    [House Hearing, 110 Congress]
    [From the U.S. Government Publishing Office]

      H.R. 1232, VETERINARY PUBLIC HEALTH WORKFORCE EXPANSION ACT OF 2007

    =======================================================================

                                    HEARING

                                   BEFORE THE

                             SUBCOMMITTEE ON HEALTH

                                     OF THE

                        COMMITTEE ON ENERGY AND COMMERCE
                            HOUSE OF REPRESENTATIVES

                           ONE HUNDRED TENTH CONGRESS

                                 SECOND SESSION

                                   __________

                                JANUARY 23, 2008

                                   __________

                               Serial No. 110-81

          Printed for the use of the Committee on Energy and Commerce

                            energycommerce.house.gov

                      U.S. GOVERNMENT PRINTING OFFICE
    48-002 PDF                WASHINGTON : 2008
    -----------------------------------------------------------------------
    For sale by the Superintendent of Documents, U.S. Government Printing
    Office Internet: bookstore.gpo.gov Phone: toll free (866) 512-1800; DC
    area (202) 512-1800 Fax: (202) 512-2104  Mail: Stop IDCC, Washington, DC
    20402-0001

                        COMMITTEE ON ENERGY AND COMMERCE

                       JOHN D. DINGELL, Michigan, Chairman

                        COMMITTEE ON ENERGY AND COMMERCE

                       JOHN D. DINGELL, Michigan, Chairman
    HENRY A. WAXMAN, California          JOE BARTON, Texas
    EDWARD J. MARKEY, Massachusetts         Ranking Member
    RICK BOUCHER, Virginia               RALPH M. HALL, Texas
    EDOLPHUS TOWNS, New York             FRED UPTON, Michigan
    FRANK PALLONE, Jr., New Jersey       CLIFF STEARNS, Florida
    BART GORDON, Tennessee               NATHAN DEAL, Georgia
    BOBBY L. RUSH, Illinois              ED WHITFIELD, Kentucky
    ANNA G. ESHOO, California            BARBARA CUBIN, Wyoming
    BART STUPAK, Michigan                JOHN SHIMKUS, Illinois
    ELIOT L. ENGEL, New York             HEATHER WILSON, New Mexico
    ALBERT R. WYNN, Maryland             JOHN B. SHADEGG, Arizona
    GENE GREEN, Texas                    CHARLES W. ``CHIP'' PICKERING,
    DIANA DeGETTE, Colorado               Mississippi
        Vice Chairman                    VITO FOSSELLA, New York
    LOIS CAPPS, California               ROY BLUNT, Missouri
    MIKE DOYLE, Pennsylvania             STEVE BUYER, Indiana
    JANE HARMAN, California              GEORGE RADANOVICH, California
    TOM ALLEN, Maine                     JOSEPH R. PITTS, Pennsylvania
    JAN SCHAKOWSKY, Illinois             MARY BONO MACK, California
    HILDA L. SOLIS, California           GREG WALDEN, Oregon
    CHARLES A. GONZALEZ, Texas           LEE TERRY, Nebraska
    JAY INSLEE, Washington               MIKE FERGUSON, New Jersey
    TAMMY BALDWIN, Wisconsin             MIKE ROGERS, Michigan
    MIKE ROSS, Arkansas                  SUE WILKINS MYRICK, North Carolina
    DARLENE HOOLEY, Oregon               JOHN SULLIVAN, Oklahoma
    ANTHONY D. WEINER, New York          TIM MURPHY, Pennsylvania
    JIM MATHESON, Utah                   MICHAEL C. BURGESS, Texas
    G.K. BUTTERFIELD, North Carolina     MARSHA BLACKBURN, Tennessee
    CHARLIE MELANCON, Louisiana
    JOHN BARROW, Georgia
    BARON P. HILL, Indiana

    _________________________________________________________________

                               Professional Staff

                  Dennis B. Fitzgibbons, Chief of Staff
                   Gregg A. Rothschild, Chief Counsel
                       Sharon E. Davis, Chief Clerk
                  David Cavicke, Minority Staff Director

                                      (ii)

                             Subcommittee on Health

                    FRANK PALLONE, Jr., New Jersey, Chairman
    HENRY A. WAXMAN, California          NATHAN DEAL, Georgia,
    EDOLPHUS TOWNS, New York                 Ranking Member
    BART GORDON, Tennessee               RALPH M. HALL, Texas
    ANNA G. ESHOO, California            BARBARA CUBIN, Wyoming
    GENE GREEN, Texas                    HEATHER WILSON, New Mexico
        Vice Chairman                    JOHN B. SHADEGG, Arizona
    DIANA DeGETTE, Colorado              STEVE BUYER, Indiana
    LOIS CAPPS, California               JOSEPH R. PITTS, Pennsylvania
    TOM ALLEN, Maine                     MIKE FERGUSON, New Jersey
    TAMMY BALDWIN, Wisconsin             MIKE ROGERS, Michigan
    ELIOT L. ENGEL, New York             SUE WILKINS MYRICK, North Carolina
    JAN SCHAKOWSKY, Illinois             JOHN SULLIVAN, Oklahoma
    HILDA L. SOLIS, California           TIM MURPHY, Pennsylvania
    MIKE ROSS, Arkansas                  MICHAEL C. BURGESS, Texas
    DARLENE HOOLEY, Oregon               MARSHA BLACKBURN, Tennessee
    ANTHONY D. WEINER, New York          JOE BARTON, Texas (ex officio)
    JIM MATHESON, Utah
    JOHN D. DINGELL, Michigan (ex officio)

                                 C O N T E N T S

                                  ----------
                                                                       Page
     Hon. Frank Pallone Jr., a Representative in Congress from the
      State of New Jersey, opening statement.........................     1
    Hon. Nathan Deal, a Representative in Congress from the State of
      Georgia, opening statement.....................................     2
    Hon. Gene Green, a Representative in Congress from the State of
      Texas, prepared statement......................................     3
    Hon. Charles W. ``Chip''Pickering, a Representative in Congress
      from the State of Mississippi, opening statement...............     4
    Hon. Tammy Baldwin, a Representative in Congress from the State
      of Wisconsin, opening statement................................     5
    Hon. Lois Capps, a Representative in Congress from the State of
      California, opening statement..................................     6
    Hon. Edolphus Towns, a Representative in Congress from the State
      of New York, prepared statement................................     7
    Hon. Tim Murphy, a Representative in Congress from the
      Commonwealth of Pennsylvania, opening statement................     8

                                   Witnesses

    Marguerite Pappaioanou, D.V.M., M.P.V.M., Ph.D., D.A.C.V.P.M.,
      Executive Director, Association of American Veterinary Medical
      Colleges (AAVMC), Washington, D.C..............................     9
        Prepared statement...........................................    11
        Answers to submitted questions...............................    58
    Ron DeHaven, D.V.M., M.B.A., Executive Vice President, American
      Veterinary Medical Association (AVMA), Schaumburg, IL..........    15
        Prepared statement...........................................    17
        Answers to submitted questions...............................    64
    Alan Kelly, B.V.Sc., M.R.C.V.S., Ph.D., Dean Emeritus, University
      of Pennsylvania, School of Veterinary Medicine, New Bolton
      Center, Kennett Square, PA.....................................    18
        Prepared statement...........................................    21
        Answers to submitted questions...............................    65
    Sheila W. Allen, D.V.M., M.S., Dean, College of Veterinary
      Medicine, University of Georgia, Athens, GA....................    33
        Prepared statement...........................................    34

                               Submitted Material

    H.R. 1232........................................................    53
    .................................................................

      H.R. 1232, VETERINARY PUBLIC HEALTH WORKFORCE EXPANSION ACT OF 2007

                                  ----------

                          WEDNESDAY, JANUARY 23, 2008

                      House of Representatives,
                                Subcommittee on Health,
                              Committee on Energy and Commerce,
                                                        Washington, DC.
        The subcommittee met, pursuant to call, at 10:08 a.m., in
    room 2322 of the Rayburn House Office Building, Hon. Frank
    Pallone, Jr. (chairman) presiding.
        Members present: Representatives Pallone, Towns, Green,
    Capps, Baldwin, Hooley, Matheson, Deal, Pitts, Murphy, and
    Pickering.
        Staff present: Lauren Bloomberg, Melissa Sidman, Chad
    Grant, Bobby Clark, Katherine Martin, and Jessica McNiece.

    OPENING STATEMENT OF HON. FRANK PALLONE, JR., A REPRESENTATIVE
                IN CONGRESS FROM THE STATE OF NEW JERSEY

        Mr. Pallone. The subcommittee hearing is called to order.
    Today we are having a hearing on H.R. 1232, the Veterinary
    Public Health Workforce Expansion Act. And I will recognize
    myself for an opening statement. I first of all want to thank
    my colleague and the chief sponsor of the bill, Ms. Baldwin,
    for her work on this legislation. You should know that she had
    been asking that we have this hearing for some time, and she is
    very aggressive in these matters. The United States is
    currently facing a significant shortage of veterinary medical
    officers. Our Colleges of Veterinary Medicine produce only
    2,500 graduates a year and are operating at full capacity. An
    estimated 50 percent of public health service veterinarians are
    currently at retirement age, and the U.S. Census Bureau
    predicts that based on current population growth and the
    corresponding growth in animal populations there will be a
    shortage of 15,000 veterinarians by 2025.
        These statistics are particularly alarming when taking into
    account that veterinarians not only perform routine animal care
    but they are also vital providers in the public health sector.
    Veterinarians work in food safety and animal disease control.
    They work in the field of bio-security and homeland security,
    and they conduct crucial research on domestic and foreign
    animal diseases as well as on animal diseases that are
    transmitted from animals to humans. In fact, the American
    College of Veterinary Preventative Medicine actually requires
    its members to have proficiency in areas of public health,
    including the fields of epidemiology and bio-statistics, food
    safety, infectious and parasitic diseases, environmental health
    and toxicology, and public administration and health education.
        The steady threat of diseases such as West Nile Virus or
    Lyme Disease, which is particularly an acute problem in my home
    state of New Jersey, as well as the recent outbreaks of food
    borne illnesses just amplify the importance of veterinarians
    serving in the public health sector and how they are becoming
    more and more crucial to protecting our citizens from
    devastating diseases. In fact, approximately 60 percent of
    infectious disease organisms are transmitted by animals, and 75
    percent of emerging infectious diseases are passed from animals
    to humans. The Centers of Disease Control and Prevention, CDC,
    estimates that food borne diseases such as salmonella and E.
    coli are responsible for roughly 5,000 deaths a year.
        Improving the safety of our nation's food supply and
    reducing the number of food borne illnesses is a top priority
    for me and many of my colleagues on this subcommittee. We have
    had hearings, and Chairman Dingell and I have introduced
    legislation to bolster the regulatory framework at FDA
    improving research and increasing FDA's oversight in order to
    prevent contamination of our nation's food supply. But there is
    only so much we can do from a regulatory perspective. We need
    to support and increase the workforce who will carry out these
    tasks, and H.R. 1232 would compliment our efforts thus far by
    strengthening the veterinary workforce we rely upon to conduct
    surveillance and research into zoonotic diseases that threaten
    our food supply as well as conduct important education and
    outreach initiatives associated with food-animal production.
        This legislation looks to solve the impending veterinary
    shortage crisis by establishing a competitive grant program to
    expand capacity and services at veterinary schools. This would
    include increased teaching labs, research facilities,
    classrooms, and administrative space. This expansion will allow
    schools to increase enrollment and produce the next generation
    of veterinary medical officers. It has been 30 years since the
    Federal government has provided funding to increase the number
    of veterinarians in our country. Considering the looming
    shortage of these critical public health specialists, now is
    the time for us to act once more.
        And again I want to thank Ms. Baldwin for her efforts on
    this cause, and I would also like to thank our witnesses for
    appearing before us today to share their expertise. I know the
    subcommittee has so many things to deal with but I do think
    that this is a very important issue that we need to move
    forward on. And I now recognize my colleague from Georgia, Mr.
    Deal.
        [H.R. 1232 appears at the conclusion of the hearing.]

      OPENING STATEMENT OF HON. NATHAN DEAL, A REPRESENTATIVE IN
                   CONGRESS FROM THE STATE OF GEORGIA

        Mr. Deal. Thank you, Mr. Chairman. I would like to start
    off by issuing a warm welcome to Dr. Sheila Allen, who is the
    Dean of the College of Medicine at the University of Georgia.
    We have met before on this very subject, and I am sure that she
    will share some of those same opinions with the committee today
    about the challenges that our current veterinary schools face
    in providing the necessary new veterinarians for our nation.
    Many of us have heard about the variety of roles played by
    individuals with training in veterinary medicine from caring
    for personal pets to playing an integral role in the livestock
    industry by maintaining the health of animals used for food
    consumption and also inspection of the meat itself and the
    products that are produced.
        Veterinarians help insure the safety of the nation's food
    supply and they are uniquely situated to address the growing
    threat of animal-related diseases. Unfortunately, our
    veterinary schools are not equipped to meet this growing need.
    Despite a high number of individuals interested in continuing
    their education at the School of Veterinary Medicine the
    schools cannot meet the demand. As a result, I have heard
    anecdotally, as I am sure some of you have, that it is harder
    to get into vet school than it is into medical school. This has
    the potential to create a dangerous public health problem as
    the demand for veterinary services continues to exceed the
    supply.
        I hope that today's hearing can focus on the reasons for
    low number of veterinary schools and the growing shortage of
    veterinarians. I also think it is important that we insure
    money spent on expanding the infrastructure of our vet schools
    translates into more veterinarians working in the fields with a
    shortage or in those fields that meet a public health need. I
    want to thank all of our witnesses for their attendance today.
    We look forward to your testimony. Thank you, Mr. Chairman.
        Mr. Pallone. Thank you. I should point out to all of you
    that unfortunately we have the debate and the vote on the
    override for SCHIP, the Children's Health Initiative, going on
    at the same time as this hearing this morning so members will
    float in and out including myself, but we are going to do the
    best we can. We never know when these things come up when we
    plan our hearings. Next I recognize our vice chair, Mr. Green.
        Mr. Green. Mr. Chairman, I thank you for explaining that
    because we have an Oversight and Investigations hearing on
    nuclear proliferation. I might have to leave shortly. But I
    would like to ask unanimous consent to place my statement in
    the record so we could go on with the witnesses. But thank my
    colleague from Wisconsin. I am a co-sponsor of the bill. And
    coming from Texas, I am surprised our ranking member didn't
    have somebody from Texas A&M here because that is our
    veterinary school in Texas. Since my son is an Aggie, not a
    veterinarian, but an Aggie, I would make sure that we do that.
    Thank you, Mr. Chairman, and I yield back.
        [The prepared statement of Mr. Green follows:]

                          Statement of Hon. Gene Green

        Mr. Chairman, I am pleased we are holding this hearing
    today on H.R. 1232, the Veterinary Public Health Workforce
    Expansion Act. As a cosponsor of this bill, I am please that we
    are moving this bill through the committee.
        Texas A&M is the only veterinary college near my district
    and one of two in the state of Texas.
        Throughout the U.S. there are only 28 Colleges of
    Veterinary Medicine producing approximately 2,500 veterinarians
    each year and those schools are at full capacity.
        According to the Bureau of Labor and Statistics, currently
    there are 86,000 practicing veterinarians in the U.S. However,
    fifty percent of those veterinarians are now eligible for
    retirement and by 2012, there will be nearly 28,000 open
    veterinary jobs. That is a turnover rate of nearly 38%.
        Over the next 40 years, the American Association of
    Veterinary Medical Colleges estimates, in order to simply
    maintain their current level of service, they will need to open
    somewhere in the area of nine new colleges. But, the federal
    government has not provided general funding to increase the
    number of veterinarians in over 30 years.
        In recent years, medical issues from human-wildlife have
    been highlighted in the media. Avian flu, Foot and Mouth
    Disease, West Nile Virus, and SARS are all diseases associated
    with human to wildlife contact. Additionally, the CDC estimates
    that 80% of potential bioterror agents are infectious diseases
    that spread from animals to humans.
        Veterinarians play a crucial role in this medical area
    because they are they only health professionals trained to link
    animal and human diseases, food safety, and bioterrorism
    agents.
        The Veterinary Workforce Expansion Act will help veterinary
    colleges by creating a competitive grants program to increase
    the number of veterinarians in the US. These grants will expand
    capacity and services at existing schools.
        We don't want to expose ourselves to an animal disease
    outbreak or a bioterrorism attack simply because we didn't
    anticipate a veterinary shortage. This piece of legislation is
    a chance for us to increase the number of veterinarians in the
    U.S.
        I strongly support this bill and I urge my colleagues to do
    so as well. Thank you Mr. Chairman, I yield back my time.
                                  ----------

        Mr. Pallone. Thank you. Now I recognize Mr. Pickering from
    Mississippi, who is the lead Republican on the legislation.

      OPENING STATEMENT OF HON. CHARLES W. ``CHIP'' PICKERING, A
        REPRESENTATIVE IN CONGRESS FROM THE STATE OF MISSISSIPPI

        Mr. Pickering. Thank you, Mr. Chairman, and I appreciate
    the chance to come and sit on the subcommittee this morning. I
    want to thank the lead sponsor this year, Congresswoman
    Baldwin, and thank her for her partnership on this very
    important initiative. With only 28 veterinary schools around
    the country and the critical link between public health and
    animal health, and as we look at the threats that could come to
    our nation whether it is Avian flu or through some type of
    bioterrorism that this type of approach that will provide the
    grants to help expand the infrastructure, build the
    institutions, and most importantly bring the resources to bear
    to train the people and to give us the leadership that we need
    around the country whether it is in our Federal agencies and
    our military or in our institutions and in private practice all
    of this is critical infrastructure with critical personnel that
    does make a difference for our country, and so I proudly join
    Congresswomen Baldwin as we look to have this bill now in its
    second Congress hopefully pass in this Congress and to be
    signed into law so that we can promote the very important
    issues of the Veterinary Public Health Expansion Act. Mr.
    Chairman, with that I yield back, and I thank you and the
    committee for your attention to this very important matter.
        Mr. Pallone. Thank you. The gentlewoman from Wisconsin.

     OPENING STATEMENT OF HON. TAMMY BALDWIN, A REPRESENTATIVE IN
                  CONGRESS FROM THE STATE OF WISCONSIN

        Ms. Baldwin. Thank you, Mr. Chairman, and I very much
    appreciate the fact that you are holding this hearing today. I
    thank our witnesses, and I also appreciate the co-sponsorship
    of Mr. Pickering. It has been a pleasure to work with you on
    this bill. I also recognize the fact that a number of our
    colleagues on this committee have taken note of how important
    this particular piece of legislation is and have joined in the
    co-sponsorship of it. As we will hear more during this
    morning's testimony of our witnesses veterinarians are truly
    more than the people who care for our cats and dogs, and while
    I am quite fond of my two cats I am glad to have a good
    veterinarian, but I am also glad that there are veterinarians
    out there who focus on large public health threats.
        The interaction between human health and animal health I
    very clear. It seems like every year we have a new public
    health threat that dominates the newspaper headlines whether it
    is Avian flu or West Nile Virus, Mad Cow Disease, Monkey Pox,
    or antibiotic resistance. It is clear that there is a great
    need for integrated animal and human health surveillance,
    diagnostic laboratory systems, and delivery of effective health
    interventions among animal, human, and public health
    professions, and veterinarians are uniquely positioned to view
    health through the lens of public health impacted to understand
    how human and animal health interact.
        However, as we have heard, we are woefully underprepared to
    meet these public health challenges. Currently there are 86,000
    veterinarians in the United States who are trained in only 28
    domestic colleges of veterinary medicine. Veterinarians make up
    less than 1 percent of the public health workforce, yet they
    play such a vital role in protecting the public health. It is
    estimated that we currently have a shortage of 1,500
    veterinarians, and as we have heard also from previous opening
    statements this shortage is expected to grow. But this shortage
    is not for lack of interest. At the University of Wisconsin
    Madison's Veterinary School they receive far more applications
    than there are spaces available.
        The facilities are designed to accommodate 80 students per
    class. Most recently, there were 1,144 applications for the
    class of 2011, 1,144 applicants for 80 spaces. If we don't
    address these capacity issues soon, we will find ourselves
    dangerously under prepared and ill equipped to deal with future
    public health threats. H.R. 1232, the Veterinary Public Health
    Workforce Expansion Act, would establish a competitive grant
    program to expand capacity at veterinary schools so that we can
    develop a public health workforce that is prepared to work at
    the interface of human, animal, and environmental health. Mr.
    Chairman, again thank you for holding this hearing and thank
    you to our expert witnesses for joining us today. I yield back
    my remaining time.
        Mr. Pallone. Thank you. The gentlewoman from California,
    Ms. Capps.

       OPENING STATEMENT OF HON. LOIS CAPPS, A REPRESENTATIVE IN
                 CONGRESS FROM THE STATE OF CALIFORNIA

        Ms. Capps. Thank you, Chairman Pallone. Thank you for
    holding the hearing. I appreciate that our witnesses are here
    with their expertise, and I don't think there is going to be a
    lot of controversy about this procedure today. I echo the
    remarks that have been made by my colleagues. We all know, and
    it is actually a matter of public awareness, I believe, that we
    all will play a role in getting the word out that veterinary
    science is an essential component of our public health
    workforce. Public health veterinarians in conjunction with
    nurses, doctors, microbiologists, and many others help to
    protect and enhance the health of our nation and the
    international community. It is really a team effort.
        I am very proud to be a co-sponsor of H.R. 1232, the
    Veterinary Public Health Workforce Expansion Act 2007, pleased
    that it was introduced by my colleague, Tammy Baldwin, and for
    the bipartisan support that it has. This legislation is one of
    many necessary steps we can take to shore up the exceptional
    public health workforce that our country needs and deserves and
    is underfunded and understaffed in almost every arena, this
    being one example and a very primary one. I am usually the
    person here speaking about the dire shortage of nurses as my
    colleagues know full well, but unbelievably I have to
    acknowledge public health veterinarians are even in shorter
    supply, and I know that is going to be the under current of the
    discussion today.
        Public health veterinarians bring critical expertise to
    disease prevention, bioterrorism preparedness, and food safety.
    I don't believe the public quite understands the values here,
    and I just say right off the bat that I want to work with our
    committee because it starts in Congress. I don't know that
    enough of our colleagues understand the importance of this work
    and that is one of the roles that we can play in the country,
    and I hope we will do that. Funding will be another aspect of
    it, I am sure, eventually or as we go along. But in this age of
    ever increasing global population, people are becoming more
    susceptible to zoonotic disease, I don't think again most of
    the public understands that 75 percent of the new diseases that
    have affected humans in the past 10 years have originated from
    plants or from animals or animal parts.
        This is astounding, and I think once the public understands
    this they are going to be very interested in supporting the
    efforts that we share here. Public health veterinarians are
    specifically trained to understand and identify diseases in
    animals and tirelessly work to prevent the diseases spread to
    humans. That is a vital piece in global health. If you are
    going to start at the top of the line or some people would
    prefer to start at the bottom and work up. I just want to point
    out that in my home state of California just last year we had
    an E. coli breakout in our Spinach crop, and that was
    disastrous to a large part of our economy, terrified a lot of
    people. We should be eating more fresh vegetables and instead
    people began to--they wouldn't go near the spinach part of the
    produce. And so it was a public health veterinarian that we
    must all thank who helped identify the cause of that particular
    disease and its manifestation and to control the spread. This
    is how vital this population is, this workforce.
        With bioterrorism a greater threat than ever before, we are
    going to be relying more and more on public health
    veterinarians who play a crucial role in developing our
    country's bioterrorism response plan. This I think some people
    understand and other people need to be educated about. With all
    the benefits public health veterinarians bring to our public
    health workforce our society needs to make every opportunity,
    and starting with this one, to support their work. H.R. 1232
    does that, and I am proud to support it. Again, I look forward
    to our witnesses and yield back.
        Mr. Pallone. Thank you, and thank you for all your support.
    I think the panel may or may not know that Ms. Capps plays a
    major role here in trying to draw attention to the need--the
    shortage of health care professionals in so many respect, which
    is really so crucial so thank you. Next, I recognize the
    gentleman from Pennsylvania, Mr. Pitts, and I told Congressman
    Pitts that I had the fortune of going to his district to look
    at the University of Pennsylvania veterinary school farm campus
    essentially, and it was so beautiful just to ride out there.
    But I also told him that there were--obviously Penn is one of
    the major veterinary schools in the country but when I was
    looking around at the facilities they needed work so that was
    sort of an eye opening to me to see that even one of the what I
    guess is probably one of the top notch schools in the country
    still has a lot of infrastructure needs. I recognize the
    gentleman.
        Mr. Pitts. Thank you, Mr. Chairman. I am sorry I am late.
    But I look forward to hearing the witnesses today on this very
    important bill. I will submit my statement for the record.
        DIDN'T SUBMIT STATEMENT
        Mr. Pallone. And next the gentleman from New York, Mr.
    Towns.
        Mr. Towns. Mr. Chairman, I will submit my entire statement
    for the record, but let me just make 1 or 2 comments because I
    am anxious to hear from the witnesses. As people travel more
    and carry diseases stemming from animal contact, and as our
    food supply comes into our ports from foreign sources, we need
    to insure that we are safe and that our food is safe.
    Veterinarians will assist our nation in coping with the 21st
    century challenges relating to food safety and animal disease
    control, bio security and homeland security research on
    domestic and foreign animal diseases, especially those animal
    diseases that affect humans.
        I welcome our witnesses, and thank you, Mr. Chairman, for
    holding this hearing. I really hope that one thing will come
    out that we will increase the amount of seats for veterinarians
    because it seems to me that that is something that we must do.
    And I want to salute Congresswoman Baldwin for her work in this
    area, and also Senator Wayne Allard's efforts as well, and I
    look forward to working with them in terms of making this a
    reality. On that, I yield back, Mr. Chairman.
        [The prepared statement of Mr. Towns follows:]

                        STATEMENT OF HON. EDOLPHUS TOWNS

        Thank you, Mr. Chairman for holding this hearing on, "H.R.
    1232, Verterinary Public Health Workforce Expansion Act of
    2007", of which I am a co-sponsor.
        I thank Congresswoman Tammy Baldwin and Congressman Chip
    Pickering for introducing this bill in the House, and Senator
    Wayne Allard, a veterinarian, who first introduced it in the
    Senate. This bill would amend the public health service act to
    establish a competitive grant program to build capacity in
    veterinary medical education and expand the workforce of
    veterinarians engaged in public health practice and biomedical
    research. We must avert an estimated shortage of 15 thousand
    veterinarians over the next 20 years. For the nation's
    survival, we must do this.
        As a congressman from the proud 10th Congressional District
    of New York, I can picture from history books, shantytown life
    in my dear Brooklyn community of the Eighteen Hundreds, when
    many raised chickens, goats, pigs and cows. In 1879, Lachlan
    McLean became the first veterinary inspector appointed in
    Brooklyn. He pushed for veterinarians to be in charge of meat
    inspection. The New York State Veterinary Medical society,
    which represents more than 3,500 veterinarians in New York
    state, was founded in 1890. Its leaders were the pioneers of
    modern veterinary medicine and were instrumental in introducing
    a practice act for veterinary medicine into law in 1895, when
    veterinarians joined physicians as one of the first licensed
    professions in New York state.
        Today, as people travel more and carry diseases stemming
    from animal contact, and as our food supply comes into our
    ports from foreign sources, we need to ensure that we are safe
    and that our food is safe. Veterinarians will assist our nation
    in coping with the twenty-first century challenges relating to
    food safety and animal disease control; biosecurity and
    homeland security; research on domestic and foreign animal
    diseases, especially those animal diseases that affect humans;
    and more. Lastly, we need the resources to ensure the health of
    our beloved family pets.
        I welcome our witnesses and urge my colleagues support.
        Thank you, Mr. Chairman.
        ###
                                  ----------

        Mr. Pallone. Thank you. The other gentleman from
    Pennsylvania, Mr. Murphy.

       OPENING STATEMENT OF HON. TIM MURPHY, A REPRESENTATIVE IN
             CONGRESS FROM THE COMMONWEALTH OF PENNSYLVANIA

        Mr. Murphy. Thank you, Mr. Chairman. And thank you for
    holding a hearing to recognize the needs of veterinarians.
    Pennsylvania's number 1 part of our economy is agriculture and
    much of that is dealing with large animals, of course. One of
    my counties in my district, Washington County, is a state
    leader, for example, in sheep and lamb production. And I know
    that the issues involved with the veterinarians and making sure
    we have enough of them who are well trained continues to be a
    concern as well as others who work in the health care sector of
    veterinary medicine. Often times when we think of veterinarians
    we think of those who take care of our dogs and our parakeets,
    et cetera, but let us not forget they are an essential part of
    our economy, and they also are really an essential part of
    other issues that we have dealt with in this committee and that
    has to do with such things as food and toxic substances that
    come through that affects our animals. They are often times the
    front line of identifying what it is that is affecting our
    animals so I am pleased we are working on these issues that
    deal with training and education our veterinarians in the
    future.
        Often times in America we only know of veterinarians from
    what we have seen about James Harriet who has made something of
    a hero of everybody who is out there slogging through the mud
    in the barn as well as seeing our dogs and cats in their
    offices but let us not forget that they are a front line of an
    essential part of our economy and certainly that way in
    Pennsylvania. So I thank you for pointing out their needs for
    their future, Mr. Chairman.
        Mr. Pallone. Thank you. I think that concludes our opening
    statements by members of the subcommittee so we will now turn
    to the panel. Let me welcome all of you and introduce you. I
    will start on my left with Dr.--I was told it was Pappaioanou.
    Did I get that right?
        Dr. Pappaioanou. Yes.
        Mr. Pallone. That was easy because we have a Congressman
    Capuano. She is Executive Director of the Association of
    American Veterinary Medical Colleges based here in Washington.
    Next we have Dr. Ron DeHaven, who is Executive Vice President
    of the American Veterinary Medical Association from Illinois.
    And then we have Dr. Alan Kelly, who is Dean Emeritus of the
    University of Pennsylvania School of Veterinary Medicine. It
    has you down as New Bolton Center, which is where I went so
    thank you for taking me there. And then we have Dr. Sheila
    Allen, who is Dean of the College of Veterinary Medicine at the
    University of Georgia in Athens, Georgia.
        The way we work it, we have 5-minute opening statements.
    Those become part of the record. And each witness may in the
    discretion of the committee submit additional brief and
    pertinent statements in writing for inclusion in the record,
    and we may also ask you to do some follow-up written responses
    to our questions. So I will start now with Dr. Pappaioanou for
    a 5-minute opening statement.

     STATEMENT OF MARGUERITE PAPPAIOANOU, D.V.M., M.P.V.M., PH.D,
       D.A.C.V.P.M., EXECUTIVE DIRECTOR, ASSOCIATION OF AMERICAN
         VETERINARY MEDICAL COLLEGES (AAVMC), WASHINGTON, D.C.

        Dr. Pappaioanou. Good morning, Mr. Chairman, and members of
    the committee. First of all, we would like to very much thank
    Congresswoman Baldwin, Congressman Pickering, and Senator
    Allard for leadership on this issue and the support by many of
    you as expressed in your opening comments. I am Marguerite
    Pappaioanou, Executive Director of the Association of American
    Veterinary Medical Colleges, the organization that coordinates
    the national and international affairs of all 28 U.S. Colleges
    of Veterinary Medicine, 9 Departments of Veterinary Science, 8
    Departments of Comparative Medicine, and 14 other veterinary
    medical institutions in the U.S., Canada, the UK, and
    Australia.
        Prior to joining AAVCM November 1, I was Professor of
    Infectious Disease Epidemiology at the University of Minnesota,
    and for 21\1/2\ years from 1983 through 2004, I was an
    epidemiologist on staff at the Centers for Disease Control and
    Prevention as a veterinary officer in the Commissioned Corps of
    the U.S. Public Health Service. I am pleased to provide
    information on the roles of veterinarians in protecting public
    health and food safety and the importance of the Veterinary
    Public Health Workforce Expansion Act to strengthen our
    national security and preparedness. Strong links exist between
    human and animal health, 61 percent of over 1,400 infectious
    disease organisms that cause illness in humans, 75 percent of
    emerging infectious diseases and 5 out of 6 CDC category A
    bioterrorism agents are transmissible from animals to people.
        In the U.S. there are an estimated 85,000 veterinarians
    compared to 800,000 physicians. Graduating veterinarians swear
    that they will use their scientific knowledge and skills for
    the benefit of society through the promotion of public health
    and the advancement of medical knowledge in addition to the
    health and well being of animals. Approximately 2,800
    veterinarians serve in public health and food safety positions
    across Federal, state, and local government and academia.
    Across CDC centers approximately 85 veterinarians on staff and
    in leadership positions conduct investigations of infectious,
    food borne and environmental disease outbreaks in the United
    States and internationally.
        They conduct surveillance for diseases, conditions spanning
    the spectrum of public health threats. They design, implement,
    and evaluate disease and injury prevention and control, and
    emergency and bioterrorism preparedness and response programs.
    They address public health threats emanating from the illegal
    importation of exotic animals. They conduct public health
    research. Veterinarians at CDC and FDA monitor and track the
    magnitude and trends of food borne infections in people, the
    source of infections, and anti-microbial resistance of food
    borne pathogens. Following the 9/11 attacks in New York City
    CDC veterinarians conducted human disease and injury
    surveillance in local hospitals. In the 2002 anthrax
    bioterrorism attacks CDC veterinarians conducted surveillance
    for new human cases of anthrax across affected cities and
    states.
        A veterinarian from EPA, Environmental Protection Agency,
    led environmental clean-up efforts right here on Capitol Hill.
    Approximately 85 veterinarians at NIH oversee the health and
    welfare care research for research animals providing expertise
    in laboratory animal medicine, surgery, toxicology, and
    comparative pathology to insure the highest quality research.
    At FDA approximately 115 veterinarians are engaged in policy
    planning, oversight of new animal drug reviews and approvals,
    development of screening tests for drug residues in meat and
    milk, and research. Currently, two of FDA's five centers are
    veterinarians. At EPA approximately 20 veterinarians address
    adverse health effects of air, drinking water, and terrestrial
    pollution and environmental contamination, emergency
    preparedness and response needs.
        Many of the 500 veterinarians in the Army and Air Force are
    in positions protecting human health of our troops. In the
    Department of Homeland Security approximately 10 veterinarians
    serve in the Medical Affairs Office and in FEMA on issues of
    national emergency preparedness and response. At the state
    level veterinarians oversee infectious, chronic, and
    environmental disease and injury surveillance, prevention,
    control, and emergency preparedness programs. Veterinary
    diagnosticians and pathologists at veterinary diagnostic
    laboratories test for causes of disease outbreaks. At
    universities veterinarians conduct biomedical research and
    develop animal models for the study of human and animal
    diseases.
        Veterinarians offer expertise in comparative medicine
    having studied diseases of multiple species. They receive
    significant amounts of training on diseases that are
    transmitted from animals to humans. They are taught population
    based approaches to disease prevention and control. Their
    unique training brings important expertise to the U.S. public
    health workforce. Many more are needed to confront today's
    multi-faceted challenges to public health and food safety.
    Thank you for this opportunity to discuss how veterinarians
    protect human health and the importance of the Veterinary
    Public Health Workforce Expansion Act to strengthen our
    national security and preparedness. I would be pleased to
    respond to any question.
        [The prepared statement of Dr. Pappaioanou follows:]

                    Testimony of Dr. Marguerite Pappaioanou

        Good morning, Mr. Chairman and Members of the Committee. I
    am Marguerite Pappaioanou, Executive Director of the
    Association of American Veterinary Colleges, or AAVMC, the
    organization that represents the future of veterinary medicine.
    AAVMC coordinates the national and international affairs of all
    28 US Colleges of Veterinary Medicine, 9 Departments of
    Veterinary Science, 8 Departments of Comparative Medicine, and
    14 other veterinary medical institutions in the US, Canada, the
    UK, and Australia. Prior to joining AAVMC this past November 1,
    2007, I was Professor of Infectious Disease Epidemiology in the
    School of Public Health, with a joint appointment in the
    College of Veterinary Medicine at the University of Minnesota
    from 2005-2007, conducting research on the human-animal
    interface of avian influenza, and for 21 + years spanning the
    period from 1983 through 2004, I was as an epidemiologist at
    the US Centers for Disease Control and Prevention as a
    Commissioned Officer of the US Public Health Service. At CDC I
    began as an epidemic intelligence service officer and later as
    staff, conducted research on malaria prevention and control in
    Africa, designed and led implementation of disease surveillance
    for HIV infections in the US, guided and supported the
    development of the US Guide to Community Preventive Services,
    and as Associate Director of Science and Policy in CDC's Office
    of Global Health, coordinated CDC's research and programs in
    Africa and Asia. I received my Doctor of Veterinary Medicine
    degree from Michigan State University in 1972, Masters of
    Preventive Veterinary Medicine and Doctor of Philosophy degrees
    from the University of California, Davis, in 1976 and 1982,
    respectively, and am a diplomat of the American College of
    Veterinary Preventive Medicine.
        As a veterinarian having worked directly in public health
    for almost my entire career, I am pleased to provide the
    Committee with information on the essential role that
    veterinarians play in protecting public health and the
    necessity for the HR 1232, the Veterinary Public Health
    Workforce Expansion Act.
        Although the public at large understands the important role
    that veterinarians play in promoting and protecting the health
    of our companion animals, largely unappreciated are the
    essential functions and roles that veterinarians play in
    protecting human health, and in promoting and protecting our
    national security and emergency preparedness and response
    capabilities at international, national, state, and local
    levels across both the public and private sectors.
        Strong links exist between human and animal health-
    including shared susceptibility across human, domestic animals,
    and wildlife species to hundreds of infectious disease agents
    that are spread though direct contact, contamination of food
    and water, insect vectors, or by intentional introduction such
    as a bioterrorist attack. Increased opportunities for
    transmission of infectious diseases from animals to humans are
    resulting from growing close contact between humans and their
    companion animals, human populations moving into peri-urban and
    rural environments as our human population grows in size, rapid
    travel and movement of people and their animals, changes in
    climate affecting insects and small mammals that can spread
    disease, globalization of our food supply, and changes in our
    food production systems.
        In 2003, the Institute of Medicine (IOM) issued a report,
    "Microbial Threats to Health: Emergence, Detection, and
    Response". That report made several recommendations for
    preventing and controlling microbial threats to human health,
    including the recommendation that human and animal health work
    more closely together. The IOM described thirteen factors
    involved in the emergence of infectious diseases, with a
    majority comprising agricultural or animal health issues that
    inevitably affect human health. The report also recognized the
    growing threat from insect-borne and zoonotic diseases-those
    diseases transmitted from animals to humans. The IOM used the
    example of the SARS outbreak in 2003 to demonstrate the close
    ties between U.S. and global health, and that controlling
    infectious diseases would require global awareness and a focus
    on the overlap of animal and human health.
        Approximately 61% of over 1400 infectious disease organisms
    that cause illness in humans, and 75% of emerging infectious
    diseases, such as West Nile Virus, avian influenza, monkeypox,
    E Coli O157, bovine tuberculosis among others-are caused by
    organisms transmissible from animals to people. These zoonotic
    infectious diseases cause many outbreaks nationally and
    internationally each year, with significant adverse health
    outcomes. In addition, the highest-priority bioterrorism agents
    listed by CDC (CDC Category A agents) are those that pose a
    risk to national security because they can be easily
    disseminated or transmitted from person to person, result in
    high mortality rates, and have the potential for major public
    health impact. Five of the six CDC Category A bioterrorism
    agents are zoonotic. Recently, the American Veterinary Medical
    Association and American Medical Association have created a
    "One Health" Task Force, which is identifying ways that human
    and veterinary health professionals can work together to
    effectively address threats to human, animal, and ecosystem
    health. The report of this Task Force is expected in the spring
    of 2008. There are approximately 85,000 veterinarians in the
    US. When compared to 2 million nurses, and 800,000 physicians,
    we are a small but important and effective profession. At
    graduation veterinarians swear they will use their scientific
    knowledge and skills for the benefit of society through the
    protection of animal health, the relief of animal suffering,
    the conservation of livestock resources, the promotion of
    public health and the advancement of medical knowledge.
        The public is most familiar with veterinarians working as
    private clinical practitioners, keeping companion animals
    healthy. Largely unrecognized are the contributions of
    approximately 2,800 veterinarians working in formal public
    health positions across federal, state, and local levels of
    government and academia, with their primary responsibility to
    promote and protect public health.
        At the Federal level, veterinarians as epidemiologists,
    researchers, program managers, laboratory scientists, risk
    assessment analysts, and higher level administrative and
    management positions, carry out important public health
    missions across several Departments of the Executive Branch.
    They provide leadership, oversight, and manpower for human and
    animal health emerging infectious and environmental disease and
    injury prevention and control programs, food safety and
    security, bio- and chemical terrorism preparedness,
    environmental health programs, emergency preparedness and
    response, biomedical research, laboratory animal medicine, and
    more.
        At the Centers for Disease Control and Prevention in the
    Department of Health and Human Services, approximately 3 to 5
    veterinarians serve as laboratory animal veterinarians who are
    critical to the conduct of high quality biomedical and public
    health research. However, there are approximately 85
    veterinarians (comprising approximately 1% of the CDC
    workforce) who are working on staff and in leadership
    positions, as epidemiologists in CDC's infectious disease and
    environmental health programs and centers. They lead teams or
    work as team members in the conduct of infectious and zoonotic
    disease, insect or vector borne disease, foodborne disease, and
    environmental disease outbreak investigations, locally in
    collaboration with state health officials, regionally,
    nationally and internationally. Veterinarians conduct disease
    surveillance for diseases and conditions that span the spectrum
    of public health threats, and they design, implement, and
    evaluate disease prevention and control programs. They are
    leaders and core team members in programs that prevent and
    control emerging infectious diseases including HIV/AIDS,
    malaria, vaccine preventable diseases, protect environments and
    ecosystems, prevent and control chronic diseases and injuries,
    prepare for, detect, and or respond to bio- and agro- terrorism
    attacks, advance medical science through research. Since 1950,
    over 250 veterinarians have graduated from CDC's Epidemic
    Intelligence Service. Veterinarians also participate in CDC's
    Emerging Infectious Diseases Laboratory Fellowship Program.
        During the SARS outbreak, monkey pox outbreak, and highly
    pathogenic H5N1 avian influenza outbreaks in 2003,
    veterinarians at CDC were critical members of CDC's
    international response teams, working as a team with physician
    and laboratory scientist colleagues, contributing their special
    training and perspective to achieving the mission.
        In the United States, there are an estimated 76 million
    cases of foodborne disease annually, with 325,000
    hospitalizations and 5,000 deaths. Dr. Ron DeHaven will be
    addressing the role of over a thousand veterinarians who are
    looking after our food safety in positions with the Animal Plan
    Health Inspection and Food Safety Inspection Services of the US
    Department of Agriculture. Veterinarians at CDC lead and or
    participate in multi-state foodborne outbreak investigations.
    In addition, veterinarians and colleagues at CDC and FDA, in
    collaboration with USDA and State health departments however,
    have developed and oversee FoodNet-an active sentinel
    surveillance system in the U.S., which helps to identify the
    magnitude and trends of foodborne infections in people, the
    source of foodborne infections so effective interventions can
    be undertaken, and serves as a platform for the conduct of more
    detailed investigations of risk factors for foodborne diseases
    and effective interventions to prevent them. Veterinarians at
    CDC, FDA, and USDA, in collaboration with selected State health
    departments, have established another key sentinel surveillance
    system called the National Antimicrobial Resistance Monitoring
    System (NARMS) for Enteric Bacteria. Veterinarians involved
    with NARMS monitor and report on antimicrobial resistance of
    six different species of bacteria that are obtained from human
    infections, to 17 different antimicrobials, in 27 sites,
    covering 158 million people in the U.S-or 56% of the U.S.
    population. Veterinarians at USDA and FDA coordinate and
    conduct testing for antimicrobial resistance of salmonella,
    Campylobacter, and E. coli isolates from infections in a number
    of food and companion animals. Veterinarians involved with
    NARMS are providing important information to inform medical and
    veterinary practitioners on the status of antibiotic resistance
    to aid in making judicious decisions on the use of antibiotics.
        Following the 9/11 attacks in New York City, the public
    heard about the wonderful care that veterinarians administered
    to working dogs that were members of the rescue operation. Less
    publicized were the efforts of several CDC veterinarians
    leading the conduct of human disease and injury surveillance
    programs in local hospitals during the emergency. Another
    example of the public health roles that veterinarians play
    should hit a little closer to home for some members of
    Congress. In the anthrax attacks of 2001 which targeted members
    of Congress right here on Capitol Hill, a veterinarian from EPA
    led environmental cleanup efforts on Capitol Hill. In addition,
    other veterinarians at CDC led the surveillance effort for new
    cases across affected cities and states during that event.
        Moving to the National Institutes of Health, there are
    approximately 85 veterinarians working to ensure the highest
    quality research, by overseeing the health and welfare care for
    research animals, and providing expertise in laboratory animal
    medicine and surgery, toxicology, and comparative pathology. In
    addition, there are veterinarians at NIH who work as scientists
    and program directors in disease research programs.
        At the Food and Drug Administration, approximately 115
    veterinarians in the Center for Veterinary Medicine and the
    Center for Food Safety and Nutrition work as epidemiologists
    and veterinary pathologists involved with policy, planning,
    budgeting, oversight of new animal drug reviews and approvals,
    surveillance for animal health /adverse drug reactions and
    antibiotic resistance. Veterinarians approve safe and effective
    products for animals, enforce applicable provisions of the
    Federal Food, Drug, and Cosmetic Act & other authorities,
    conduct animal drug review, oversee compliance-related actions
    and post-approval monitoring, oversee animal feed safety, and
    conduct surveillance for antibiotic resistance of food borne
    bacteria. Veterinarians at FDA develop screening tests for drug
    residues in meat and milk, and conduct research to support
    animal drug approvals. Dr. Steve Sundloff, a veterinarian at
    FDA recently was named Director of FDA's Center for Food Safety
    and Nutrition.
        As of 2004, there were approximately 20 veterinarians
    working in public and environmental health at the Environmental
    Protection Agency. At EPA, veterinarians conduct risk
    assessments of and evaluate Superfund sites, Eco-toxicological
    pathogens and or contaminants such as metals, antimicrobials,
    sludge borne, water and food borne pathogens. They conduct
    policy analysis and development, lead or participate in
    emergency preparedness and response and environmental
    contamination, conduct research on the adverse health effects
    of air, drinking water and terrestrial pollution, and address
    environmental issues related to intensive or concentrated
    animal feeding operations.
        In the Department of Homeland Security, approximately 10
    veterinarians work in leadership and staff positions in the
    Medical Affairs Office and FEMA, contributing toward national
    emergency preparedness and response goals and objectives.In the
    Department of Defense, approximately 500 veterinarians are
    protecting and promoting human health and welfare in the Army
    and Air Force, working as public health officers, on medical
    intelligence, deployment health support, decontamination of
    chemical/biological/ radiological casualties, and food safety
    as well as clinical veterinarians who care for working animals.
    At the State level, veterinarians serve as State
    Epidemiologists, State Public Health Veterinarians, State
    Veterinarians, and State Wildlife Veterinarians (and Deputies
    and Assistants to these positions). State Epidemiologists
    oversee disease prevention and control across acute infectious
    disease, chronic disease, environmental, occupational, and
    injury programs. State Public Health Veterinarians oversee and
    conduct surveillance for diseases that are transmitted from
    animals to people, such as rabies, West Nile Virus, and others,
    and prevention and control programs for zoonotic and food
    safety programs, and coordinate bio- and chemical bioterrorism
    preparedness. State Veterinarians oversee livestock and poultry
    health /disease prevention and control programs, health issues
    involving exotic and domesticated animals, animal care and
    welfare, and more. State Wildlife Veterinarians oversee
    wildlife health and conservation programs, which are gaining
    increasing importance with the recognition of wildlife health
    in the epidemiology and ecology of emerging zoonotic infectious
    diseases, which threaten human health and which appear to be
    increasing in occurrence.
        Increasingly, veterinarians at the state and local levels
    are playing critical roles in leading the development and
    implementation of plans for emergency preparedness and
    response. Veterinary colleges and their diagnostic
    laboratories, with faculty and staff (including veterinary
    diagnosticians and pathologists) are playing an important role
    in surveillance, laboratory testing including providing surge
    capacity for human laboratories, education and training, and
    research. Following Hurricane Katrina and in preparation for
    Hurricane Rita, at the request of Brazos County Health
    Department and the Texas State Health Department, Faculty at
    the College of Veterinary Medicine at Texas A&M partnered with
    medical colleagues to convert their large animal veterinary
    hospital into a facility to care for several hundred "special
    needs" patients from Houston and Galveston. By the evening
    Hurricane Rita arrived, the hospital was emptied of animals and
    sanitized, and ultimately 650 people including patients,
    families and caregivers were housed in the facility.
        At universities as well as in health agencies,
    veterinarians dedicated to the conduct of public health and
    biomedical research are needed to develop new public health
    interventions, to research the factors that influence the
    ability of viruses and bacteria to both animals and people, to
    study our immune systems which can make us more susceptible to
    diseases, to develop vaccines, to develop animal models of
    human diseases to study disease processes better and to
    identify new treatments for humans and animals.
        In the roles and contributions I have described,
    veterinarians either lead or work as part of multidisciplinary
    teams. In their training, veterinarians receive the same basic
    science preparation as physicians and other allied health
    professions; however, they study anatomy, physiology, and
    diseases of multiple species, making them comparative medicine
    specialists.
        Veterinarians are keen observers as their patients cannot
    offer information on symptoms they are feeling. Veterinarians
    receive extensive training in diseases of animals caused by
    parasites, bacteria and viruses and that are transmissible to
    people. Veterinarians are trained to consider the environment
    in which disease processes are taking place, and to expect the
    unexpected. In food animal medicine, they are taught
    population-based approaches to disease prevention, control, and
    health promotion, and in food systems that bring our food to
    the tables from our farms. In general, Veterinarians are taught
    to see the world as an ecosystem, in contrast to the education
    of the allied health professions which tends to target
    individuals alone. The training and perspective of
    veterinarians are unique and add value to the public health
    team. When veterinarians are not present to address a public
    health outcome, that lost perspective can present added
    challenges in arriving at effective public health solutions.
    And with an increasing human population, increasingly mobile
    human and animal populations, global climate change,
    globalization of our food supply, changing human behaviors with
    regard to animals that that increase human exposure to zoonotic
    pathogens, and changing microbes, the need for and benefit of
    veterinary knowledge, perspective, and expertise to contribute
    toward solving an increasing number of global health
    challenges, will only increase into the future. Many more
    public health veterinarians than the 2,800 currently serving
    (with many due to retire in the near future), are needed to
    take on the growing number of challenges to human, animal, and
    ecosystem health.
        The Institute of Medicine has defined public health as
    "what we, as a society, do collectively to assure the
    conditions in which people can be healthy". Veterinarians are
    an essential component of the US public health workforce.
    However, the profession and numbers of veterinarians working in
    public health are extremely small compared to the other health
    professions. Many more veterinarians are needed to keep up with
    the increasing human population accompanied by increasing
    numbers of companion and food animals, as well as to ensure
    sufficient numbers of veterinarians working in the public
    health areas I have described. With yearly graduating classes
    similar in size to those of 35 years ago, the profession cannot
    meet societal needs and fulfill its obligations to promote and
    protect public health.
        Our nation's Colleges of Veterinary Medicine, located in 26
    of our 50 States, are working with their universities and
    states to graduate the greatest number of new veterinarians
    possible with the facilities and infrastructure that exist, but
    many more veterinarians are needed to ensure our national food
    safety, preparedness, and security, to prevent, detect and
    control outbreaks of emerging infectious diseases, and to
    fulfill our responsibilities for national preparedness and
    response. Our national security and preparedness are at stake.
    Federal support, as described in the Veterinary Public Health
    Workforce Expansion Act (HR 1232) is essential to complement
    public and private support provided at state and local levels
    to meet the national need.
        Thank you for this opportunity to discuss the important
    roles that veterinarians play in protecting our public's
    health, in assuring our national security, our national
    veterinary public health workforce shortage, and efforts needed
    to address the national need. I would be pleased to respond to
    any questions.
                                  ----------

        Mr. Pallone. Thank you. Dr. DeHaven.

      STATEMENT OF W. RON DEHAVEN, D.V.M., M.B.A., EXECUTIVE VICE
      PRESIDENT, AMERICAN VETERINARY MEDICAL ASSOCIATION (AVMA),
                             SCHAUMBURG, IL

        Dr. DeHaven. Mr. Chairman and members of the subcommittee,
    thank you for giving the American Veterinary Medical
    Association the opportunity to speak in support of the
    Veterinary Public Health Workforce Expansion Act. I am Dr. Ron
    DeHaven, the executive vice president of the AVMA. Previously,
    I served for nearly 3 decades with the U.S. Department of
    Agriculture's Animal and Plant Health Inspection Service most
    recently as its administrator. In that capacity, I was
    responsible for protection of U.S. agriculture and natural
    resources from pest and disease. The AVMA represents some
    76,000 veterinarians who are involved in every aspect of our
    veterinarian medical profession. Our members insure the well
    being of our companion animals. The protect human health
    through the control of zoonotic disease.
        They conduct research into animal and human health and they
    help preserve endangered species. Many of our AVMA members are
    also working to insure the health of our nation's livestock,
    and in doing so ultimately enjoy the safety of our food supply.
    These veterinarians have their work cut out for them. According
    to the CDC food borne diseases such as salmonella and E. coli
    are responsible for an estimated 76 million human illnesses,
    over 300,000 hospitalizations, and 5,000 deaths each year just
    in the United States. Food safety and the risk of illness from
    eating contaminated food remain on the collective conscience of
    our nation's public, and we just saw on January 12 the recall
    of nearly 200,000 pounds of ground beef over concern about E.
    coli contamination.
        As our nation continues to rely on protein-based diets the
    number of food animals that will be needed to meet that demand
    will grown proportionate with our population. The U.S. Census
    Bureau projects that the United States population will reach
    335 million by the year 2020 and in fact 413 million or 419
    million by the year 2050. This population growth will put
    increased demands on our food supply system as well as on those
    who are responsible for its safety and quality. Veterinarians
    have and will continue to play a critical role in that regard.
    Animals and humans are inextricably linked when it comes to
    disease. Veterinarians have been working on diseases of public
    health significance such as tuberculosis and brucellosis for
    over 100 years.
        SARS, monkeypox, West Nile Virus, Lyme disease, highly
    pathogenic avian influenza, bovine spongiform encephalopathy or
    BSE are just a few of the more recent examples of animal
    diseases that have had tremendous implications for public
    health. Veterinarians have played a pivotal role in the
    diagnosis, treatment, control, and surveillance for each one of
    those diseases. This connection between animals and humans is
    truly an issue of one health, that is, as goes the health of
    our nation's animals so goes the health of our nation's people.
    As guardians of our nation's food supply veterinarians will be
    the first medical professionals to diagnose and contain
    diseases in animals that may spread to humans. Unfortunately,
    the number of veterinarians available to serve society in these
    critically important roles does not meet that demand.
        A recent study conducted at Kansas State University
    projects this shortage to worsen by 4 to 5 percent each year
    into the foreseeable future. Reports indicate that 50 percent
    of the U.S. Public Health Service veterinary medical officers
    are now eligible to retire. The U.S. Department of Agriculture,
    which is already underserved by veterinarians is projecting
    huge deficits in the future in that same regard. A survey of
    the AVMA membership shows that the mean age of food supply
    veterinarians is approximately 50 years of age and so many of
    them are nearing retirement. At the heart of the issue is the
    fact that our country's veterinary medical colleges lack the
    capacity to produce more food supply and public health
    veterinarians. Our nation's 28 accredited veterinary colleges
    are currently at or above capacity graduating approximately
    2,500 veterinarians each year.
        According to a recent report by the Bureau of Labor
    Statistics veterinary medicine ranked 9th among the 30 fastest
    growing occupations for the years 2006 to 2016. It is estimated
    that jobs for veterinarians will increase by 35 percent in the
    next several years, and it is our collective responsibility to
    insure that there are veterinarians to fill those positions.
    Fiscal concerns are also playing an important role in this
    shortage. Only 26 states currently cover the lion's share of
    the cost of producing veterinarians who protect the entire
    nation's food supply and public health. There has also been a
    dearth of Federal funding for veterinary colleges. According to
    a 2005 report by the National Research Council the last major
    Federal funding program to support construction of facilities
    for colleges of veterinary medicine ended more than 40 years
    ago.
        Out country's ability to protect its food supply and its
    capacity for zoonotic and food animal disease research is
    insufficient and these realities could have devastating long-
    term consequences. Food animal production adds approximately
    $124 billion annually to the U.S. economy. A single highly
    infectious disease that is not rapidly diagnosed could destroy
    much of our nation's livestock resulting in shortages, not just
    dietary protein, but also result in huge economic losses. In
    addition, the CDC estimates that 80 percent of the bio-terror
    agents are infectious diseases that spread from animals to
    humans. Failure to quickly diagnose these diseases in animals
    before they are spread to humans could have huge consequences
    and catastrophic loss of human life.
        There are ways of addressing this problem, and we need look
    no further than the Veterinary Public Health Workforce
    Expansion Act. This act would create a competitive grants
    program designed to produce more veterinarians working in
    public health practice and enhance our capacity for research on
    diseases that threaten both public health and food safety. Mr.
    Chairman, the AVMA fully supports the Veterinary Public Health
    Workforce Expansion Act. We thank you for holding this hearing
    and thank you for providing the AVMA the opportunity to address
    the subcommittee.
        [The prepared statement of Dr. DeHaven follows:]

                          Testimony of W. Ron DeHaven

        Mr. Chairman and members of the Subcommittee, thank you for
    giving the American Veterinary Medical Association the
    opportunity to speak in support of the Veterinary Public Health
    Workforce Expansion Act.
        I am Dr. Ron DeHaven, executive vice president of the AVMA.
    Prior to joining the AVMA, I served nearly three decades with
    the United States Department of Agriculture's Animal and Plant
    Health Inspection Service, most recently as APHIS
    administrator. In that capacity, I was responsible for the
    protection of U.S. agriculture and natural resources from
    exotic pests and diseases, administering the Animal Welfare
    Act, and carrying out wildlife damage management activities.
        The American Veterinary Medical Association represents more
    than 76,000 American veterinarians engaged in every aspect of
    veterinary medical science. Among other things, we ensure the
    well-being of our nation's companion animals, we protect human
    health through the control of zoonotic disease, we conduct
    research into animal and human health, and we help preserve
    endangered species. Many of us are working to ensure the health
    of our nation's livestock, and ultimately our food supply.
        As you can see, veterinarians do much more than take care
    of our beloved family pets. They also play a vital role in
    preserving our country's public health by protecting humans
    from diseases spread by animals and assuring the safety of our
    food, from poultry to pork and beef.
        These veterinarians have their work cut out for them.
    According to the Centers for Disease Control and Prevention,
    foodborne diseases, such as Salmonella and E. coli, are
    responsible for an estimated 76 million human illnesses,
    300,000 hospitalizations and 5,000 deaths each year in the
    United States. Food safety and the risk of illness from eating
    contaminated food items remain on the nation's collective
    conscience, as we just saw January 12 with the recall of nearly
    200,000 pounds of ground beef because of concerns of E. coli
    contamination.
        As our nation continues to rely on protein-based diets, the
    number of food animals needed to meet that need will rise
    proportionately with population growth. The U.S. Census Bureau
    projects that the United States population will grow to more
    than 335 million by 2020 and to more than 419 million by 2050.
    This population growth will put increased demands on our food
    supply system and those who are responsible for its safety and
    quality. Veterinarians will play a critical role in that
    regard.
        Animals and humans are inextricably linked when it comes to
    disease. Veterinarians have been working on diseases of pubic
    health significance, such as tuberculosis and brucellosis, for
    more than 100 years. Severe acute respiratory syndrome (SARS),
    monkeypox, West Nile Virus, Lyme disease, avian influenza and
    bovine spongiform encephalopathy (BSE) are more recent examples
    of zoonotic diseases that have had significant public health
    implications. Veterinarians have played a pivotal role in the
    identification, diagnosis, treatment, control and surveillance
    of each one of these diseases.This connection between animals
    and humans is truly an issue of "one health." That is, as goes
    the health of our nation's animals, so goes the health of its
    people.
        The veterinarians working in food safety and public health
    can be found in both the public and private sectors. At the
    Centers for Disease Control, veterinarians work in areas such
    as bioterrorism, environmental health, viral and bacterial
    diseases, and food safety. At the Food and Drug Administration,
    veterinarians working in the Center for Veterinary Medicine
    help regulate the manufacture and distribution of food
    additives and drugs that are given to animals, including those
    animals from which human foods are derived. At the United
    States Department of Agriculture, veterinarians work in food
    safety and animal health. In the private sector, food supply
    veterinarians are involved in keeping food animals healthy and
    their environments free of contaminants.
        Simply put, all of these veterinarians serve as guardians
    of our nation's food supply, and they will be the first medical
    professionals to diagnose and contain diseases in animals that
    may spread to humans.
        Unfortunately, the number of veterinarians available to
    serve society in these key roles does not meet demand. A recent
    study conducted at Kansas State University projects this
    shortage to worsen by 4 percent to 5 percent annually for the
    next several years. This shortage is being felt across the
    board. Reports indicate that 50 percent of U.S. Public Health
    Service veterinary medical officers are now eligible for
    retirement. The USDA, which is already underserved, is
    predicting a shortfall of several hundred veterinarians. A
    survey of the AVMA membership shows that the mean age of food
    supply veterinarians is around 50 and nearing retirement,
    placing an even greater burden on the profession and our
    society.
        Added to the mix is the fact that the country's veterinary
    colleges lack the capacity to produce more food supply and
    public health veterinarians. Our nation's 28 accredited
    veterinary colleges are currently at or above capacity,
    graduating about 2,600 veterinarians each year. According to a
    recent report by the Bureau of Labor Statistics, veterinary
    medicine ranked 9th in the list of the 30 fastest-growing
    occupations for 2006 through 2016. It is estimated that jobs
    for veterinarians will increase by 35 percent in the next
    several years. And it is our joint responsibility to fill them.
        While some of that growth will be met with the addition of
    new graduates into the workforce, there are national concerns
    that many jobs in food supply and public health will go
    unfilled. There are about 8,850 U.S. veterinarians working in
    the food animal field. Around the turn of the 20th Century,
    virtually every veterinarian was a food animal veterinarian.
    Today, only about 17 percent of veterinarians work in food
    supply and more than 70 percent of veterinarians work with
    companion animals. This trend is likely to continue as
    veterinary school graduates enter the workforce.
        Apart from the workforce issues I have highlighted, fiscal
    concerns also are playing a role in this shortage. Only 27
    states currently share the cost of producing the veterinarians
    who protect the entire nation's food supply and public health.
    There has also been a dearth of federal funding for veterinary
    colleges. According to a 2005 report by the National Research
    Council of The National Academies, titled, "Critical Needs for
    Research in Veterinary Medicine," the last major federal
    program to support construction of facilities for colleges of
    veterinary medicine ended more than 40 years ago.
        Our country's ability to protect its food supply, and its
    capacity for zoonotic and food animal disease research is
    insufficient, and these realities could have devastating
    consequences.
        Food animal production generates about $124 billion
    annually to the U.S. economy. A single, highly infectious
    disease that is not rapidly diagnosed could destroy much of our
    livestock, resulting in shortages of dietary proteins and
    significant economic losses. In addition, the CDC estimates
    that 80 percent of potential bioterror agents are infectious
    diseases that spread from animals to humans. Failure to
    diagnose these diseases in animals before their spread to
    humans could result in a catastrophic loss of human life.
        Additionally, as food animal operations become more
    centralized, there is even greater risk of a single disease
    spreading throughout an entire herd that could easily number in
    the tens of thousands, prompting an outbreak of enormous
    proportion that would require veterinarians' talent, experience
    and expertise to contain and eliminate.
        There are ways of addressing this problem, however, and we
    need look no further the promise behind the Veterinary Public
    Health Workforce Expansion Act. This Act would create a
    competitive grants program designed to produce more
    veterinarians working in public health practice and enhance our
    capacity for research on diseases that threaten public health
    and food safety.
        Mr. Chairman, the AVMA fully supports the Veterinary Public
    Health Workforce Expansion Act.
        The shortage of veterinarians working in food supply and
    public health positions poses a threat to our country's
    security. Though the federal budget is strained, national
    investment in our veterinary colleges and our capacity in
    zoonotic and food animal disease research is necessary. The
    potential costs of failing to make this investment far exceed
    the cost of the investment itself.
                                  ----------

        Mr. Pallone. Thank you. Dean Kelly.

       STATEMENT OF ALAN KELLY, B.V.SC., M.R.C.V.S., PH.D., DEAN
      EMERITUS, UNIVERSITY OF PENNSYLVANIA, SCHOOL OF VETERINARY
            MEDICINE, NEW BOLTON CENTER, KENNETT SQUARE, PA

        Mr. Kelly. Chairman Pallone and members of the Health
    Subcommittee, thank you for giving me the opportunity to
    testify before you today. I would like to take the opportunity
    of thanking Congressman Baldwin and Congressman Pickering for
    the support of the bill. My name is Dr. Alan Kelly. For 12
    years I was dean of the School of Veterinary Medicine at the
    University of Pennsylvania, and I have been on the faculty at
    Penn for 45 years. Let me start by saying that the veterinary
    profession provides an extraordinary and important link between
    agriculture and human medicine. Our testimony presents the case
    for increasing enrollment in the nation's 28 veterinary schools
    and is largely driven by public concern over the safety of the
    food supply and the security from diseases that are
    communicable from animals to humans such as avian influenza and
    SARS.
        In my written testimony, I describe the background of the
    Workforce Expansion Act, starting with the Veterinary Medical
    Education Act of 1966 that recognized the need to upgrade aging
    facilities to increase enrollment in the nation's veterinary
    schools. As a result, enrollment increased by approximately
    1,000 students per year between 1963 and 1983. Since that time
    enrollment in U.S. veterinary schools has remained more or less
    flat at about 2,400 students per year. As a result, veterinary
    schools are very difficult to get into. For example, at Penn
    this year we received 1,500 applicants for 112 places, and now
    1,200 American students are obtaining veterinary education
    overseas and this number is growing.
        This number represents more than 10 percent of the total
    enrollment in veterinary schools in this country. Veterinary
    public health and safety begins on the farm. For the past 30
    years American livestock and poultry production has undergone
    dramatic changes with consolidation and integration of the
    poultry and swine industries into large production units that
    use less veterinary services per animal than in more
    traditional farming. The dairy industry is undergoing the same
    trend. Small dairy farms are going out of business and the
    number of herds of over 1,000 milking cows is increasing
    rapidly. With the increased size of herds the amount of
    veterinary services is declining, and it is increasingly
    difficult for farm animal veterinarians to survive in the rural
    setting.
        As a consequence of this shift, large areas of the United
    States are now without veterinary coverage. The decrease
    threatens to undermine the nation's capacity to protect animal
    and human health and to respond to potential emergencies should
    they arise. As my colleagues have described veterinarians
    employed in multiple ways in the Federal and state governments
    to insure the safety of the food supply from farm to fork as
    well as the safety of imported foods and live animals.
    Veterinary schools are not able to meet present needs, and let
    me give you some examples. The average age of USDA Food Safety
    Inspection Service veterinarians is 54 and approximately 500
    USDA veterinarians are expected to leave in the next 5 years.
        Even with replacement of retirees the veterinary services
    division of the Animal and Plant Health Inspection Service
    project a shortfall of 298 veterinary offices by 2011. The
    Center of Disease Control and Prevention estimates the needs of
    200 specially trained veterinarians in the next decade. The
    U.S. Public Health Service has more than 50 unfilled positions
    and 50 percent of the present U.S. Public Health Service
    veterinarians are now eligible for retirement. To maintain its
    current defective strength the U.S. Army Veterinary Corps which
    has responsibility for the safety of food supplies to the
    military requires an additional 45 new veterinarians each year.
    There is an acute shortage of lab animal veterinarians which
    threatens research activity not only in the pharmaceutical
    industry but also in health-related research in the nation's
    universe of these research institutions.
        Veterinary pathologists are critically important to the
    U.S. drug and chemical industries and to diagnostic labs. In
    the U.S.A. today there are 1,300 board-certified veterinary
    pathologists. Currently there are 90 open positions and in the
    next decade this number is projected to increase to 300 to 500
    and fill positions because of increased demand. To meet these
    needs projections are that the U.S. veterinary schools must
    graduate over 420 more veterinary students per year. In
    addition, because of the sophistication of clinical and
    research training now required slots for 219 more graduate
    students are needed. The schools need additional faculty and
    funding for capital improvements to be able to fulfill these
    needs. Draining and basic research must also be expanded
    especially in immunology and infectious disease research and
    food safety.
        Infectious diseases research is of special importance for
    veterinary schools since most of the new and emerging
    infectious diseases that have appeared in the last 15 years and
    affect humans have come from reservoirs of infection in
    wildlife. As people intrude further and further into wildlife
    areas and as unregulated live animal markets and the sale of
    bush-meat continues, more and more of these diseases will
    emerge to threaten the global community. It is here that a
    partnership must be forged between human and veterinary public
    health as one health to control the spread of these infections
    and to sustain the safety of Americans and their food supply.
    Thank you for your attention.
        [The prepared statement of Mr. Kelly follows:]

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Mr. Pallone. Thank you, Dean Kelly. Dr. Allen.

     STATEMENT OF SHEILA W. ALLEN, D.V.M., M.S., DEAN, COLLEGE OF
         VETERINARY MEDICINE, UNIVERSITY OF GEORGIA, ATHENS, GA

        Dr. Allen. Good morning, Chairman Pallone, Congressman
    Deal, and members of the subcommittee. It has been my privilege
    to be involved in educating future veterinarians at the
    University of Georgia for 27 years. My testimony will focus on
    what veterinary colleges are doing to address the manpower
    shortage and why our Federal government should assume some of
    the responsibility for addressing this critical shortage. The
    demand for enrollment in U.S. colleges remains high and the
    interest among students in public service and food animal
    medicine is strong. Young people pay attention to the news and
    they recognize the threat to human health that is posed by the
    prevalence of animal pathogens and would like to help meet this
    challenge. We are admitting students with interest in public
    health, nurturing that interest while they are in school and
    providing incentives such as scholarships and loan forgiveness
    programs.
        As a result of these and other incentives veterinary
    graduates are entering careers in which the shortage exists. At
    the University of Georgia, more students entered public health,
    food animal practice, and biomedical research careers in last
    year's graduating class than ever before. Although we are
    pleased with this progress the harsh reality is that it will
    not come close to filling the need. We must increase enrollment
    in our veterinary colleges. Feasibility studies conclude that
    it is cost prohibitive to establish new colleges of veterinary
    medicine. As a result, many of the states that do not have a
    veterinary college partner with an existing college in another
    state to provide a veterinary education for their citizens.
    Examples include Nebraska's partnership with Iowa State
    University, and the relationship between South Carolina, West
    Virginia, and Delaware with the University of Georgia.
        Each college's annual cost of educating a veterinary
    student ranges between $55,000 and $65,000 per year per
    student. With the average yearly tuition paid by the in state
    student being 15,000 and the out of state student 29,000 the
    balance must be paid by the state supporting these institutions
    at an average state appropriation of over $20 million per year.
    The average annual cost assumed by each student to attend
    veterinary school including tuition, books, and living expenses
    is $37,000 for in-state residents and $53,000 for out-of-state
    residents. It is no wonder that the average educational
    indebtedness after completing the 4-year program is over
    $100,000. We cannot rely exclusively on tuition increases to
    pay the escalating costs of operating a veterinary college much
    less expanding them.
        To do so would exacerbate the student's debt burden and
    further diminish the number of graduates who can afford to
    enter underserved careers in public service, biomedical
    research, and rural practice. State governments continue to pay
    the recurring expenses involved in running a veterinary
    college, all of which are escalating rapidly. What we need help
    with is construction to expand our colleges. We need larger
    classrooms, larger instructional laboratories, and expansion of
    all the support areas that increased enrollment requires. Most
    U.S. colleges have major capital expansion projects proposed to
    their state legislatures. Even if all were fully funded, we
    cannot increase our enrollments sufficiently to meet the needs
    of the future. Our Federal government has recognized its
    responsibility to protect the health of the nation by
    establishing the National Animal Health Laboratory Network,
    diagnostic laboratories that are dedicated to the disease
    surveillance of animal populations.
        The proposed National Bio and Agroterrorism Defense
    Facility or NBAF is another example of our Federal government
    assuming the responsibility of protecting our nation's animal
    resources. Unless we work together to expand the capacity for
    training more veterinarians there simply won't be enough
    qualified veterinary professionals to work in these federally
    funded facilities. What we are proposing is a competitive
    grants program that will administer awards to institutions that
    are devoted to graduating more veterinarians who will enter
    fields of veterinary medicine that are of vital importance to
    the health of our nation. The institution's awarded funds will
    be expected to document that the enrollment increase resulted
    in more graduates entering fields of public health importance.
    We expect to be held accountable for demonstrating this desired
    outcome.
        I hope we have explained the vital role that veterinarians
    play in keeping the interface between people and animals a
    healthy one. Whether that interface is the milk we drink, the
    eggs and meat that we eat or the wildlife in our forests
    veterinarians play an important role in insuring that animal
    disease are monitored for, detected earlier, and hopefully
    prevented so they don't threaten the well being of people. We
    believe that increasing the number of veterinarians devoted to
    this work is vitally important and that the U.S. government
    should contribute towards this national priority. I thank you
    for your time and attention, and I also thank Congresswoman
    Baldwin, Congressman Pickering, and Senator Allard for their
    leadership in this effort.
        [The prepared statement of Dr. Allen follows:]

                          Testimony of Sheila W. Allen

        Good morning Congressman Pallone, Ranking Member Deal, and
    members of the subcommittee. I am Dr. Sheila Allen, dean of the
    College of Veterinary Medicine of the University of Georgia. It
    has been my privilege to be involved in training future
    veterinarians at the University of Georgia for 27 years. I
    thank you and the subcommittee for the opportunity to speak to
    you today about the Veterinary Public Health Workforce
    Expansion Act. This legislation is vital not only to the future
    of the veterinary profession, but to the health of our nation.
    My colleagues Drs. DeHaven and Pappaioanou have outlined the
    many critical roles that veterinarians play in protecting
    people from diseases transmissible from animals to man, whether
    that transmission occurs by direct contact (such as highly
    pathogenic avian influenza), from ingestion of contaminated
    food or water (such as E. coli 0157 or salmonella), or through
    insect borne means (such as West Nile virus). They and Dr.
    Kelly also have described the workforce shortage that already
    exists in the federal agencies devoted to this important work.
    My testimony will focus on why the federal government should
    assume some of the responsibility for expanding the capacity of
    US Colleges of Veterinary Medicine to help address this
    critical shortage.
        There are currently 28 Colleges of Veterinary Medicine in
    the United States, supported by 26 states. The states that do
    not have a College of Veterinary Medicine have contracts with
    existing colleges to provide a veterinary education for their
    citizens. Many of these states have conducted feasibility
    studies to determine what it would take to establish a College
    of Veterinary Medicine, and all have concluded that it is cost
    prohibitive. It is much more cost effective to expand existing
    colleges to meet the demand for enrollment and the market for
    veterinary graduates than to build new schools. Many of the
    states that do not have a College of Veterinary Medicine, yet
    have a high demand for enrollment among its citizens, have
    chosen to partner with an existing College in another state to
    provide funds to allow those Colleges to expand. Examples of
    such partnerships include Nebraska's partnership with Iowa
    State University, and the relationship between South Carolina
    and the University of Georgia.
        The demand for enrollment in Colleges of Veterinary
    Medicine in the US remains high. The interest among our
    students in entering careers in public health, biomedical
    research, and food animal medicine is strong. Young people pay
    attention to the news and recognize the threat to human health
    that is posed by the prevalence of animal pathogens, and would
    like to be part of the veterinary workforce that will meet this
    challenge. Colleges of Veterinary Medicine are trying to
    address the shortage by admitting students with these
    interests, nurturing that interest while in veterinary school,
    and providing incentives such as scholarships and loan
    forgiveness programs. Students who pursue a masters of public
    health or doctoral research degree programs are awarded
    stipends to minimize the added cost of obtaining such training.
    As a result of these and other incentives, veterinary graduates
    are entering these careers in which a shortage exists. At the
    University of Georgia, more students entered public health,
    food animal practice, and biomedical research careers from last
    year's graduating class than ever before. Although we are
    pleased with this progress, the harsh reality is that it will
    not come close to filling the need. In order to preserve the
    health of our nation and its animal resources, we must have an
    overall expansion of enrollment in our veterinary colleges.
        Some of the most severe shortages in veterinary workforce
    are in those fields devoted to protecting public health: food
    safety and food animal practice, public health officials, and
    biomedical research. The federal government has recognized its
    responsibility to protect the health of the nation by
    establishing the National Animal Health Laboratory Network,
    which is a network of diagnostic laboratories dedicated to the
    disease surveillance of animal populations. The proposed
    National Bio and Agroterrorism Defense Facility (NBAF) is
    another example of our federal government assuming the
    responsibility of protecting our nation's animal resources.
    Ladies and gentlemen, unless we work together to expand the
    capacity for training more veterinarians, there won't be enough
    qualified veterinary professionals to work in these federally
    funded facilities.
        The states that have Colleges of Veterinary Medicine have
    invested heavily to educate veterinarians who will serve
    society, and will continue to do so. The average annual
    operating budget for a veterinary college is $56 million.
    Colleges of Veterinary Medicine estimate the annual cost of
    educating a veterinary student to be $55,000 to $65,000 per
    year per student. With the average yearly tuition paid by the
    in-state student being $15,000, and the out of state tuition
    average being $29,000, the balance is paid by the states
    supporting these institutions, at an average state
    appropriation of $20 million per year.
        The average annual cost assumed by each student to attend
    veterinary school, including tuition, books, and living
    expenses is $37,000 for in-state residents, and $53,000 for out
    of state residents. It is no wonder that the average
    educational indebtedness after completing the four-year program
    is over $100,000. We cannot rely exclusively on tuition
    increases to pay the escalating costs of operating a veterinary
    college, much less expanding them. To do so would exacerbate
    the students' debt burden, further diminishing the number of
    graduates who can afford to enter underserved careers in public
    service, biomedical research, and rural practice for which the
    financial compensation is less than in suburban private
    practice and specialized veterinary medicine.
        State governments will continue to assume the ongoing costs
    of paying faculty and staff, facility maintenance and
    utilities, and all the other recurring expenses involved in
    running a veterinary college, all of which are escalating
    rapidly. We also will continue to award scholarships and
    administer loan forgiveness programs for students who pursue
    careers of great need in our profession. We will continue to
    place emphasis on admitting students who demonstrate a desire
    to pursue underserved career paths. What we need help with is
    capital construction to expand our colleges. We need larger
    classrooms, larger instructional laboratories, and an expansion
    of all the student support areas an increased enrollment
    requires (locker rooms, computer labs etc.). Most US Colleges
    have major capital expansion projects proposed to their state
    legislatures. Even if all were fully funded, we cannot expand
    our enrollments sufficiently to meet the needs of the future.
        House Resolution 1232 seeks federal assistance to expand
    the infrastructure in existing Colleges of Veterinary Medicine
    so that more students can be trained to enter careers that are
    vital to our nation's health: animal and human. What we are
    proposing is a competitive grants program. The grants will be
    awarded to institutions that are devoted to graduating
    veterinarians who will enter fields of veterinary medicine that
    are of vital importance to the health of our animal resources,
    our environment, and ultimately our citizens. The institutions
    awarded funds will be expected to document that the enrollment
    expansion resulted in more graduates entering fields of public
    health importance. We expect to be held accountable for
    demonstrating this desired outcome.
        I hope we have explained the vital role that veterinarians
    play in keeping the interface between people and animals a
    healthy one. Whether that interface is the milk we drink, the
    eggs and meat we eat, or the birds in our backyard bird feeder,
    veterinarians play an important role in ensuring that animal
    diseases are monitored for, detected, and hopefully prevented
    so they don't threaten the well-being of people. We believe
    that increasing the number of veterinarians devoted to this
    work is vitally important, and that the US government should
    contribute toward this national priority.
        Thank you for your time and attention. I'll be happy to
    respond to any questions you may have.
                                  ----------

        Mr. Pallone. Thank you, Dr. Allen, and thank all of you. We
    will have questions for the panel now, and I will start out
    with myself and I am going to start out with Dean Kelly. When
    you took me for the tour of the New Bolton Center it was
    painfully obvious that there were many infrastructure needs
    there. I had no idea how many buildings, you know, how much in
    terms of resources it takes to just maintain the farm campus or
    whatever it is, and of course I am looking at U Penn, which I
    assume is probably, I could be wrong, but I assume is probably
    one of the wealthiest of the veterinary schools, and yet there
    were so many needs. But of course the opposite side of that is
    we have all kinds of needs here, you know, whether it is
    doctors, veterinarians, nurses, whatever, so I wanted to ask a
    couple of--a few questions that sort of maybe are in the
    negative, if you will.
        You talked about how there is an increasing number of
    overseas schools and veterinarians being educated there. One
    could sort of assume that so what, OK, let them be educated
    overseas. It doesn't cost us much. Let the states continue to
    pay the cost or maybe we can get wealthy benefactors to
    contribute, and then there is the other issue about why do
    veterinarians have to perform these public health functions.
    Maybe they can be performed by people that aren't educated to
    that degree. Why do we need the Federal government to step in
    and why do we need to have more veterinarians for these public
    health purposes.
        So I am asking that in the negative. If you want to respond
    to all that because these are some of the questions that come
    up.
        Mr. Kelly. So far as the students going overseas, one of
    the characteristics of veterinary education is that it is by
    states and it revolves around the type of agriculture there is
    in a state so the type--Pennsylvania, for example, we have a
    large dairy industry so a lot of our large animal education is
    focused on the dairy industry. In Texas it is the beef
    industry. If you go overseas, you are looking at a totally
    different type of agriculture and actually a totally different
    type of education that they will get which is not necessarily
    relevant to this country, and they certainly are not going to
    get the type of education in public health that we would
    recommend.
        Now so far as why veterinarians are concerned, let me give
    you one example, and it focuses on Britain in relation to the
    Foot and Mouth disease outbreak that occurred there a few years
    ago where epidemiologists who were not veterinarians designed
    the plan for eradicating the disease. Because they didn't
    understand the disease and the type of transmission that that
    particular strain of Foot and Mouth disease, it is probable
    that at least 5 million animals that did not need to be
    destroyed were destroyed, and that is where you get the figure
    of $10 million. As a veterinarian, you have to understand the
    interplay between disease and the animal population and how it
    should be best handled, how you would best limit the spread of
    a disease.
        These are the reasons why knowledge of animal health,
    animal physiology actually, probably the most important thing
    is understanding animal physiology. That is the training that a
    veterinarian has and other people don't have. It is critically
    important and that is understanding the issues that we are
    confronted with.
        Mr. Pallone. I know Dr. Allen mentioned the state support
    but what about those other 2 aspects? In other words, why not
    just let the states continue to support this, why does the
    Federal government have to be involved? And what about just
    getting the big private benefactors. You know, there are all
    these people out there that love animals. They can just give us
    millions of dollars. I don't really believe this is happening
    but I want a response.
        Mr. Kelly. Well, so far as private benefactors are
    concerned, they are interested, and you saw New Bolton Center
    and we have a large equine clinic, a lot of that is supported
    by private benefactors who are interested in the horse. They
    have money and they want to provide the best quality care for
    horses. They are not interested in public health, and you will
    not be successful in raising funds from the private sector for
    public health. It just won't happen, I can tell you. So far as
    the states are concerned Pennsylvania, Congressman Pitts has
    been very generous to us when he was in the state legislature
    in supporting us to the extent that they are able. We are a
    private institution. We don't get capital funds from the state.
        And I think in large measure the states have done as much
    as they possibly can but these are very large numbers and the
    state budgets are not able to go further.
        Mr. Pallone. And I assume from what Dr. Allen said that
    creating new veterinary schools would even be more expensive
    than using this money for infrastructure needs to create more
    public health purposes at the existing ones, I am a little
    prejudiced because being from New Jersey, I have always thought
    it would be great for Rutgers to have a veterinary school, and
    I would still like to see that some day but I just wanted your
    response. I assume it is just a lot more expensive to build new
    schools as opposed to create slots at existing ones.
        Dr. Allen. That is correct. A feasibility study was done by
    the State of Connecticut for the very reason that you
    suggested. They wanted to have a veterinary school there and
    they quickly realized that the capital construction costs and
    the annual operating budget were not something that the state
    was prepared to embark upon, and so they are looking for other
    schools to expand their enrollment and accept their students.
    The State of South Carolina is doing the same thing. They are
    growing rapidly and have asked the University of Georgia to
    expand the enrollment of South Carolina citizens in our college
    because they recognize that it is cost prohibitive for them to
    develop their own veterinary college.
        Mr. Pallone. OK. Thank you. Mr. Deal.
        Mr. Deal. Thank you. This bill that we are considering is
    an amendment to the Public Health Safety Act and that has part
    to do with jurisdiction of this committee and part the focus of
    what the legislation directs the capital money that would be
    authorized to be used for, namely, aimed at public health
    service roles by veterinarians. One of the concerns that people
    have expressed is how does a college of veterinary medicine
    segment capital funds for the purpose of giving emphasis to the
    public health arena. And, Dr. Allen, I would ask you that
    question because you mentioned that your number of graduates
    last year at the University of Georgia vet school that were
    going into this area that this bill is designed to emphasize
    increased. How would you convince somebody in a competitive
    grant environment that you were doing that and what percent of
    those graduates last year went into this area?
        Dr. Allen. Well, a number of things have been done at the
    University of Georgia and other veterinary schools to increase
    the number of students or graduates who are entering these
    fields. For example, we started a food animal veterinarian
    incentive program, and what this does is identifies student in
    high school who have a demonstrated interest in food animal
    food safety questions and give them early admission to
    veterinary college as they are mentored through their
    undergraduate career. That is one example. The number of
    colleges that have developed combined DVM, MPH or Master's of
    Public Health degree programs has gone from 6 to 16 in recent
    years because the colleges recognize that it is important to
    encourage students to enter these careers.
        At Georgia we provide scholarships for those students to
    diminish the financial burden for them to enter these careers
    so----
        Mr. Deal. Does it give preference to this area of the
    public health sector or is it across the board?
        Dr. Allen. Yes, sir, it does. And what has resulted is we
    have more students going in these areas, and I think those
    institutions that are awarded this competitive grants program
    must be held accountable to show that the overall increase in
    the expansion of their facility will result in more students
    going in these careers.
        Mr. Deal. What percentage of your last year's graduates
    went in this area?
        Dr. Allen. We had over 10 percent last year go in public
    health, lab animal, these types careers, but we had more
    students go into large animal and mixed animal practice than
    ever before. So we are very encouraged by that.
        Mr. Deal. Pardon the intended pun but there is concern that
    we don't want this to all go to the dogs.
        Dr. Allen. Understood.
        Mr. Deal. The University of Georgia not included in that.
    That literally is one of the concerns obviously is to focus the
    training of veterinarians in the areas that we are concerned
    with, and in that regard, Dr. DeHaven, as you are aware there
    is a companion, if you would, provision in the Farm Bill, as I
    understand, that is in conference now that comes from a little
    different jurisdictional point of view. What is your opinion as
    to whether we need this with this emphasis from public health
    as a companion to or as an augmentation to what may come out of
    the Farm Bill? Would you comment on that, please?
        Dr. DeHaven. Yes, Congressman Deal, thank you for the
    question. I think it is one that needs to be clarified. While
    we are not responsible for it both the AVMA and the AVMC, the
    Association of Veterinary Medical Colleges, support the Farm
    Bill language, and we think that is because the Agriculture
    Committees recognize that indeed there is a shortage of food
    animal practitioners, those veterinarians in the field that
    provide the hands-on care to our production food animals. So
    while there is certainly a connection or an apparent overlap
    you can't separate food animal practice from food safety and
    public health. They are inextricably linked as we have already
    talked about. It would be most likely those food animal
    practitioners in the field that would be the first to see and
    diagnose a new or emerging disease or foreign animal disease in
    our nation's livestock, so the two are very closely linked.
        We want to make sure that the language in the Veterinary
    Public Health Workforce Expansion Act and the Farm Bill
    language would compliment each other as opposed to any conflict
    or duplication of effort so while we recognize again this
    inextricable linkage between production farm animal practice
    and public health veterinary medicine, we would be anxious to
    work with the committee to insure that there is not unnecessary
    duplication or conflict between the 2 pieces of legislation.
        Mr. Deal. Thank you, Mr. Chairman. I will yield back.
        Ms. Baldwin [presiding]. I will now recognize myself for
    questioning. Dr. Poppaioanou, we know now with the global
    economy there is a lot more movement of people traveling across
    the globe and public health threats don't adhere to national
    borders. I am wondering how the U.S. Public Health Veterinary
    Workforce compares to that of other nations and how we play a
    role in identifying and monitoring zoonotic diseases abroad.
    Does our veterinary shortage affect our capacity to assist
    other nations in conducting surveillance?
        Dr. Pappaioanou. Thank you very much for that question,
    Congresswoman Baldwin. I think the Centers for Disease Control
    and other agencies in the Public Health Service and the
    Department of Health and Human Services are a model really for
    other countries. Several other countries in Europe have
    actually formed like CDC agencies because of the very special
    role that CDC and its sister agencies play in the United
    States. And veterinarians, and they see the role that
    veterinarians play actually working side by side with
    physicians, with nurses, with statisticians as part of the
    public health team in conducting food borne and outbreak
    investigations, other zoonotic disease outbreaks, the
    surveillance that you have mentioned actually working in
    disease prevention and control, the CDC veterinarians actually
    have been a part of our nation's international response teams
    on the SARS, monkeypox, and Avian highly pathogenic H5N1 Avian
    Influenza outbreaks working as part of the WHO multi-national
    teams that were sent out to the field.
        Our veterinarians also have worked, for example, they led
    surveillance efforts at the Olympics in Greece. I don't know
    for certain but I wouldn't be surprised that they are right
    there working and planning, helping the Chinese, so they really
    do play a role. Other nations have looked to what occurs in the
    United States, the training that we get. Veterinarian
    participation in the EIS program at CDC, right now I think it
    is close to 250 veterinarians have graduated from that program,
    and so we really are showing the way of one health, if you
    will, of really linking human and animal health.
        Ms. Baldwin. Continuing on this vein, I know that in
    Congress we are aware that we ought to act in preventative ways
    but often times we don't act until the crisis is upon us so I
    am going to give you all a chance to maybe scare us a little
    bit into thinking about how important it is to take early
    steps. But focusing in on the pandemic flu, Avian flu, this
    subcommittee and in fact the full Energy and Commerce Committee
    has been told by experts who have appeared before us before
    that it is a matter not if but when we will see some sort of
    pandemic occur. And animal surveillance clearly will be
    critical to early identification of a more dangerous strain of
    H5N1. The earlier identified the strain the better our chances
    of containing an outbreak and beginning production of a
    pandemic vaccine, and we know that veterinarians are integral
    to these surveillance efforts.
        If you could just talk to our subcommittee a little bit
    more about the role of public health veterinarians, the role
    that they will play in the diagnosis of Avian flu, and if a
    highly pathogenic Avian influenza were introduced into the U.S.
    how would veterinarians work with other public health officials
    to help control the disease, minimize loss of life, and
    economic loss in this country?
        Dr. Pappaioanou. I will begin, I guess. There are a number
    of ways that public health veterinarians can make a huge impact
    in this area. The true prevention of a pandemic influenza comes
    with the prevention and control of Avian influenza in poultry.
    That is truly where the prevention of a pandemic is period. And
    recently just as an example about a year and a half ago I was
    in Vietnam actually working on a joint Avian influenza project
    that the University of Minnesota was embarking upon with
    Vietnam, and they asked if University of Minnesota's College of
    Veterinary Medicine could work with their veterinary school to
    develop curricula and training on Avian influenza because the
    veterinarians in Vietnam actually received very little training
    on poultry disease and health, and so this was a way, and many
    countries in Asia actually are looking to partner with U.S.
    institutions to develop this type of training which would build
    their capacity to detect the disease early and to control it at
    that level.
        Should the unfortunate, I mean the tragedy of a pandemic
    influenza occur it is veterinarians really in the U.S. Public
    Health Service at the various agencies working with their
    medical colleagues and its counterparts in the colleges working
    on disease surveillance, of providing education and training,
    that can provide search capacity for laboratories that exist,
    and very much engage in biomedical research that actually would
    lead to the development of a vaccine or the understanding of
    how immunity works or how it even crosses species. Texas A&M
    actually post Hurricane Katrina converted their large animal
    clinic into facilities to house people who had lost their
    homes, and so it was tremendous to see how they could then--
    that partnership could really kick in on emergency preparedness
    and response. I will stop there.
        Dr. DeHaven. Congresswoman Baldwin, if I could add to that
    bringing a decidedly agricultural perspective to the table
    since that is my background, I think that H5N1 highly
    pathogenic Avian influenza is probably the current poster child
    for this whole issue of the convergence of animal health,
    public health, and as you pointed out environmental health as
    well. There is really a 3-prong approach with regard to H5N1
    from an animal disease perspective, and this still very much is
    an animal disease and the better we can control it in animals
    the less likely it is to mutate into that all feared pandemic
    virus. But the 3 prongs would be exclusion, let us keep it out.
    The second is early detection. If it arrives, let us find it
    very quickly, and then if we do find it rapid response to
    contain and eradicate it.
        There is ongoing surveillance in wild bird carried out by
    veterinarians involved in wild bird surveillance, in fact, the
    largest wildlife surveillance program of its kind anywhere in
    the world. There was ongoing surveillance by veterinarians
    involved in food animal practice in the industry who test
    virtually every flock of birds before they go to slaughter in
    the United States. In terms of laboratory capacity, Dr. Allen
    mentioned the National Animal Laboratory Network that we have
    so we have a network of laboratories that are all trained to do
    this diagnostic work, and then we have had in place and have
    certainly improved the overall planning for a response
    mechanism so while the efforts that I am talking about are
    certainly directed towards the disease in animals again if it
    finds its way here we would want to eliminate it in animals,
    and in doing so we protect the health of our public.
        Ms. Baldwin. Next I would recognize Mr. Murphy from
    Pennsylvania for questions.
        Mr. Murphy. Thank you, Madam Chairman, and thank you for
    introducing this bill. This is an important issue. I wish we
    had more veterinary schools in Pennsylvania, but we do have a
    great one there. I want to ask about a couple things about this
    and extend what we were just discussing with Avian influenza
    for the panel, and you have expanded some things that vets can
    do with regard to disease surveillance, education, training and
    research, serge capacity, et cetera. Do you see now that in the
    public health sector and in CDC for anybody on the panel that
    this is something that currently we need more veterinarians
    working on these issues now because of the potential what is
    occurring or are we invested enough, anybody? Yes, Doctor.
        Dr. Pappaioanou. Very briefly, the short answer is yes, and
    you could probably clone each veterinarian working in public
    health 10 to 20 times over.
        Mr. Murphy. We are not into cloning people.
        Dr. Pappaioanou. Well, to multiply them 10 to 20 times over
    to really have sufficient numbers to actually really engage
    with our human health counterparts on solving these problems.
    Because we are such a small profession right now, and so few
    veterinarians are actually working in public health, each
    public health veterinarian is actually a rare commodity, and
    therefore right now there has to be very strategic thinking
    really in terms of where they work because there are
    insufficient numbers to be there as part of the public health
    team across these areas.
        Mr. Murphy. Do other members agree with the same thing? Let
    me ask this. I think, Dr. Allen, you had mentioned about the
    tuition costs in particular that someone may graduate with over
    $100,000 in debt, similar to medical school as well. On this
    bill, I think it authorizes about $300 million if I am not
    mistaken in capital costs, which is good and helps with a lot
    of the necessary facilities. Does it do enough to take care of
    tuition costs?
        Dr. Allen. This bill will not address the tuition costs.
    There is a separate law, the National Veterinary Medical
    Services Act, that does help with a loan forgiveness program
    for graduates who go in underserved areas of veterinary
    medicine. What this bill will do is allow us to expand the
    capacity of our veterinary colleges so that we can admit more
    students. There may be some marginal return kind of economies
    of scale, if you will, that will help with the cost of per
    student but I don't expect that this bill will impact the
    tuition rates in our existing schools.
        Mr. Murphy. Do we have a number of what this bill will do
    to actually expand the number of veterinarian students across
    the country? Does anybody know?
        Mr. Kelly. The intent is that it would increase the
    enrollment by 423 students per year. That would be the
    objective of this bill.
        Mr. Murphy. And do we know in terms of numbers what the
    need is nationwide?
        Mr. Kelly. It is very difficult to come up with exactly the
    need. There is a study by the National Academy that was trying
    to look at that but we are not far enough along to give you
    numbers on that. We will happily give them to you when we have
    them.
        Mr. Murphy. Thank you. And with regard to some loan
    forgiveness programs is that an area we need to be expanding
    to? We talked a great deal about the public health sector. It
    is extremely important, the E. coli, the Avian influenza, a
    whole host of things. Do we have enough there in terms of the
    breadth and depth of our loan forgiveness programs now to take
    care of that, Dr. DeHaven?
        Dr. DeHaven. Congressman Murphy, thank you for bringing
    that up. We think the two bills in fact are very inextricably
    linked. The National Veterinary Medical Services Act has in
    fact been passed but it is authorized legislation and so far
    has only been funded at a level of about $1 million. We would
    anticipate to really have an impact and get veterinarians
    involved in food animal or public health practice to the areas
    where they are needed most that we would like to see funding in
    the level of $50 million to really have an impact. So this
    bill, the Veterinary Public Health Workforce Expansion Act, if
    you will, would increase the number of students going in the
    pipeline where the National Veterinary Medical Services Act,
    which authorizing legislation is already in place, with
    adequate funding would help us get those students, those
    graduates, to the locations where they are most needed, the
    underserved areas.
        Mr. Murphy. When you say underserved areas, are you talking
    about geographically underserved areas or are you talking about
    things, for example, people work for CDC or work for the
    military as employees of those branches of government that can
    have loan forgiveness while they put their time in. For
    example, every year they work they get a certain amount of loan
    forgiveness, is that what you would foresee?
        Dr. DeHaven. Actually both in that there are underserved
    areas within government and in private practice in terms of
    disciplines, if you will, but the bill is primarily intended to
    put graduates in geographical locations where there is the
    greatest need recognizing that foreign animal disease of human
    health implications could be introduced anywhere in the country
    if we don't have an adequate number of veterinarians in those
    locations then it is going to be a longer period of time before
    that disease is diagnosed.
        Mr. Murphy. If I could squeeze in one more brief question,
    I just want to know what this also does for undergraduate
    training as well. There is a graduate level of doctors of
    veterinary medicine. Do you see this bill, the Baldwin-
    Pickering bill, of expanding also undergraduate level training?
        Dr. Allen. This bill is primarily intended to increase the
    capacity for the professional DVM program. Now there are a lot
    of students who are pre-vet, if you will, at the undergraduate
    level, who are disappointed by not being able to get into
    veterinary college so indirectly it will impact those students
    who are in animal and dairy science programs or what have you
    throughout the United States so indirectly it will increase the
    number of students who are able to attain admission to
    veterinary school.
        Mr. Murphy. Thank you very much, and thank you, Madam
    Chairman. I would love to be a co-sponsor of the bill.
        Ms. Baldwin. Excellent. We will add you. Next I would
    recognize Ms. Capps from California.
        Ms. Capps. Thank you, and I want to thank you again for the
    bill and for this hearing for our subcommittee because I have
    learned so much and I realize I already felt like I knew some
    things about health care and I didn't know a lot about this.
    And I am extrapolating that to my colleagues and then to the
    rest of us that you are really providing a valuable service
    here for us today. This is going to--there are a limited number
    of questions we can ask and so some of this might seem
    repetitive but I think a good case can be made to the public
    about Avian flu and that threat because people kind of
    understand what it is. And I know that, Dr. Kelly, we have been
    working on ways to prepare for an outbreak of Avian flu, and I
    want to look at what you have done in Pennsylvania, that Penn
    has been working with your state's Department of Agriculture to
    implement a statewide Avian flu surveillance program. Other
    states, Minnesota, I think has, but some states have really
    lagged in this area. And this partnership is something I am
    interested in. This probably falls outside the range of what
    the bill is. We are talking about a broader thing, but I want
    to understand more about how our veterinary schools are
    constrained in their ability to conduct surveillance, testing
    and training for infectious diseases. Is it because of limited
    funds strictly or are there some other things? I want to see if
    1232 would help the public health community in ways that maybe
    I don't understand yet.
        Mr. Kelly. Well, we certainly need to do more research on
    Avian influenza and ways in which we can limit the spread in
    animal facilities what we do is GIS lapping of the poultry
    facilities in Pennsylvania. That has come about because we have
    had repeated outbreaks of Avian influenza in Pennsylvania and
    other states have lagged simply because they haven't had the
    experience. There is much more we can do in terms of
    understanding the populations of poultry in the state and how
    we would control a disease should it arise, and that needs to
    be expanded across the country.
        Ms. Capps. I guess what I am getting at is I come from
    California. If you got all this research that you are compiling
    there and the first case or a bunch of cases happen in another
    state how good are we--and other people can jump into this too.
    I just think it is an interesting place. Right where we are
    today, do we have that structure in place and what do we do.
        Dr. Allen. Thank you for that question. At the University
    of Georgia we have a unit called the Southeastern Cooperative
    Wildlife Disease Study, and the purpose of this unit which has
    4 faculty, 2 of whom are veterinarians, is to conduct disease
    surveillance of wildlife through a 15-state region. There are
    similar units elsewhere in the country so to answer your
    question there are individuals who are funded for this purpose
    but each state typically does not have their own simply
    because, A, there is not funding for it and, B, there aren't
    really enough veterinarians in this area right now to provide
    the manpower.
        Ms. Capps. So this bill will help, maybe indirectly, but
    maybe we can educate ourselves well enough that we will say,
    now we need to do this because there is more that needs to be
    done. I guess I have been so focused on shortages of nurses, I
    just see so many corollaries. Our public health workforce is
    really short--and the fact that you are in Georgia and CDC is
    there, is there a role there too?
        Dr. Allen. Absolutely. The CDC has a program that allows
    our veterinary students to come to their facility for training,
    and it also helps with their recruiting effort to get more
    veterinarians in the public health arena.
        Mr. Capps. Somebody else might want to jump in. I am not
    going to go to my other question. I find this very fascinating,
    and this piece of it we haven't talked about yet, I don't
    think.
        Dr. DeHaven. Congresswoman Capps, thank you for the
    opportunity to add to that and again coming from an
    agricultural background there has been a--again I think Avian
    influenza is the perfect poster child of how we can work
    together cooperatively to develop programs that integrate
    public health and animal health. Dr. Kelly or Dr. Allen
    mentioned the National Animal Health Laboratory Network, which
    is a consortium of over 50 laboratories at the state diagnostic
    university diagnostic level that now have the capacity to do
    diagnostic testing on a number of diseases including highly
    pathogenic Avian influenza.
        Ms. Capps. Let me interject. Is the Federal government a
    partner with you in that?
        Dr. DeHaven. Indeed. It is a partnership between Federal
    government who oversees and administers the network and then it
    is the state laboratories that actually do the testing and much
    of that testing is done at the request of the affected industry
    so we at this point have virtually 100 percent surveillance on
    every commercial flock of birds. There are many states that
    have live bird markets where birds are brought from multiple
    locations for resale and you couldn't design a better way to
    spread disease but we have surveillance at those live bird
    markets as well. And so that partnership, I think, is working
    very well between the industry, the state diagnostic
    laboratories, and the state departments of agriculture who have
    response plans in places as well as these surveillance programs
    in place, so there is I think a very good cooperative effort
    there.
        One of the limiting factors though is the veterinarians
    that we have to participate in all of those activities, and
    ultimately it has to be those that work--either veterinarians
    or those that are working directly under the supervision of a
    veterinarian who have the oversight and make sure that we have
    all of our bases covered.
        Ms. Capps. I certainly can understand that from a public
    health nurse point of view because in the shortcuts that we
    want to take in cutting funds we try to think that a non-
    professional or a different kind of professional person can
    understand that, and just as you mentioned earlier if you don't
    have that basic veterinary science which some other countries
    and other places might, we got to keep the quality really high
    as you are saying, and we need more veterinarians at the table
    of the interdisciplinary groups that are doing that. Thank you.
    I think I have gone over but this is very interesting.
        Ms. Baldwin. Next I recognize Mr. Pitts for questions.
        Mr. Pitts. Thank you, Madam Chairman. And it is a
    particular delight to welcome Dean Kelly and the panel here and
    to have heard your testimony. I had the privilege of working
    with the dean at New Bolton Center, which is in my district,
    for many years when I was in the state legislature. It is the,
    as I don't know if you said, the only vet school in
    Pennsylvania, and one of the premier veterinarian institutions
    in the United States. And with agriculture being so important
    in Pennsylvania, it plays a very key role in keeping ag number
    one. I know a few years ago you were at the forefront of
    catching the Avian flu epidemic in the ag poultry population.
        Dean Kelly, you mention in your testimony the new methods
    of livestock and poultry and wildlife methods that must be
    developed that require research and translation into the field.
    Could you just elaborate, does the university receive faculty
    grants to do research from Federal agencies? What types of
    grants are awarded on these issues?
        Mr. Kelly. We receive funds from the National Institute of
    Health. This would entirely be for diseases of animals that
    have relevance to human health. We receive funds much less from
    the USDA for various aspects of production agriculture. When we
    are talking about surveillance and new methods we don't have
    those resources. We need to find these resources because this
    has to be the future in surveillance of the livestock and
    poultry populations across the country. I think this is
    critically needed. There was one state grant that was given
    about 3 years ago but it is fairly limited funding, as you
    know, in those agencies. So we need funds because we have to
    really invent a new system for surveillance of livestock and
    poultry across the country.
        Mr. Pitts. And there is a need for more faculty to be
    hired.
        Mr. Kelly. Yes.
        Mr. Pitts. H.R. 1232 is designed to fund, I think,
    construction and capital costs, not training for advance
    research or faculty. Do you believe that that is a shortcoming
    in the bill or how would you----
        Mr. Kelly. In more advanced training typically a graduate
    student will work in the laboratory of a faculty so if you
    increase the laboratory space you increase the capacity to do
    advance training. There are funds in there for I think it is
    290 post-doctoral students because we need much more
    specialization and much more sophisticated training in so many
    areas that are relevant to veterinary medicine.
        Mr. Pitts. Dr. Allen, you wanted to add something.
        Dr. Allen. Yes. I appreciate being able to respond to that
    question. We regard it as the state's responsibility and the
    colleges' responsibility for faculty positions. The University
    of Georgia recently allocated three new faculty positions for
    infectious disease research specifically. So this bill does
    not--has nothing to do with faculty positions. The states that
    are awarded these grants will be for infrastructure expansion.
    When we expand our enrollment, we recognize we are going to
    have to increase the number of faculty and staff to keep our
    faculty to student ratio appropriate to have a good quality
    education but we recognize that as the state's responsibility.
        Mr. Pitts. And you heard the dean mention the $7 billion
    endowment. I know people are mumbling and questioning about the
    sources of funding. I know when we were in the state
    legislature we helped with capital costs at New Bolton, but
    would you expand a little bit about what is done with endowment
    money and how various pots and phases of funds are used to
    expand facilities and operations?
        Mr. Kelly. Endowments typically don't provide funds for
    facilities. Endowments typically would be for an endowed
    professorship in a particular area that is of interest to the
    donor. So the endowment is overwhelming focused on faculty
    particularly in specific areas. In clinical veterinary medicine
    we get endowments in companion animal veterinary medicine and
    in equine veterinary medicine. Basic sciences there is no
    endowed professorships, and in public health I don't think we
    have a single one. So it is very focused. It doesn't cover the
    whole of the needs of the veterinary school. It is important
    sources of funding no doubt but it is not going to take care of
    public health needs, I can assure you.
        Mr. Pitts. Would those who give have the opportunity to
    require that you spend it in certain ways? For instance, I know
    with large animals out at New Bolton and the horse industry,
    the racing industry, you are required to spend money in certain
    ways without a doubt, is that correct?
        Mr. Kelly. That is exactly correct, Congressman. Yes.
        Mr. Pitts. Dr. Allen.
        Dr. Allen. Endowments that are receive the typical spending
    limit will be 5 percent of that endowment so even if someone
    were to give you a million dollar gift it is only going you
    $50,000 amount of money annually that you can spend. And they
    are typically, as Dr. Kelly indicated, for the research efforts
    and for recruitment purposes to get new faculty on board.
    Annual operating budget for a veterinary college averages
    around $56 million. Very little of that is endowment income or
    private gifts. Most of it is state appropriation, service
    income from hospital activities, research activities, and a
    very small amount of it is private giving.
        Mr. Pitts. And really there is none given for public health
    purposes?
        Dr. Allen. Very rarely is any of the money given for public
    health purposes. We did have one endowment last year that was
    donated for infectious disease professorship to help us recruit
    more faculty members to do this important work, but again it is
    pretty rare for it to be in a public health arena.
        Mr. Pitts. Well, my time is up, but thank you for your
    testimony. Dean Kelly, it is great to see you, and thank you
    for your leadership for many years.
        Mr. Pallone. Thank you. The gentleman from New York, Mr.
    Towns.
        Mr. Towns. Thank you very much, Mr. Chairman. Let me begin
    by thanking you for your testimony. I thought it was very, very
    informative. Let me begin by asking you, and I am in strong
    support of H.R. 1232, the Health Workforce Expansion Act, but
    is it really enough? Let us go right down the line starting
    with you, Dr. Allen. Just go right down the line.
        Dr. Allen. Do you mean is the legislation itself enough or
    is the amount of money enough?
        Mr. Towns. Both.
        Dr. Allen. If it were fully funded as the bill is written.
    We did do feasibility studies of what it would take to expand
    our veterinary colleges to address the shortage as it was
    estimated at that time, and we do feel that the amount in the
    bill will help the existing colleges expand sufficiently for
    the future. And as far as the bill itself, we would welcome the
    staff of the subcommittee to help us with the language if it is
    felt it were needed to more clearly describe what the intended
    purpose is, but if the desired outcome--if the bill is funded,
    I think the desired outcome will be met.
        Mr. Towns. Thank you. Dr. Kelly.
        Mr. Kelly. I think, and Dr. Allen used I think the very
    important phrase, and that is if the bill is fully funded. If
    it is not, we are going to continue to be short. We are looking
    at over a 15, 20-year period. If you look over a much longer
    period there is not going to be enough. It is crucial that we
    get the funds to at least address the demand and the need. For
    example, I used the figure that there were 1,200 Americans
    getting veterinary education overseas. That is 400 students per
    year. We can accommodate that number with this current bill.
    So, as I say, if it is fully funded it will take care of the
    need.
        Mr. Towns. Dr. DeHaven.
        Dr. DeHaven. Thank you. I would agree with my colleagues
    that if it is written and fully funded it would provide enough
    capacity. Recognize that today the majority of graduates out of
    our 28 veterinary colleges are going into companion animal
    practice, and that is critically important. The human animal
    bond is stronger than ever before and indeed we add to our
    public health through our association with pet animals so it is
    not that we are talking about a huge number of new graduates
    that need to go into this public health arena with the
    provisions in the bill. If in fact that increased capacity were
    devoted to the public health arena, we feel that it would meet
    the need.
        Mr. Towns. Thank you.
        Dr. Pappaioanou. I would agree with my colleagues although
    I would add that there really is an urgency about this, and not
    only absolutely to begin to meet the needs in public health but
    also from a construction point of view that with construction
    costs, and I am sure many of you may have this experience, but
    every day or week or month you delay when you talk back with
    contractors your cost just went up. So I think the more quickly
    this bill could be passed and implemented and funded then
    adequate study has gone into the figures that have gone into
    it, but if there is a lot of delay construction costs do go up,
    and I think that would impact on the numbers.
        Mr. Towns. Right. I think you, Dr. Kelly, mentioned about
    the amount of students that are being trained in foreign
    countries. How many of them return, would you know? How many of
    them would return after training?
        Mr. Kelly. I would think these are American students. The
    vast majority will come back to this country, I would fully
    expect. There students who have not been able to get into a
    veterinary school in this country and desperately want to
    become veterinarians but there will be deficiencies in their
    education and that is a significant problem. Just to add, if I
    may, we are concerned about public health, students going into
    public health. There is a remarkable change in our students in
    their interest in public health which frankly wasn't there 5 or
    6 years ago. To give you an example, I think this weekend there
    is CDC Day down in Atlanta. There are 300 veterinary students
    going down to CDC Day to learn more about CDC and public
    health, and it is an example of the change of interest amongst
    our students.
        Mr. Towns. Thank you. Thank you very much. Yes, Dr. Allen.
        Dr. Allen. One thing I wanted to point out is that although
    there are a lot of students, American students, who don't gain
    entrance to a U.S. veterinary college who end up going
    overseas, first of all, they are not trained in the public
    health arenas that we are talking about. And, secondly, the
    cost for their education to them, they end up with an
    educational debt that is staggering, $200,000 to $300,000 per
    student. The likelihood that they are going to go into a public
    health career with that kind of educational debt is very low.
    So although there are students that are able to get an
    education in veterinary medicine it is not an education that
    will fulfill the need we are talking about today.
        Mr. Towns. Let me ask, is there a preference given to state
    students in terms of grants, is there a preference?
        Dr. Allen. There is a preference given to students from
    that state for admission to veterinary college, yes, but in
    terms of scholarships for veterinary college it depends on the
    source of the funds. Typically a scholarship is from a private
    donor, and we have many private donors who will believe it or
    not stipulate what county the student should be from. So
    indirectly, yes, there is a preference for in-state students
    because of the source of our scholarship funds tends to be from
    our alumni from our state.
        Mr. Towns. Go ahead, Dr. Kelly.
        Mr. Kelly. Most schools have an in-state and an out-of-
    state tuition. For example, there is a $10,000 difference in
    the cost of your education if it is in-state or out-of-state.
    The taxpayers of Pennsylvania bear the brunt of the cost of our
    school and our education, and it seems to me only reasonable
    that there would be a price differential as far as the students
    from out of state are concerned.
        Mr. Towns. I was actually talking about in terms of a
    preference in terms of admissions.
        Mr. Kelly. We would admit--at Penn we will admit 60 percent
    of the students are Pennsylvania residents, 40 percent come
    from out of state. That varies with the different colleges
    though.
        Mr. Towns. Let me ask, this is just for help.
        Mr. Pallone. Just let me remind the gentleman he is 2
    minutes over, but we will take one more.
        Mr. Towns. I yield. I am sorry. Thank you very much. Let me
    thank all of you for your testimony. Thank you so much. Thank
    you, Mr. Chairman.
        Mr. Pallone. I am sorry. I recognize the gentlewoman from
    Oregon, Ms. Hooley.
        Ms. Hooley. Thank you, Mr. Chair. I am proud to represent a
    veterinary school in my state, Oregon State, and I am a co-
    sponsor of this bill and proud to do that. Oregon State
    includes public health as part of its core curriculum, and it
    is in the process of developing a collaboration between the
    school of public health and the school of pharmacy trying to
    strengthen public health. I have a question. Dr. Allen, you
    mentioned that 16 out of the 28 veterinarian medicine schools
    now have dual degrees, and what is the capacity of those 16
    programs and what educational paths do most public health
    veterinarians pursue? Do they do it--how do we build our
    capacity? Is it in those dual programs or traditional
    veterinary college?
        Dr. Allen. As far as the capacity of the DVM, MPH programs,
    which I think is what you were referring to, at University of
    Georgia we have scholarships for two students per year.
    However, we don't have any limitation in the number of students
    who can enroll. We only have a limitation in the number of
    scholarships. So consequently we typically will have of course
    the two students who get scholarships but also additional
    students who will enter the dual degree program. I am afraid I
    can't speak for the other colleges of veterinary medicine as
    far as what their capacity is for the number of students who
    will graduate per year. So right now at Georgia though, we are
    only doing say three students per year/
        Ms. Hooley. Yes.
        Dr. Pappaioanou. I can provide some information on the
    other schools. The University of Minnesota, for example, has
    close to 40 or 50 students who are enrolled in the dual degree
    DVM, MPH program there. That program actually accepts students
    from several of the other schools in the Midwest, Michigan
    State for one, Ohio, Indiana, et cetera, that come in and
    actually participate in that program, and all of them report
    absolutely, you know, the interest of the students really going
    off the chart, so the student interest is there. In addition to
    the 16 schools with the dual degree programs there are at least
    6 others who have public health programs, and again they are
    seeing a growing number of students. Where these students go
    when the leave are many of the opportunities that I alluded to
    in my testimony and across the Federal government, the state
    government, local governments working in academia, even
    international organizations so there is a tremendous
    opportunity out there for these graduates.
        Ms. Hooley. Does anyone else want to comment? So you think
    the dual program, dual degree program, probably produces more
    of our public health veterinarians?
        Dr. Pappaioanou. Absolutely.
        Ms. Hooley. OK.
        Mr. Kelly. We will form a dual degree at Penn. We just
    haven't gotten far enough along in doing it.
        Ms. Hooley. When I talked to Oregon State, their
    veterinarian medical association, they indicate there is a lot
    of reasons why there is a decreasing supply of food animal
    practitioners, and one of the main reasons is a lack of earning
    a decent living in that area. They serve in rural communities.
    I look at one of my counties in my district, for example, is
    Tillamook County. They have lots and lots of dairy farms.
    Having a food animal practitioner is really important in those
    areas. How do we get more veterinarians into the rural
    communities? Do we have an answer? Does this bill help that?
        Dr. DeHaven. If I could.
        Ms. Hooley. Go ahead.
        Dr. DeHaven. Thank you. I think we all want to answer that
    one, Congresswoman.
        Ms. Hooley. Good. I would like to hear from all of you.
        Dr. DeHaven. I think there is a couple different ways.
    Really the recruitment needs to start with the pre-veterinary
    students or even before that to generate an interest in this
    food animal public health arena, and we are, as Dr. Kelly
    mentioned, already seeing that increase in some of these
    disciplines that heretofore there hadn't been a lot of
    interest. This bill will increase or this bill if passed would
    increase the number of students in the pipeline for these
    potential kinds of jobs. It is the National Veterinary Medical
    Services Act that is really intended to give veterinarians who
    have already graduated through a loan repayment program into
    these underserved areas. It is particularly important in the
    food animal arena, and again making this linkage between food
    animals and public health, in that it is those individuals that
    are most likely to be the first to identify a disease in
    animals that have public health implications, and so this is
    critically important.
        There will actually be a hearing on the National Veterinary
    Medical Services Act talking about the need for funding for
    that program but also the need for the U.S. Department of
    Agriculture to do the regulations, promulgate the regulations
    that will implement this program and identify such things as
    what are under represented areas and how do we identify them.
        Ms. Hooley. Do you think this bill will help?
        Dr. DeHaven. It certainly would help in terms of getting
    more students in the pipeline that would be interested in going
    to those areas in that kind of work.
        Ms. Hooley. Dr. Allen, maybe your idea of having these
    scholarships from a county might not be such a bad idea. Go
    ahead. Anybody else that wants to answer that question.
        Mr. Kelly. One of the issues, this is a problem of rural
    America in general, and to support a veterinarian in an area
    needs a certain value of animals in a geographic area, and what
    you have to do is--increasingly you will find veterinarians
    still in Lancaster County in Pennsylvania, which is a very
    heavy dairy industry. What you have to do is expand that
    geographic area, and I think we have to use digital
    technologies on the farms so you have every day surveillance,
    electronic communication to a veterinarian who is in a central
    office working with somebody who is trained as a technician to
    provide the every day surveillance on the farms. I think that
    is the direction that I believe we must progress in.
        Ms. Hooley. Dr. Allen.
        Dr. Allen. You asked a question of how we can address this
    lack of veterinarians in rural America, and I think it is two
    main things. One is financial through scholarships and loan
    forgiveness programs. Nothing helps address a shortage like
    money and so what we have done at Georgia is a loan forgiveness
    program that has been suggested and proposed to our state
    legislature, but we have also had the food animal veterinary
    incentive program whereby we are identifying students who come
    from rural Georgia, in high school we identify them, and put
    them into this program that nurtures their interest and helps
    them through the undergraduate years because we know if a
    student comes from an area they are much more likely to go back
    to that area. And so we have started this program to try to
    address that need in rural Georgia, and I know there are other
    programs elsewhere in the country in other states that have
    done the same thing.
        Mr. Pallone. We are almost at three now although it is very
    interesting.
        Ms. Hooley. This whole thing is totally fascinating.
        Mr. Pallone. I agree. I agree. I am sorry to cut you off
    but we are going to have a vote pretty soon on the SCHIP
    override so we have to conclude. I think that concludes all our
    questions by the members. I do want to thank you all though.
    This has really been enlightening to us. I mean some members
    obviously represent areas, rural areas, and have more knowledge
    than others, but it has been very helpful I think to us in
    terms of knowing the significance of this legislation. And I
    would also encourage members if they are from more urban or
    suburban areas like myself to get out to some of these colleges
    like I did at Dean Kelly's initiative because otherwise you
    don't really know what it is all about. So thank you very much.
        Let me mention that members can still submit written
    questions for the record so within the 10 days they have to
    submit those so you may get additional questions from us to
    answer in writing, and the clerk would notify your offices if
    that happens and the procedures and all that. But again thank
    you all, and thank you, Congresswoman Baldwin, and without
    objection this meeting of the subcommittee is adjourned.
        [Whereupon, at 11:50 a.m., the subcommittee was adjourned.]
        [Material submitted for inclusion in the record follows:]

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]