NIH Director Dr. Collins Testifies Before House and Senate LHHS Appropriations Subcommittees on the President’s Proposed FY2022 NIH Budget, including Creation of ARPA-H

On May 25 and May 26, respectively, the Labor, Health and Human Services, and Education (LHHS) Appropriations Subcommittees of each the House and Senate conducted a hearing with National Institutes of Health (NIH) Director Francis Collins, MD, PhD and several Institute Directors (see box below) about President Biden’s proposed Fiscal Year (FY) 2022 NIH budget. Prior on April 15, Department of Health and Human Services (DHHS) Secretary Xavier Becerra testified before the House Subcommittee on the President’s FY2022 DHHS budget proposal—which included discussion about NIH—and on May 19 the House Subcommittee held its Public Witness Day hearing on the proposed DHHS budget, which featured NAEVR witness Michael Crair, PhD (Yale University) testifying about NIH and National Eye Institute (NEI) funding.       

Chairwoman Rosa DeLauro (D-CT) welcomed the NIH representatives, stating her intent to hold additional hearings that engaged Institutes and Center (I/C) Directors not currently present. In her Opening Statement she:

  • recognized that Congress has provided $4.8 billion in stimulus funding to NIH for COVID-19 related research, which along with the $12.9 billion in NIH funding increases in the FY2016-FY2021 timeframe (40% increase) has funded research resulting in vaccines, therapies, and diagnostics for COVID-19;
  • Expressed her support for the Biden Administration’s proposed FY2022 NIH funding at $51 billion, with $6.5 billion to create the Advanced Research Projects Agency-Health (ARPA-H) to speed translation of research discoveries and $2.5 billion in funding for NIH’s core activities, as well as the budget’s inclusion of such issues as a health disparities, mental health, and maternal health for funding increases;
  • Commented that she was “intrigued” by the ARPA-H concept and stressed the need to strike the appropriate balance between supporting basic research and this new approach. She added that she wants to continue to invest in all areas of research, know how ARPA-H’s research priorities will be set, and understand how ARPA-H will relate to the NIH's National Center for Advancing Translational Sciences (NCATS).

In his Opening Statement, Subcommittee Ranking Member Tom Cole (R-OK) recognized that this is his “favorite hearing of the year” and that he agreed with Chairwoman DeLauro’s comments about NIH support, noting that “every dollar invested in NIH is a down payment for our future.” He expressed his support for the proposed NIH, Centers for Disease Control and Prevention (CDC), and Strategic Stockpile funding in the President’s proposal but expressed concern that it increases domestic discretionary spending by 18 percent while defense spending is essentially flat.       

In his testimony and in response to specific questions from Chairwoman DeLauro and Ranking Member Cole, Dr. Collins provided greater detail on ARPA-H, specifically that:

  • The $6.5 billion ARPA-H funding in FY2022 appropriations would be spent over three years.
  • ARPA-H is intended to add a layer of translation to NIH’s work, not detract from its existing work. He said there is enthusiasm to apply a DARPA-like (Defense Advanced Research Projects Agency) approach to support bold and risk-taking research that brings a number of partners, including those who would not traditionally apply for NIH grants, together to advance certain research topics. In that regard, he said that all I/Cs would be involved in the work of ARPA-H, offering up their best ideas for rapid translation of research that would benefit all Americans.
  • ARPA-H is different than NCATS since the latter works on a modest scale and the former is more like the “NCATS model on steroids.” Currently, there is no best clear option for the relationship between ARPA-H and NCATS, and that stakeholder input is needed on this issue.

As in past hearings with Dr. Collins, Subcommittee members had two rounds of five minutes to ask questions, which covered a variety of topics, including the origin of the COVID-19 virus, addressed primarily to Dr. Fauci.

In her Opening Statement at the May 26 Senate hearing, LHHS Appropriations Subcommittee Chairwoman Patty Murray (D-WA) recognized with respect to the recent COVID-19 pandemic and NIH’s response that “we never know how discoveries of today—free of politics—will address the future.” She commended NIH on its initiatives to increase diversity in the scientific workforce, eliminate workplace harassment, and address health disparities stating that, “cures are only as good as access to them.”

In his Opening Statement, Ranking Member Roy Blunt (R-MO) recognized the Subcommittee’s past bipartisan efforts to increase NIH funding over the past six fiscal years which has “encouraged early-stage and mid-career scientists to stay in research.” He recognized the NIH’s Rapid Acceleration of Diagnostics (RADx) and DHHS’s Operation Warp Speed initiatives for quickly translating NIH basic research into COVID-19 vaccines, therapies, and diagnostics—noting that these employed novel approaches that included partnerships with private industry. In that regard, he commented that ARPA-H should use similar novel approaches to speed translation of breakthroughs across the NIH portfolio, and that its funding “should not take away from NIH’s basic research, because that has brought us to where we are.” He recognized the President’s proposal to increase funding of core NIH programs by $2.5 billion, noting that is was close to the average increase over the past six fiscal years.

As in the House hearing, Dr. Collins responded to specific questions raised by Chairwoman Murray and Ranking Member Blunt about ARPA-H. When asked about the impact of ARPA-H on I/C budgets, Dr. Collins responded that” it would “augment, not subtract from, I/C budgets because it would address ideas presented from a variety of research areas for rapid translation.”

As in the House hearing, Subcommittee members had two rounds of five minutes to ask questions, which covered a variety of topics, including the origin of the COVID-19 virus.

At the conclusion of the hearing, Ranking Member Blunt asked about disruptions in research due to COVID-19 lab closures and whether NIH was being flexible with grants, especially for trainees and early-stage investigators. Dr. Collins acknowledged that NIH’s Intramural labs are currently at only 50 percent operation and that it has tried to have as much flexibility with extramural grantees and trainees—even extending the length of training grants. In closing, he estimated that the COVID-19 pandemic resulted in a loss of $16 billion to the research enterprise—about $6 billion more than the $10 billion he estimated at  the Subcommittee’s July 2020 hearing.

I/C Directors joining Dr. Collins at the House hearing:

Dr. Diana Bianchi
Director, Eunice Kennedy Shriver National Institute of Child Health and Human Development

Dr. Anthony Fauci
Director, National Institute of Allergy and Infectious Diseases

Dr. Gary Gibbons
Director, National Heart, Lung, and Blood Institute

Dr. Norman Sharpless
Director, National Cancer Institute

Dr. Nora Volkow
Director, National Institute on Drug Abuse

I/C Directors joining Dr. Collins at the Senate hearing:

Dr. Diana Bianchi
Director, Eunice Kennedy Shriver National Institute of Child Health and Human Development

Dr. Anthony Fauci
Director, National Institute of Allergy and Infectious Diseases

Dr. Gary Gibbons
Director, National Heart, Lung, and Blood Institute

Dr. Norman Sharpless
Director, National Cancer Institute

Dr. Eliseo Perez-Stable
Director, National Institute on Minority Health & Health Disparities

Dr. Bruce Tromberg
Director, National Institute of Biomedical Imaging and Bioengineering