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As Budget Resolution Discussions Continue, Appropriations Hearings Continue; NAEVR Submits Testimony to File of April 21-22 Hearings of the House LHHS Appropriations Subcommittee

Legislative Update
April 23, 2004

House and Senate budget conferees continue to meet to hammer out differences in their respective budget bills, primarily related to budget enforcement mechanisms. Currently, leaders are predicting a final Conference Report during the week of April 26, with House and Senate floor action late that week and potentially into the week of May 3.

In the meantime, hearings continue on the 13 Appropriations bills that Congress must pass (subsequent to the development of a Budget Resolution, which sets the budget caps under which the Appropriators must work) to finalize government spending in FY2005. On April 1, the Labor, Health and Human Services, and Education (LHHS) Subcommittee of the Senate Appropriations Committee held its hearing on National Institutes of Health (NIH) appropriations (see April 9 Legislative Update).

On April 21-22, the Labor, Health and Human Services, and Education Subcommittee of the House Appropriations Committee conducted two days of hearings on NIH Appropriations. The first day focused on the NIH Roadmap for Medical Research, the second day on NIH Management issues. Chaired by Cong. Ralph Regula (R-OH), the hearings were well attended by the sixteen other members who all made appearances on one or both days. NIH Director Dr. Elias Zerhouni spoke on behalf of NIH, and was joined by various Institute Directors during the two days in responding to questions. These hearings were cordial with no major controversies.

In the April 21 discussion of the NIH Roadmap, Dr. Zerhouni prefaced his comments by identifying NIH's five top public health challenges:

  • chronic diseases
  • aging population
  • health disparities
  • emerging diseases (primarily co-morbidities, such as onset of diabetes from obesity)
  • biodefense

Eye disease and vision impairment are characterized by four of these five top public health issues: many of these conditions are chronic; they have a significant impact on the elderly, as borne out by the National Eye Institute's (NEI) recently released data on the increased prevalence of eye disease in the aging population; the Hispanic and African American communities have a disproportionately high incidence rate of glaucoma and cataracts, which are now the leading causes of blindness in those communities; and diabetic retinopathy is just one example of a co-morbidity associated with the onset of diabetes from obesity.

In commenting generally on the importance of the early detection and treatment of diseases, Dr. Zerhouni specifically cited two NEI-sponsored research programs. He noted that NEI's Early Treatment Diabetic Retinopathy Clinical Trials Network helped to determine the best treatments that have been 95% effective. He also stated that "AMD is the number one emerging public health issue for seniors," and described the results of the NEI-sponsored Age-related Eye Diseases Study (AREDS) that found that high levels of antioxidant nutrients and zinc significantly reduce the risk of advanced AMD.

Although Dr. Zerhouni provided an extensive discussion of the types of inter-Institute and collaborative research projects being conducted, Subcommittee members focused primarily on obesity (a major subject at the April 1 Senate Subcommittee hearing, too), which enabled Dr. Zerhouni to speak in depth about the NIH Obesity Research Task Force and its recently released plan. A variety of other topics were addressed, such as Clinical Trial Networks (and NIH's ability to manage data from trials), Stem Cell Research, and specific disease research.

Although all panel members were extremely complimentary of Dr. Zerhouni's leadership and the work of NIH, minority members expressed concern that the 2.6% increase for FY2005 would not be sufficient.

On April 22, Dr. Zerhouni described the steps he had taken to revamp the internal management process (create a Steering Committee of 9 Institute Directors) and reduce administrative costs from 4 to 3.5% (the latter likely being the limit of cuts unless more Information Technology can be utilized). The Members were especially interested in how Dr. Zerhouni would manage within the small increase in the budget, whereupon he cited the trade-off in grants (cutting the inflationary factor from 3.5% to 1.9% for existing grants in FY2005 so that he could increase the number of new grants back up to the FY2003 level of 10,393).

The remainder of the day focused on specific disease conditions and associated research. In concluding, Chairman Regula asked Dr. Zerhouni to elaborate in follow-up how much additional money he would need to conduct the ten key projects identified by Sen. Arlen Specter in the introductory comments to his March 11 amendment to increase NIH funding in FY2005 by $1.3 billion over the President's Budget request of $700 million+. As previously reported (see March 12 Legislative Update), an AMD Clinical Trial Network was one of these ten projects cited as a reason for an NIH increase beyond the President's budget proposal.

NAEVR submitted a written statement by Board President Dr. Stephen Ryan and accompanying testimony that urged Congress to fund the NIH at $30 billion and the NEI at $711 million in FY2005.