On March 17, the House Energy and Commerce Subcommittee on Health held a hearing to examine the National Institutes of Health’s (NIH) management of its research portfolios in preparation for reauthorizing the agency’s programs. Stating that the subcommittee has held 10 hearings on NIH over the last 2 years, Chair Nathan Deal (R-GA) expressed his hope to “achieve legislative reform in the administrative structure” and urged his colleagues to work in a bipartisan manner to enact reauthorization legislation.
Ranking Member Sherrod Brown (D-OH) agreed that Congress must support NIH so that it remains “the flagship research institution.” He urged the subcommittee to consider improved congressional oversight, adequate NIH funding, and translational research.
NIH Director Dr. Elias Zerhouni detailed the NIH’s research portfolios and priorities. Saying that the NIH “works very hard to maintain a research portfolio that balances public health needs and scientific opportunities,” he told the subcommittee, “Ideas for scientific initiatives in specific areas of science come from many sources—advocacy groups, the biomedical research community, Congress, the NIH staff, among others. Ideas for stimulating a particular field or letting it lie become reality only after rigorous vetting at a number of levels.” In an effort to meet new challenges, Dr. Zerhouni stated that he has requested $2 million in the FY2006 budget to establish an Office of Portfolio Analysis and Strategic Initiatives within the Office of the Director. “This office will be charged with evaluating the entire Agency research portfolio to ensure that urgent public health needs are addressed in a timely way and that a sound decision support system is established that is based on rigorous and uniform sources of evidence.”
Detailing specific areas of research, he said, “In the case of HIV/AIDS research, we are shifting resources to fund vaccines to respond to urgency as well as opportunity.” Further, Dr. Zerhouni stated, “As an illustration of our responsiveness to emerging public health threats, NIH launched the Strategic Plan for Obesity, a multi-disciplinary approach to addressing a burgeoning health crisis. There are 130 million obese American adults who are at risk of premature death, chronic illness, and reduction in quality of life…We have 18 Institutes and Centers conducting research on such factors in the epidemic as behavioral, sociocultural, economic, environmental, genetic and biological causes.”
During the question and answer session, Dr. Zerhouni fielded a number of questions regarding human embryonic stem cell research from Members on both sides of the aisle. Rep. Diana DeGette (D-CO) asked how much money was being spent on human embryonic stem cell research and whether it would be helpful to researchers to have more lines available. Dr. Zerhouni responded that between 2002 and 2004, $10-24 million was spent on such research. With respect to additional lines, he said, “It may help us with research,” noting that there are 31 lines that are not available under current law, 16 of which are thought to be free of contamination by animal cells. “We would like those lines to be available for federal funding if that is proven true,” adding that “it would be desirable to have some cells that are not contaminated.”
Rep. Mike Ferguson (R-NJ) wondered if the claims by proponents of human embryonic stem cell research that such research could result in hundreds of millions of cures were based on science. Dr. Zerhouni responded that “it’s a little too early in the science to make a prediction about a cure,” adding, “There is no doubt that we need to understand what goes on in adult and embryonic stem cells. Can you reprogram the DNA of a cell?”
Rep. Michael Bilirakis (R-FL) expressed his concern about primary pulmonary hypertension, “a serious and often fatal condition; a devastating disorder that disproportionately affects young women and often leaves them with the only option of a heart/lung transplant.” He encouraged the NIH to step up its efforts with respect to research and clinical trials.
Rep. Fred Upton (R-MI) questioned the director about specific research grants, such as one that examined prostitution at truck stops. Responding that the incidence of sexually transmitted diseases (STDs) and HIV in the U.S. is rising, Dr. Zerhouni said, “The trucking industry and prostitution at trucking stops is a major mode of transmission of HIV and STDs in the U.S. Not knowing that through research is a threat to public health.”
Focusing on minority health and health disparities, Rep. Bobby Rush (D-IL) asked whether the National Center on Minority Health and Health Disparities should be elevated to an institute. Dr. Zerhouni explained that within the NIH structure, centers and institutes are on the same level, “Whether it’s a center or an institute doesn’t matter.” He argued that there was a need to have “one competent structure” focusing on health disparities, but added that the center needed to be cross-cutting.
Rep. Rush also questioned what the NIH is doing to increase “racially and ethnically diverse populations in clinical trials, not just as participants but as researchers as well.” Saying that the NIH is “doing well with participants,” Dr. Zerhouni said that it is harder with scientists because “our own children are going less and less into science, especially in racial and ethnic populations. We’re working to have better representation in terms of recruitment.”
