[Congressional Record Volume 144, Number 97 (Monday, July 20, 1998)]
[House]
[Pages H5862-H5863]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             NIH MUST ESTABLISH PRIORITIES BASED UPON NEED

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 21, 1997, the gentleman from Florida (Mr. Stearns) is 
recognized during morning hour debates for 5 minutes.
  Mr. STEARNS. Mr. Speaker, no one, including myself, would ever fault 
the

[[Page H5863]]

National Institutes of Health, NIH, and the valuable research being 
done by them. I know how important NIH is to our Nation's future, 
including its economic well-being. Advances in medical research to 
prevent, cure, or at least minimize the degree of financial devastation 
caused by such diseases experienced in the United States is a major 
reason why it is so necessary that we fund these vital research 
projects.
  That being said, however, I must admit that I have been troubled by 
several newspaper stories I have read recently concerning the manner in 
which NIH chooses its spending priorities. One such article appeared in 
the Washington Post on July 9, and used as its source a recently 
released report from the Institute of Medicine, IOM.
  The roughly 200-page report, entitled ``Scientific Opportunities and 
Public Needs,'' warns that NIH must do a better job of justifying its 
spending decisions or it could lose its historically elevated 
credibility. The premise of the report is that political pressures 
often play a crucial role and can influence funding decisions.
  I have always steadfastly defended the work being done at NIH, and 
assured its critics that, contrary to what they may think, this was not 
true. However, when I read the conclusions made by the IOM, I decided 
to look into this report further. I have with me, Mr. Speaker, a chart. 
Let us take a look at this chart prepared by the Institute of Medicine 
on NIH spending priorities.
  As Members will note, heart disease is the number one killer in 
America; 732,400 people die. The spending is $852 million; cancer, 
534,300 die. We spend $2,571,000,000.
  Let us go further down and look at AIDS-HIV. It is listed as the 
eighth leading cause of death. It kills 42,100 a year, yet it receives 
$1.4 billion. The death figures are for 1994 and the spending 
priorities are for 1996.
  Mr. Speaker, in other words, NIH spends approximately $43,000 per 
death researching AIDS and HIV, while heart disease, which kills over 
20 times as many people each year, receives only $1,160 per year per 
death. Heart disease was the number one killer in 1995, 1996, and 1997. 
Research dollars at NIH do not reflect this.
  According to a Centers for Disease Control, CDC, 1997 report, the top 
five killers are: cardiovascular disease, one; two, cancer; three, 
stroke; four, chronic lung disease; five, accidents. Mr. Speaker, note 
that HIV-AIDS does not even appear in the top five killers, but 
receives almost the top funding from NIH.
  It is very difficult to justify such types of funding disparities. 
Other diseases, such as diabetes, were responsible for causing 56,700 
deaths in 1996, making it the sixth leading cause of death in the 
United States. By contrast, diabetes research received only $299 
million research dollars.
  Not only has scientific research made important strides in 
identifying the causes of certain diseases, it has also launched tests 
of new drugs to enhance recovery from stroke and spinal cord injury and 
produce a new drug for the treatment of epilepsy.
  In these days of trying to balance the budget, we must not lose sight 
of the fact that by delaying the onset of diseases such as Alzheimer's, 
stroke, and cardiovascular disease, we would save almost an estimated 
$35 million through a reduction in the need for nursing home care.
  Now, to my way of thinking, that is not a small amount of money. 
However, this can only occur if the huge spending increasess that NIH 
receives do in fact flow to all the institutes, so that all the 
diseases benefit from these new sources of dollars.
  I respect the work being conducted at NIH and believe it has some of 
the finest first-class scientists and researchers in the world. I would 
caution, however, that the articles of criticism about the way it runs 
its shop are becoming more and more frequent. They also need to 
restructure their priorities based upon the needs. That is my message 
this afternoon.
  Congress has an obligation to ensure that all of its citizens are 
represented, and this includes how their tax dollars are being spent, 
especially when it comes to funding for biomedical research.

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