Pulmonary Hypertension Research Act of 2005

Madam Speaker, it is now my pleasure to yield 3 minutes to the chairman of the Health Subcommittee, the gentleman from Georgia (Mr. Deal).

Madam Speaker, I yield myself such time as I may consume.

I would like to read a letter from Leo T. Furcht, M.D. who is the president of the Federation of American Societies for Experimental Biology. In his letter to Chairman Barton Dr. Furcht wrote: ``We thank you for your leadership in protecting the National Institutes of Health from disease-specific funding set-asides. From the FASEB perspective, directed research initiatives fail to recognize several principles inherent to the nature of medical research. Thus, we doubly appreciate your legislation's emphasis on investigator initiated competitive research.''

Madam Speaker, I yield 2 minutes to the gentleman from Pennsylvania (Mr. Murphy), an esteemed psychologist.

Madam Speaker, it is my great pleasure to yield 2 minutes to the gentleman from Michigan (Mr. Rogers).

Madam Speaker, I would remind the gentleman that President Reagan was no fan of high taxes, and I would also remind this body that the Republicans in this body have been responsible for the largest increase in NIH funding in America's history, period, end of discussion; except to add that Chairman Barton was a leader in that regard.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield myself the balance of my time.

I want to add to the list that Chairman Barton read about individuals and groups that support this NIH reauthorization: the American Society of Clinical Oncology, the Autism Society of America, the Colorectal Cancer Coalition, the Men's Health Network, the Society for Gynecologic Oncologists, and the Deirdre Imus Environmental Center for Pediatric Oncology. Truly a diverse group that supports this legislation.

Madam Speaker, last week, many of us had constituents from our districts come through our offices who were cancer survivors, and the question always comes up, and Mr. Markey asked it tonight, are we doing enough? Well, another question that we could ask, and we should ask, is do we know what we have already done?

Let me quote, Madam Speaker: ``This year, for the first time in history,'' for the first time in history, ``the absolute number of cancer deaths in the United States has decreased. We now have 10 million cancer survivors. We can detect and treat cancer at earlier stages. Targeted therapies have emerged, using specific molecular targeting to treat tumors with new agents.''

This quote was from Elias Zerhouni as he addressed our committee.

Madam Speaker, let me just add that, thanks to the tools and technologies developed by the Human Genome Project at the National Institutes of Health, changes in the genetic blueprints that are associated with all types of cancer are now known. A new generation of targeted diagnostics, therapeutics, and preventatives for all cancers will pave the way for more personalized cancer medicine.

What does this mean? It means that we are well on our way to a time when, should a person be diagnosed with cancer, their physician will be able to say whether or not certain therapeutics are appropriate. Think of the dollars that that will save. Not everyone who receives a diagnosis has to go through the same treatment. There are some genetic makeups that will be helped; there are some that will not be helped. Let us target our therapy where it does the most good. We are clearly moving in the right direction in this regard.

We heard the chairman, we heard people from the other side describe the National Institutes of Health as the crown jewel of the Federal Government. I believe that is correct, and we should all be proud of the organization's dedication to improving the health of Americans and mankind.

The bill before the full House tonight improves on that commitment by providing sustainable funding increases for medical research, granting the NIH Director more authority and increasing accountability, and it creates the Common Fund to put dollars toward trans-NIH research activities. These trans-NIH research initiatives will make historic breakthroughs in medical research.

Already, the National Cancer Institute and the National Human Genome Research Institute are collaborating on the Cancer Genome Atlas. This project will develop a useful atlas of the changes that occur in the human genetic blueprint associated with all types of cancers. This project will give medical professionals a new generation of targeted diagnostics, therapies and preventative services to treat a host of different cancers.

We are, indeed, Mr. Speaker, moving in the right direction. We are, indeed, doing good work for the American people with the reauthorization of this bill, and this bill maintains that important momentum. Be it a cure for cancer or greater understanding of the human genome or advances in heart disease, an avian flu vaccine, the National Institutes of Health has a proven record of innovation.

Mr. Speaker, this is a good bill. By increasing the authorized level by 5 percent, Chairman Barton and Chairman Deal have produced a bipartisan approach to capitalizing on the gains made by the NIH over the past several years.

Vote for your constituents and the future of medical care by voting in favor of H.R. 6164.

Federation of American

Societies for Experimental Biology,

Bethesda, MD, September 26, 2006.

Hon. Joe Barton,

Chairman, House Energy and Commerce Committee, House of

Representatives, Washington, DC.

Dear Chairman Barton: Please accept my thanks again for the

opportunity to testify in support of your NIH reauthorization

legislation on behalf of the Federation of American Societies

for Experimental Biology (FASEB), The biomedical research

community continues to support your vision for our nation's

premier medical research agency.

I fully appreciate that one of the fundamental questions

faced by your committee in producing this legislation was how

to balance the responsibility of setting priorities for

funding within NIH. FASEB strongly concurs with your view, as

delineated in the reauthorization bill, that Congress

continue to set overall funding levels for Institutes,

Centers and the Common Fund, but that the selection of

specific research areas to be funded remains principally the

responsibility of NIH, through merit-based peer review. We

believe that the NIH has the fullest understanding of not

only the human and economic costs of a disease, but also of

the scientific challenges and current opportunities that

exist in specific areas and more broadly in biomedical

research. Moreover, FASEB feels this role will only be

strengthened by the portfolio management provisions of the

NIH Reform Act.

We thank you for your leadership in protecting NIH from

disease-specific funding set asides. From the FASEB

perspective, directed research initiatives fail to recognize

several principles inherent to the nature of medical

research. Basic research, recognized universally as the

foundation of most advances in disease-specific research,

will inevitably suffer in a politically based system of

allocating scarce dollars. Thus, we doubly appreciate your

legislation's emphasis on investigator-initiated competitive

research. ``Furthermore, earmarking by disease is not

necessarily the way to produce breakthroughs in a particular

area, since research in one area often produces unpredictable

results that find specific use in another. There are numerous

examples of the ``serendipity of science'' and there will be

many more in the future. Disease specific funding runs

counter to this well observed phenomenon.

In conclusion, FASEB reiterates its support for the NIH

Reform Act of 2006. It is a tremendously successful balance

that both improves upon the current system and preserves

those aspects that have allowed NIH to achieve its global

preeminence in medical research.

Sincerely,

Leo T. Furcht,

FASEB President.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

Madam Speaker, I move to suspend the rules and pass the bill (H.R. 6164) to amend title IV of the Public Health Service Act to revise and extend the authorities of the National Institutes of Health, and for other purposes.

Madam Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on the matter under consideration.

Madam Speaker, I yield myself such time as I may consume.

Madam Speaker, this is a big day for me, or I guess I should say a big evening for me. When I became chairman of the Energy and Commerce Committee 3 years ago, I asked the staff to do two things: number one, prepare a list of all of the major agencies and major pieces of legislation that were under the jurisdiction of the committee; and then, number two, to prepare a list of those agencies and those major bills that were not authorized.

I was extremely surprised to find out that the National Institutes of Health, which at that time we were doubling the budget of, had not been authorized in 10 years. I said that is a very, very important agency, and because there is tremendous bipartisan support for the NIH, let's make that the first agency that we bring up to speed and reauthorize and, if necessary, reform. I thought, quite frankly, that that effort might take 3 to 6 months.

Well, 3 years later, as one of the last acts of this Congress, we are bringing to the floor an NIH reauthorization bill. It is a bill that has been the result of tremendous cooperation in the stakeholder community and within this Congress, Mr. Dingell and myself as leaders of the committee, and many, many Members on both sides of the aisle, rank and file Members in terms of input.

The bill has gone through three to four drafts. We had a very intense markup on this bill in committee last week, and the result is a work product that is before us.

Fifty-one stakeholder groups have endorsed the bill, and I will put the endorsement sheet into the record. I am not going to read all 51 out, but I do want to read some of them: the American Cancer Society, the American Heart Association, the American Physical Therapy Association, the Association of American Medical Colleges, the Association of America and Universities, the Christopher Reeve Foundation, the Federation of American Societies for Experimental Biology, the Friends of Cancer Research, the Juvenile Diabetes Research Foundation, the Lance Armstrong Foundation, the March of Dimes, the National Association of State Universities and Land Grant Colleges, the National Coalition for Cancer Research, and the Parkinson's Action Network are just a few of the national organizations that have endorsed or supported this legislation.

Why is NIH reauthorization important, beyond the mechanical aspect of trying to have funding that is authorized and is given full oversight? Well, I think when you talk about major pieces of legislation you tend to talk in abstract terms, but I want tonight to personalize it a little bit.

My brother, John Barton, died of liver cancer 6 years ago. At the time that he passed away, he was taking an experimental NIH drug that, had it worked, would have saved his life. We were told by his doctors there was an 80 percent chance it would really, really help him, but there was a 20 percent chance it would exacerbate the disease. We took that risk. He signed the protocol, took the medication and, obviously, in his case it didn't work. He is no longer with us, but that NIH research program later did make a significant breakthrough that is helping liver cancer patients today.

My father passed away 10 years ago from complications of diabetes. The NIH has invested and is investing tremendous resources in trying to find a way to combat the scourge of diabetes.

I had an aunt who passed away from breast cancer 16 years ago. As we all know, that is one of the priority areas for NIH research.

I myself had a heart attack last December 15th, but I was able to be successfully treated because of NIH research that has created what we now call these coated stents. I have a number of these stents in my heart; and, because of prior NIH research, I am able to give this floor speech.

So when I talk about the need to reauthorize and reform the NIH, I am talking in an academic sense, but I am also talking very personal. It helps my

family. It helps every American's family sense.

The bill before us would authorize the NIH for 13 years. It would freeze the number of existing institutes, there are 27, at 27. It would set up an internal time line controlled by the scientists and the administrators at NIH to review their internal organizations. If they want to make some changes, they can. They have to report to the Congress what those changes are.

For the first time, it would set up a common reporting system so that we know all the research that is being done at NIH and give the public an opportunity to track that research. It would set up for the first time a common fund which, over time, we would put sufficient funds in so that you could have peer-reviewed grants across the NIH structure so that the scientists in one institute that were working on, let's say, lung cancer in the Cancer Institute might work with people in the Lung Institute might work with the people at the Institute of Applied Biology. So they would all come together, and they would share their research on a merit-based research grant project.

It sets up a formal reporting system with NIH and again requires that those reports be standardized in a format that the public can easily understand and easily have access to. It gives the director of NIH some discretionary funding in which he can apply towards specific projects that he thinks are high-priority areas.

The bill before us sets up and maintains the merit-based peer review program that is already in existence at NIH, but it creates a reporting system, an accounting system of transparency that allows the public to see what is going on, and through the creation of this common fund actually gives the ability on a merit-based, peer-reviewed process to put the research dollars where they will do the most good and have the biggest impact.

So I think this is a very, very important piece of legislation. I consider it the signal achievement of the Energy and Commerce Committee in this Congress. I hope that, if we pass it this evening, that we can get the other body to take it up very quickly and also pass it over there. It will really, really help the NIH maintain its status as one of the crown jewels of the Federal Government.

I do want to thank Ranking Member Dingell for his cooperation and his staff. John Ford of his staff has worked very, very hard working with the majority staff. Katherine Martin has worked on the majority side. And from the leadership side, Cheryl Jeager has worked very, very hard. We could not have done it at the Member level if it had not have been for the hard work at the staff level.

Again, I am very proud of this piece of legislation. I hope everybody in the body votes for it this evening.

Support for NIH Reauthorization

American Association for Cancer Research

American Cancer Society

American Heart Association

American Physical Therapy Association

American Society of Clinical Oncology

American Society for Microbiology

American Society for Therapeutic Radiology and Oncology

American Stroke Association

Association of American Medical Colleges (AAMC)

Association of American Universities (AAU)

American Urological Association

Autism One

Autism Society of America

Autism Speaks

California Healthcare Institute

Cancer Research and Prevention Foundation

Christopher Reeve Foundation

Coalition of Cancer Cooperatives Groups

C3: Colorectal Cancer Coalition

Community Oncology Alliance

I yield myself such time as I might consume.

Madam Speaker, I want to start off by saluting Chairman Barton. This is a great achievement for the chairman and for the country. Joe, you did everything for the right reasons; and you did it the right way with everyone.

This jurisdiction of NIH, which I very affectionately call the National Institutes of Hope, is really a crown jewel in the jurisdiction of the Energy and Commerce Committee. But it has been 13 years, I believe, since there has been a reauthorization; and it is extraordinary that a bill of such import has been brought to the floor and will receive the support, I think almost unanimously, of Members in the House of Representatives. And that is a tribute to you of how you have done this and how much you have cared about it.

There is the letters of endorsement from, it is really one of the greatest honor rolls of endorsers and stakeholders in the country, and the chairman made reference to them. So, to Chairman Barton, congratulations, job well done, something really important for the people of our country.

We are considering this bill. It is the National Institutes of Health Reform Act of 2006, H.R. 6164. It is a very important piece of legislation that will reauthorize our foremost medical research center and the Federal focal point for medical research in our Nation.

The goal of the NIH is to acquire new knowledge to help prevent, to detect, to diagnose and to treat diseases and disabilities from the rarest genetic disorder to the common cold. The American people look to the NIH. They trust the NIH. They want us to make investments in it, because it does represent hope for the future.

The NIH conducts research in its own laboratories. It supports research of non-Federal scientists in universities. And I am proud that Stanford Medical School, under the great leadership of Dr. Phil Pizzo, is one of the supporters of this legislation. It supports medical schools, hospitals, and research institutions throughout the country and abroad. I think many people don't realize that, that there is a portion of this that takes place abroad. And it helps in the training of research investigators, and it fosters communication of medical health and health sciences information.

This Act is going to help to ensure the continued success of the NIH. There are many, many commendable provisions of this bill. The establishment of the common fund should serve to stimulate trans-NIH research in areas of emerging scientific opportunities, rising public health challenges, or knowledge gaps that deserve special attention and are going to benefit from additional research that involves collaboration between two or more institutes or centers.

Another significant provision of the legislation is the creation of an infrastructure to evaluate and report on the NIH research portfolio. It is very, very important, very difficult to go through and to document the contributions of the NIH in key areas, and this is going to provide for that.

The bill contains many admirable goals and provisions that are going to help NIH in its long-term battle to overcome human disease and disability.

What the bill does not address, and some Members raised this at the committee, is the issue of funding. Some of us think there could be more funding, that there is insufficient funding. This really is the largest problem facing the NIH today. After years of significant funding increases for NIH, this Congress has effectively chosen to flat-fund the agency. After adjusting for inflation, this could turn out to actually be a funding cut.

In an effort to address this problem, Representative Markey offered an amendment during our full committee markup last week. His amendment sought to ensure that this Congress provided a real 5 percent increase in funding for NIH, not one that could be diminished by inflation. But the amendment did not pass. It was defeated along a party line vote.

A significant increase in the number of grant applications combined with a frozen level of congressional funding has really taken its toll on the NIH. That is why some of us thought that it was very important to act and to provide more resources to ensure that NIH's funding levels don't fall any lower.

Despite the fact that this bill offers no assurances of what I just described, it is still a good bill, it is a solid bill, it makes progress, and I will support its passage, and I urge my colleagues to do that.

I also want to acknowledge the work of the Energy and Commerce Committee staff. Again, John Ford, who is a hero of so many of ours on the Democratic staff, Katherine Martin of the Republican staff, as well as Cheryl Jeager of Mr. Blunt's staff, as well as my chief of staff, Jason Mahler. They all have had an important hand in this. We are all grateful to them.

Madam Speaker, I reserve the balance of our time.

At this time I would like to yield 3 minutes to my wonderful colleague from California, Representative Lois Capps, an extraordinary member of the committee and a great supporter of the NIH.

Madam Speaker, I yield 3 minutes to the gentleman from Illinois (Mr. Rush), our colleague on the Energy and Commerce Committee.

Madam Speaker, I am pleased to yield 4\1/2\ minutes to one of the most respected members of the Energy and Commerce Committee, the gentleman from Massachusetts (Mr. Markey).

Madam Speaker, I have no further requests for time, and I yield back the balance of my time.

Mr. Speaker, tonight's debate on the National Institutes of Health Reform Act of 2006 is extremely important to the well-being of our Nation. The National Institutes of Health (NIH) is the world's greatest medical research center with its 27 separate institutes and centers. The lives of millions of Americans are directly impacted by the work of NIH helping prevent, detect, diagnose, and treat disease and disability. Medical research conducted by NIH has a proven record and with our support NIH will provide medical miracles for tomorrow.

I am pleased that the University of California, San Francisco (UCSF), in my congressional district is a leader in providing biomedical research, educating health care professionals and providing patient care. Its medical research developed gene-splicing techniques that have revolutionized biology and opened the biotechnology industry to save lives. NIH provides essential funding for USCF's promising research to treat AIDS, cancer, and diabetes and leading the way in stem cell biology.

Mr. Speaker, this bill aims to restructure NIH and reauthorize the agency for the first time since 1993. Among its provisions are a 5 percent increase in the budget for fiscal years 2007-09, and the creation of a common fund that would finance research projects that involve multiple institutes or centers at NIH.

NIH is a beacon of hope for millions suffering from everything from the common cold to cancer, and we cannot fail in our commitment or turn our backs on those most in need of benefits of vital research.

One of the beneficiaries is my granddaughter, Charity. As many of you know, she has been diagnosed with Pulmonary Hypertension (PH), a chronic and progressive disease. Unlike systemic hypertension or ``high blood pressure'', PH is typically fatal. The blood vessel walls that make up the pulmonary artery and supply the lungs get thicker and often constrict. Reducing the capacity of the blood vessels makes them unable to carry sufficient blood to the lungs. This causes pressure to build up within the heart, which works harder to pump blood. Eventually, it cannot keep up, and there is less blood circulating through the lungs to pick up necessary oxygen. While PH is characterized as a disease of the lungs, patients ultimately die of heart failure.

This is why I joined with my dear friend, Congressman Kevin Brady of Texas, in introducing H.R. 3005, the Pulmonary Hypertension Research Act of 2005. This bipartisan legislation is cosponsored by almost 250 Members of Congress. Mr. Brady and I have worked very hard for the passage of this bill. Senators Mikulski and Cornyn have introduced a companion bill in the Senate. Its bipartisan, bicameral support highlights this body's concern for PH patients.

The Pulmonary Hypertension Research Act requires the Director of the National Heart, Lung, and Blood Institute to expand the activities of the Institute with respect to research on Pulmonary Hypertension. Furthermore, it calls for the creation of centers of excellence to conduct research on PH, including basic and clinical research into the cause, diagnosis, early detection, prevention, control, and treatment of the disease. The bill also establishes a data system for the collection of data derived from patient populations with Pulmonary Hypertension and an information clearinghouse to facilitate the understanding of PH by health professionals, patients, industry, and the public.

It is my hope, Chairman Barton, that there will be report language in the NIH reauthorization bill that directly addresses the looming specter of Pulmonary Hypertension. We need to deal with this disease during the I09th Congress and not put off our duty until next year.

NIH, impressively led by Dr. Elias Zerhouni, and the National Heart, Lung and Blood Institute, NHLBI, under the outstanding leadership of Dr. Elizabeth Nabel, are doing their utmost to tackle this issue that is so personal to me. They also are working on thousands of other diseases, which attack both large and small populations, to ensure the well being of our Nation's most vulnerable.

I particularly would like to thank Dr. Mark Gladwin at NHLBI for his tireless efforts and unbreakable optimism as Chief of the Vascular Medicine Branch. He has been an incredible example of the selfless efforts of so many thousands of investigators throughout the many branches of NIH whose sole purpose is to find a cure. They set their sights on the cure for HIV/AIDS, breast cancer, or Pulmonary Hypertension and they do not waiver from their cause.

Mr. Speaker, I urge my colleagues to join me in supporting NIH. NIH needs our support. We cannot hamper scientific progress. The lives of millions of Americans depend upon this critical Institute.

Madam Speaker, I thank the gentlewoman, and I thank her for her excellent work on this legislation. And I thank the Members of the majority for their work on this legislation as well.

But I come to the floor in order to identify the single most glaring deficiency in the legislation. This is a promise of a 5 percent increase in the NIH budget each year. But the reality is that this 5 percent is an imaginary 5 percent because this 5 percent does not account for the reality of health care inflation.

On an average year, health care inflation is 3 to 4 percent. In some years it is 5 to 10 percent, meaning that a 5 percent increase is actually in some years an actual reduction in the amount of money which can be used for health care research.

In fact, what we have seen over the last 3 years is that while the Republicans have flatlined the NIH budget, it has actually lost 11 percent of its purchasing power in new research that targets the diseases which affect American families. Research is medicine's field of dreams from which we harvest the findings that give hope to American families, the clues that can unlock the diseases which they fear will affect their family, and there is no family that doesn't have some disease that they believe runs through their family's history. It could be Alzheimer's, Parkinson's, heart disease, cancer, diabetes, you name it; but it goes right down to some diseases that have very small numbers of Americans that are affected, like cystic fibrosis, which might only have 30,000 Americans.

What happens in a situation like this is because of the huge tax cuts which the Republicans have pushed through Congress year after year, we are incapable here in Congress of then gaining their support in order to increase above inflation by 5 percent the NIH budget.

And so who do we quote on a subject like this? Who do we quote on the subject of inflation and the impact that it has on American families? Who has been the single most articulate American on the subject of inflation in our lifetime? That person is Ronald Reagan. This is what Ronald Reagan said about inflation. He said: ``Inflation is as violent as a mugger, as frightening as an armed robber, and as deadly as a hit man.''

Mr. Speaker, we don't want the NIH research budget to be robbed by inflation. That is what is happening. It has

happened since 2003. It is going to continue. Between 12 and 16 million American baby boomers are going to contract Alzheimer's. There is a belief that if we could make a breakthrough in Alzheimer's, we could delay its onset by 7 years, saving at least 50 to $60 billion because they won't need care during those years.

This is without question in my opinion the most important budget that comes through Congress because this is, more than terrorism, the one issue that puts the fear of God in the hearts of every family. It is that one of these diseases will come into one of their family members.

My belief is that there has been a series of choices made in the last 6 years to have these massive tax cuts that makes it impossible for us to give a cost-of-living increase on top of inflation. It is wrong, and I believe that this bill, as good as it is in so many places, is deficient in the one central area which is central.