Hearings to examine modernizing the National Institutes of Health

[Gavel sounds.] The Committee on Health, Education, Labor, and Pensions will please come to order. The National Institutes of Health funds more than 50,000 biomedical research projects a year, more than any other institution in the world. NIH is careful to say public institution, but it's hard for me to imagine that's not more than any institution. These investments drive life-saving advances addressing chronic disease, curing cancers, treating other conditions affecting millions of Americans and people worldwide. I'm a physician who treated patients in my medical practice for over 25 years. I've seen the power of NIH-driven innovation to save lives. And I've seen the tragedy when a patient suffers and dies from a disease for which there is no treatment. And everybody in this room has seen that tragedy. And we don't wish to see more of it. For decades, Republicans and Democrats supported the NIH mission. Now, just about every 10 years, Congress considers NIH legislation. In 2006, we passed the NIH Reform Act, empowering the director to advance science through the Common Fund and better oversee all 27 institutes and centers. In 2016, we passed the 21st Century Cures Act, historic legislation accelerating large-scale research, bringing treatments and cures to Americans. Well, if my math is right, it's been 10, 10, and now it's 10 again. It is now 2026. Once more, we are on schedule to strengthen NIH and American leadership in biomedical research. Now, putting down partisan jerseys, working together to improve families' health, we in Congress and this committee can do this. I released a white paper in May 2024 with ideas from those who worked with the agency as to how to modernize the agency to make it better able to fulfill its mission and deliver more life-saving cures to those who desperately need. By the way, if you're dying, you're desperate. And we always have to have that perspective. Somebody watching on C-SPAN right now is dying and looking to this hearing to give her, to give him hope for the future. If we just keep that in front of us, it will give us a seriousness of purpose. So, in our white paper, we consider how to improve the NIH grant review process and application process to help researchers who are applying for NIH funding move away from risk-averse behaviors and fund more big ideas and fewer incremental experiments. And our current director is all on board with that. Secondly, how can the NIH intramural program, with its in-house scientists, laboratories, and research hospital, better complement research happening at universities? How can intra- and extramural scientists better work together tackling complex problems, sharing resources and expertise? Any scientist should be able to leverage NIH technology and the clinical center in the same way that a physics professor, wherever that physics professor is across the nation, can use a particle accelerator funded by the Department of Energy. This would allow genius at a small university to access the equipment to allow her genius to shine through as opposed to being thwarted by the lack of the equipment she needs in order to prove her theory. We have mid-career scientists who feel their careers are stagnating because they don't work at a university in San Francisco or Boston. Those are great universities, but there's a lot of bright people out there. We need their input if we're going to maximize the potential of the NIH. Next, how can we harness the power of AI to make findings from all studies, be they positive or negative, more easily accessible so that the scientist does not go down a blind alley that others have explored, but because it was a negative study, it just wasn't published and they would not know that it's a blind alley? And by the way, every now and then, at the end of a blind alley, you find something that points you in the right direction. Finally, Congress must strengthen trust in federally funded research by ensuring that the NIH funds high-quality, well-constructed experiments, particularly of research conducted in other countries, in a way that does not add unnecessary administrative burden upon the researcher. Dr. Bhattacharya, thanks for coming before the committee to discuss the agency's efforts and how Congress can assist. Since your confirmation, you've brought fresh ideas and a willingness to rethink how NIH operates, which will strengthen the agency in the long run. Now, I hope that the Trump administration's collaboration and support will move congressional reform efforts forward and get shared ideas over the finish line. But, but, but, we must acknowledge recent actions at NIH have created uncertainty within the American research enterprise and potentially undermine the agency's ability to serve. Now, right now, I'm just channeling. For just a moment, I'm going to be the channel from folks I've heard from. Republicans and Democrats on this committee have heard concerns about grant cancellations and the message that those cancellations and the lack of transparency around them have sent to the broader innovation community. Last year, NIH terminated more than 1,000 awards amounting to $721 million. Among were 58 projects on Alzheimer's, 99 on HIV/AIDS, and 97 related to life-saving vaccines. We have spoken about this, but I look forward to hearing your comments. It even appears to have canceled six projects examining biological differences between women and men, which I thought was a priority for President Trump. Beyond NIH, the Department of Health and Human Services last year announced the cancellation of roughly $500 million in mRNA research. Within the last two weeks, Moderna announced it would no longer invest in late-stage clinical trials for vaccines using mRNA technology. Now, this technology was advanced through NIH partnerships. It enabled President Trump's Operation Warp Speed, an historic achievement bringing a vaccine from conception to being administered within 10 or 11 months, saving millions of lives and reopening economies worldwide. Losing this critical tool in our defense against future pandemics puts our national security and an individual's personal health security at risk. I say this as a strong conservative. We need taxpayer dollars to research to help families, not to have it subject to political ideology, which masquerades as science. This includes correcting progressive Biden-era actions that coerced scientists into including DEI language in thousands of NIH-funded grants, even when it had zero scientific relevance and was a waste of money and certainly did not make Americans healthier. But we can get rid of DEI without upending life-saving research and America's biomedical leadership. Canceling critical investments that have long enjoyed bipartisan support erodes trust and makes substantive reforms less likely. Dr. Bhattacharya, this is an opportunity for you to address these concerns, to tell us about your path forward, which I've been very impressed with. I want to, and I think we want to be a good partner in this. I want the Trump administration to have the greatest NIH in history. And we have the power, the ability, the opportunity, the challenge to unleash American innovation to solve our biggest health challenges. NIH and Congress must work together to meet the moment and to improve Americans' health. The families, the patients, the desperate person watching is counting on us. With that, I recognize Senator Sanders.

Thank you, Mr. Chairman. Dr. Bhattacharya, thank you very much for being with us today. Since taking office, President Trump has repeatedly promised that he would, quote-unquote, make America healthy again. He said he is, quote, committed to restoring a gold standard for science. He claimed that, quote, we have made tremendous strides in cancer research, far more than anyone has done. He promised to stop pharmaceutical companies from, quote, getting away with murder, unquote, by ensuring that Americans pay the lowest prices in the world for prescription drugs. In August, Trump said he would fire, quote, every single one, unquote, of his top officials if they didn't, quote, have drug costs that drop like a rock. Well, Mr. Chairman, has President Trump lived up to the promises he made to the American people? Has he been telling the American people the truth? And the answer, obviously, not surprisingly, is not that he lies all of the time. Trump's so-called big beautiful bill made the largest cut to Medicaid in American history. When you throw 15 million people, low-income and working-class people, off their healthcare they have, people die. And there are studies out there that 50 or 60,000 Americans a year will die because they no longer able to get to a doctor when they should. I don't think you make America healthy again when you provide a death sentence to 50 or 60,000 Americans. And that's not all. For generations, and the chairman touched on this, American families facing cancer, Alzheimer's, diabetes, and heart disease have looked to the NIH for hope. They have relied on NIH-funded research, basic research, for new treatments and cures. And yet, while Congress fully funded NIH, the Trump administration has made the deliberate policy choice to terminate grants mid-study, abandon patients in clinical trials, and driven a generation of scientists to question whether they can conduct serious research in the United States. And according to a new report that I am releasing this morning, instead of making, quote, tremendous strides in cancer research, unquote, the NIH has terminated or frozen $273 million in cancer research since Trump was inaugurated. The chairman talked about how all over this country, people with serious illness are looking for hope. They want breakthroughs. They want to know if they will survive cancer. Trump administration NIH has terminated $273 million in cancer research. But it's not just cancer research. In total, the NIH has terminated or frozen at least $561 million in research and defunded more than 300 clinical trials dealing with heart disease, Alzheimer's, diabetes, dementia, and pediatric brain tumors. Moreover, instead of substantially reducing the price of prescription drugs, something that I have worked on for years, everybody here has worked on, everybody here knows that one out of four Americans cannot afford the prescription drugs they need. We have all talked to pharmacists who have told us that people walk into the drugstore with a prescription and they're shocked by the price they have to pay and they can't pay for that. So, instead of substantially reducing the price of prescription drugs, as President Trump promised, the prices of more than 870 prescription drugs have gone up, not down, this year alone. And relevant to this hearing, the price of every single drug invented with the help of NIH scientists is higher in the United States than it is in other countries. Here are just a few examples. These are drugs developed, basic research done, by American taxpayer dollars through the NIH. Johnson & Johnson charges Americans $57,000 a year for the HIV drug Symtuza. That same exact drug costs $11,000 in the UK. $57,000 in America, $11,000 in the UK, $9,000 in Japan. Gilead charges Americans $504,000 for the cancer drug Yescarta. That same drug costs $266,000 in Germany, half the price. Bristol Myers Squibb charges Americans $544,000 for the cancer drug Abecma, while that same exact drug costs $394,000 in China. Bottom line is we pay for the research, drug gets developed, other countries charge substantially less to their people than we do, we pay in this country. Mr. Chairman, the American people are sick and tired of paying by far the highest prices in the world for prescription drugs. People are dying because they cannot afford those prices. We need real action to take on the greed of the pharmaceutical industry and substantially reduce the cost of prescription drugs for all Americans, not more lies and phony press releases from the White House. Several months ago, I introduced legislation that would cut the price of prescription drugs by more than 50 percent by making sure that Americans don't pay more for prescription drugs than Europeans or Canadians. Not a hard proposition. See what they are paying, what Canadians are paying, what Europeans are paying, we pay the same rate. That will lower prescription drug costs in America by half. If President Trump and his administration were serious about lowering the price of prescription drugs, they would support this bill. So, Dr. Bhattacharya, thank you very much for being here today. I hope you will tell us in a little while that you are prepared to lower the cost of prescription drugs in this country by 50 percent by supporting that legislation. Thank you very much.

Thank you, Senator Sanders. We're joined today by Dr. Jay Bhattacharya. The first time I met him, he said he preferred to go by Dr. Jay. So, for basketball fans, you can appreciate his fantasy. He is the director of the National Institutes of Health. Marshall's a basketball fan. Dr. Jay has had a distinguished career focused on improving public health, widely recognized for his research in health economics, holding medical degrees, a medical degree and a PhD in economics from Stanford, where he has also served as a professor. Sir, thank you for being with us. We look forward to hearing you.

Chairman Cassidy, Ranking Member Sanders, and distinguished members of the committee, thank you for the opportunity to discuss modernization of the National Institute of Health. I'm honored to lead the NIH, where research investments have supported major advances in human health and disease over decades. The chronic disease crisis facing the American people is severe, with unacceptably high rates of diabetes, heart disease, cancer, Alzheimer's disease, and so many other conditions. Life expectancy for Americans is barely above 2010 levels. The solution to this problem is to modernize the NIH to fulfill its mission of investing in research that improves the health and longevity of Americans. Some NIH investments have a track record of success. For example, just this year, decades-long work of NIH-supported researchers culminated in not just one, but two new gene therapies to cure sickle cell anemia. When I was in medical school learning about the sickle cell disease, I never expected to see a cure in my lifetime, and yet here we are, thanks to NIH-supported research. NIH-funded researchers built on this gene-editing technology to deliver personalized treatment to an infant with rare, previously fatal disease. You may have heard of Baby KJ. The treatment was supported by the NIH Common Fund, which, Senator Cassidy, you mentioned, the Common Fund Somatic Cell Genome Editing program. But despite these incredible successes, we can do more and we can do better. And as director, one of my top priorities is to rebuild public trust in the NIH. Meaningful reforms that increase transparency, strengthen scientific rigor, and ensure accountability are necessary to bolster the NIH's ability to meet America's current and future public health needs. The NIH is a large and complex organization operating in a rapidly changing technological environment that is accelerating discovery at an unprecedented pace. As science itself evolves, so too must the structures that support it. Under my leadership, reform is already underway at the NIH. We are consolidating and restructuring core functions within the Office of the Director to enhance coordination and improve efficiency and strengthen accountability. For instance, we've centralized peer review, which is the basic and most important function of evaluating scientific grants. This consolidation is projected to save millions by eliminating duplication while ensuring more consistent, agnostic, rigorous scientific evaluations of research applications. A new office within the Office of the Director will support rigorous analysis of the NIH research portfolio with the mission of coordinating NIH investments to solve the replication crisis in biomedical sciences, leading to greater impact of our scientific investments on population health. In concrete terms, I expect these efforts will deliver greater value for every taxpayer dollar the NIH is entrusted with. Through our new unified funding strategy, the NIH is empowered to make research portfolio decisions that are better aligned with strategic priorities of the institutes and to take advantage of research opportunities in every field of biomedicine and the urgent health needs that our country is facing. To improve public health, scientific discoveries must be translated into more effective interventions. The NIH is investing in new human-based models and emerging technologies to improve the translatability of research into human health and responsibly reduce animal research where scientifically appropriate. The NIH is actively engaging with the White House and other federal partners to develop and implement a policy for increased oversight of dangerous gain-of-function research. This is a necessary and long-overdue step to ensure that NIH-funded research does not lead to significant adverse social consequences. In addition to the reforms underway, we're pursuing additional opportunities to steward taxpayer dollars responsibly and keep pace with a rapidly evolving scientific landscape. We need to invest in and support young scientists to build and retain the brightest biomedical workforce in the world. We also need to move the needle and incentivize high-risk, high-reward research. Research portfolios at the NIH under my leadership will be judged by their success at curing disease, improving population health, and creating fundamental scientific breakthroughs, rather than simply how many scientific papers each project yields. Serving alongside the extraordinary scientists at the NIH and across the country, as well as the dedicated colleagues at the NIH, is a privilege of my professional life. I'm committed to restoring trust in the NIH and building a more accountable, transparent agency that leads to discoveries that enable Americans to live longer, healthier lives. Congress is an essential partner in these efforts. And I want to thank you for your time today, and I look forward to your ideas and questions.

I will defer to Senator Marshall.

Great. Thank you, Chairman, and welcome, Dr. Bhattacharya. Glad to see you again. Let's talk about gain-of-function research to start with. I think it's now very well established that COVID was the result of gain-of-function research partially funded by Dr. Fauci, American dollars. The vast amount of evidence supports that. Yeah, gain-of-function, in my opinion, is a greater threat to Americans than nuclear warheads are right now. Can you tell me what you're doing to try to end gain-of-function research?

Thank you for that question, Senator Marshall. First, I want to assure the American public that's listening that we have ended any support for dangerous gain-of-function at the NIH. We will not be supporting any such projects. The problem is broader than just the NIH. And I've been working very closely with White House partners in developing a framework for making sure that this sort of research is never supported again by the American government. And I think the key idea is that we have to take a risk-based approach. The old regime used to look at a list of agents and said, okay, are you working on something that is like Ebola or something that might be, if you make it more dangerous, more transmissible? Now, for that approach, even the virus that came out of the Wuhan, the bat caves, would never have been on that list. Now we have a risk-based approach to make sure that there's an independent evaluation of every single project that has the potential for causing gain-of-function, dangerous gain-of-function. And so we don't support that ever again.

And Congress needs to codify that plan eventually as well, in my humble opinion. Let's talk about long COVID for a second. 20 million, tens of millions of people suffer from long COVID. Previous administration, we gave them almost $2 billion, made no progress. And certainly we've formed committees, we prayed about it. Tell me the progress you're making on long COVID. I think that there's now some studies out there supporting that this is probably more of a venous inflammation, maybe it's a lymphatic inflammation. There's actually some good tests out there you can do to identify long COVID.

So, Senator, I've been working with private partners and Secretary Kennedy has organized roundtables where you were so kind to join and contribute. I'm actually tremendously hopeful. For the NIH's part, we have refocused our investments to evaluate treatments that people are actually receiving and promising new treatments, rather than just trying to find a biomarker. Seems like there's lots of progress that's been made in the private sector for this. And for the NIH's part, we will continue to make investments. It is very important that we have an answer for so many Americans that are suffering from long COVID, as well as so many other conditions where we don't have great science. We're going to at the NIH have replicable science focused on these problems. And with your partnership, I'm really grateful that we can make this progress.

Is there a, there's people out there listening to this hearing right now with long COVID. Is there something on the website that you would say, here's a starter spot?

Yeah, I mean, so there's a long COVID, they're called the RECOVER initiative at the NIH, and folks can go look there for sort of the latest information. We've shifted the portfolio away from trying to find a set of biomarkers that are absolutely perfect, because if you have long COVID, you know what's happened to you. The key thing is answers for long COVID patients, validated treatments. There's a lot of treatments that have been proposed out there, but people really need is great randomized, high-rigor scientific evidence so that they know what they're doing is going to work.

Have we started those studies yet?

We absolutely have, Senator.

And is it, are we a year away from, it'll take a good year yet?

I mean, it's hard, Senator, to say with promising timelines in science, as you know, it's always a difficult thing, but we are moving as absolutely fast as we can.

Okay. Let's finish up with antimicrobial resistance. You know this issue better than I do. What are you guys doing to study antimicrobial resistance?

Antimicrobial resistance is a huge problem as so many of the newest antibiotics tend to are causing evolution in bacteria that become resistant. We've shifted the portfolio of antimicrobial resistance to think not just about, because it's not just whether you have a bug that's evolved and that in the lab is no longer susceptible. It's within patients. So it's a patient-centered antimicrobial resistance-focused research agenda. And the folks who are working on this are very hopeful that with this new paradigm, we can sort of solve the problem in a way that we're not just racing against the latest bug.

Thank you, Chairman. I yield back.

Senator Sanders.

Thank you, Mr. Chairman. Dr. Bhattacharya, according to the American Medical Association, which represents over 270,000 doctors, quote, an abundance of evidence from decades of scientific studies shows no link between vaccines and autism, end quote. That includes over a dozen rigorous scientific studies involving hundreds of thousands of children. Last week, you said, quote, the caricature, end quote, of Secretary Kennedy you've seen, quote, in the press is just totally unfair. You have seen him change his mind, you said, when you've sent evidence to him. So my question is, have you shown Secretary Kennedy the existing evidence that shows that vaccines do not cause autism? What steps are you taking to make sure that our nation's health policy is guided by scientists and not conspiracy theorists?

Senator, it's a...

Could you please talk into the mic a little bit closer?

Oh, I'm sorry, Senator. Thank you for that question, Senator. I mean, I'm absolutely convinced that, for instance, the measles epidemic that we are seeing currently is best solved by parents vaccinating their children for measles. And I've said that publicly and I've said that privately. I mean, I think, as I said in that quote, I've seen him caricatured quite unfairly. I think the key thing to me is that we have to address the deep distrust that has developed over the last several years by the public regarding...

I'm sorry to interrupt you. I don't have a lot of time. You're right, there is deep distrust. Do you think that deep distrust now has something to do when you have an organization like the American Medical Association telling us that vaccines do not cause autism, but you have a Secretary of HHS who says the very opposite? Do you think that causes concern and mistrust among parents?

You know, Senator, in 2024, there was a study published in the Journal of the American Medical Association that said that only about 40 percent of patients still trust their doctors. As someone who went to medical school myself, it's absolutely shocking. And that's before Secretary Kennedy took office. We have to address this distrust, but it has to be a bipartisan effort.

Let me ask you a simple question. Tell the American people, I appreciate your thoughts on measles. Do vaccines cause autism? Tell that to the American people. Yes, no.

I do not believe that the measles vaccine causes autism.

No, no, no. I didn't ask measles. Do vaccines cause autism?

I have not seen a study that suggests any single vaccine causes autism.

Okay. Thank you. One of the issues that the American people are deeply concerned about is the high cost of prescription drugs. I think everybody on this committee worries about that. President Trump has said that we're going to have the lowest prices anywhere in the world for prescription drugs and your drug prices will go down 600, 700, 800 percent. Pretty good. Now, if I walk into a pharmacy and my drug prices have gone down 800 percent, you know what? Not only do I not have to pay anything for the drug, the pharmacy is going to give me money back. Is President Trump telling the truth when he says that drug prices in America are going to go down 600, 700, 800 percent? ...will lower the cost of prescription drugs in this country by half through not paying more than other countries are paying.

Senator, I'm not in a position to support or not support legislation, but I'm very happy to work with anyone to help reduce lower the price of drugs.

Well, thank you very much.

Next is Senator Tuberville. Coach?

Thank you, Mr. Chairman. Doctor, thanks for being here today. Thanks for coming to my state of Alabama not too long ago. I hear you had a great visit. And thanks for trying to put the genie back in the bottle on trust in my state. Nobody trusts healthcare anymore. It's been a disaster. The four years, five years of COVID has put us in a tailspin. So thank you for trying to work with that. Hopefully we can all help you in that situation because we need to believe in our healthcare system. NIH is accelerating public access to federally funded research by removing temporary delays known as embargo periods, allowing taxpayers to see results sooner and increasing transparency. Do you think making NIH funding research immediately available would help rebuild trust among Americans who feel science has become politicized or disconnected from the public?

Absolutely, yes. There's no reason why there should be red tape when American-funded science then is published and then you have to wait to see it. It's ridiculous, and we've ended that, Senator.

Thank you. A couple weeks ago, you announced that NIH was ending the use of human fetal tissue from elective abortions in all taxpayer-funded research conducted or funded by NIH. I'm grateful that you took action to prevent tax dollars from being used for research that exploits the remains of aborted children. Can you please explain how advances in technology and innovation allow us to conduct life-saving medical research without having this?

Absolutely, Senator. So we did an analysis, and actually even when it was legal during the Biden administration, the use of human fetal tissue had been plummeting because there are better alternatives available that are not ethically conflicted. And so we took this action because we wanted to make sure that the fruits of NIH research was morally acceptable to the entire American population.

Thank you. You know, my state has two schools of osteopathic medicine. The funding for osteopathic medicine is 0.1 percent of NIH funding, while MD-granting schools are receiving roughly 40 percent. What's your thoughts on that disparity between the two?

I think generally that the NIH portfolio of research investments outside are too concentrated in a relatively few institutions. I think it's like 0.4 percent of the top institutions get 20 percent of our funding for extramural research. I'm thinking of ways to broaden the base of that so that it includes a much larger range of ideas, much larger set of places than currently enjoys NIH funding.

Thank you. And one quick question to you. You said earlier gain-of-function research was not being funded. Is that just domestically or worldwide?

Well, I don't have control over all the whole world's research investments, but I'd love to figure out ways...

I'm talking about our money, though. Our money that we're investing.

Worldwide. Yeah. We're not going to fund any dangerous gain-of-function. No more futures of research programs in Wuhan, China.

Yeah. Thank you. Thanks, Mr. Chairman.

Senator Murray.

Thank you, Mr. Chairman. NIH funds thousands of clinical trials around the world for families. These trials really represent hope and a chance for new treatments and cures. But last year, one in 30 NIH-funded clinical trials were disrupted by the Trump administration's grant terminations. It affected more than 74,000 trial participants. Dr. Bhattacharya, what do you have to say to patients who were receiving that life-saving treatment whose clinical trials were impacted by those cuts?

Senator, we made sure that if there was any disruption, that the researchers had resources available to make sure that the patients receive continuity of care. Ultimately, we worked with researchers across the country to make sure that the clinical trials were really focused on advancing health and not on other political agendas and renegotiated them. Ultimately, we have preliminary estimates that I think ultimately ended up maybe only a dozen clinical trials were terminated rather than...

Again, my time is short. Let me just say that the Trump administration terminated or froze 5,478 NIH grants last year. In less than six months, the Trump administration terminated 383 active NIH clinical trials. That included 118 cancer clinical trials. Those patients are in a race for time. Can you guarantee to us today that NIH will not terminate grants in this wide-range, haphazard way again this year?

Senator, I mean, most of those trials were restored after...

My question to you wasn't going backwards, it's going forwards. Do you guarantee you will not terminate any NIH grant trials this year?

I mean, Senator, it's in 2020, a very large number of clinical trials were terminated during... it's hard to predict the future, but what I will guarantee... so clinical trials... Senator, can I just real fast? I can guarantee that we will focus our clinical trial efforts on advancing health and not on ideological fights.

Well, tens of thousands of real people rely on these clinical trials. It's not easy to get into them, and I think we deserve an answer that's much clearer, more direct than you just gave. Let me move on. This time last year, all of NIH's institutes and centers were prohibited from holding advisory council meetings, which is the final step, it is mandated by law, before NIH can award any grants. Under your leadership, advisory council members have not been replaced at the end of their terms. And for the first time in NIH's 139-year history, you completely disbanded the advisory committee to the director. It has not met in more than a year. More than half of NIH institutes are set to lose all of their voting advisory committee members by the end of 2026. In fact, one of the institute's councils is going to have no members by the end of this month. Since grants cannot be funded without council approval, this poses a very serious threat to NIH's ability to fund research. How many, tell us how many institute advisory councils and other review panels have been disbanded under your leadership and tell us how you're going to fix this?

So I've ordered the institutes to nominate new members. We're working as fast as we can with dozens and dozens and dozens of new members for, including for the advisory committee to the director, I just sent up a slate. We're going to have those FACA committees working. There will be no delay.

Well, if you can provide this committee, please, with information on the status of every one of these councils and your agenda for getting them done. This is, we can't, you can't by law extend any research dollars until those are in place, and without any members, there's no council.

It's a priority of mine to make sure that those councils are staffed.

Okay. One more question. Two weeks ago, NIH issued a ban on fetal research tissue research. This policy immediately halted all research that has led to groundbreaking medical advances, from the development of the polio vaccine to IVF. This stops irreplaceable research in a new treatment for everything from Alzheimer's to Parkinson's. What is the scientific evidence for you banning fetal tissue research?

As I said earlier, fetal tissue research has been declining in use because of the availability of new alternatives, including induced pluripotent stem cells and a whole host of other new technologies. We did a study, an investigation, to make sure that the impact, the scientific impact...

But you don't have any evidence that you're going to put in front of us. You're just saying something else is there, and there's not always better alternatives. And in fact, for stem cell research, there's very, very limited.

So just real fast...

So you're not presenting us any... this seems, I'll tell you why I'm asking. This seems to me like a political decision by NIH. You made the decision right when we were having a mass gathering of anti-abortion activists here in D.C. So you can see why all of us go, what's this about? But I am very concerned that NIH issuing this ban with very little notice is going to have a huge impact on patients in this country. And I want you to commit to providing to us a complete list of affected projects so we on this committee know what's been terminated, hopefully by the end of this week.

Absolutely, you can have that. But I'm telling you, we did not terminate projects. We recommended that the... we required that the scientists find alternatives, and there are alternatives available. Using tissue from aborted embryos, from aborted babies, is not necessary for science.

We've been around on this topic many times. We know well, full well, the scientific research that this enables and what is being cut off. And in fact, what is really disconcerting is your announcement that NIH is threatening the use of human embryonic stem cells. That will affect upwards of 600 NIH projects totaling $325 million. Mr. Chairman, you can bet I'll be following this very closely.

Senator Moody.

Thank you, Mr. Cassidy, Chairman Cassidy, for convening this important hearing. And thank you, sir, for being here today. It is great to see you again. You know, I think this hearing is important because we want to make sure that the NIH has the public's trust, that it is focused on transparency and scientific rigor when it comes to how we're using taxpayer funds to improve American health. And I commend you for taking on this role and this enormous responsibility, not just in what is mandated of you in this role in terms of improving NIH and how we are prolonging American lives, but restoring trust, which I think is a big agenda item that you have taken on and are committed to achieving. Thank you very much. Indeed, the NIH's support has led to revolutions in health, mapping the human genome, breakthroughs in treatment of HIV and AIDS, and CAR T therapy, just some of the accolades of the NIH. But in addition to this storied legacy, we have to question where we may have gone off path. And I think that's part of what you are bringing to this role now. Under the last administration, there was a point in time where the American life expectancy hit its lowest level since 1996. What we see from some reports, this is probably due to more than just COVID. There was a drug epidemic and many other things going on. But I think it raised a lot of eyebrows and concerns when the NIH seemed to start inserting political agendas outside of meeting high scientific standards and promoting American health in how it was disseminating taxpayer money. There's no doubt, no doubt, that the Biden administration required in grant funding for applicants to show DEI standards and numbers and measures and took that into account, right? I think some of the things that were canceled by the Trump administration were for research grants like sexual education programs for transgender and gender-expansive youth, cannabis use among sexual minority and gender-diverse individuals, an LGBTQ+ inclusive teen pregnancy prevention program for transgender boys, even transgender procedures on mice. There are more examples of this, but I point out that at a time when the life expectancy in America hit its lowest in decades, this is what we were pushing and making sure that our grant applicants were including in their applications rather than how will your grant application expand life expectancy for Americans? And there were so many instances during the COVID years where Americans' constitutional rights in response to the pandemic were just wrecked. As Attorney General in Florida, when we went to become known as the free state in the nation, the great free state of Florida, I had to push back against a lot of what was going on during the last administration, and that was coming out of these health institutions out of Washington. Americans were forced to take vaccines, forced to stay in their homes, forced to shut down their businesses, forced out of their jobs, forced to stay home from school and church. I mean, I can keep going, but this was becoming commonplace during those years, pushed out of health institutions in Washington. In fact, when I was Attorney General, our office conducted a grand jury investigation, and the grand jury found that while we were pushing things out of Washington, pushing for more and more vaccines, more and more boosters, that scientists that were raising concerns, they saw their careers destroyed for speaking publicly. I mean, these were scientists, doctors. And I think one of the things that you bring back to bear is how can we encourage dialogue, scientific rigor? And so can you tell us what your steps since taking office have been to restore American trust in the NIH, that it is in fact mission-driven to improving American health and not other political agendas?

Senator, thanks for that question. To me, the key measure of my success as NIH Director will be have we actually made Americans healthier at the end of the term and the discoveries continue to make Americans healthier, reverse the life expectancy flatlining that we've seen since 2010. The steps I've taken are to direct the institute directors who make the portfolio choices, I'm going to evaluate them on the basis of do they actually make Americans healthier, all Americans? Every single American should benefit from NIH-funded research tangibly. Senator Cassidy talked about loss hope. We have to address that by better treatments, better cures, better understanding of disease. And I've worked to depoliticize the agency, to remove the kind of focus on tangential things that have nothing to do with making Americans healthier that I think characterized some of what we had before, but instead now focused directly only on improving American health.

Thank you, sir. Thank you.

Senator Hassan.

Well, thank you, Mr. Chairman, and I thank you and Senator Sanders for this hearing. And Doctor, it is good to see you. Thank you for being here. Let me just start with a question really important to my state. A decade of evidence from the NIH shows that medication is the most effective treatment that we have to treat opioid addiction. Unfortunately, despite this evidence, only one in five Americans with opioid addiction receive medication-assisted treatment. Last week, the White House announced a new initiative focused on addiction recovery. As part of this White House recovery initiative, will you commit to funding additional research on how we can expand access to medication-assisted treatment?

I'd commit to funding any research program that will improve outcomes because I completely agree with you, Senator. It's a major problem. I think 80,000 Americans died in 2024.

If you come to my state, you will meet families who've lost more than one child or one family member to the fentanyl epidemic in particular.

I want to take any steps I can. Happy to work with you on that.

Thank you. Now, the National Cancer Institute at the NIH awarded 300 fewer research projects last year compared to the year before, meaning that Americans fighting cancer will have to wait longer for potential breakthrough treatments and cures. This is due to the cuts that the NIH has made to critical areas of medical research, something that the Chairman raised in his opening comments. For example, one of the ways in which you cut research is by requiring researchers to spread out one year of funding over multiple years, which means that there's less money available for new projects. Has the NIH conducted a comprehensive review of how National Cancer Institute funding disruptions have harmed cancer patients?

Okay, so just it's not true that we cut funding. We spent the entire NIH budget last year was spent. So we did not cut funding.

The researchers in New Hampshire whose patients have suffered would like to know have you studied the impact of your funding disruptions, and I'm using the word disruption here, have you studied the impact on actual cancer patients who were in mid-trials?

So we made sure that if there was any disruption in a trial, that the patients had the resources they needed to get continuity of care. The commitment the NIH has to funding cancer research is undiminished. Undiminished.

Well, my question is have you done a study to look at the impact, the harms that cancer patients have experienced? If they haven't, doing a good, objective, scientific study will show that. But have you done a study?

I mean, the NIH funds studies, we don't conduct directly the studies like that. So let me just say very clearly, I do not believe that patients' care was disrupted because I ordered if there was any disruptions at all that the patients would have continuity of care. If there were disruptions, then it is the responsibility of the researchers that were managing the patients, not the NIH.

That is really an unacceptable and outrageous response. You all disrupted funding. You can make an edict from Washington, D.C., oh, don't disrupt continuity of care, but that can be a very complicated thing. And I know that in my state there were disruptions in these studies that have really put patients at risk, and you all should be interested in that data and you should be working to find out whether it happened. Now, I'm going to move to another topic. I've got only about a minute 20 seconds, so I want to go to my next topic. Last week, Secretary Kennedy appointed vaccine cynics to the Interagency Autism Coordinating Committee, a federal advisory committee responsible for coordinating the federal government's autism programs and research. Several of these new members have stated that they believe vaccines cause autism. Now, I know you've had an exchange with Senator Sanders about this, but I want to just be clear: do you believe that vaccines cause autism?

I don't believe... I believe there's great evidence that the measles vaccine does not cause autism. I have not seen any scientific study for any other vaccine that convinces me that it causes autism.

Dozens of studies involving more than one million children have thoroughly debunked the theory that there's a connection between vaccines and autism. Do you agree with that?

I agree that when you're studying anything like this, you can't just say vaccines, you have to say vaccine by vaccine, right? So I believe, I've seen so many studies on measles vaccines and autism that establish that there is no link. Other vaccines are less well-studied.

But the theory of what caused the alleged link is about a component that is used for the delivery of vaccines and is a common one used throughout vaccines. I really, you know, that theory has been debunked by a broad set of studies with over a million children, and relitigating debunked theories about vaccines doesn't get us closer to the answer of what causes autism. In fact, there is good science that indicates it's probably a combination of genetic factors and possibly environmental factors, right? And there's a good summary of that in a Washington Post article from late December of the science here. And I would hope that what the NIH is doing is moving forward on what the science is telling us so that we can address autism rather than relitigating this. And when vaccine cynics who say that vaccines cause autism are put on the advisory board, this hurts people all around the country. It is very dangerous to our public health and to our families who experience autism. Thank you.

Just very fast, we funded a study, this autism data science initiative that's looking at the environmental and genetic potential causes of... I mean, I don't know what causes autism. I don't think anybody really does. And so that's the NIH is committed to getting an answer for the millions of families that have...

And I appreciate that, Mr. Chair, with one minute of indulgence. The smart and responsible thing to do then would be to say to families, there is promising science, we don't know for sure, but this is where it's leading us, and to relieve their concern that getting their kids vaccinated is going to cause autism. That would be the responsible thing. Thank you.

Senator Banks.

Thank you, Mr. Chairman. Dr., you don't know what causes autism, but it's clear that there has been a significant increase in the number of cases of autism, correct?

Correct.

What can you give us some color on that? I mean, what are those statistics?

I mean, I think in let's say 1985, there were one in 10, one in 20, one in 30,000 kids were diagnosed with autism, and now it's one in 31. An enormous exponential increase in just a few short decades.

I wasn't going to bring this up listening to the questioning before me. I mean, it's also true that this administration under your leadership is doing more to study and try to find the causes of autism than any administration before you. Is that correct?

Absolutely, that's correct. I mean, we've established, as I was telling Senator Hassan, that we've established a new program to study autism to try to get an answer for millions and millions of families, what is the reason why? And it's going to be complicated. Autism is a complicated condition with severe disease and less severe disease. The biology is complicated. It's not just simply genetic, although that's been a theory. People have been saying it's just psychiatric, but that's been a theory. I think it's going to the answer's likely to be a very complicated biomedical process and it's going to be different for different groups of autistic patients.

This doesn't seem like a Republican or Democrat issue. It seems like one that we should all be thanking you and this administration for doing more to figure out what's causing it and what we do about it. So I wasn't planning on asking you about that, but thank you for your leadership on studying the causes of autism because there are a lot of families in Indiana that are affected that appreciate that focus. Indiana is home to three R1 research institutions: Indiana University, Purdue, and Notre Dame. Just to give a few examples, IU is making groundbreaking discoveries into early-onset Alzheimer's research treatments. Purdue is focused on treatments for opioid addiction and pioneering the science of suppressing cancer-related genes as just one example. Notre Dame is exploring how to make malaria less resistant to antibiotics. Those are just a few examples of the type of important research that's going on in my great state to make Americans healthier. Dr., despite having the country's largest medical school at Indiana University and several top-notch research institutions, Indiana only gets about $350 million of NIH funding last year. To contrast that with the state of Massachusetts, which is virtually the same size as my state, received nearly $3 billion last year in NIH funding. What's going on here? Can you explain why schools on the coast seem to get more NIH funding than schools in states like my state that's doing a lot of research as well?

I mean, we have programs to try to get more money to places like Indiana that have been under... I think frankly, I've been around the country, I've been to Alabama, I'm hoping to visit Indiana and Kansas, a whole bunch of places. There are great ideas everywhere, Senator. What happens is the NIH, the way that we fund the facilities is tied to having great researchers already there that can win NIH money. But there's a catch-22 here, right? In order to attract great researchers, you have to have great facilities. You see the problem, right? It's a catch-22 that guarantees that our funding is going to be concentrated. I would love to work with Congress to find a way to break that link so that maybe introduce a market for facility support. So if Purdue can have a square foot of lab space more inexpensively than some other institution, that they would get a leg up in getting that money. Introduce sort of market thinking into distributing the facility support and unlink it from the grant projects. The projects are amazing, but linking the projects to the facility support I think is what leads to that concentration that you're talking about.

Yeah, I like the sound of that. Six states receive nearly half of all NIH funding, but the bottom 30 states only get 13 percent of the funding, I think to your point. How are you making sure that universities all over the country can compete equally for that funding? What does that metric look like? How can we help you develop a more competitive process?

Well, I think especially for that delinking, I'm going to need folks in Congress to help. But we're already using have something called the IDEAS program to direct more funding to places that have great ideas that don't necessarily always get our funding. The other thing is we've changed the way that the institutes select projects to make sure that there is this sort of geographic diversity. It makes scientific sense because you want schools of thought, competition, concentrating in a couple places gets scientific groupthink.

I appreciate your leadership, appreciate everything that you're doing. Mr. Chairman, I yield back.

Senator Banks, my staff is very interested in pursuing this, so we'd love to collaborate with you on this. I agree with Bhattacharya that we need to have good institutions, but you also need it not to be self-fulfilling. So thank you. And now to Senator Kaine, wearing a really good tie.

Very Mardi Gras. Dr. Bhattacharya, thank you for being here. I want to begin with an interchange you had with Senator Marshall about long COVID. When you and I met in my office prior to the hearing around your confirmation, I talked about my own long COVID experience that has been consistent for now six years. Thank goodness it's mild and annoying rather than debilitating, but I have Senate colleagues who have also dealt with their own long COVID issues and also Senate colleagues' family members have. This is a big issue. I was happy to hear that Secretary Kennedy convened roundtables that included Senator Marshall and Senator Young in September. ...is a priority that's being taken seriously. Can I get your commitment to send me more?

Absolutely, Senator. Happy to, because the NIH is committed to finding an answer for long COVID patients.

And I appreciate your point that it's not just about finding the biomarker. If you can, even if that's confusing, if you can find treatments that are working, that's a really good thing. And so I look forward to talking to you about that. You preside over an agency that has shrunk dramatically. Before you were confirmed at the end of 2024, NIH employed more than 21,000 people. Entering this year, the workforce has been reduced to 17,300, and of those nearly 5,000, I'm sorry, nearly 4,000 departures, 1,100 were doctoral-level scientists. In preparation for this hearing, I reached out to Virginia grantees, and here's what I hear about their interactions with NIH. First, significant delays in peer review and award cycles. In 2025, NIH canceled scores of peer review meetings, delaying evaluations of thousands of applications for about $1.5 billion in funding, a backlog that you're still resolving. Much of this happened before the government shutdown that began in October. That made it worse, but it was already a serious problem. Second, I hear from grantees increased burdens about the funding drawdown process. As they're trying to get funds drawn down on grants they've received, there are additional requirements that have been added to requirements that were already pretty burdensome. Third, backlogs and reduced award rates. NIH fell behind in awarding grants in 2025. Again, this started well before the October 1 shutdown. Fourth, disruptions to research programs and personnel. I think Senator Hassan asked you about that. Fifth, increased communications challenges. Grantees report communication with NIH has ground to a halt in many ways, and that NIH staff appear to be overstretched, carrying increased responsibilities. And finally, rapid policy changes without sufficient community input. Policies need to change, but there ought to be a dialogue about that. These, this is what grantees are telling me about their interaction with NIH now. And I look at that, those concerns, and I look at this shrinking of the workforce, and I believe that they have to be connected in some way. What are you doing to address these backlogs and challenges that the Virginia grantees and others are expressing?

Just don't have a ton of time, but let me just focus on the backlog. I am tremendously proud of our, of the NIH employees because we got all of those grants reviewed by the end of the fiscal year by, but that's why we were able to get the money out. Tens of thousands of reviewers devoted their time. I used to be one of those reviewers myself. And even after the Senate, after the shutdown in October, I thought I was really worried about that. Since the reopening of the NIH after the shutdown, people have just stepped up at the NIH and all across the country to review the grants. And we're basically not going to have any delay as a consequence of those of the shutdown. I mean, it's people have really stepped up, Senator. And we're working on filling personnel holes and all that. I mean, I personally don't want to see any delays because I was a researcher myself once. So it's something that we've worked on heavily and achieved a lot of success. I think there were disruptions last year, but I'm hoping this year that even with the shutdown and all that, we've figured out processes to be more efficient, reduce the amount of administrative burden and red tape, so to make researchers' lives easier to propose amazing ideas that will improve health.

I'll keep giving you feedback on what my grantees are expressing as we enter 2026. Thank you.

Thank you, Senator.

Doctor, welcome.

Thank you, Senator.

The signals that the administration is sending on medical research by proposing deep cuts in NIH's budget, which fortunately the Appropriations Committees in both the House and the Senate rejected, and the clawing back or termination of hundreds of grants could jeopardize our country's global leadership in medical research. There's another part of this that goes beyond the money, and that is the signal that it sends to young scientists and researchers. We know that China and Europe are actively recruiting the very best young minds that we have in this country. It used to be the flow was the opposite direction. We got the best of the best from around the world. But now we see young scientists and researchers, particularly at smaller institutions, which are already at a disadvantage compared to larger institutions when grant applications are scored under the current peer review system, considering is there room for me in America to pursue my passion? Just recently, the research professors at Bowdoin College in Maine mentioned this problem to me, but I've heard it from many other colleges and universities and young researchers themselves. Will the changes in NIH's new unified funding strategy improve the ability of these early-career scientists to be selected for funding?

Absolutely, yes. Funding early-career scientists is not just a scientific priority, because that's often where the source of new ideas come from, new promising ideas, but also, as you say, a national security priority. And it's a priority of mine specifically. I think this is a problem that goes way back. Once upon a time, you could get a large grant at the NIH, your first one, in your early 30s, and now it's in your mid-40s before you do. And so I've been focused on trying to solve this problem. I should say up front, though, that the United States is still the single best place in the world to have a career in biomedical research. I think 85 percent of all public funding for biomedical research, including foundation money, worldwide is the NIH. So if a researcher goes abroad, they're going to have a tougher time getting their ideas funded than if they stay in the United States. And that's the message I want to reach out to tell young researchers, early-career researchers. The NIH is absolutely committed to finding ways to give you the training you need and the support you need to try your ideas out, because that's the only way we're going to make America healthier.

That's a message that needs to be repeated time and again. And we don't need any more of these huge budget cuts submitted as part of the President's budget, which should be coming out soon. I want to touch you about an issue that we've discussed in our meetings, and that is women's health. I believe that some of the emphasis on doing away with diversity has had the unintended effect of worsening the neglect of research aimed at women's health. And we also know that there are health disparities. That, for example, pregnant women who are Black have a higher maternal morbidity rate than white women. We know that Asian women have a better outcome than white women. So I'm concerned that we not pull back from looking at these health disparities and figuring out why that is. And you and I have talked before about the flawed study that led to many women not receiving hormone replacement therapy during menopause. And so that points to the need for replication as well. But talk to me generally about how you are going to proceed to look at these health disparities and women's health if we're removing diversity as a criteria.

Senator, I'm absolutely committed to improving research that improves women's health. And we have not stepped back from that at all. And I think just broadly speaking, it's also true for minority populations. The mission of the NIH is to do research that improves the health and longevity of Americans, all Americans: women, minorities, everybody. In a way, the diversity frame, it sort of sets the bar too low. If we can improve the health of every single person in the United States, whether there's differences in outcomes or not, that's much less relevant or important than the fact of making people healthier. That's what I'm much more interested in. I'm interested in improving women's health, I'm interested in improving the health of minorities, and yes, especially for minority populations, there are worse health outcomes that need to be addressed.

Thank you.

Senator Hickenlooper.

Thank you, Mr. Chair. Thank you, Dr. Bhattacharya. You've previously described the mRNA platform as promising technology. There's recent research coming out of University of Florida, MD Anderson Cancer Center, that suggests that there's additional benefit from mRNA vaccines in terms of the body's immune response to cancer. In our recent past, NIH researchers have conducted numerous studies on the platform mRNA, and that research has been used as the basis for vaccine development projects at the Biomedical Advanced Research and Development Authority, BARDA, to great success and goes back through, I mean, some of that research actually goes back to University of Colorado and Tom Cech, and then through Jennifer Doudna and Emmanuelle Charpentier, and you have a Nobel Prize in there somewhere. And yet Secretary Kennedy has canceled all of the mRNA projects at BARDA. So $500 million of research got canceled. What's up?

Well, first, Senator, we have not canceled the mRNA, so for instance, we have research projects at the NIH for mRNA for cancer vaccines. And it seems to me like a quite promising technology. I mean, we'll see if it works out, but that'll depend on nature. But we haven't stopped our research on cancer vaccines for using mRNA.

Okay, but aren't you concerned that we're taking $500 million of research already in projects, PhD students are two years, three years into their PhD and their research is stopped? You talk about trying to keep young people excited about the field. How are you going to address that?

Well, I mean, I think, Senator, if you're asking me about the BARDA contracts, of course I'm not in charge of BARDA, but I'll say that refocusing the money on places where people trust the vaccines makes more sense to me, right? So the mRNA vaccines for COVID, for instance, had very, very low uptake. So it doesn't make a lot of sense to invest in a technology, instead invest in technologies that are promising, that have already much more public trust, seems like a better public health investment. That's separate from the NIH investment. The NIH investment is about research for the future: better vaccines, better treatments for cancer, and that's where I've focused my efforts.

Got it. I guess I'm concerned about that uptake, that you're saying there's not as much uptake with the mRNA vaccines. I don't think there's any science that backs that. So we should all be concerned about that and make sure that we are pursuing those delivery vehicles that are the most successful. Let me switch to the INCLUDE project, which we've discussed and are aware of. It's an effort to make groundbreaking discoveries about conditions that disproportionately affect people with Down syndrome, as one example, things like Alzheimer's disease, the probability that they'll get Alzheimer's is dramatically higher. So led by the office of the NIH Director, the INCLUDE project brings together multiple NIH institutes under a coordinated approach that is delivering significant scientific discoveries and new treatments simultaneously. And we've worked hard to advance the bipartisan DeOndra Dixon INCLUDE Project Act, which would finally codify this, I think, extraordinary initiative. How can the INCLUDE project serve as a model at NIH for improved scientific collaboration and return on taxpayer investment?

It's a wonderful project, Senator, as you know when we spoke, and I wholeheartedly support it. I mean, I think the reason why it works is because it does involve work from multiple institutes, right? Collaboration with the National Institute of Aging, with the National Institute of Child Health and Development. I mean, so it's kind of a model and other institutes as well. It's a model of scientific collaboration that can happen only at a place like the NIH. I've been working to break down those walls, not just for the INCLUDE project, but for so many other, the long COVID projects, for instance, is a good example involving multiple institutes. It's so easy when you're in academics to just focus on your field, but that's not how you get big advances.

Right. Well, I hope the congressional report language directs NIH to fund no less than $90 million for the INCLUDE project and calls for increased baseline research funding for Down syndrome. Hopefully we can stay focused on that. I do feel, and I hear this from people in Colorado all the time, that they feel there's a war on science in Washington. They feel that there's kind of widespread, reckless disassociation or deconstruction of some of the foundations of our research. So I know from our conversations that you share the concern and probably disagree with how real the threat is.

I guess I'd say come spend a day with some of the scientists at the NIH. There's no war on science. There's just a desire to have our science really help the American people get healthier. That's what I see every day at the NIH.

Great. Well, thank you for your work. Appreciate it.

Senator Murkowski.

Thank you, Mr. Chairman. Dr. Bhattacharya, welcome back to the committee. I appreciate the responses that you had to Senator Collins, particularly as it related to challenges for early-career scientists and what we do to inspire, to encourage them, to keep them here in this country to view the opportunities here. So I am hopeful that the modernization plans that you are prioritizing really do focus in on some of these retention matters. I think it's so important in so many different spaces. I also want to acknowledge her question and your response as it related to women's health and the need to ensure that when we're talking about health disparities, when we are talking about those matters where we are looking at specific populations, we don't just say, well, we have to put everybody in the same bucket. Everybody, rising tide lifts all ships, and so we're just going to focus on everybody, when in fact there are certain populations that do have health disparities that are so remarkable, and remarkable usually in a negative way. And that's certainly the case for Alaska Natives, Native Hawaiians. You and I have had a conversation about this. These communities continue to experience some of the highest health disparities, lower life expectancy, higher rates of chronic disease, behavioral health challenges, suicide, particularly in the remote and rural areas. And so making sure that when it comes to health research and access to care, we are evening these areas so that we can really focus in on why we have these significant health disparities. So you've mentioned in response to Senator Collins your effort when it comes to women's health, you mentioned minorities in general, but can you speak to your understanding again to the disparities as they affect Alaska Native, Native American communities? And NIH's responsibility, because it's a different responsibility here, you've got a federal trust responsibility to our tribal nations. Can you put that in context for me?

Absolutely, Senator. Thank you for that question. I've had the privilege of multiple multi-day meetings with tribal councils to understand the challenges of doing research on those populations, or with those populations, I should say. You're absolutely right, the health needs of those populations are severe: higher rates of diabetes, higher rates of alcoholism and drug abuse, a much lower life expectancy. And we entirely agree we have a special obligation, special treaty obligation to help. At the same time, there's deep distrust in those communities for researchers. They don't want a pinheaded scientist like me descending on them and doing research. What they want is community participation in research. And I've been working with folks at the NIH to make that happen, make that a reality, where the Native communities have an input into the research questions that get asked, have control over the biosamples that they contribute to these research projects. I want to build that trust relationship so that we can help answer the questions that can make those communities healthier.

Well, and I would offer some of the expertise that we have in Alaska and would welcome a visit for you to sit with some of these experts just about this. Let me ask about some of the vacancies that we are currently seeing within the NIH. I'm concerned that 15 of NIH's 27 institutes and centers are under some form of interim leadership. In other words, they don't have any permanent directors. It's my understanding that you haven't replaced these directors yet. Efforts are ongoing. At least one institute, the National Human Genome Research Institute, has been operating without a director for 10 months now. We get you've got to have good folks in place, and I respect that you're seeking that, but can you give the committee any quick update on the process and timeline for filling some of these really important leadership roles?

Sure, Senator. So I've established a process to make sure that there's excellent scientific input as the primary driver for who I suggest take control of those agencies. We're moving as fast as we possibly can. Just this week, I made recommendations for two of those institutes. The Secretary, of course, has the final say, but he's listening to my scientific judgment. So we're working as fast as we can, but I don't want to shortcut the process of identifying dozens and dozens and dozens of candidates who have applied for every single one of those positions. We're interviewing them, we're having scientific staff interview them. The focus is on getting professional judgment of the NIH folks to help make good advice about who should be the next director of those institutes. I agree with you, those institutes and leadership are tremendously important.

Appreciate that. Thank you, Mr. Chair.

Senator Blunt Rochester.

Thank you, Mr. Chairman, and thank you, Director Bhattacharya, for being here today. I want to start by saying I was really pleased to hear you as the head of the NIH encourage parents to vaccinate their children for measles, especially in light of the outbreaks in Texas and South Carolina. So thank you for that. On Monday, January 5, 2026, the CDC Acting Director Jim O'Neill announced an immediate and sweeping overhaul of the child and adolescent vaccine schedule after signing off on a decision memo requesting this change from you, CMS Administrator Oz, and FDA Commissioner Makary. Is that correct?

Yes.

The new vaccine schedule downgrades the recommendation of vaccines for all children from 17 diseases to 11. Historically, this type of decision would have been made through the public process of convening the ACIP. So since this is kind of out of the norm, very out of the norm, I wanted to ask you a few questions about the process and outcomes. First, how many fewer children are you projecting will be vaccinated due to this change?

I suspect, I expect more children will be vaccinated due to this change, not fewer.

And if you can, can you share the analysis or study that demonstrates that more children will be vaccinated?

It's a question of public trust, Senator. I've watched with...

But was there a study?

I mean, we did, yes, there was a study. It was released with this. Part of the decision memo was a study of the vaccination schedules as it was...

Can you share it? I only have a little bit of time, and I've got a lot of questions. Could you just share that study with us? That would be great.

Yeah, I think that was publicly released, but happy to share the study.

Okay, great. And in that analysis, how many more children will be diagnosed with meningitis or hepatitis or the flu?

Again, I think that there will be more children vaccinated as a result of the change, not fewer.

Did you recommend any type of plan to measure the impact of the changes to this childhood vaccine schedule on health outcomes?

I mean, the CDC tracks that carefully. So those measures will be released publicly just as the CDC always does.

And we know that specific vaccination rates must be met to prevent outbreaks. So it seems very reasonable that this is something that would have or should have been evaluated before making that kind of sweeping decision. Your memo notes that the changes were made after, quote, "careful review of the current vaccine schedule, peer nation schedules, and best practices." And these are just a couple of yes or no questions. Did you consider the unique patterns and causes of disease in each region, like the U.S. versus Europe?

I mean, I didn't, I'm not the author of the memo itself, of course. But I read the memo very, very carefully. I mean, it was a careful analysis of the vaccine schedules of other countries, of our peer nations, the Danish schedules, the Scandinavian schedules, other Scandinavian schedules.

I'm going to get to that. In that assessment, do we look at the differences in pre- and postnatal, pediatric and primary care, or consider maternity leave policies or health insurance or healthcare workforce?

I mean, we considered that there are differences in healthcare policies, absolutely. I mean, we, I mean, this memo considered the differences in healthcare policies, absolutely. I think there's a fallacy here, right? The idea that Americans have sort of different ways of accessing healthcare than Scandinavians, and in some ways Scandinavians it might be easier. That makes it harder for Americans. If you want to have a larger vaccine schedule by essentially making parents feel guilty over things that they don't have control over.

Well, it was just strange to me that we're comparing ourselves to Denmark as a peer nation. Denmark has 6 million people, we have 340 million people from all walks of life. That's like 57 times larger. Denmark has socialized medicine and universal healthcare, the United States does not. Parents in Denmark are entitled to paid parental leave, in the U.S. this is not guaranteed. So I'm trying to understand the comparison of Denmark to the United States, with the exception that they have one of the lowest recommended vaccine rates.

The key thing in Denmark is that they have strong public trust in public health. That's what we're trying to do is re-establish that public trust, because the vaccination rate responds, and this is there's a ton of literature on this, the vaccination rate responds very sensitively to the level of public trust in public health.

I totally agree with you on the public trust piece. And I think that's what is concerning me, is that instead of modernizing, we're actually going backwards to a time when we didn't even have vaccines. So to me, it's very important that we be really clear about the science. I look forward to you sharing...

And I'm going to combine, I'll take my time now. Dr. Bhattacharya, we'll combine the conversation with Murkowski and Blunt Rochester. There are sections of our country that look like Denmark, in which highly educated folks who have easy access to vaccination. But the diversity that Murkowski was speaking about, which you agreed with, there are areas in our country where that is not the case. And those that put together vaccine schedules in the United States take into account the behaviors of different types of patients. Again, if you're wealthy from Boston, you're going to have one experience. And if you're less wealthy, if you're poor from a rural town in Louisiana, you're going to have another. Now, if we pattern after the place that is wealthy, we're not meeting the needs of those who are poor. And so I have to admit, I was a little bit kind of like, what? We're like Denmark? I was just kind of like, that's a crazy idea.

I mean, so Senator, I guess the way I'm thinking about it is a place like Louisiana and others where there's more distrust of the public health.

Can I stop you for a second? You had mentioned, and I thought this was very positive, that you have found that the stereotype of the Secretary being unopened to new ideas. Have you discussed vaccines and autism with him?

Yes.

And did he change his ideas?

I mean, you'll have to ask him, Senator, but I've discussed...

I've discussed, and he's not. And I say that because at some point, there's a wonderful scripture about how the clear note sounds. If the clear note is, yes, you can trust. And to the credit to the Secretary, after two kids died in West Texas from measles, a vaccine-preventable disease, the clear note finally went out: you should get vaccinated. My fear is that we're going to have meningococcemia with children losing fingers and legs and noses because now we don't vaccinate routinely for meningococcemia, rare but highly consequential. This is dangerous, and I'm afraid that that cacophony of notes is going to further undermine trust. Do you not see that?

I mean, I guess I think of it differently. I think that we have to re-establish trust. Absolutely, I share your goal entirely. And the question is the method of re-establishing trust. I think that if you just double down on what we've previously done that led to the loss of trust, we're not going to change it.

Well, we were both professors, I don't mean to interrupt, but we're both professors, and we know that, it may seem lofty, but education is the way that you address trust. Now we have a measles outbreak among those who did not trust. Now is it to further cast doubt upon the measles vaccine that say that the MMR should be divided into three doses, for no scientific reasons, to increase the number of shots that a child has to take? No, that's not going to increase trust and it's going to decrease complete immunization rates. We know that from experience. I'm just curious about that.

I'm not certain that that's true, Senator, that we will not. I mean, I think the key thing about the Danish experience is that establishment of public trust by being open...

That's because the Denmarks are, it's a club. It's not a country, it's a club. If you go to Denmark, you know it's like going to your Kiwanis Club. Everybody knows each other, they all look alike. And that ain't our country, you know what I'm saying?

I mean, I don't know. I know several Danish people and they are very different from each other, but I don't want to stereotype. I think the key thing is how do we re-establish trust? ...reestablish trust.

How?

And I think that's a clear note. If you keep on telling people permutations of what is false, they don't know who to believe. Let me just move on to something else and I may have a second round since I'm here till the very end. I want to quickly develop, and you and I spoke to this on the phone, there are researchers in every state in this nation that if they had access to that wonderful equipment and those resources at NIH, they could achieve their goal of helping our country get healthy. Please elaborate on your ideas and the things we discussed of how that can become a possibility.

Absolutely. So the NIH is divided into two parts: the intramural program and an extramural program. The intramural program is what happens, for instance, in Bethesda, at Rocky Mountain in Montana, a whole bunch of other places where NIH employees, scientists themselves, do research. Extramural is all the scientists that we support all across the country in universities and elsewhere. I want, just as you do, I think, I know that I want to make sure that we have collaboration, that the intramural program serves as a resource for scientists all across the country. We have some great examples of that: the National Institute of Aging, the Center for Alzheimer's Research, where people, extramural scientists, can use resources at the NIH that they wouldn't otherwise have access to, especially in places that universities that don't have those facilities. There's the NCATS repurposed drugs program where they can participate. I think that's such a great idea, Senator, and I would love to work with you on making that more expansive across the NIH.

Okay, I appreciate that. Now we'll go to Senator Alsobrooks.

Thank you, Mr. Chair. We are sitting here, it's almost exactly a year since this committee's nomination hearing for Secretary Kennedy, when he asserted to both this committee and to me, given that he was neither a scientist, researcher, nor doctor, and in my opinion, he was wholly unqualified, that he would not substitute his uneducated judgment for science. Since then, Secretary Kennedy has made it his mission to weaponize science by slashing and delaying billions of dollars of critical grant funding, settling old scores by gutting research based on his personal views. So Dr. Bhattacharya, and this is so sad, you seem to know different, but much of this has happened on your watch. Now, the NIH under your leadership has canceled hundreds, over 383 clinical trials, impacting well over 74,000 patients, and this administration delayed thousands more because of politics held up by DOJ or other political appointees. One in particular, I have to tell you, the funding cut and this interruption was not just on a quote woke study in trial, but I am the daughter of a parent with Alzheimer's. And so I am very concerned, and particularly concerned with the Alzheimer's and dementia funding that this administration has recklessly delayed. So many Americans understand, like I do, so many families, just how precious time is for these patients and their loved ones in a battle against this unforgiving disease. And one trial delayed for over 205 days was a clinical trial of a brief anxiety intervention for mild cognitive impairment and mild Alzheimer's disease and their care providers. Now, this trial, interestingly enough, wasn't in a blue state, it was at Florida State University. And so Dr. Bhattacharya, why is this trial not a good use of taxpayer dollars or in line with this administration's agenda? Why was it delayed for over six months?

I mean, I'd have to look at the specifics of the trial, but generally on the Alzheimer's, there were supplements that were not actually directly linked to the study themselves, and those were the subject of our revisions.

But you're not familiar with this one, so your...

The specifics I'd have to look into. There's 383, you know, there's we've, as I said, like there's tens of thousands...

So not familiar with that one, but another trial delayed for over 200 days to the Hebrew Rehabilitation Center for the Aged in Massachusetts was entitled Trial to Reduce Antimicrobial Use in Nursing Homes. Now, you just said a moment ago that antimicrobial is very important, and with Alzheimer's disease and other dementias, and this trial was attempting to lower the rates of urinary tract infections in patients with Alzheimer's and dementia. And this trial, again, can you tell us why it was not a good use of taxpayer dollars in line with this administration's agenda?

Can I just say one thing? So I've heard so many different numbers about the number of trials we supposedly have canceled. I mean, ultimately what we did is we renegotiated the trials. And so I think my estimates, the estimates I'm hearing from my folks, is that ultimately it's only a dozen or so trials that were actually terminated. Almost every single other one of them, we've refocused to remove to depoliticize them and focus them on the actual science.

Well, there's nothing political about Alzheimer's, Dr. Bhattacharya, and as a matter of fact, it's not...

There were supplements to these trials that were political, and we renegotiated with the...

Well, let me, I have so little time. Let me name another one: Early Clinical Development of Modified PH8 for the Treatment of Alzheimer's Disease, Understanding the Mechanisms Linking Small Vessel Vascular Disease and Alzheimer's Disease. All of these were delayed for months by this administration. There's nothing political about these particular studies, and I disagree with you, there were not 12 that were canceled, there were 383 or so that were canceled. And so...

Or more, right? I mean, I think that that's the key point. Like we renegotiated...

Well, some of them were restored as a result of a lawsuit. So let's be honest about that. Some of these as a result of lawsuits the court had to force.

Senator, I don't want to disrupt essential science. In fact, I've made sure that when we do the renegotiation, we rescue the essential science and remove the politicization of it. So most of those restorations have to do with making sure that the researchers are focused on the scientific questions that can advance health, not on politics.

Well, I don't think that Secretary Kennedy agrees with you, and as a result of his disastrous decisions, what we know is that so many of our families are now waiting length of time...

That's not the Secretary I know. I mean, he wants these research...

Well, the facts don't lie. 383 trials canceled, seven, for example...

I'm saying like the ultimate, our estimates, the estimates I'm hearing from my folks, is a dozen, ultimately a dozen, not 383. Of the maybe 383 were paused, but they were restored.

Well, I again, I think that these are, there are so many, 10 grants at Indiana University terminated by Indiana, terminated by this administration. These were not restored, and the ones that I have mentioned have not been, and it's been disastrous and without reason. So I yield my time.

Senator Hawley.

Thank you very much, Mr. Chairman. Dr. Bhattacharya, good to see you again. Welcome. Two topics for you today. I want to start on the question of public trust. You were talking about it earlier, public trust in public health. One of the things that's so badly undermined public trust in the NIH in particular, and I think you addressed this when you were before the committee the first time for your confirmation hearing, was the work that NIH did and funded at the Wuhan Institute of Virology for coronavirus gain-of-function research and of course lied about it for two years or more. NIH denied that there had been any funding whatsoever that had gone to Wuhan and then ultimately had to admit after public reporting that indeed there had been gain-of-function research with NIH money through EcoHealth Alliance that had gone to Wuhan. My question to you is this: Has the NIH done under your leadership now a thorough review of all of the grants or other funding streams that may have gone not only to Wuhan but to other labs in China? Do we have a handle now on what NIH was doing over the last decade plus in funding? I think this is so important because we were misled, I say we, I mean the American people, were misled and lied to, and those of us who said, wait a minute, we think there's a funding stream there, we were called conspiracy theorists, kooks, crazies. It turns out it was 100 percent correct. So has NIH done a review of what funding streams have gone to Wuhan and to other labs?

Senator, I've been focused primarily on making sure that we don't currently have or in the future have. So I've put in policies to have better oversight of foreign collaborations. I've worked very hard on the dangerous gain-of-function. We've paused 40 grants that have some potential risk of dangerous gain-of-function and put in policies so that never happens again because that's to me, that's the most important thing. We can't ever do it again. I'm working on the review. It's a long, long review and it's going to, and I'd love to work with Congress and it's something that other parts of the administration are also interested in. It's a complex, it's a long, complicated story that unfortunately doesn't just involve the NIH. It also involves partners, foreign partners. And so I think it's something that we really should do, but we haven't, I can't tell you we've completed it at this point.

Don't you think that that accountability is important? I mean, don't you think to restore public trust is important that we level with the American people, that there's transparency, that we correct the record and say, here's actually what your government did with your tax money? Maybe it'll be little. I mean, maybe there won't be much beyond what went to Wuhan. I hope that's the answer. Maybe it's more than that. Whatever it is, I think the public deserves to know. And frankly, having been misled, this body was misled, maybe this committee, certainly the Homeland Security Committee was misled for the better part of two years when we were told over and over and over and over no tax money ever went to Wuhan, no gain-of-function research. That was a lie. That was a lie from the leaders of NIH at the time. I think those lies need to be corrected and the facts, all of the facts, however sordid and unpleasant they may be for the institution, need to come out so that the public can say, okay, we've cleaned house here, we've got some confidence in what our own government is doing with our tax money. Don't you agree with that?

I do agree with that. After a patient dies in a hospital, there's often a conference, a morbidity and mortality conference, where there's just an honest conversation of what went wrong. I think the United States desperately needs that.

Desperately. Well, will you make that a priority in your time at NIH?

Happy to, happy to collaborate with you and others in Congress to make that happen.

Good, I think it's absolutely vital. Let me switch topics now and ask you about the health of America's children. I'm wondering how closely you've looked at the effect of social media, Big Tech, social media, and AI on children's health. And I submit that this is increasingly becoming a public health crisis. Here's what I'm thinking. I've heard from parents who've testified before me in other committees that I chair that their children have been led to experiment with suicide and ultimately self-harm and ultimately in many instances sadly carry out plans for suicide at the behest of AI chatbots. The data on social media and children's mental health, children's physical health is astounding. Is NIH, here's my question, is NIH studying the effects of social media including AI-driven social media on children? Are you looking at that linkage from a health perspective?

I've seen those reports also, and as a parent myself, tremendously concerning to me. The NICHD, the National Institute for Child Health and Development, has a program on this, although specifically on AI and suicide, I'd have to look to see. But you know, that's a focus to make sure that our children grow up in a country where they're not exposed to those kinds of dangers, and we're going to have excellent science on that. If we don't already, we will make sure to focus on it.

Good, we desperately need scientific focus on it. We need good science on it, we need good data. And I will just tell you as a parent, I've got three children of my own, three pretty small children, and when I talk to my fellow parents and when I look at the numbers, I mean, in a recent study, 84 percent of parents said that they were very concerned or at least somewhat concerned about the effects of social media on their children. And when you talk to parents who have had chatbots urge their children to harm themselves, harm family members, harm parents, or heaven forbid take their own lives, this is a crisis. And it's not an isolated crisis, it is a systemic crisis in every school and I dare say in almost every home across the country. I think we need to have a comprehensive look from a data perspective and a science perspective of what this is doing to our children so we can figure out what we're going to do to protect kids and protect parents.

I entirely agree with you, Senator.

Thank you, Mr. Chairman.

I think I see an RFP coming. I just learned last night that there's a Mardi Gras in St. Louis. How about that? Yeah. Well, we'll go to the woman wearing the Mardi Gras jacket. So Senator Baldwin.

Thank you, Mr. Chairman. Good morning, or yes, it's still morning. Lost track of time. Thank you for having me. Last year, OMB Director Vought directed NIH to significantly change the way it funds grants by requiring half of all its research project grants to be multi-year funded. This would be a seismic shift with devastating consequences for research with no benefit whatsoever. Implementing this change would mean thousands fewer grants for life-saving research, fewer clinical trials to discover new treatments and cures for disease, and ultimately less hope for families who are pleading with us for help. So Dr. Bhattacharya, I am struggling to understand how increasing the use of multi-year funding was anything but a setback for NIH research. And how many, and there's a very specific question, how many fewer grants did NIH fund as a result of this policy last fiscal year?

Okay, so normally the NIH funds, just before, say 2020, about 20 percent of our portfolio was multi-year funded. It sometimes makes scientific sense to do it. For instance, you have a new research...

No, I don't want to get into an analysis. I'm asking how many fewer grants were funded as a result of this policy shift ordered by OMB last year.

I don't have an answer for the specific number.

I do. The answer is that NIH awarded 2,000 fewer grants last year because of this policy. That is 2,000 fewer opportunities for breakthroughs, etc. The good news is that Congress just rejected that harmful proposal. As the ranking member of the Labor, Health and Human Services Appropriations Subcommittee, I fought to get a provision to prevent the administration from implementing Russ Vought's multi-year funding scheme, including in it's included in the Labor-HHS bill. And I'm relieved that we were able to do the same or do that in the bill that passed the Senate last week. This was common sense and we shouldn't have had to have it come to that.

Well, I appreciate the bill, but I'm...

At NIH, decisions about science have always been left to scientists, free from political interference. In an agency of over 20,000 employees, historically only two have been political appointees. But that has changed under your leadership. As of last July, there were 10 political appointees at NIH, many of whom replaced career civil servants who served decades in those positions. So Dr. Bhattacharya, how many political appointees are there currently at NIH, and why do you need so many?

I mean, you say 10, I'll take your word. But I think the key to me is to make sure that the grant reviews that we do are not political. As you said, the...

And so having five times as many political appointees as before helps make them less political? I'm not sure that I understand that. But I also want to move on with a minute and 15 seconds left, that I share Senator Murkowski's alarm about the number of NIH institute and center director vacancies. They've left a serious vacuum in critical leadership positions. By my count, there are currently 14 institute director positions that are vacant. Is that correct?

I think it's 15, but yeah. 14. In just one year, this administration has fired or pushed out 12 NIH institute directors, nearly half of the agency's leadership. And on top of all of this chaos and tumult, you've changed the process for finding and recruiting the best and brightest leaders to fill these critical director positions. So Dr. Bhattacharya, is it true that you ended the long-standing practice of including external scientists as part of institute director search committees? Senator, I've been working very hard to make sure that the scientific... we've changed the process so that there's no formal committee because we don't have time for that. What we've done instead is we've informally reached out to external partners, but we've also made sure that the scientists at the NIH are the ones that are leading the selection of the new leaders. There's a dozen, I mean, some of the positions hundreds of people have applied, and we've made sure that...

I just want to remind you that the final fiscal year 2026 Labor-HHS bill that passed the Senate last week requires all institute director search committees to include external scientists and stakeholders with relevant experience. And I'm glad my Republican colleagues in both chambers agreed to making sure that NIH institute directors are the best qualified leaders in their field.

I share that commitment.

Senator Markey.

Thank you, Mr. Chairman. I was able to include the $15 million in the NIH budget for the research on social media's impact on children two years ago. So you've got the money, please complete the study. Dr., I'd like to begin with a straightforward question. Since you were confirmed as director, have any clinical trials been disrupted or stopped because of cuts to NIH grant funding?

There was no cuts to NIH grant funding, but there were disruptions last year in some clinical trials.

But there have been disruptions to some clinical trials.

Okay, but in my estimate, roughly about a dozen.

Well, HHS Secretary Robert F. Kennedy Jr. told Massachusetts Governor Healey in October that no clinical trials had been stopped. Do you agree with that statement?

I'd have to see what Secretary Kennedy actually...

That's what he said. He said that no clinical trials had been stopped.

We've not, we made sure that the clinical trials that were disrupted were renegotiated so that they were focused on the science and not on the political aspects of them.

Well, he challenged Governor Healey to show proof that these clinical trials had been stopped, and we now have the proof.

I'm just saying that there's been no patients... we've made sure that when there was the disruptions that the investigators had the resources to make sure that the patients had continuity of care.

Well, in January, Governor Healey wrote to RFK Jr. with evidence backed up by a JAMA study showing that 383 clinical trials lost NIH funding between February and August of 2025, affecting more than 74,000 patients nationwide, including 18 trials affecting 13,000 patients in Massachusetts alone. So I have these letters that I'd like to submit to the record, Mr. Chairman. And so this is the JAMA study for the record and the Governor's letter. And at your confirmation hearing in March, you said that you would absolutely commit to supporting research that advances the health of the American people. Are you saying that none of these nearly 400 clinical trials, including 118 cancer trials, 97 infectious disease trials, 47 mental health trials, advanced the health of the American people?

No, Senator, I'm saying that that number, that 383 number, I read that JAMA study. I'm saying that that number is not reality. Like the reality is at most something like a dozen clinical trials, by the estimates that we've seen, actually were terminated, and primarily because they were focused on political aims, not on advancing health. The disruption...

So you're saying JAMA, the JAMA study is wrong? Is that what you're saying? It's inaccurate?

It's inaccurate. It's based on an inaccurate list that didn't take into account the fact that we renegotiated and restarted the trials, removing the political component of it and focusing more on the health component.

So how many trials are you saying should be...

I mean, we're still working on the numbers, but the preliminary estimates I've heard is something on the order of a dozen, and they were many of them were basic experimental studies on humans, not actually clinical trials. Whereas the 383 number, I think, is just based on an inaccurate list.

Okay, well, that's not the number that we have developed in Massachusetts, and it's not the JAMA number either. Okay, so we're in a huge dispute with you on that. One of the pillars of your new priorities for NIH is to focus on training future physicians and scientists, yet everything we have seen from NIH since your confirmation contradicts this. Dr. Christopher Loker from Lowell told me how NIH grant cuts have forced his biotech company to cancel student fellowships, lay off 12 employees, and caused junior scientists to leave the profession entirely. And I can't help but agree with Dr. Loker's conclusion that, quote, 'Under your leadership, we are witnessing the sunset of American scientific preeminence.' So I request unanimous consent to submit Dr. Loker's testimony, Mr. Chairman, for the record. I also heard from a researcher at Northeastern University whose lab has done mental health research for over 16 years. NIH cuts have forced her lab to lay off research staff, and they did not even have enough money to fund their doctoral students' research through graduation. Back in December, the UMass Chan Medical School Chancellor Michael Collins told you in a meeting that if NIH funding uncertainties continue, quote, 'We could lose a whole generation of scientists, and it will take us a couple of generations to build it back.' The Chinese right now are absolutely gleeful that we are doing this to ourselves. It is an absolute historic mistake which we are making. How does cutting active research advance NIH's mission to support future biomedical researchers?

Senator, we didn't cut any funding. We spent the entire allocation that Congress gave for 2025. I think, as I said earlier, the United States remains the single best place in the world to do biomedical research, especially for young researchers.

Okay, thank you, Mr. Chairman.

All right, we'll wrap up here. First, I'll submit for the record a letter from Keith Yamamoto in Issues in Science and Technology, and there will be a question for the record regarding the better way to evaluate research results and reproducibility. Everybody agrees who's still here. Secondly, you've done a great job presenting yourself. Obviously well-attended, a lot of interest in this. Let's finish on a really positive note because there's a lot of positive things, Dr. J, that you've been doing. We speak about the 21st Century Cures Act and the All of Us program, allowing scientists, American scientists, to leverage the power of genomics and big data. And you've taken steps to improve access to these datasets from across NIH, not siloed, from across. Can you elaborate on that and tell us your vision for improving further access to these samples?

I mean, the All of Us dataset is an incredible dataset, Senator, as you know, almost a million...

Tell people what it is, because people are watching and they don't know what it is.

It's essentially a million genomes, right? Remember the Human Genome Project was to get one genome or a couple of genomes. We have a million people's genomes, and we're going to expand that access.

A million Americans across all walks of life, genetics, whatever.

Completely representative of every single aspect of America. And we've been working to make sure that many, many, many scientists have access to these data. I think the last estimates I saw were 21,000 scientists now have access to these data to ask...

Repeat that: 21,000 scientists now have access to it.

Yes, or 21,000 projects, I have to check. But I'll just give you an example, one project, right? So using the human genome to better predict whether you're at risk of heart disease, right? That's a that would be a big advance, especially as these genome sequencing technology becomes much more much cheaper and more widely available. We can use it to prevent heart disease at scale. I mean, I'm very excited by this and so many other projects that All of Us is producing.

And reasonably speaking, we opened up by speaking about the person who's desperate with his or her cancer, watching for hope. And this is a project which you are spreading out the information across scientists that can give them greater hope that we will find a cure.

Absolutely. For cancer, it is the it is potentially the future, like genetic characterization of cancer, personalized cancer treatment, moving away from very, very toxic chemotherapies and instead toward immunotherapy that are specifically tailored for the particular cancer you have. I mean, that's what the future is.

And one more thing, just to end on again just telling people what you're doing that's good. You told me about some dataset that you are allowing scientists from across the nation and another to access to allow a cancer type to be tested against different drugs. Could you elaborate on that?

Yeah, so there's a project at NCATS, the National Center for Translational Medicine, that essentially we have 3,000 small molecules, including almost every single drug that's approved by the FDA. And any researcher anywhere in the country can offer up a tissue sample, like maybe it's a cancer that they're studying or whatever, and see if any of those drugs have any action against that against that cancer or modifies the disease. It's a tremendous program because it allows researchers anywhere to take advantage of the resources we have available at the NIH that are almost unparalleled anywhere else.

So the person watching with a rare cancer can trust that somebody is testing his or her rare cancer against this however many drugs there are to see if there's anything with a clinical benefit.

Absolutely. And actually for Senator Sanders, I wish he'd let me talk about this, that's how we reduce drug prices. Because many of these drugs are off-patent or they're generic or they're and so if they work and they're off-patent, they're I mean, essentially you have a low-cost treatment for treating a disease. That's that's the NIH way of addressing drug price problems.

Great. Again, for any Senator wishing to ask additional questions, questions for the record are due 5:00 PM Wednesday, February 18. Thank you again, sir, for being here. The committee stands adjourned.

Thank you, Senator.