[Congressional Record Volume 146, Number 81 (Friday, June 23, 2000)]
[Senate]
[Pages S5719-S5721]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   THE DEPARTMENTS OF LABOR, HEALTH, AND HUMAN SERVICES AND RELATED 
                AGENCIES APPROPRIATIONS, 2001--Continued

  The PRESIDING OFFICER. The Senator from North Dakota.
  Mr. DORGAN. Mr. President, I am going to be offering an amendment to 
the pending appropriations bill that I want to talk about this morning.
  I commend the chairman, Senator Specter, and the ranking member, 
Senator Harkin, for their work to increase funding for the National 
Institutes of Health. As all of us know, Congress is on track toward 
doubling the funding for important health research and investigation 
through the NIH. That is critically important to this country.
  I am one of those who has been supportive of doubling the funding for 
the National Institutes of Health. The NIH is trying to unlock the 
mystery of many of the diseases that ravage the

[[Page S5720]]

bodies of people who are suffering from Parkinson's disease, cancer, 
heart disease, and so many other diseases that afflict the American 
people and people around the globe. The type of research that is taking 
place at the National Institutes of Health is exciting and vibrant and 
paying big dividends.
  I thought I would mention, as I start, something I saw one day at the 
NIH called the healing garden. This was an exhibit out at the NIH 
campus where they had a series of plants growing in this aquarium-like 
device called the healing garden. I asked the folks at NIH for an 
explanation, and they told me about it.
  They said a lot of people think modern medicines, especially the 
medicines that are developed through research at NIH to respond to the 
challenges of treating diseases, come from chemicals. But they told me 
that a lot of medicines come from natural substances we find all over 
the Earth. They were displaying some of those substances in this 
healing garden.
  I want to describe a couple of the things they were displaying 
because it is interesting. NIH is gathering from around the world 
50,000 to 60,000 different species of plants, shrubs, and trees and 
testing and evaluating what kind of properties they have to heal and 
treat diseases.
  The common aspirin comes from the bark of a willow tree. The Chinese 
knew that a couple of thousand years ago. If they had a headache, they 
would chew the bark of a willow tree. In modern medicine, aspirin is a 
chemical modification of that active ingredient derived from willow 
tree bark. Now aspirin is produced chemically, but the bark of the 
willow tree was the derivative.
  The java devil pepper was in the healing garden. Drugs used to treat 
hypertension, or high blood pressure, which were used formerly as a 
tranquilizer, come from the java devil pepper. Who would have guessed 
this connection if not for the research by the scientists who 
discovered it?
  Agents that fight tumors, leukemias or lymphomas, come from the plant 
called the mayapple.
  The rose periwinkle produces drugs used as anticancer agents 
primarily in treating Hodgkin's disease and a variety of lymphomas and 
leukemias.
  Foxglove is used in the medications digitalis and digitoxin, which 
are used to treat congestive heart failure and other cardiac disorders.
  Of course, we all know about aloe, an active ingredient, of course, 
in skin care preparations.
  It is interesting that, as funding has increased for studying plants 
and animals, scientists at the NIH are finding quite remarkable things. 
Deep in the Amazon rain forest lives a frog that has a deadly toxin on 
its skin. They believe that from studying the toxin of that frog, they 
can create a painkiller that is 200 times more powerful than morphine 
and not addictive. Think of that: 200 times more powerful than morphine 
and not addictive.
  There is another frog which is very rare that has a toxin on its skin 
that is so deadly that a drop of it on the skin of a human being causes 
the heart to stop.
  The scientists asked the question: If there is something this 
powerful that it causes a human heart to stop, can we unleash the power 
of that toxin to do something positive?
  That is the kind of evaluation and study that is occurring at the NIH 
routinely.
  As we double the funding for the National Institutes of Health, there 
are all of these wonderful scientists and researchers doing this 
massive amount of research--research to decode the human genome, 
research to grow new heart valves around parts of the heart muscle that 
are clogged, deep brain research to uncover the secrets of Parkinson's 
disease.
  As all of this research occurs through the doubling of funding at 
NIH, we should say thanks to Senator Harkin and Senator Specter for 
their leadership and commitment over several years to move this 
Congress to invest in these efforts that are so important to this 
country's future.
  Now, let me go from that compliment to talking about how this 
research is dispersed across this country. There is a trend for how 
this research funding is allocated throughout the country that is very 
similar to what happens in other areas of the federal Government's 
research budget. The research that comes through the billions and 
billions of dollars that we spend--nearly $20 billion proposed for 
fiscal year 2001 at the NIH alone --has historically been clustered in 
a few areas of the country. In most cases, big universities get big 
grants that make them bigger, and from around those universities, you 
see the development of businesses springing up from that research. You 
will see the result of NIH research in a few areas of the country 
producing very significant opportunities. Then you will see other 
significant parts of America with almost no research base through the 
NIH.
  Should research be done where it is done best? Yes, of course. But 
the largest universities in this country, in a handful of States, get 
most of the research dollars in part because the grants are peer 
reviewed by people from the same institutions that get the grants in 
the first place. It becomes a self-fulfilling prophecy.
  The chart I have here shows the way NIH funding is currently 
distribution across the country. If you look at the States in this 
country shown in the white shaded areas--mostly in the middle of the 
country--you will see that these States get very little funding for 
medical research.
  The States shown in the blue and red areas--California, Texas, New 
York, Massachusetts, and so on--are the States that get most of the 
research grants.
  This pie graph here shows what happens as a result of this imbalance. 
As you can see, three States get 35 percent of all of the medical 
research funds provided by the NIH. Institutions in three States get 
over a third of all the Federal dollars on medical research. In fact, 
one state alone received 15 percent of total NIH funds.
  This little white slice shown on the chart represents 21 States that 
share only 3 percent of the research.
  Why does that matter? If you live in one of these States, and you 
have Parkinson's disease, or you have breast cancer, or you have any 
one of a number of very serious health problems, and you want to 
participate in the cutting-edge medical research conducted by the NIH 
through one of its grantees, you may well have to travel hundreds and 
hundreds or perhaps thousands of miles to avail yourself of the 
clinical trials.
  Second, there are wonderful institutions in the middle part of 
America that have the capability to provide unique and beneficial 
research on a range of issues ranging from cancer, to heart disease, to 
diabetes, and more through the funds we are providing at NIH. But they 
do not get the opportunity because the system is stacked against them.
  At the NIH, we have a program called IDeA, or the Institutional 
Development Award program, that is intended to rectify this 
geographical inequity by helping historically under funded states to 
build their medical research capacity. IDeA is very similar to the 
EPSCoR program that exists in other federal agencies.
  This program is under funded at NIH. The IDeA program is funded at 
the level of $100 million in the House-passed bill, which I think is 
too low. But it is funded at only $60 million here. That is an increase 
from $40 million to $60 million, and for that, I appreciate the efforts 
of Senators Specter and. But we ought to at least meet the House level. 
And we ought to do even more.
  My amendment will take our proposed funding to the level of $100 
million in the House bill. Through this amendment, we will simply say 
that we want to encourage the distribution of research across this 
country to all of the centers of genius--no matter where they are--that 
exist.
  In States such as North Dakota, Iowa, South Dakota, and up and down 
the farm belt, we are losing a lot of population. This map shows that. 
All these red blotches on this map indicate counties that have lost 
more than 10 percent of their population.
  What you see is that the middle part of our country is being 
systematically depopulated. Why has that happened? Why, when you have 
so many people living on top of each other in apartment buildings in 
big cities and fighting through traffic jams just to get to and from 
work each day, is the middle part of our country being depopulated?

[[Page S5721]]

  At least part of the answer to that question relates back to what we 
do at the Federal level. We say that $20 billion will be made available 
through the National Institutes of Health to form centers of excellence 
for scientific research in medicine. We move that money to specific 
areas of the country where there is already a significant population, 
and from that springs economic opportunity and biotechnology companies 
and new jobs. We simply exacerbate all of these problems with the way 
we spend our money at the Federal Government.
  There are centers of genius in the middle part of this country, in 
Minnesota and North Dakota and South Dakota and Kansas and Oklahoma. 
There are small centers of excellence that could do wonderful 
scientific research, but they do not get the funding. Why? Because the 
biggest States get all the money. Three States get a third of all the 
money through the NIH.
  I am not suggesting that anything illegal is going on. It is just 
that we have a system that perpetuates itself and creates a 
circumstance where three States get fully one-third of the billions of 
dollars we provide for medical research and 21 other States are left to 
share 3 percent of the medical research. And that predicts and 
predetermines where the centers of excellence will be in the future.
  It also, in my judgment, is unfair to all of those folks who live so 
far away from the biggest centers, where most of the money is moving 
to, because it is not going to be very easy for them to be involved in 
clinical trials for such things as their breast cancer, their lymphoma. 
They are going to have difficulty getting cutting-edge medical 
therapies.
  That ought not be the case. I want to change that. I am hoping, with 
the cooperation of Senator Specter and Senator Harkin, and with a new 
determination in the House and the Senate, that we can come to an 
understanding that, as we double the funding for the NIH, we can also 
do much better for this program at NIH called IDeA. Again, this program 
lets us reach out and find ways to use NIH funding all across this 
country, to get the best of what everyone in this country has to offer, 
to find all the centers of excellence that exist everywhere, and have 
them come to bear on research and inquiry. I am convinced that this 
represents our best chance to try to find ways to cure some of these 
diseases that ravage people who live in this country and the rest of 
the world.
  We are making a lot of progress. With this amendment, I do not mean 
in any way to suggest we are not making great strides. Doubling the NIH 
budget is a terrific thing to do. It will produce enormous rewards for 
all who live in this country and those who will come after us. But it 
is also the case that we must do better in the distribution of this 
research money if we are going to be able to have access to all the 
best minds this country has to offer. That is the purpose of my 
amendment.
  Mr. President, I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. SPECTER. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. SPECTER. Mr. President, I believe the amendment offered by the 
distinguished Senator from North Dakota is a meritorious amendment on 
institutional development within the National Institutes of Health. We 
have a figure of $60 million there as part of $2.7 billion.
  The subcommittee and the full committee have been very--aggressive, 
is the right word--to increase NIH funding. We did it at $2.7 billion 
in this bill. We had $2.2 billion last year, $2 billion the year 
before, a billion before that. I agree totally with the thrust of what 
the Senator wants to accomplish.
  When we sit down with the House in conference, there is always a lot 
of give-and-take with a bill that is at $104.5 billion. It would be my 
intention to do what we can to reach the figure of $100 million, which 
is what the Senator wants, because I think that is the right figure. 
What I suggest is that the Senator give Senator Harkin and me and the 
other conferees the flexibility to negotiate. There is a lot of give-
and-take.
  For those watching on C-SPAN, the process is, after we pass our bill, 
we go to a conference with the House, which has passed a bill. Then we 
sit down with long sheets and go over all the points and try to reach a 
compromise. To have that flexibility would be helpful. I know there are 
a number of programs the Senator from North Dakota would like to stay 
at the Senate figure, as opposed to the House figure which may be 
lower. If we could reach that accommodation, I believe we would obtain 
the objectives which the Senator from North Dakota wants, to give the 
conferees that flexibility to assert the Senate position on other 
matters.
  The PRESIDING OFFICER. The Senator from North Dakota.
  Mr. DORGAN. Mr. President, the Senator from Pennsylvania is alluding 
to the analogy of the legislative process being akin to the making of 
sausage. Often, neither are a pretty process, so it is better, perhaps, 
to speak less of it. I say to the Senator from Pennsylvania that I am 
more concerned about the destination than I am about the route by which 
we get there.
  He has indicated that he supports the $100 million level in the House 
bill for the IDeA program. Senator Harkin has indicated the same. For 
that reason, I will not proceed with my amendment, with the 
understanding that their intention will be to reach that level in 
conference.
  My sense is that we are making a lot of progress. Before the Senator 
was in the Chamber a few moments ago, I said he and Senator Harkin will 
have the undying gratitude of the American people for their persistence 
and relentless work to increase funding at NIH. This is very important, 
not just for people who live here now but for generations to come.
  My concern, as we do that, is to make sure we get the full genius of 
all the American people working on these scientific inquiries into 
treating and curing these ravaging diseases. I want more funding in the 
IDeA program so that smaller States have the opportunity to access 
these grants and we can put to work their scientists and their medical 
schools and their communities to meet our nation's medical research 
goals.
  I appreciate my colleague's response.
  I will not ask for a vote on my amendment. What I will do is ask that 
we handle it in conference, as the Senator has suggested.
  Mr. SPECTER. Mr. President, I thank the Senator from North Dakota for 
his comments about what Senator Harkin and I are trying to do--and, 
really, it is the whole committee and the full Senate. We will, I 
think, accomplish what he is looking for--the $100 million--in the 
final analysis. I think the old saying that you don't want to see 
either sausage or legislation made may have some merit. I think when we 
deal with our national health, we are dealing with ``prime rib.'' We 
will make some tasty morsels here for the benefit of America, I think.
  Mr. President, in the absence of any other Senator in the Chamber, I 
suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. DORGAN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DORGAN. Mr. President, I ask unanimous consent to speak as in 
morning business for 5 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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