policy that OMB uh the OMB director cooked up that requires NIH to expand multi-year funding forcing the entire cost of, uh multi-year grant to be paid in advance. This wasn't based on science. or boosting the discovery of new treatments and cures. This was a political decision. And as a result, NIH spent two point five billion dollars more on multi-f- year funded grants in fiscal year twenty- twenty-five than it did the year before, an unprecedented amount. And what that means is that two point five billion dollars was locked away in bank accounts for future years' expenditures that can't be spent on research now or today. That's two point five billion dollars that could have funded over two thousand more research grants, each one a shot we didn't take at discovering the next medical breakthrough. There is simply no reason to do this. All it does is dramatically reduce the number of NIH uh uh grants funded. Take cancer research. Last year, the National Cancer Institute funded three hundred and thirty-four, or twenty-one percent fewer, new research grants. That's three hundred and thirty-four fewer opportunities to discover new cancer treatments and cures. An untold number of patients and families that won't benefit from this research. And this was, uh, the case across the NIH. The National Institutes on Aging, the primary funder of Alzheimer's disease research, funded four hundred and thirty-eight or thirty-three percent fewer grants last year. That's not creating stability for researchers, it's kicking the chair out from under them. I pushed hard to limit multi-year funding in our fiscal year twenty twenty-six bill, and although we included a provision that prevented the administration from de- doing even worse damage, I was disappointed that we weren't able to do more to stop it. This chaos has ramifications across the country. Hiring freezes are hollowing out research labs and forcing institutions to rescind job offers to young scientists. Clinical trials are being canceled or postponed. For decades, NIH funding decisions were guided by scientific expertise in independent peer review, as they should be. Now political appointees and ideological screening decide which grants get funded. Researchers are spending more time trying to decipher shifting political priorities than finding treatments and cures. Ground-breaking research is being stifled. Notices of funding opportunities that NIH uses to solicit research on specific topics are down by ninety percent. These specialized funding calls are necessary for type one diabetes research, expanded access for ALS um and cancer and HIV research. Even after this committee provided four hundred and fifteen million dollars in increased funds for NIH in this fiscal year, the White House delayed getting that money out the door and left NIH unable to fund research for forty days. I can't comprehend why this administration is so hell-bent on sabotaging the lifesaving research NIH supports. But they are doing so at every turn. What concerns me most is that this damage will take years, if not decades, to undo. Because the cost is so much higher than lab closures, cancelled clinical trials, or young investigators leaving science. The cost will be fewer treatments and cures, lost loved ones, and an entire generation of scientists gone. Congress should do more to stop this administration, uh, what they're doing to our biomedical research enterprise. I've certainly been pushing to do that. But Congress also needs to get serious again about running a budget and appropriations process, that truly, uh, allows us to prioritize biomedical research. From twenty seventeen to twenty twenty three, we provided meaningful increases for NIH, and NIH a- awarded more grants each of those years. But that progress has stalled. Republicans' insistence on squeezing and cutting nondefense funding has meant NIH funding hasn't kept up with rising research costs. This combined with misguided administration policies like multi-year funding will mean that NIH will award fewer research grants this year than any year since twenty seventeen meanwhile the president is asking for one point five trillion dollars an increase of four hundred and fifty billion dollars or forty two percent for defense spending if we can find additional funding for bombs we should be able to find additional funding for cancer research We need meaningful increases in non-defense funding to be able to do that, and that's what I will be pushing for during the fiscal year twenty twenty-seven appropriations process so that scientists can discover the next breakthrough, and families can have hope for new treatments and cures.

Thank you. Uh, welcome, Doctor Bhattacharya. We will welcome you for your, uh, five-minute opening statements before we go to questions. Thank you.

Uh, Chair Capito, Ranking Member Baldwin, and distinguished members of the subcommittee, it's an honor to appear before you again to discuss the work that's being done at the National Institutes of Health. NIH's mission is to turn scientific discovery into better health outcomes and longer life for the American people. It's central to the Make America Healthy Again initiative. The NIH plays a leading role in confronting the chronic disease crisis, advancing rigorous nutrition science, prioritizing prevention, and so much more. Chronic disease remains the leading cause of death and disability in the United States, driving most healthcare costs and affecting millions of Americans. NIH's intensifying investment in research that identifies the root cause of these conditions enables earlier more effective interventions, including studies that integrate genetics, behavior, environment, and diet. Diet is a major driver of chronic disease risk, yet critical gaps remain in understanding how specific foods affect health. Ultra-processed foods now account for about sixty percent of daily caloric intake, with growing links with obesity and metabolic conditions. To address this, the NIH is supporting multidisciplinary research, advancing targeted interventions to address chronic disease at its source so we can make America healthy again. The NIH continues to deliver measurable progress by building on decades of foundational science. Our sustained investment in basic research is resulting in formative clinical advances across multiple areas of medicine. In twenty nineteen, President Trump announced the ending the HIV epidemic initiative, predicting that we could essentially eliminate HIV in the United States by twenty thirty. Decades of NIH investments in basic science laid the groundwork for drugs like lenacapavir, a long-acting rent-r- antiretroviral agent. A single injection lasting six to twelve months offers near total protection against HIV acquisition. Together with other antiretrovirals, also supported by NIH research, this provides a credible pathway for ending the HIV transmission in the United States in coming years. 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 that can cure sickle cell anemia, a disease disease long thought, uh, intreatable, untreatable. NIH-funded researchers Built on this same platform to deliver personalized therapy to an infant with a rare and previously failed uh condition, baby KJ. Enabled by the NIH common fund, this treatment um edited genes directly in the liver to correct a lethal mutate mutation so that baby KJ will live a long and healthy life. NIH is harnessing advances in artificial intelligence and data science. For example, NIH supported researchers recently developed AI tools to match patients to clinical trials more efficiently. reducing the barriers to participation and accelerating access to potentially lifesaving therapies. And then I think she's advancing partnerships to expand the frontiers of biomedical science. We're proud to work with NASA on the Artemis-two mission to the Avatar project, which uses cells from astronauts to create organ-on-a-chip biosystems. Uh, I think my colleagues have brought, uh, brought, brought, brought an example if you can show around, um, to show how, uh, uh, to model how deep space radiation and microgravity affect human biology. You may be asking how this helps the average American. Well, microgravity reveals aging-related changes in cardiovascular, immune, and muscular cell systems, and this work informs treatment for chronic diseases here on Earth. While innovation is critical, affordability remains essential. Drug repurposing is a powerful lever to reduce the cost and accelerate access to this new technology. Testing FDA-approved drugs for new indications can happen faster, and with less risk than for new drugs. NIH supported studies suggest a shingles vaccine called Zostavax may reduce dementia risk and my colleagues uh at the national institute of aging are organizing a uh a uh a round table on this uh terazosin long use for benign prosthetic hyperplasia shows potential on Parkinson's disease while more research is needed this approach allows us to deliver interventions more cost-effectively while maintaining scientific rigor improving how science is conducted and funded NIH is advancing a a coordinated agency-wide effort to improve rigor, replication and reproducibility, including the comment fund replication initiative and new investments of approximately one hundred million dollars to validate key findings I'm grateful to Congress for making that possible. These efforts ensure the NIH supported science is reliable, generalizable and ready to inform clinical care. The NIH fosters innovation by supporting a d- a balanced research portfolio. Through a unified funding strategy, the NIH is strengthening its ability to curate portfolios that span the full spectrum of scientific approaches, and align with national priorities. We're working to broaden the geographic scope of funding strengthening research capacity in institutions across the country while expanding the use of human-based research models to improve translatability, responsibly reducing animal use when appropriate. Let me just finish with uh the just just a bit. The the strength of the American Bi- biomedical research lies in its rigor, transparency, and its early stage investigators, its ability to deliver durable results. Our role as careful stewards of resources entrusted to us ensures that every taxpayer dollar produces reliable knowledges produces measurable health gains, and has a lasting public benefit. We remain committed to scientific excellence and to improving the health of all Americans. Thank you and I look forward to your questions.

Thank you very much, and we I will now turn to the chair of the full committee, uh, Senator Collins, for uh several minutes for a statement or questions or whatever she Whatever she can have, whatever she wants.

I like that attitude.

Yeah.

Uh, thank

Just remember I'm the one who said it.

Thank you so much, Madam Chair. Uh, first of all, let me welcome all of you this morning. I have worked so closely with many of the members of this panel and admire your dedication to improving the health of the American people. Uh, there are, however, some budget issues that I find to be inexplicable in some ways, and I do wanna discuss some of those with you today. In fiscal year twenty twenty-five, the NIH awarded more than a hundred and twenty million dollars in grants and contracts to entities in my home state of Maine. This funding directly supported one thousand three hundred seventy-eight jobs and more than two hundred eighty million dollars in economic activity. I mentioned that because there is an economic impact, uh, to the research that we're doing, as well as an impact on the health and well-being of Americans. This funding has also led very exciting developments such as a clinical trial for a new Lyme disease vaccine and another clinical trial investigating how GLP dash one drugs could be used to treat long COVID. Really exciting developments. Breakthroughs like these can only be sustained if research institutions are able to cover this cost. Yet the administration's budget request once again proposes a fifteen percent arbitrary across the board cap for indirect research costs, after Congress specifically blocked a similar proposal last year. Such a cap would negatively negatively affect cutting edge research happening at universities, nonprofits, laboratories, medical centers around the country and undermine the foundation of our nation's global leadership in biomedical research and technological innovation. Doctor, we discussed the fair model and other alternatives last year to have more accountability, increase transparency on indirect costs that are funded with taxpayer dollars. I would like to ask you um whether you have a specific proposal for improving the current indirect cost system without adopting this one size fits all, arbitrary, very harmful cap across the board.

Senator, we absolutely remain committed to making sure that the the research institutions of this country receive the support that they need to uh to to to have the success that you described that the uh i'm really grateful that you started with the examples of a of the potential vaccine for uh lyme disease glp-ones for so many different uses um uh and and so much more i'm sure you you could have gone on for for a very long time um the the the key uh thing that i'd love to have happen and we uh i'm gonna commit uh convene a committee of the of my advisory committee director so that we can discuss this openly and and uh is a proposal to de-link the way to to to to to compete uh to allow competition free and open competition for these facilities money the nih has for for uh uh institutions um the key idea is that right now in order for main and other places to to win the facility support you have to have excellent scientists that win the grants and linked to that is the facilities money But, in order to have people win the grants in the first place, you have to have the you have to attract the the great scientists to your facility, you have to have great facilities. This catch-twenty-two guarantees that our that our uh investments in institutions will be concentrated. Oh, twenty institutions get about a third of our facility support. Um, we need to fix that. And uh uh I'd love to work with you all, and I know we've had such great conversations about this, to de-link this this connection and then allow there to be sort of more open competition for the facilities' money, uh, by places li- like Maine, like Kansas, like I I've met, I visited so many of these, uh, of great institutions a- across the country where there are so many great scientists.

Yes.

We need to make it easier to build up facilities. NIH is like seed money for these places. Uh, once you invest, once we invest, you get other other foundations investing as well. And I wanna, I wanna work with you to to launch a, uh, launch of uh the the essentially a renaissance in biomedical research um uh, across the country, uh where it's it's one which has to have a couple of uh super biomedical hubs, uh but but everywhere across the country where there are amazing scientific ideas, you they people should be able to get support for it.

Thank you. Doctor Rogers, it's great to see you again, although I don't think this hearing will be quite as moving and inspiring as the children's congress uh uh hearing of which you testified last summer, seeing all those delegates with type one diabetes from across the country, including little six year old Caroline from the state of Maine, uh who traveled to share her story, was truly moving. Recent type one diabetes research funded by NIH has led to some exciting developments. And clinical trial data resulting from NIH funding, a clinical eyelid transplantation consortium has contributed to FDA's approval of the first ever stem cell treatment for type one diabetes. And I realize the clinical trials have been small so far, but it is so exciting that after receiving this treatment ten out of twelve patients in clinical trials no longer needed insulin that is extraordinary. Therefore, for the life of me I cannot understand why the budget would propose a hundred and sixty-seven million dollar cut for your institute, the National Institute of Diabetes and Digestive and Kidney Diseases. Um, by contrast, we have increased funding for the special diabetes program. But this is the last point of which we should be cutting funding for biomedical research period but your institute uh given that we're finally seeing real progress. Could you please comment upon this?

Sure. Uh, Senator Collins, first of all, thank you for your ongoing support for the special diabetes program and yours and your colleagues uh this has really led to some major breakthroughs in the way that people uh in this uh country uh with type one diabetes have enjoy long and uh very the quality of life has changed dramatically you mentioned the uh first ever fda approved uh stem cell uh treatment transplantation but also the first drug under your watch Toplizumab, which can delay the onset of type one diabetes by at least three or more years. And - and - and also it was that SDA s- uh, SDP support that's responsible for five of the six commercially available artificial pancreas technologies. And these are now being applied in - in - in many other areas. A reduction in uh, funding will have consequences of course, we would have to either delay or postpone many of our efforts including our trial-net effort which was actually the vehicle which led to this uh approval ultimately of the first drug to delay the onset. And uh we're right on the cusp of understanding what the the environmental determinants of diabetes uh in youth are, the so-called TEDDI study. Uh we're right at that point where we're in a intense data analysis phase. This could uh certainly delay that to some extent. Nonetheless, we're very help we're we're very thankful for what we get and we'll make the appropriate adjustments as necessary to ensure that all of our funding goes out as required by the law. Thank you.

Thank you. Thank you, Madam Chair. I know I've gone over my time. I will submit for the record uh questions on Alzheimer's disease, which is also one of our top priorities and women's health care grants.

Great.

Thank you.

Thank you. Senator Baldwin.

Thank you. Um, the the current Ebola, uh, outbreak highlights the potential use of MRNA technology to respond rapidly to viral threats, especially ones we don't have vaccines or treatments for like the Ebola strain that is emerging in Central Africa. But last year, health and human services terminated five hundred million dollars in contracts for cutting edge MRNA vaccine development and then redirected that funding to eighty year old vaccine technology Experts have expressed serious concerns that this technology is outdated and inferior and that the way the funding was awarded circumvented the scientific review process. Doctor Bhattacharya, will you commit to providing this subcommittee with the contracts that awarded that funding?

Senator, uh, so first I should say that the um the Boonavigil virus that uh Ebola virus that's now in um in the DRC um we don't have a vaccine for it um but we do have with the N I H one

So, I'm I'm raising an issue that there was five hundred million dollars in contracts for MNR n a research vaccine development that was cut off and then redirected and so i was wondering what i asked was will you commit to providing this committee with the contracts that awarded that funding

so so first those those were those were

is that a that's an easy yes or no

well those are those are contracts not nih contracts so uh you can ask hhs specifically as far as nih contracts absolutely we're we're we're an open book for that

ok was there a an open fair transparent call for proposals for this funding.

The we use this for uh for the funding for the uh the universal flu vaccine, you mean.

For the funding that was uh taken from uh the MRNA contracts and uh redirected.

For for the so the universal flu vaccine that the NIH is investing in for research, uh as for research purposes followed our normal processes for identifying intramural research opportunities. Um so uh the answer is yes, we've

So was there review of that process?

It's it's the same standard process that we use for all our intramural researchers. Uh, this is a very promising vaccine platform. Um, so I I I the uh the idea that we can get a single vaccine that can and

So, it's essentially bypassed the standard peer review competitive process and

No, that's not that's not accurate, Senator.

award one hundred million dollars internally to two NIH researchers,

Sen- Senator, I'm sorry, Senator, that's

one of whom is your deputy director.

Senator, that's just not accurate. It it followed the normal process for just determining how intramural you know it's NIH has uh a tremendous number of amazing scientists some of them you see here at the table with me um there's a normal process for deciding where where which projects get funded

so five hundred million dollars in contracts were terminated a hundred million redirected to eight eighty year old uh uh technology um uh without competition and um uh the researcher uh one of them is best known for being a COVID vaccine skeptic, um, uh, had his lab's annual operating,

Sen- Senator, uh.

uh, budget increased by more than fifty times. Did Secretary Kennedy, um, s- his special assistants direct, uh, NIH to award this funding to these two investigators?

Senator, the, uh, the - the project you're talking about is a tremendously promising project that could end H I could - could end - could -

Did - did Secretary Kennedy's special assistant direct NIH to award this funding to these investigators.

So the - the N- the NIH followed normal processes for deciding whether to - to invest in this universal flu fa- platform. If - if the - the - if the project works out and looks for tremendously early results look very promising, we could have a single injection, so you don't have to get annual flu shots that can solve it.

I'm very concerned about the process, um, uh, lack of competition, lack of peer review. This funding was appropriated in the American Rescue Plan. Congress agreed in our fiscal year twenty twenty-six labor HHS appropriations bill to rescind that funding. That bill was made public on January twentieth. NIH obligated this funding on January thirty-first, well after the bill was public, but three days before it was enacted into law and would have been rescinded. In late January, did anyone at NIH discuss needing to award this funding before Congress rescinded it?

Senator, we followed the law on - on allocating the funding, and we've allocated to a pr- very promising project that promises to end,

Look.

uh, the need for annual flu vaccines with a single injection

I

that can protect people from the flu forever.

My understanding is that those discussions did happen, and to be clear, the Trump administration rushed out, um, American Rescue Plan funding before Congress could rescind it, as we tried to do in our bill. Um, Secretary Kennedy has his own narrative about the effectiveness or lack thereof of MRNA vaccine technology. And hiding studies to show their effectiveness is something that I'm deeply disturbed about. And meanwhile, NIH is bypassing its actual gold standard scientific review process to unilaterally award more than one hundred million dollars to two NIH researchers, one of whom is best known for being a COVID vaccine skeptic, and the other, uh, who reportedly just stepped down. as NIAID director without any public explanation.

Forg- Forgive me, those those researchers you're talking about are among the most important flu flu vaccine researchers in the world they've had a tremendous track record of success in uh in in flu in flu uh infectious disease for flu and particularly flu vaccination research. I mean they're NIH funded researchers, uh NIH researchers they've been here for decades. They're among the world's leaders in in flu vaccine research.

And we'll expect to see those contracts. Thank you.

Well, I was gonna start my question with Doctor Letai, but I have to respond a little bit and Senator Baldwin and I get along really well. But I'm the insinuation from the markets we're sitting in front of six incredible scientists for our country that are trying to solve some of the most deepest devastating problems that it's being done on the lamb or done illegally or done suspiciously, uh, i- is very offensive to me. And uh and so I I I I just wanted to to say that before I ask Dr. Ledeye, as he probably knows he knows what I'm gonna ask him, I think. Um, I am from a rural state, as we know, and I'm very interested in the uh NCI Cancer Center designations and I've seen several projects where it talks about the concentration of cancers in rural areas, uh, such as mine, such as many of our states here, and some of the uh states that bear the highest cancer incidence and mortality rates remain largely without access to NCI designated care where it's proven the care is better, more successful and has better uh rates of of cure. So um you know we have the IDEA program which has great success and uh to help uh get some of that biomedical research uh out to our rural areas what I would like to see is this NCI cancer designation branch sort of an alternative designation pathways or or something so that the structural barriers that are preventing our uh eligible institutes and states, such as mine, from getting and I know mine's working towards this, so uh and I know you're working with them and I appreciate that. Um will you continue to to keep looking at this comprehensive review of cancer center support? And maybe you could give us just like a thirty second how much more successful the rates are around cancer center designations for the patients that are being served in those immediate or regional areas.

So, uh, thank you, Senator. First, I'd, I'd like to say that, uh, I think an undercurrent of your question is that, uh, it's no good to have major advances in cancer research unless we can reach all Americans with them.

Correct.

And the, I and the NCI wholeheartedly agree with you on that. With respect to West Virginia, we are working closely with Doctor Hazard Jenkins to make sure that, uh, when an application is submitted it will be a successful application. As you may know, NCI designated cancer centers uh are specifically designated because of their devotion to research,

Right.

uh as well as clinical as well as basic research if they are a comprehensive cancer center. Uh, and I think that's a very laudable goal and I agree with you that our cancer centers, not only in providing clinical care but also in advancing the standard of care, our NCI designated cancer centers have been essential to that function. And we look forward to uh uh to cancer centers from rural states joining that group i will i also wanna make the point though that nci designated cancer centers aren't the only way that we bring top quality care to the more rural areas of america we also have n corp sites mmm as well as nctn sites throughout the country where people can uh enroll in nci uh nci supported cancer uh clinical trials and that's a way of getting cutting edge clinical research to people whether they're in rural environments or uh urban environments and we look forward to continuing that.

Thank you, thank you very much. Uh, Doctor Volkoff, you you know in your visit of West Virginia and and your many years of uh working in the uh in your area of expertise uh that we still got big problems. We're having breakthroughs also in in your area. Um, some exciting opioid research results from uh NIDA intramural research team, and I'm gonna I'm not even gonna try to say his last name, so I'm just gonna say Doctor Mike. uh and his team identified a novel highly potent opioid that shows potential therapy for pain and opioid use disorder could you describe that research please

yeah thanks very much for the question and it is actually quite important because the overdose crisis was born out of lack of treatments for people suffering from chronic pain that led to the use of opioids so a priority for the our institute in partnership with others is to develop safer treatments for people with severe pain and so the one that by doctor Michael Littes actually works. It's an opioid itself. So you can either go to mechanisms that don't invoke the opioid system or those that do. And most of the most powerful drugs we have actually activate that opioid system. What he has been able to document in animals is that this molecule activates the opioid receptor in a different way such that that signaling inside the cell results in does not result in the response respiratory depression or the addictiveness of typical opioid drugs. So,

Mm-hmm.

in that respect, it's a breakthrough because you are manipulating chemistry to create a conformation that can lead you to the analgesia but it's safer.

Right.

So, of course, we need to bring this into humans.

Right. So, basically, what I'm saying is, or what you're saying is, an opioid that's non-addictive, uh, that can address the pain, uh, um, element uh that opioids are are really good at at numbing the pain but also have the side effects of the uh addictiveness

exactly but we need to test that in humans

alright right ok uh senator moran

chairman are you sure i'm next a democrat maybe i am next on our side

oh you know what you are right uh excuse me god i hate saying that to you um

in my opinion

senator durbin

Thank you, Senator Moran and Madam Chair. Um

Thought on her part.

I was a sophomore in high school, fourteen years old. My father had lung cancer, and he died at age fifty-three. And I stood by his hospital bed, and felt absolutely helpless and destroyed as a kid. I never forgot that experience. I never will. So when I came to Congress, I decided to take on big tobacco. Thirty-six years ago, I introduced a little amendment. It banned smoking on airplanes. That amendment triggered a reaction I didn't even anticipate. It was a tipping point. At the time we passed that amendment to ban smoking on airplanes, twenty-seven percent of high school students were smoking tobacco products. Twenty-seven percent. Today, it's two percent. But our kids aren't safe from another product, a big tobacco. It's called vaping. Are you all familiar with vaping? Sure you are, as medical doctors. Doctor Volkow, is vaping dangerous to children?

Uh, yes. Vaping is if um by itself, but even more so if it has nicotine, it can produces addiction in and particularly in children, this can actually escalate. So, yes.

Do you uh hear any statistics about the percent of kids in high school and junior high who are vaping today?

Yes, we monitored very carefully. Unfortunately, we have seen significant reductions in vaping among teenagers in our country over the past three years, four years. So, yes, fortunately, because the levels were very high.

How high?

They were

Went up to twenty-three percent of twelve graders, and now we are much lower than that.

So big tobacco is no longer peddling tobacco to your kids and grandkids, they're peddling vaping. With the same addictive qualities of that nicotine, and the same danger to these kids. So the question, Doctor Bocceria, is what is this administration doing about vaping?

Senator, you heard uh, you heard uh, Doctor Volkow talk about our our research programs in vaping. I I agree that it's dangerous for kids. Um, but and I think that for the NIH our role is to document uh the ways that it it that uh that that uh vaping and other other things affect the health of children um as well as other other other people so

do you see any connection between fruit flavored vaping and children being attracted to it

uh i mean it i i would have to do research but i absolutely i think that that is probably inappropriate for children to be using fruit flavored vapes

do you realize that the announced policy of this administration within the last two weeks is going to make it easier for these companies to peddle fruit monster vaping, candy king vaping, raspberry slushy va- vaping to our children in high and junior high and high school now.

Senator, I think that vaping for, for kids is a, is a dangerous thing. And I think that it's, the role of the NIH isn't to set policy, it's to do research, to document the, the, the ways to address these health, health problems.

But, but you've conceded the obvious.

So

They're peddling flavors that attract children. children who don't have the maturity to make the decision. And they become addicted to a product which is dangerous to them, according to Doctor Volkow, which I couldn't agree more. So how can we in good conscience say that this administration has the best interest of children at heart when they're exposing them to this deadly product?

Senator, all all all I can say is about the N the NIH's commitment to make sure that we study this issue as as fairly and and evenly and objectively as possible in a rigorous way.

We don't need a study.

Um, uh, s-

We need action. We need to stop this. And the previous administration wasn't much better, to be honest with you. And I was pretty critical of them as well. To think that these companies, many from China, are gonna peddle some product to our kids, that they're gonna vape in this steamy uh concoction of chemicals, chromium and God only knows what else is in it. And we're going to look the other way, as this administration says, let's get, have some more fruit flavors on, on hand for kids to dabble in and to try to uh make a decision. Does this make sense to you?

I mean, Senator, having kids uh have act more access to vaping does not make sense to me.

Is there anyone on the panel of you six doctors who think this is a sensible decision by the Trump administration to make it easier to peddle fruit flavored vaping to kids in high

But, but can it can

I'm asking panel. Uh kids in high school and junior high school, is there anyone among you who thinks that's a good idea? Thank goodness, you're honest in your response.

So.

Well, I, there's a disclosure today and I don't know the source of it here, about a five million donation, five million dollar donation from Big Tobacco that preceded the vaping decision. Reynolds sent along a check for five million and the president switched his position on this. This is ghastly, to think that we're allowing this to occur. And here I am, thirty-six years after passing, banning, and smoking on airplanes, seeing us in introducing a new product and new variations on it to addict our children. For God's sake, is there one person in the administration besides those who've already resigned, who will stand up and say enough? This violates my conscience. I yield.

Thank you, Senator Durham, before I go to Senator Moran, and thank you for correcting me, by the way. I would like to recognize two of the ACS volunteers, youth uh volunteers from West Virginia that are in the audience, Nicole and uh Brendan. Can you guys stand up real quick? Thank you all for what you're doing. OK, Senator Moran.

Chairman Capito, thank you very much. Um, Doctor Bhattacharya, I appreciated the opportunity to welcome you to Kansas, uh, at last November. I appreciate your visit. Uh, I have already, uh, invited Doctor Rutter to come home, uh, to Kansas. Doctor Hodis volunteered, uh, to come visit Kansas on his own volition this morning. Uh, Doctor Letai, uh, you are the only cancer director. And it's, uh, it's amount of time that you've been in office, not any other criticism, that hasn't been with me in at uh in Kansas to see what we're doing. And I would extend the the opportunity and welcome the chance to showcase, but more importantly, those visits I hope uh affect how you look at research uh i- uh decisions that you make, but perhaps the most value is for us to figure out how we can do our jobs better uh to meet the needs of this country and this world in uh solving the problems related to uh, diseases and afflictions, and so I'm very appreciative of your presence here today and I appreciate the relationship that uh we've developed with you all in the past, and look forward to that continuing. Uh, I want to raise first a topic uh, and I don't know that I've asked about Parkinson's disease in any one of these hearings before, but it certainly be- I'm becoming more aware of the challenges people face in regard to this disease. FY twenty-six, we were successful in adding a five million dollar uh, amount of money for implementation of the national plan to end Alzheimer's. And, Doctor Bharticharya or Doctor Hotis, tell me what that means as a, what - what - what's going to happen as a result of that.

I'm gonna let my colleague, Doctor Hotis, say, cuz he,

Doctor Hotis?

yeah.

So the - the, uh, national plan for, uh, or Parkinson's disease, uh, w- for which NINDS is the - will - will be taking a major lead, follows the pattern for Alzheimer's disease, in which there's a national advisory. Council has been established. This brings together scientific experts, advocates members from private and public sector, to work together in an unusual, uh, committee structure to survey and make recommendations for progress in research, in care, in long-term services. And I think the Parkinson's initiative is intended to model very much after this very effective and very all-encompassing approach to an important neurodegenerative disease.

I was involved in at least the funding and the initiation of efforts to to do what you just described in the world of Alzheimer's. And I'm pleased to see it's seen as a a role model for other things that we hope can we can address, uh, as we are doing Alzheimer's now. Um, I want to ask a question, uh, perhaps to all of you, cuz I think every institute may have something to do with this. topic. I'd like to discuss NIH research on CMV. Uh, it's not a thing that's well known, uh, but it is a common, generally harmless virus that can be contracted at any age. CMV is the most common congenital viral infection affecting newborns. According to the CMV Foundation, one in two hundred children born with congenital CMV each year. When transmitted to a child during pregnancy, the virus is is often symptomless. but in some cases can lead to developmental dis- disabilities and medical conditions in children. I'm telling you something that you know but I want my colleagues and I to understand what I'm talking about. There are treatments that are available for children who are born with congenital CMV and display symptoms like hearing loss, if administered, that, uh, that treatment is administered to that child shortly after birth. But there's a current, uh, patchwork of approach across our states for screening, testing, treatment. Um, in Virginia you have a hearing test on the birth of a child, in Kansas you do not. And my question is, um, NIH has funded CMV research for decades, and in recent fiscal years there's been dozens of new grants awarded for the study. Would you speak to the developments in this issue that I've raised?