[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
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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
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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
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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.]
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