House Committee Members Actually Agree on NIH Budget Increase

Lawmakers experienced a “kumbaya” moment as they discussed the NIH funding request for fiscal year 2022, during a House subcommittee hearing on Tuesday.

Over the last 14 months, Congress saw fit to steer $4.8 billion in funding to NIH COVID-19-related research, pointed out Rep. Rosa DeLauro (D-Conn.), chair of the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies.

That investment, coupled with certain private sector partnerships, led to the development of three FDA authorized COVID-19 vaccines in “record time,” of which nearly 300 million doses have been administered nationally, she added.

“In my view, this is a remarkable achievement made possible not only by targeted investment in COVID research, but also by the annual … sustained investments in biomedical research made by this committee in recent years,” DeLauro said in her opening statement.

“Amen,” said Ranking Member Tom Cole (R-Okla.). “There’s simply nothing in your opening statement that I don’t agree with wholeheartedly.”

President Biden’s proposed budget for fiscal year 2022 seeks to boost funding for the NIH by about $9 billion, with $2.5 billion for “core activities,” including research grants, clinical trials, and infrastructure support. Some of the funding would be directed toward research to address maternal health and mental health disparities that disproportionately affect minority communities. It also would double funding for gun violence research, said DeLauro.

The budget proposal also includes $6.5 billion for the development of the new Advanced Research Projects Agency-Health (ARPA-H), which is intended to speed the development of new therapies and cures, DeLauro explained.

Committee members on both sides of the aisle seemed to agree that the budget request would be money well spent. DeLauro stressed the importance of continuing to invest in “all areas of research,” rather than steering new funding toward a handful of “high-profile diseases.”

Cole offered support for “the president’s top-line budget number for the NIH … and I throw in the CDC and the Strategic [National] Stockpile as well.”

Over the last 6 years, Congress has boosted NIH funding by $12.9 billion, including a $1.25 billion increase over the fiscal year 2020.

Moving Research ‘Nimbly and Aggressively’ Forward

DeLauro asked NIH Director Francis Collins, MD, PhD, to explain the goal of ARPA-H, which the Biden administration has characterized as a version of the military’s Defense Advanced Research Projects Agency (DARPA).

Collins said the proposed initiative would “speed innovative, transformational ideas.” Examples included the development of a blood test to detect cancer growth, a micro-needle patch that could deliver vaccines to people in hard-to-reach communities, and an “innovation funnel” that would help scale new technologies to dramatically change blood pressure management.

DeLauro asked how ARPA-H differed from the National Center for Advancing Translational Sciences (NCATS), and Collins explained that the former has the potential “to move biomedical research even more nimbly and aggressively forward to make the kinds of discoveries that the public is waiting for.”

Collins stated that the lessons and momentum of the “COVID experience” ought to be applied to other areas of research, stating that ARPA-H could mirror the “bold, risk-taking” approach of DARPA — responsible for the internet and self-driving cars — and apply it to a “subset of biomedical research.”

For instance, researchers could build on the most recent data on mRNA platforms to hasten the development of a cancer vaccine, he said, or identify “the zip codes” of all human cell types to improve the delivery of drugs or gene therapies.

“This basically takes the NCATS model and puts it on steroids at a much more rapid pace,” he said.

Fostering Diversity

Rep. Barbara Lee (D-Calif.) expressed concern about Black men and women’s underrepresentation in science, medicine, and engineering, citing a recent report from the National Academies of Sciences, Engineering, and Medicine. She asked what the NIH was doing to address the issue.

Collins stressed that the NIH recognizes the issue of structural racism, and said the agency is taking a “fresh, aggressive look at what we can do” to address it. He highlighted the UNITE Initiative, described on the NIH website as “established to identify and address structural racism within the NIH-supported and the greater scientific community.”

“When you look at the diversity of our workforce, it does not look like our country,” Collins said. He acknowledged that there has been some progress in terms of the diversity of grant recipients, but “we’re still well short of where we need to be.”

He also emphasized that retaining minority professionals is key. “It’s one thing to recruit Black [people] into biomedical research, it’s another if they find an environment that is not welcoming and then they don’t stay. We have to work on that part as well,” he said.

The Wuhan Lab-Leak Debate

Despite the overwhelming praise and support for the NIH expressed by most committee members, a few Republicans raised concern over funding previously appropriated for the agency.

Rep. Andy Harris, MD (R-Md.) called for closer oversight of NIH funding and raised the issue of the “Wuhan lab-leak debate.” Citing a recent Wall Street Journal article, he asked for some “clarifications” regarding oversight of money that was given to Chinese researchers.

The U.S. did not directly fund the Wuhan Institute of Virology, but the government sent roughly $3.7 million in grants to EcoHealth Alliance, which sent $600,000 of those funds to the institute, Harris suggested. “Is that true?”

Collins confirmed that it was.

When Harris asked whether the Wuhan institute conducts gain-of-function research — research that attempts to make a virus more transmissible or virulent — Collins said the NIH did not approve any such research at the institute. The agency is “not aware of other sources of funds or other activities they might have undertaken outside of what our approved grant allowed,” said Collins.

“We had a modest collaboration with very respectable Chinese scientists who are world experts on coronavirus,” said NIAID Director Anthony Fauci, MD, the chief medical adviser to President Biden, reminding the committee that in 2002-2003 there was a “big scare” with the original SARS.

SARS-CoV-1 “unquestionably” was transmitted from a bat to an “intermediate host,” and then set off an epidemic and a pandemic that killed nearly 800 people, he said.

“It would have been almost a dereliction of our duty if we didn’t study this,” said Fauci, and to do so meant going “where the action is.”

Fauci explained that the research — carried out through the $600,000 “subgrant” over a roughly 5-year period, drawn from the EcoHealth Alliance grant — was intended to conduct surveillance of the “animal-human interface” and “to determine if these bat viruses were even capable of transmitting infection to humans.”

On the assertion that the NIH potentially funded gain-of-function research, Fauci said there was nothing in the grant or application for that type of research.

“That categorically was not done,” he said.