[House Hearing, 106 Congress]
[From the U.S. Government Publishing Office]




 
      DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, EDUCATION,
              AND RELATED AGENCIES APPROPRIATIONS FOR 2000
                 DEPARTMENTS OF LABOR, HEALTH AND HUMAN
               SERVICES, EDUCATION, AND RELATED AGENCIES

                        APPROPRIATIONS FOR 2000

_______________________________________________________________________

                                HEARINGS

                                BEFORE A

                           SUBCOMMITTEE OF THE

                       COMMITTEE ON APPROPRIATIONS

                         HOUSE OF REPRESENTATIVES

                       ONE HUNDRED SIXTH CONGRESS
                              FIRST SESSION
                                ________
  SUBCOMMITTEE ON THE DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, 
                    EDUCATION, AND RELATED AGENCIES
                 JOHN EDWARD PORTER, Illinois, Chairman
 C. W. BILL YOUNG, Florida            DAVID R. OBEY, Wisconsin
 HENRY BONILLA, Texas                 STENY H. HOYER, Maryland
 ERNEST J. ISTOOK, Jr., Oklahoma      NANCY PELOSI, California
 DAN MILLER, Florida                  NITA M. LOWEY, New York
 JAY DICKEY, Arkansas                 ROSA L. DeLAURO, Connecticut
 ROGER F. WICKER, Mississippi         JESSE L. JACKSON, Jr., Illinois 
 ANNE M. NORTHUP, Kentucky
 RANDY ``DUKE'' CUNNINGHAM, 
California                         
                                   
 NOTE: Under Committee Rules, Mr. Young, as Chairman of the Full 
Committee, and Mr. Obey, as Ranking Minority Member of the Full 
Committee, are authorized to sit as Members of all Subcommittees.
  S. Anthony McCann, Robert L. Knisely, Carol Murphy, Susan Ross Firth,
                and Francine Salvador, Subcommittee Staff
                                ________
                                 PART 4B

                      NATIONAL INSTITUTES OF HEALTH

                              

                                ________
         Printed for the use of the Committee on Appropriations
                                ________
                     U.S. GOVERNMENT PRINTING OFFICE
                            WASHINGTON: 1999
 56-686




                                  COMMITTEE ON APPROPRIATIONS

                   C. W. BILL YOUNG, Florida, Chairman

 RALPH REGULA, Ohio                      DAVID R. OBEY, Wisconsin
 JERRY LEWIS, California                 JOHN P. MURTHA, Pennsylvania
 JOHN EDWARD PORTER, Illinois            NORMAN D. DICKS, Washington
 HAROLD ROGERS, Kentucky                 MARTIN OLAV SABO, Minnesota
 JOE SKEEN, New Mexico                   JULIAN C. DIXON, California
 FRANK R. WOLF, Virginia                 STENY H. HOYER, Maryland
 TOM DeLAY, Texas                        ALAN B. MOLLOHAN, West Virginia
 JIM KOLBE, Arizona                      MARCY KAPTUR, Ohio
 RON PACKARD, California                 NANCY PELOSI, California
 SONNY CALLAHAN, Alabama                 PETER J. VISCLOSKY, Indiana
 JAMES T. WALSH, New York                NITA M. LOWEY, New York
 CHARLES H. TAYLOR, North Carolina       JOSE E. SERRANO, New York
 DAVID L. HOBSON, Ohio                   ROSA L. DeLAURO, Connecticut
 ERNEST J. ISTOOK, Jr., Oklahoma         JAMES P. MORAN, Virginia
 HENRY BONILLA, Texas                    JOHN W. OLVER, Massachusetts
 JOE KNOLLENBERG, Michigan               ED PASTOR, Arizona
 DAN MILLER, Florida                     CARRIE P. MEEK, Florida
 JAY DICKEY, Arkansas                    DAVID E. PRICE, North Carolina
 JACK KINGSTON, Georgia                  CHET EDWARDS, Texas
 RODNEY P. FRELINGHUYSEN, New Jersey     ROBERT E. ``BUD'' CRAMER, Jr., 
 ROGER F. WICKER, Mississippi            Alabama
 MICHAEL P. FORBES, New York             JAMES E. CLYBURN, South Carolina
 GEORGE R. NETHERCUTT, Jr.,              MAURICE D. HINCHEY, New York
Washington                               LUCILLE ROYBAL-ALLARD, California
 RANDY ``DUKE'' CUNNINGHAM,              SAM FARR, California
California                               JESSE L. JACKSON, Jr., Illinois
 TODD TIAHRT, Kansas                     CAROLYN C. KILPATRICK, Michigan
 ZACH WAMP, Tennessee                    ALLEN BOYD, Florida               
 TOM LATHAM, Iowa
 ANNE M. NORTHUP, Kentucky
 ROBERT B. ADERHOLT, Alabama
 JO ANN EMERSON, Missouri
 JOHN E. SUNUNU, New Hampshire
 KAY GRANGER, Texas
 JOHN E. PETERSON, Pennsylvania    
                                   
                                   
                                  (ii)




                            C O N T E N T S

                              ----------                              

                               LABOR/HHS
                               VOLUME 4B

                                                                   Page
National Institute of Nursing Research...........................     1
National Heart, Lung, and Blood Institute........................    61
National Institute of Environmental Health Sciences..............   169
National Institute of Neurological Disorders and Stroke..........   285
National Institute on Aging......................................   389
National Institute of Mental Health..............................   467
National Institute of Diabetes, Digestive and Kidney Diseases....   559
National Institute of Arthritis and Musculoskeletal and Skin 
  Diseases.......................................................   687
National Center for Research Resources...........................   775
National Institute of Allergy and Infectious Diseases............   839
National Eye Institute...........................................   969
NIH-Panel: Office of the Director, Buildings and Facilities, 
  National Center for Complementary and Alternative Medicine, 
  Office of AIDS Research........................................  1047
Nobel Laureate Panel.............................................  1487

                                 (iii)







[FULL TEXT OF HEARING IS NOT AVAILABLE.  SEE COMMITTEE FOR COMPLETE HEARING.]





                           W I T N E S S E S

                              ----------                              
                                                                   Page
Baldus, A.C......................................................   285
Barros, C.F......................................................   389
Berg, Dr. Paul...................................................  1487
Cech, Dr. T.R....................................................  1487
Chang, Dr. D.D...................................................  1487
Chiang, Sabrina..................................................   969
Duff, Judith.....................................................   969
Faui, A.S........................................................   839
Ficca, S.A.......................................................  1047
Fischbach, Dr. G.D...............................................   285
Fitzsimmons, W.T.................................................   467
Goldstein, Dr. J.L...............................................  1487
Gorden, Dr. Phillip..............................................   559
Grady, Dr. P.A...................................................     1
Harlan, Dr. William..............................................  1047
Hausman, Dr. S.J.................................................   687
Heberlein, Dr. Ulrike............................................  1487
Hernandez, Milton................................................   839
Hodes, Dr. R.J...................................................   389
Hyman, Dr. S.E...................................................   467
Itteilag, A.L....................................................  1047
Johnson, Laurie..................................................   169
Katz, Dr. S.I....................................................   687
Kerza-Kwiatecki, M.S.............................................   687
Kirby, K.E.......................................................   285
Kirschstein, Dr. Ruth............................................  1047
Kupfer, Dr. Carl.................................................   969
La Montagne, John................................................   839
Laurence, L.E....................................................   559
Lenfant, Dr. Claude..............................................    61
Leveck, Dr. Mary.................................................     1
McLaughlin, Dr. J.A..............................................   969
Nakamura, Dr. R.K................................................   467
Nathanson, Dr. Neal..............................................  1047
Olden, Dr. Kenneth...............................................   169
Penn, Dr. A.S....................................................   285
Pine, J.R........................................................   467
Ramm, Dr. L.E....................................................   775
Rivers, Heriberto................................................     1
Ross, K.S........................................................   389
Roth, Dr. Carl...................................................    61
Strachan, R.J....................................................   687
Summers, A.E.....................................................   775
Thomas, P.J......................................................  1487
Tibbs, John......................................................    61
Vaitukaitis, Dr. J.L.............................................   775
Varmus, Dr. Harold61, 169, 285, 389, 467, 559, 687, 775, 839, 969, 1047
Wehling, James...................................................    61
Weiblinger, G.M..................................................   467
Wetle, Dr. Terrie................................................   389
Williams, D.P.....61, 169, 285, 389, 467, 559, 687, 775, 839, 969, 1047
Williams, Thomas.................................................   839
Wilson, Dr. S.H..................................................   169
Zellers, C.R.....................................................   559





                               I N D E X

                              ----------                              

                 National Institute of Nursing Research

                                                                   Page
Assisting Families Whose Children Have Diabetes..................    19
Budget Mechanism Table...........................................    20
Chronic Illness..................................................     1
Diabetes and Minorities..........................................    15
Dissemination of Research Results on Diabetes....................    10
End of Life Research.............................................     3
Genetics and Nursing Research....................................    16
Health Promotion and Disease Prevention Research.................     2
Health Disparities...............................................     2
Introduction of Witnesses........................................     1
Justification of the FY 2000 Budget Estimates....................    26
Opening Statement................................................     4
Priority Setting.................................................    24
Quality Home Health Care.........................................    22
Research of Home Care and Caregivers.............................    11
Research on the Internet.........................................    10
Size of the NINR Budget..........................................    12
Specialized Research Center......................................    21
Telehealth Research..............................................    14
The Future Supply of Nurses......................................    11
Transferring Research Results into Practice......................    17
Transitional Care................................................    24
Unfunded Research Applications...................................    13
Wound Healing Laboratory.........................................    19

               National Heart, Lung, and Blood Institute

Abdominal Aortic Aneurysm........................................    96
Acute Respiratory Distress Syndrome (ARDS).......................    95
Asthma.....................................................97, 112, 114
Asthma Web Site..................................................    73
Behavioral Research..............................................    84
Cardiovascular Disease...........................................    97
Cardiovascular Disease and Diabetes.............................95, 103
Cardiovascular Disease Prevention in Young People................   105
Cardiovascular Diseases..........................................   109
Centers for Genomic Analysis.....................................    90
Clinical Research Networks.......................................    82
Clinical Trial Recruitment.......................................    83
Cooley's Anemia.................................................81, 116
Cord Blood.......................................................    90
Coronary Artery Bypass...........................................   100
Creutzfeldt-Jakob Disease and the Safety of the Blood Supply.....   100
Death Rates for Heart Disease in Whites and Blacks...............    79
Designer Estrogens...............................................    89
Diabetes.........................................................   114
Emphysema.......................................................87, 107
Emphysema and Retinoic Acid......................................    73
Enviornmental Health Research....................................    85
Fiscal Year 1999 Initiatives.....................................    66
Fiscal Year 2000 Budget Justification............................   121
Freedom of Information Act.......................................   101
Funding for Disease Areas........................................    87
Funding for Heart Disease Research...............................    81
Heart Disease....................................................   113
Heart Disease Care...............................................    83
Heart Disease in Mississippi.....................................    78
Heart Disease Risk for Women.....................................    75
High Blood Pressure..............................................   118
Infections and Chronic Disease...................................    76
Lifetime Risk for Heart Disease..................................62, 76
Lifetime Risk of CHD.............................................63, 64
Mechanism Table..................................................    93
Minority Programs................................................   120
NIH Network......................................................    74
Nutrition........................................................    88
Overweight and Obesity..........................................92, 104
Prevention and Education.........................................    70
Primary Pulmonary Hypertension...................................   111
Research:
    Advances.....................................................    68
    Opportunities................................................    61
    Training.....................................................    74
Salt Consumption.................................................    98
Sleep Disorders..................................................    91
Socioeconomic Status.............................................    92
SOCRATES.........................................................    96
SPARK Working Group..............................................    93
Specialty Care...................................................   109
Tissue Remodeling................................................    91
Tobacco Use and Heart and Lung Problems..........................   108
Witnesses, Introduction of.......................................    61
Women's Health Initiative.......................................88, 116

          National Institute of Environmental Health Sciences

Alternative Medicine.............................................   191
Animal Testing...................................................   228
Asthma...........................................................   231
Autoimmune Diseases..............................................   206
Birth Defects....................................................   198
Blood Samples....................................................   209
Breast Cancer....................................................   214
Budget Mechanism.................................................   207
Children's Environmental Health Centers..........................   217
Children's Health..............................................173, 215
Citizen Input....................................................   213
Collaborations with NCI..........................................   192
Community-Based Studies..........................................   226
Community Concerns...............................................   196
Coordination with EPA............................................   195
Critical Environmental Health Research Areas.....................   170
Definition of Environment........................................   194
Dietary Supplementals............................................   206
Dioxin.........................................................220, 224
Electric and Magnetic Fields.....................................   205
Environmental Causes of Disease..................................   193
Environmental Factors That Impact Health.........................   197
Fibroids.........................................................   198
Freedom of Information...........................................   210
Frog Mutations...................................................   200
Gender Differences...............................................   235
Health Disparities:
    Environmental Justice......................................203, 236
    Poverty and Health...........................................   216
International Programs...........................................   203
Introduction of Witnesses........................................   169
Justification of FY 2000 Budget..................................   238
Juvenile Diabetes................................................   216
Medicinal Herbs..................................................   218
National Allergen Study..........................................   235
National Toxicology Program....................................201, 226
Neurodegenerative Diseases.......................................   229
Nutrition Research...............................................   219
Opening Statement................................................   169
Parkinson's Disease..............................................   213
Pfiesteria.......................................................   233
Phthalates.......................................................   189
Pollution Prevention.............................................   211
Single Nucleotide Polymorphism Project...........................   190
Statement of Kenneth Olden, Ph.D., Director, NIEHS...............   179
Strep A..........................................................   199
Success Rate.....................................................   220
Superfund........................................................   201
Testing Chemicals................................................   214
Town Meetings..................................................206, 230
Transgenic Animal Models.........................................   200
Type 1 Diabetes..................................................   209
Women and the Environment........................................   202

        National Institute of Neurological Disorders and Stroke

AIDS.............................................................   335
Amyotrophic Lateral Sclerosis (ALS)..............................   337
Autism.........................................................326, 330
Blood Supply Safety..............................................   308
Brain Research, Intramural.......................................   333
Brain Attack Coalition...........................................   315
Budget Mechanism Table...........................................   313
Commitment to NIH Funding........................................   300
Diabetes.........................................................   326
Dystonia:
    Early-Onset Dystonia Research................................   316
    Dystonia Research............................................   317
Epilepsy:
    Anti-Epileptic Drug Development..............................   319
    Epilepsy and Aging...........................................   321
    Epilepsy Research..........................................287, 318
    Epilepsy and Women...........................................   320
Funding for Specific Diseases....................................   310
Justification of FY 2000 Budget Estimates........................   338
Laboratory of Neurogenetics......................................   311
Mutiple Sclerosis................................................   332
Muscular Dystrophy...............................................   327
Nerve Cell Death.................................................   300
Pain.............................................................   311
Parkinson's:
    Environmental Influences in Parkinson's......................   333
    Parkinson's Centers........................................300, 312
    Parkinson's Disease........................................287, 304
    Surgery for Parkinson's......................................   307
Pediatric Brain Imaging..........................................   312
Restless Legs Syndrome...........................................   324
Rett Syndrome....................................................   329
Spinal Cord Injury...............................................   329
Specialized Research Centers.....................................   315
Spinal Muscular Atrophy..........................................   321
Statement of the Director........................................   291
Stem Cell Research...............................................   301
Strategic Planning...............................................   286
Stroke:
    Intramural Stroke Research...................................   316
    Stroke and African-Americans.................................   305
    Stroke and Home Care.........................................   324
    Stroke Prevention............................................   322
    Stroke Research..............................................   287
    Stroke Research Funding......................................   305
    Stroke Therapies.............................................   334
    Stroke Treatment.............................................   300
    The Stroke Belt..............................................   306
Use of FY 1999 Increase..........................................   286
Witnesses........................................................   285

                      National Institute on Aging

Alzheimer's Disease:
    Brain Biology Research.......................................   400
    Clinical Trials..............................................   407
    Neuroscience of Aging........................................   427
    Prevention Initiative......................................391, 407
    Research...................................................390, 413
Applied Gerontology Centers......................................   410
Baltimore Longitudinal Study on Aging............................   405
Behavioral and Social Research...................................   438
Biology of Aging..........................................394, 401, 431
Caregiving Research..............................................   417
Elder Abuse......................................................   417
Exercise.........................................................   408
Gene Therapy.....................................................   408
Growth of New Nerve Cells......................................393, 406
Health of the Aging Population...................................   416
Health and Retirement Survey.....................................   410
Hypertension..............................................396, 397, 406
Justification of FY 2000 Budget..................................   421
Minority Aging Research Centers..................................   413
National Institute on Aging Funding..............................   411
Opening Statement..............................................389, 399
Outreach.........................................................   405
Premature Aging: Werner's Syndrome and Yeast.....................   395
Reducing Chronic Disease and Disability..........................   435
Reducing Disease and Disability..................................   402
Reproduction of Brain Cells......................................   414
Significant Items in the House, Senate and Conference Reports....   451
Special Populations..............................................   419
Stem Cell Research...............................................   406

                  National Institute of Mental Health

Assertive Community Treatment....................................   495
Children's Mental Disorders......................................   474
Clinical Treatment and Services Workgroup........................   491
Clinical Trials and Cognitively Impaired Persons.................   497
Clinical Trials and Depression...................................   469
Combating School Violence........................................   473
Consensus Conference on the Definition of Attention Deficit 
  Hyperactivity Disorder.........................................   488
Diabetes in Children.............................................   497
Disability From Mood Disorders...................................   479
Dissemination of Improved Treatments...........................501, 508
Expanded Clinical Trials For Mental Illness......................   473
Experiments on Mental Patients...................................   503
Extramural Research Centers......................................   506
Funding for Specified Disorders..................................   489
FY 2000 Funding Needs............................................   499
Genetics of Mood Disorders and Other Mental Illnesses............   468
Genetics Research at NIMH........................................   473
Global Burden of Illness Spurs Collaboration With WHO............   472
Impact of Budget On FY 1999 New Initiatives......................   479
Impact of Managed Care on Treatment of Mental Illness............   481
Improving Treatment for Schizophrenia............................   512
Justification of the FY 2000 Budget Estimates....................   514
Longitudinal Studies Of Mental Health............................   480
Mental Disorders in Children and Adolescents.....................   503
Mental Illness and Poverty.......................................   511
Mental Illness in Children.......................................   480
Mood Disorders...................................................   467
Need for Behavioral Scientists...................................   482
Neuroimaging.....................................................   480
New Specialized Research Center..................................   497
NIHM Budget Mechanism Table Including AIDS.......................   496
Objectives of NIMH Research......................................   471
Obsessive-Compulsive Behavior....................................   491
Outreach to the General Public...................................   485
Overcoming Stigma of Mental Illness..............................   485
Prevention and Mental Illness....................................   469
Research:
    Base for Schizophrenia Research..............................   499
    Behavioral Aspects of Gambling...............................   488
    Children's Mental Disorders..................................   508
Results from Workshop on Eating Disorders........................   484
Review and Reorganization of Initial Review Groups...............   471
Revitalization of Research Structure.............................   472
Schizophrenia....................................................   504
Status of Brain Molecular Anatomy Project........................   483
Suicide Research...............................................502, 509
Translation Research and the African American Community..........   501
Treatments for Children's Mental Disorders.......................   500
Victims of Torture...............................................   490

    National Institute of Diabetes and Digestive and Kidney Diseases

Budget Mechanism Table...........................................   594
Career Development...............................................   616
Centers..........................................................   596
Conference on Female Urology.....................................   602
Cystic Fibrosis................................................588, 597
Diabetes.......................................................593, 625
Diabetes and PKD Research........................................   617
Diabetes in Children...........................................572, 574
Diabetes Prevention Education....................................   619
Diabetes Research Funding.................................569, 577, 579
Diabetes Research Working Group.................571, 578, 621, 622, 623
Disease Funding..................................................   590
Effect of Drugs on the Kidney....................................   588
End-Stage Renal Disease..........................................   598
Epidemiology of Urologic Diseases................................   602
Erythropoietin for Anemia of Renal Failure.......................   598
Foodborne Disease................................................   611
FY 2000 Budget Request...........................................   570
Gene Therapy Core Centers........................................   590
HCFA and Pancreatic Transplants..................................   579
Inflammatory Bowel Disease and Irritable Bowel Syndrome..........   603
Infrastructure Development.......................................   565
Interdependence of Research Fields...............................   580
Interdisciplinary Centers........................................   599
Interdisciplinary Centers for PKD................................   604
Interstitial Cystitis............................................   607
Introduction of Witnesses........................................   559
Justification of the FY 2000 Budget Estimates....................   627
Kidney Disease Education Program.................................   606
Kidney Research..................................................   596
Molecular Medicine and Hemochromatosis...........................   593
National Diabetes Education Program..............................   591
Nutritional Assessments..........................................   613
Nutritional Requirements of Dialysis Patients....................   606
Obesity Genes and Diabetes.....................................575, 577
Office of Research on Minority Health..........................573, 585
Office of Research on Women's Health.............................   615
Opening Statement of Dr. Phillip Gorden..........................   559
Pancreas Transplant..............................................   598
Pancreatic Islet Cell Transplantation............................   571
Partnerships with Private Organizations..........................   572
Peptic Ulcers....................................................   589
Polycystic Kidney Disease Research........................604, 608, 616
Prevention of Lower Extremity Amputation.........................   618
Research Related to Prostate Cancer..............................   602
Statement of Dr. Phillip Gorden..................................   562
Stem Cells.......................................................   600
Technologies that Drive Clinical Advances........................   564
Trans-NIH Funding................................................   591
Trans-NIH Initiatives............................................   594
Treatment and Prevention of Disease..............................   563
Type 1 Diabetes..................................................   608
Type 1 Diabetes Research Funds...................................   576
Urinary Incontinence.............................................   601
Urology Funding..................................................   603
Urology Research.................................................   601
Vaccine for Ulcers...............................................   589
Vaccine for Urinary Tract Infections.............................   588
Workshop on Prostate Research....................................   596

 National Institute of Arthritis and Musculoskeletal and Skin Diseases

Alopecia Areata..................................................   708
Autoimmunity.....................................................   691
Bioengineering...................................................   724
Budget Policy....................................................   748
Ceramic Implant Materials........................................   697
Duchenne Muscular Dystrophy......................................   717
Ehlers-Danlos Syndrome...........................................   702
Exercise Physiology and Sports Injuries........................693, 703
Fiscal Year 1999 Investments.....................................   687
Funding for Disease Areas........................................   707
Gene Therapy for Treating Arthritis..............................   712
Health Disparities...............................................   693
Heritable Disorders of Connective Tissue.........................   726
Joint Replacements...............................................   688
Justification of FY 2000 Budget Estimates........................   730
Low Back Pain..................................................697, 701
Lupus...........................................698, 704, 707, 715, 727
Medical Research Makes A Difference In People's Lives............   694
NIAMS Budget Mechanism...........................................   710
Orthopaedics.....................................................   706
Osteoarthritis.................................................709, 723
Osteogenesis Imperfecta..........................................   714
Osteoporosis..............................................688, 692, 703
Psoriasis and Skin Cancer........................................   700
Research:
    Centers....................................................707, 712
    Grants.......................................................   720
    Initiatives..................................................   719
    Opportunities................................................   721
    Training.....................................................   724
Rheumatoid Arthritis...........................................688, 713
Science Advances and Initiatives.................................   737
Skin Cancer Research.............................................   701
Sports Injuries................................................688, 698
Statement of the Director......................................687, 690
Ultra Violet Radiation and Tanning...............................   709

                 National Center for Research Resources

Animal Facility Improvement......................................   792
Bioengineering, Computers and Advanced Instrumentation...........   781
Budget Mechanism Table...........................................   796
Clinical Research................................................   802
Clinical Research Training.......................................   792
Diabetes Research Plan...........................................   801
Extramural Facilities............................................   798
Funding for Selected Programs....................................   794
Gene Therapy.....................................................   776
Genetic Medicine.................................................   780
High Field Nuclear Magnetic Resonance............................   799
Infrastructure...................................................   775
Integrated Genomics..............................................   776
Justification of FY 2000 Budget Estimates........................   803
National Gene Vector Laboratories................................   798
Non-Human Stem Cells.............................................   795
Opening Statement of Judith L. Vaitukaitis, M.D..................   779
Primate Research Centers.........................................   794
Research Capacity................................................   782
Research Centers in Minority Institutions........................   789
Stem Cell Research...............................................   776
Use of Animals in Research.......................................   788

         National Institute of Allergy and Infectious Diseases

Introduction of Witnesses........................................   839
Opening Statement................................................   839
AIDS:
    Clinical Trials..............................................   880
    Drugs........................................................   880
    Funding....................................................875, 902
    Hemophiliacs.................................................   890
    International Research.......................................   889
    Minorities...................................................   893
    Treatment Strategies..................................876, 878, 885
    Vaccines.....................................................   879
    Women........................................................   886
Asthma...........................................................   887
Autoimmunity and the Immune System...............................   875
Autoimmune Diseases............................................896, 907
Bioterrorism...................................................882, 883
Drug-Resistant Microbes..........................................   886
Genome Sequencing................................................   906
Group A Strep....................................................   890
Hemophilia.......................................................   890
Hemophilus Influenza B...........................................   892
Hepatitis Viruses................................................   891
Hepatitis C Virus.........................................880, 890, 899
Human Mucosal Immunity...........................................   901
Human Papilloma Virus and Cervical Cancer........................   888
Immune Tolerance.................................................   900
Inflammatory Bowel Disease.......................................   881
International Health.............................................   892
Investigator Initiated Research..................................   909
Justification of FY 2000 Budget Estimates........................   909
Lyme Disease..............................................877, 900, 905
Microbicides.....................................................   910
Minority Research................................................   912
Office of the Director Staffing..................................   904
Organ Transplants................................................   899
Primary Immune Deficiency Diseases...............................   907
Rotavirus Vaccine................................................   884
Salary Increases for Award Winners...............................   909
Sexually Transmitted Diseases....................................   901
Spending Levels..................................................   896
Syphilis Vaccine.................................................   899
Tolerance........................................................   905

                         National Eye Institute

Additional Research with Additional Funding......................  1003
Age-Related Macular Degeneration...............................985, 987
Autoimmune Diseases...........................................977, 1001
Budget Mechanism Table...........................................   995
Cell Transplantation in Autoimmune Research......................   982
Clinical Trials for Retinal Degeneration Therapies...............   992
CMV Retinitis....................................................  1004
Corneal Disease..................................................   976
Cryotherapy for Retinopathy of Prematurity.......................   995
Degeneration of the Retina.......................................  1000
Diabetes.......................................................974, 989
Diabetic Retinopathy.............................................  1006
Eye Diseases in Children.........................................  1004
Genetics.........................................................   991
Glaucoma.........................................................   990
Health Disparities and Minorities................................   975
Interactive Exhibits.............................................   980
Introduction of Witnesses........................................   969
Justification of FY 2000 Estimates...............................  1008
Laser Surgery:
    Accuracy.....................................................   985
    Myopia.......................................................   981
    Regulation...................................................   982
Laser Pointers...................................................  1002
Lasik............................................................   998
Low Vision/Vision Impairment...................................977, 988
Macular Degeneration.............................................   987
Myopia.........................................................976, 990
National Eye Health Education Program............................   979
NEI Funding......................................................  1003
Neuroscience.....................................................   998
Opening Statement of Dr. Carl Kupfer.............................   972
Outreach Efforts to Minority Populations.........................  1007
Programs to Benefit American Population..........................   993
Racial Differences in Responses to Glaucoma Treatments...........  1001
Radiation Therapy for Age-Related Macular Degeneration...........   985
Research Opportunities with Budget Increase......................   990
Research Centers.................................................   997
Retinal Degenerations............................................   972
Retinitis Pigmentosa and Diabetes................................   983
Retinitis Pigmentosa.............................................   989
Summary of Eye Disease Funding...................................   994
Trabulectomy.....................................................   995
Vision Research Strategic Plan...................................   984
Vitamins and Nutritional Supplements.............................   999

     Office of the Director, National Center For Complementary and 
Alternative Medicine, Office of AIDS Research, Buildings and Facilities

Office of the Director:
    Affirmative Action...........................................  1110
    Animal Facilities at Minority Institutions...................  1092
    Behavioral and Social Sciences Research......................  1308
    Behavioral and Social Sciences Research Findings.............  1141
    Cost of Scientific Journals..................................  1125
    Council of Public Representatives............................  1210
    Dietary Supplements Workshop.................................  1310
    DOD Research.................................................  1098
    Doubling the NIH Budget over Five Years......................  1184
    Emerging Infectious Diseases.................................  1200
    Fiscal Authority--ORMH and OAR...............................  1322
    Five-Year History of Grant Applications......................  1191
    Full Funding for Research Awards.............................  1287
    Funding for Increased Diversity..............................  1288
    Funding Instrumentation and Technology.......................  1292
    Funding for Interdisciplinary Research Consortia.............  1289
    Funding for Public Outreach Activities.......................  1317
    Funding Levels for Intramural vs. Extramural Facilities......  1320
    Funds Needed to Maintain Grants..............................  1191
    Grant Application Review Time................................  1137
    GPRA Compliance..............................................  1137
    Healthy Behaviors............................................  1108
    History of Reasonable Pricing Clause.........................  1197
    Human Genome Project.........................................  1201
    Human Pluripotent Stem Cells.................................  1212
    Hypertension.................................................  1095
    Incentives for Health Behaviors..............................  1109
    Increased Training Capacity..................................  1292
    Increasing Size of Awards....................................  1287
    IOM Priority Setting Report Recommendations..................  1211
    Justification of the FY 2000 Budget Estimates................  1325
    Lupus........................................................  1307
    Medical Center Infrastructure................................  1319
    Minority Health Initiative...................................  1138
    Minority Programs:
         Centers for Minority Health.............................  1095
        Minority Health Disparities..............................  1093
        Minority Research Fund...................................  1098
        Recruitment of Minorities to Research....................  1104
        Website for Minority Health..............................  1096
    Mind/Body Centers............................................  1139
    Motivational Issues..........................................  1107
    Multiple Grantees............................................  1132
    NIH Administrative Management................................  1316
    NIH Consultant File..........................................  1140
    NIH Organizational Levels....................................  1323
    NIH Professional Judgment Budget.............................  1171
    Number of Research Project Grants Funded.....................  1287
    Number of Training Positions.................................  1290
    Obesity and Health Prevention................................  1106
    OD Office Coordination Functions.............................  1322
    OD Office Funding Levels.....................................  1132
    Office of Dietary Supplements--Botanical Centers.............  1140
    Office of Dietary Supplements--Scientific Goals..............  1139
    Office of Research on Minority Health....................1056, 1321
    Office of Research on Women's Health.........................  1056
    Opening Statement--Dr. Kirschstein...........................  1058
    Outlays by Institute.........................................  1134
    Outreach.....................................................  1092
    Pediatric Cancer Treatment and Research......................  1318
    Pipeline of Young Investigators..............................  1291
    Priority Setting.............................................  1126
    Qualifying for Research Funding..............................  1095
    Renovation and Construction of Extramural Laboratories.......  1295
    Report on the Office of Dietary Supplements..................  1124
    Revision of OMB Circular A-110...............................  1223
    Safety Factor of Dietary Supplements.........................  1310
    Stem Cell Research...........................................  1097
    Strategic Plans by NIH Institute.............................  1224
    Strengthening the Intramural Program.........................  1295
    Therapy for Rare Diseases....................................  1140
    Trends in Clinical Research..................................  1293
    Unobligated Carryover Balance................................  1133
    Workshop on Pharmacology.....................................  1139
National Center for Complementary and Alternative Medicine:
    Alternative and Complementary Approaches.....................  1090
    Associate Secretary for Complementary and Alternative 
      Medicine...................................................  1301
    Center Director..............................................  1299
    Chrondroitin Sulfate Research Protocol.......................  1305
    Clinical Trials..............................................  1144
    Development of an Anti-HIV Combination of Natural Products...  1157
    Efficacy of Complementary and Alternative Medicine...........  1090
    Efficacy of Supplements......................................  1101
    FDA Responsibility...........................................  1103
    Future Projects..............................................  1299
    Future Requests for Applications.............................  1300
    Gonzalez Regimen.............................................  1152
    Herbal Alternatives..........................................  1102
    International Program........................................  1302
    Intramural Research..........................................  1305
    Investigator-Initiated Projects..............................  1158
    Justification of the FY 2000 Budget Estimates................  1438
    Level of Technology Assistance...............................  1304
    Moving ODS to the NCCAM......................................  1299
    NCCAM Advisory Board.........................................  1306
    NCCAM Clearinghouse..........................................  1303
    Office of Alternative Medicine...............................  1101
    Opening Statement of William R. Harlan, M.D..................  1083
    Outreach.....................................................  1092
    Percentage of Budget for Research............................  1301
    Placebo Effect...............................................  1090
    Potential of Alternative Therapies...........................  1128
    Replication of Clinical Trials...............................  1302
    Research:
        Agenda...................................................  1307
        Management and Support...................................  1157
        Centers..................................................  1153
        Results..................................................  1304
    White House Commission on CAM................................  1106
Office of AIDS Research:
    AIDS Treatment Mutations.....................................  1311
    Behavior Modification Associated with AIDS...................  1110
    Biological Warfare...........................................  1130
    Consolidated AIDS Appropriation..............................  1106
    Cross-Over Benefits of AIDs Research.........................  1112
    Extramural Research Centers..................................  1129
    Immune Response..............................................  1100
    International Initiatives....................................  1313
    Justification of the FY 2000 Budget Estimates................  1403
    Microbicides.................................................  1127
    Office of AIDS Research......................................  1142
    Office of AIDS Research-Discretionary Fund...................  1142
    Opening Statement--Dr. Nathanson.............................  1068
    Ran White Care Act...........................................  1126
    Research on AIDS Benefits Efforts Against Other Disease......  1113
    Resistant Strains of HIV.....................................  1124
    Vaccine Research Center......................................  1124
Buildings and Facilities:
    Animal Facility..............................................  1105
    Asbestos Abatement Program...................................  1169
    Caribbean Primate Research Center............................  1169
    Central Vivarium.............................................  1051
    Clinical Research Center.................................1050, 1169
    Essential Safety and Health Improvements.................1051, 1167
    Fire Protection and Life Safety Program......................  1169
    FY 2000 Budget Summary Estimate..............................  1053
    Government Performance and Results Act (GPRA)................  1053
    Justification of the FY 2000 Budget..........................  1466
    Master Plan..................................................  1049
    NIH Animal Center............................................  1169
    Parking......................................................  1296
    Renovations and System Upgrades..............................  1052
    Repair and Improvement Program...............................  1052
    Role in the Research Mission.................................  1049

                          Nobel Laureate Panel

Nobel Laureate Panel.............................................  1487
Questions and Answers......................1498, 1516, 1527, 1534, 1543
Testimonies:

    Dr. Paul Berg................................................  1491
    Dr. Thomas R. Cech...........................................  1519
    Dr. David D. Chang...........................................  1529
    Dr. Joseph L. Goldstein......................................  1503
    Dr. Ulrike Heberlein.........................................  1539