[Congressional Record (Bound Edition), Volume 147 (2001), Part 5]
[Extensions of Remarks]
[Pages 6887-6888]
[From the U.S. Government Publishing Office, www.gpo.gov]



                      DOUBLING FUNDING FOR THE NIH

                                 ______
                                 

                          HON. GEORGE W. GEKAS

                            of pennsylvania

                    in the house of representatives

                         Wednesday, May 2, 2001

  Mr. GEKAS. Mr. Speaker, I am pleased to report that the Congressional 
Biomedical Research Caucus, which we initiated in 1990 to increase 
awareness and support for basic biomedical research, has commenced its 
twelfth year of briefings. With my co-chairs, Representatives Sonny 
Callahan, Nancy Pelosi, and Ken Bentsen, and over 100 other Members, 
this bipartisan Caucus has provided nearly 100 briefings where Members 
and staff have interacted directly with the researchers who lead the 
world in important scientific discoveries.
  This year, we are strongly supporting the fourth step in doubling the 
budget of the National Institutes of Health over five years. We commend 
President George W. Bush for including a $2.8 billion increase for the 
NIH in his FY2002 budget proposal. However, it is our hope that 
Congress can provide an increase of $3.4 billion in order that the 
doubling commitment can be achieved within five years.
  Why is this so important? What scientific evidence exists that such 
funding for the NIH will indeed result in better health, improved 
quality of life and reduction in national health care expenditures?
  To answer these questions, in February we invited two distinguished 
biomedical research scientists to our Caucus to discuss ``The Promise 
of Biomedical Research.'' First, Dr. Maxine Singer, President of the 
Carnegie Institution, clearly explained the need to support biomedical 
research infrastructure--instrumentation, facilities, information 
technology and strengthening science and mathematics education in 
primary schools.
  Dr. Marc Kirschner, Chairman of the Department of Cell Biology at 
Harvard Medical School, was the second speaker and his comments follow 
this statement. We recall that in the magazine ``Science'' (1993), he, 
along with Drs. J. Michael Bishop and Harold Varmus, recommended that 
the NIH budget should be increased by 15% per year which would double 
the budget in five years. These scientists placed their reputations on 
the line, and I believe we can rely on them. These scientists were also 
part of a small group who helped us organize and conduct the Biomedical 
Research Caucus.
  The attempt to double NIH funding actually began in 1997, with the 
initiative of Senators Arlen Specter and Tom Harkin along with 
Representative John Porter. We in the Caucus have continued to support 
these efforts since that time.
  I believe that the clear and compelling remarks presented to the 
Congressional Biomedical Research Caucus by Dr. Singer and Dr. 
Kirschner will be helpful in our deliberations concerning this year's 
budget priorities.

      Transcript of Remarks by Marc Kirschner, Ph.D., Before the 
      Congressional Biomedical Research Caucus, February 28, 2001

       Thank you for coming today. It is my hope and Dr. Singer's 
     hope that all of you can become as knowledgeable as possible 
     about medicine and science at the beginning of the 21st 
     century. Science affects us in the present and in the 
     future--our personal lives, our economic well-being and even 
     our national defense against some fiendish new enemies. 
     Medical issues often lurk beneath the surface and then 
     explode like the AIDS epidemic, mad cow disease or hoof-and-
     mouth disease in Europe; new issues reach prominence in the 
     news and confuse many of the public like genetic engineering 
     of crops and stem cell biology. The chronic issues of cancer 
     and heart disease and depression also remind us of our need 
     for a better defense against disease. Planning in science 
     often seems intuitively clear to scientists, and yet even for 
     us the path is very convoluted. In my own experience, many 
     years ago we discovered one of the major proteins that goes 
     awry in Alzheimer's disease--but we weren't working on 
     Alzheimer's disease at the time; we were working on cell 
     division and cancer. So I can understand that it is often 
     difficult to understand what to do and what priorities to 
     set. Science is complex. Every time I try to explain what I 
     do to my wife and my mother, I have to start all over each 
     time. But there is hope. My kids seem to understand much 
     better. Yet despite these difficulties, progress in medicine 
     is astonishing and it is very clear to all of us that our 
     expectations for tomorrow should be considerable.
       I will try to briefly review where we are and what we need 
     and what you can do to help. Scientists in general have faith 
     in rationality. We feel that if you understand the issues--
     the problems, the accomplishments, the needs and the true 
     state-of-affairs in science that you and the American people 
     will make the right decisions. It is for that reason that the 
     goal of the Caucus has always been education. From that 
     policies should naturally flow.


                             Where Are We?

       February 12 was the announcement of the human genome 
     sequence by an international consortium led by the United 
     States and by private efforts built heavily on exploiting the 
     openness and accessibility of that public investment. We now 
     have a list of parts. Some people think that 30,000 is a 
     small number, but this is completely misleading. We are 
     really a gigantic Lego set with 30,000 different pieces, but 
     the number of pieces is a million, billion, billion--so we 
     are pretty complicated--and the design of even the simplest 
     organism is beyond our present understanding. We know some of 
     our problems lie in faulty pieces--cystic fibrosis, sickle 
     cell anemia, muscular dystrophy. Perhaps there are simple 
     signals for adult onset diabetes and schizophrenia, but they 
     are not likely to be single faulty pieces, maybe instead two 
     or more pieces when they come together reinforce their 
     weaknesses--we hope to learn that soon. Some are diseases of 
     systems, such as rheumatoid arthritis and cancer. Some are 
     foreign enemies--viruses and bacteria--AIDS and tuberculosis. 
     Some things may be easy to figure out, some will turn out 
     much harder than we think.
       A few years ago, Alzheimer's disease seemed hopeless. There 
     were no animal models. There was no convincing epidemiology--
     no smoking gun as we had in polio. It was a sporadic disease 
     of late and variable onset. Today we have an exquisite idea 
     of the cause and we have many promising targeted 
     pharmaceutical interventions.
       In some ways it now seems like it could be a relatively 
     easy disease to treat. It can be diagnosed much earlier by 
     MRI. Also, if it takes seventy years to appear--all we have 
     to do is slow it down to 50% so the age of onset is 140. 
     There are not many things where a two-fold change is a 
     complete cure.
       Well, I know that this is a Congress where the usual 
     situation is to bring you problems that no one can solve. You 
     have to work on those, too. But medical science is something 
     that you can work on and have a big effect. You have an 
     opportunity today that is more significant in many ways, but 
     akin to the Eisenhower Interstate Highway Program of the 
     1950s. Like that program, the country can survive without it. 
     But like that program, the effects are likely to be profound, 
     with many long-term and unintended benefits. Whatever the 
     state of the finances, today, the circumstances of science 
     tells us that this is the time to invest. The progress in 
     biomedical science will affect every person equally in this 
     country and on our planet (if

[[Page 6888]]

     we take care to distribute its largesse fairly). But it will 
     take a long-term infusion of funds. The plans to double the 
     NIH budget will have to be followed by a long-term plan of 
     increased funding that will allow us to realize the value of 
     investment that you have already paid for and which will 
     allow dividends to be paid to all of our children, and their 
     children. I know a long-term view is difficult for a Congress 
     that is elected every two years and has annual budgets. We 
     all realize that things may intervene. But progress is best 
     achieved with a long-term budgetary plan. Now, let me return 
     to education, starting with some of today's important 
     buzzwords.


                               The Genome

       What did we learn from the genome--not much--yet. What we 
     will learn is unimaginable. Genomics is the most 
     revolutionary technology in biology today. It will produce 
     hundreds of new targets for intervention in disease, new 
     understanding of disease itself, new methods for diagnosis, 
     and also in a very profound way a new appreciation of life. 
     It is not and should not be the beginning of human 
     engineering. We study biology to appreciate life, to preserve 
     it and to value it. Despite all the hype about gene 
     technology, scientists are happy working around the margin to 
     protect what we have, not to restructure it. Also, about the 
     30,000 genes, most of which are the same in frogs--that is 
     not the main point of the genome. The genome contains the 
     instructions on how to put these genes together, how much to 
     make, when to make things, and where to make things. With 
     enough diligence we eventually might have found most of the 
     30,000 genes by other means; only the genome sequence tells 
     us about the instructions.


                                Cloning

       Cloning is the most common word in a biomedical scientist's 
     vocabulary and the most misunderstood by the average citizen. 
     In scientific discourse it never means cloning people. 
     Usually it means isolating pieces of DNA for study. Sometimes 
     it means isolating a line of cells that are genetically 
     identical from animals, human beings, or often tumors. 
     Sometimes it means making genetically identical animals which 
     will serve as a model for disease. None of these uses raises 
     ethical problems.


                               Stem Cells

       Stem cells are the great promise of regeneration. Most stem 
     cell biology carries with it no ethical problems. There are 
     skin stem cells, bone marrow stem cells, stem cells for 
     muscle. But we don't really have what we need--we need brain 
     stem cells for spinal cord and brain injury; we can't get 
     heart muscle to regenerate--we cannot get kidneys to 
     regenerate as we can liver.
       The hot button issue is around stem cells derived from 
     discarded human eggs or from human fetuses. For some people 
     this is an ethical issue and if they truly understand the 
     issues and still feel opposed we have to respect that, but 
     not necessarily accept their judgment. The desire to work 
     with embryonic stem cells is that they, in principle, can 
     regenerate all tissues and we can learn from them how to 
     develop applications that may in the future allow us to use 
     other sources of material. From the study of human stem cell 
     biology could come treatments for Parkinson's disease and for 
     type I diabetes. The hope for lifting these terrible burdens 
     on our loved ones has to be weighed against the ethical 
     objections of some. The decision is not simple but at least 
     we can try to understand the issues in concrete terms.


                         Animal Experimentation

       Today we are learning more and more from fruit flies, worms 
     and cultures cells--even from computers without doing a wet 
     experiment but none of this will benefit human beings without 
     animal experiments, mostly in rodents, less often in 
     primates. The vast majority of these experiments cause no 
     discomfort, but some do. It is hard to study regeneration 
     from stroke without inflicting damage and yet most of us who 
     have seen the devastating effect of stroke on our loved ones 
     are willing to sacrifice animals. Scientists will do 
     everything to avoid the cost, difficulty and discomfort of 
     animal experimentation. But we all have to accept the fact 
     that our ability to contribute to biomedical science will be 
     in proportion to the amount of animal use. Anyone who thinks 
     otherwise is not realistic. They may wish it were not 
     otherwise--I may wish it were otherwise--but the simple fact 
     is that we will not benefit from our discoveries, we will not 
     cure cancer or heart disease, or manic depression, by making 
     animal experimentation too difficult or too expensive.
       What are the big targets for the NIH? Here are seven 
     examples of them:
       1. Using the genome to find targets to attack diseases like 
     cancer.
       2. Immunology everything from type I diabetes to autoimmune 
     diseases to cancer therapy to allergy.
       3. Regeneration--finding the signals to stimulate our 
     bodies to repair itself--I include stem cell biology here.
       4. Mental illness, mental retardation as organic diseases, 
     and how to treat them much more specifically.
       5. Obesity and type II diabetes--going beyond failed 
     attempts at self-discipline.
       6. Alzheimer's disease and aging--finding not a cure but a 
     way to slow things down.
       7. Infectious diseases--here the genomes of all the 
     pathogens have increased our targets by 100-fold but we must 
     always be diligent.
       This is just a sampling.


                 How Much Should medical Research Cost?

       We should pay no more money than can be used wisely. The 
     NIH is not perfect; you need to keep our oversight of NIH 
     intramural and extramural spending. But this does not mean a 
     failed experiment is wasted money. The biggest failure is not 
     doing an experiment that could make a difference. The biggest 
     enemy in science is timidity, not overspending.
       We should spend as much as we can to speed up the 
     application of science to health. Yet to work on application 
     before we understand the processes can be very inefficient.
       Would we be better off today if we had spent our money on 
     better iron lungs, rather than on a vaccine against the polio 
     virus?
       Is this science cost-effective? Maybe this is not the right 
     question, but we can try to answer it anyways.
       If we are truly successful, things should be cost-
     effective. It took years to make a Hemophilus influenza type-
     B vaccine--but this major cause of meningitis, with its 
     concomitant death and hearing loss in young people is now 
     completely preventable.
       Surgery for gastric ulcers was an expensive and risky 
     business. Today we control the disease with a cheap 
     antibiotic. Yes, there were major costs in the discoveries, 
     but the savings accrue forever. If one takes a long-term 
     view, all of this should make sense financially.
       Four years ago before budget surpluses--the long view was 
     developed with strong bipartisan support--in Congress, to 
     double the NIH budget. The expectations of science are even 
     higher today than there were four years ago. I hope you can 
     complete that effort and after that, renew the investment.
       Pardon me for my pitch for joining the Caucus. I do 
     appreciate the support of Representative Gekas and all the 
     members of the Caucus for being passionate advocates over the 
     past years and for serving to educate the Members and their 
     staff. I am not sure it gained them votes--but it was the 
     right thing to do. It has meant a lot to scientists, 
     particularly the young scientists who have come here from all 
     over the U.S. They recognize the deep and thoughtful support 
     that you have given. That means a lot. We all realize that 
     you deliberate over many problems--it is just that much more 
     reassuring that you have taken the time to understand these 
     complex issues.
       One last thing, together we have built the greatest 
     scientific establishment in the world. Today, as I travel the 
     country, I find first-class research done all over. Important 
     discoveries are coming from laboratories in all of our 
     states. Mao Tse-Tung said ``let a thousand flowers bloom''--
     ignoring his politics for a moment we would have to say that 
     it was a good slogan for science. There is no guaranteed path 
     to discovery--but the opportunity to take chances--the path 
     to discovery that you have supported--is the best strategy to 
     guarantee that we employ every tool and use all our ingenuity 
     to improve the health of the world.

     

                          ____________________