[Congressional Record Volume 145, Number 157 (Tuesday, November 9, 1999)]
[Senate]
[Pages S14422-S14423]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BIDEN:
  S. 1897. A bill to amend the Public Health Service Act to establish 
an Office of Autoimmune Disease at the National Institutes of Health, 
and for other purposes; to the Committee on Health, Education, Labor, 
and Pensions.


           the nih office of autoimmune diseases act of 1999

 Mr. BIDEN. Mr. President, today I am introducing the NIH 
Office of Autoimmune Diseases Act of 1999. This legislation, which is 
very similar to a bill introduced in the House of Representatives by 
Congressman Waxman, would create an Office of Autoimmune Diseases as 
part of the Office of the Director of the National Institutes of 
Health. I would like to outline briefly why I feel that this office and 
this legislation are needed.
  To understand autoimmune diseases, it is first necessary to talk 
about the body's immune system. The immune system is a collection of 
tissues which is designed to fend off any foreign invaders into our 
body. For example, we live in a world surrounded by microbes of various 
kinds, many of which would be harmful to us if they could set up shop 
in our bodies. However, the immune system recognizes that a foreign 
microbe has entered our body and it mobilizes a variety of defenses to 
expel this foreign invader.
  The critical importance of the immune system can be easily seen when 
something goes wrong with it. For example, when a baby is born with a 
major defect in its immune system, it is extremely vulnerable to 
attacks by bacteria that a healthy baby would be able to fight off. 
Such immune-deficient babies need to be protected from their 
environment in order to preserve their lives. You may have seen the TV 
programs about such ``bubble babies'', who have to spend their entire 
lives in a protective plastic bubble or a spacesuit.
  However, although the immune system is essential for human life, it 
sometimes can cause problems with our health. When someone gets a 
kidney transplant, for example, it is the immune system which tries to 
fight off this ``foreign invader'', a process called rejection. The 
survival of the transplant requires that the recipient be

[[Page S14423]]

given treatment in order to suppress the immune system.
  Occasionally, the body's immune system goes haywire and starts to 
attack the body's own tissues as if they were foreign invaders. This 
process is called autoimmunity, and diseases in which autoimmunity is 
thought to play an important role are called autoimmune diseases. The 
spectrum of human illnesses for which there is evidence of an 
autoimmune component is extremely broad, ranging from lupus to diabetes 
to multiple sclerosis. At the National Institutes of Health, these 
different diseases are often studied in completely different 
institutes: diabetes in the National Institute of Diabetes and 
Digestive and Kidney Diseases; lupus in the National Institute of 
Allergy and Infectious Diseases; multiple sclerosis in the National 
Institute of Neurological Disorders and Stroke; and so forth.
  Despite being studied in different locations, these diseases all have 
one thing in common: abnormalities of the immune system that lead to an 
autoimmune process in which the body actually attacks itself. It is 
vital that researchers on one autoimmune disease understand what 
research advances are being made on other autoimmune diseases; the key 
to understanding the autoimmune process in multiple sclerosis might 
very well be uncovered by a researcher working on autoimmunity in 
diabetes.
  This is where the need for an NIH Office of Autoimmune Diseases 
arises. Its purpose is to make sure that there is cooperation and 
coordination across scientific disciplines for all those working on the 
broad spectrum of autoimmune diseases. Researchers working on 
autoimmunity in one narrowly defined disease must be able to benefit 
from research advances in autoimmune research. The history of medicine 
is replete with examples where breakthroughs in one area were actually 
a direct consequence of advances in a completely unrelated field.
  This bill sets up an Office of Autoimmune Diseases at NIH, along with 
a broadly representative coordinating committee to assist it. The 
director of the Office of Autoimmune Diseases will be responsible for 
setting an agenda for research and education on autoimmune diseases, 
for promoting cooperation and coordination among the disparate entities 
that are working on autoimmune diseases, for serving as principal 
advisor to HHS on autoimmune diseases, for husbanding resources for 
autoimmune disease research, and for producing reports to keep other 
scientists and the public informed about progress in autoimmune disease 
research.
  Mr. President, I'd like to explain why I have a particular interest 
in the area of autoimmune diseases. A very close friend of mine in 
Delaware, Ms. Tia McDowell, is fighting valiantly against a chronic 
disease. At present, the treatments for this disease no longer seem to 
be working very well, so Tia's hope lies in new research advances. 
Although doctors are not sure what causes Tia's disease, they do think 
that autoimmunity plays an important part. For Tia, and for others with 
diseases where autoimmunity is important, I want to make sure that we 
are moving ahead with research in the most efficient manner possible, 
and I think that creation of an NIH Office of Autoimmune Diseases is 
one way to help this process along.
  Mr. President, I urge my colleagues to support the NIH Office of 
Autoimmune Diseases Act of 1999 as something we in Congress can do to 
help our research scientists conquer this puzzling and pernicious group 
of diseases. I ask that the text of the bill be printed in the Record.
  The bill follows:

                                S. 1897

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``NIH Office of Autoimmune 
     Diseases Act of 1999''.

     SEC. 2. ESTABLISHMENT OF OFFICE OF AUTOIMMUNE DISEASES AT 
                   NATIONAL INSTITUTES OF HEALTH.

       Title IV of the Public Health Service Act (42 U.S.C. 281 et 
     seq.) is amended by inserting after section 404D the 
     following section:


                         ``autoimmune diseases

       ``Sec. 404E. (a) Establishment.--There is established 
     within the Office of the Director of NIH an office to be 
     known as the Office of Autoimmune Diseases (in this section 
     referred to as the `Office'), which shall be headed by a 
     Director appointed by the Director of NIH.
       ``(b) Duties.--
       ``(1) In general.--The Director of the Office, in 
     consultation with the coordinating committee established 
     under subsection (c), shall carry out the following:
       ``(A) The Director shall recommend an agenda for conducting 
     and supporting research on autoimmune diseases through the 
     national research institutes. The agenda shall provide for a 
     broad range of research and education activities relating to 
     biomedical, psychosocial, and rehabilitative issues, 
     including studies of the disproportionate impact of such 
     diseases on women.
       ``(B) The Director shall with respect to autoimmune 
     diseases promote coordination and cooperation among the 
     national research institutes and entities whose research is 
     supported by such institutes.
       ``(C) The Director shall promote the appropriate allocation 
     of the resources of the National Institutes of Health for 
     conducting and supporting research on autoimmune diseases.
       ``(D) The Director shall annually prepare a report that 
     describes the research and education activities on autoimmune 
     diseases being conducted or supported through the national 
     research institutes, and that identifies particular projects 
     or types of projects that should in the future be conducted 
     or supported by the national research institutes or other 
     entities in the field of research on autoimmune diseases.
       ``(2) Principal advisor regarding autoimmune diseases.--
     With respect to autoimmune diseases, the Director of the 
     Office shall serve as the principal advisor to the Secretary, 
     the Assistant Secretary for Health, and the Director of NIH, 
     and shall provide advice to the Director of the Centers for 
     Disease Control and Prevention, the Commissioner of Food and 
     Drugs, and other relevant agencies.
       ``(c) Coordinating Committee.--The Director of NIH shall 
     ensure that there is in operation a committee to assist the 
     Director of the Office in carrying out subsection (b), that 
     the committee is designated as the Autoimmune Diseases 
     Coordinating Committee, and that, to the extent possible, 
     such Coordinating Committee includes liaison members from 
     other Federal health agencies, including the Centers for 
     Disease Control and Prevention and the Food and Drug 
     Administration.
       ``(d) Report.--Not later than October 1, 2001, the 
     Comptroller General shall prepare and submit to the 
     appropriate committees of Congress a report concerning the 
     effectiveness of the Office in promoting advancements in 
     research, diagnosis, treatment, and prevention related to 
     autoimmune diseases.
       ``(e) Definition.--For purposes of this section, the term 
     `autoimmune diseases' includes diseases or disorders in which 
     autoimmunity is thought to play a significant pathogenetic 
     role, as determined by the Secretary..
       ``(f) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $950,000 for fiscal year 2000, and such sums as 
     may be necessary for each of fiscal years 2001 and 
     2002.''.

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