I want to welcome everyone to our hearing. I'm going to give an abbreviated statement and I will be adding more into the record. I want to thank Dr. Bhattacharya and all of his colleagues for joining us this morning. This is really an important opportunity after to look at the NIH budget from last year to see how we can understand priorities for 2027. I think all of us care a lot about biomedical research. It's long been a bicameral and bipartisan priority and I'm proud of the work that we did last year where we secured an additional $415 million for NIH funding. Areas of concern for me and those at the dais know this are things where ground zero for the opioid epidemic in West Virginia communities. We still have some of the highest rates of overdose deaths but we're making positive strides as we are across the country. Some of the CDC data shows a decrease and I want to thank Dr. Volkow for coming to West Virginia and coming back maybe to West Virginia for visiting. We just had Dr. Hotez there as well and we're really pleased because of what's going on at the Rockefeller Neuroscience Institute. I think he was pretty wowed to see what WVU is doing in the innovative and groundbreaking work that we're doing there. As a child of two parents who had Alzheimer's, I don't want to just find ways to keep people in a steady state. I want to find ways to cure and I think that's what the NIH is all about. So one other area of interest for me is the Childhood Cancer STAR Act. I did that with Senator Reed. So Dr. Letai, thank you for coming to my office and looking forward to hearing about how you're going to grow our clinical trials in that area. So with that I'm going to go ahead and turn to Senator Baldwin for her opening statement.
Thank you, Chair Capito, and I want to welcome Dr. Bhattacharya and the institute and center directors here today. I also want to note that the director of the National Institute of Allergy and Infectious Diseases was slated to testify, but stepped down from his position. Other top officials at NIAID have also reportedly been reassigned and forced out of their positions in the midst of an emerging Ebola outbreak. We have a leadership vacuum at the world's premier infectious disease institute and across our health agencies. This is of great concern, and that of course is in addition to the unprecedented termination and forcing out of thousands of career scientists across the NIH as part of this administration's anti-science and frankly anti-vaccine bent. Over the past 16 months, the Trump administration has waged war on science. And I'm not talking about isolated policy disputes or partisan disagreements. I'm talking about systemic systematic dismantling of long-standing research programs and the deliberate erosion of research institutions that make America the global leader in biomedical innovation. Across the country, researchers, universities, cancer centers, children's hospitals, and patients are experiencing disruptions because this administration has thrown NIH into chaos. They have terminated over 5,000 NIH grants, slashed nearly a quarter of the NIH workforce, and cut the number of new research grants by more than 2,000 or 22%. That cut was largely due to a policy that the OMB director cooked up that requires NIH to expand multi-year funding, forcing the entire cost of a multi-year grant to be paid in advance. This wasn't based on science or boosting the discovery of new treatments and cures. This was a political decision. And as a result, NIH spent 2.5 billion dollars more on multi-year funded grants in fiscal year 2025 than it did the year before, an unprecedented amount. And what that means is that 2.5 billion dollars was locked away in bank accounts for future years' expenditures that can't be spent on research now or today. That's 2.5 billion dollars that could have funded over 2,000 more research grants. Each one a shot we didn't take at discovering the next medical breakthrough. There is simply no reason to do this. All it does is dramatically reduce the number of NIH grants funded. Take cancer research. Last year the National Cancer Institute funded 334 or 21% fewer new research grants. That's 334 fewer opportunities to discover new cancer treatments and cures. An untold number of patients and families that won't benefit from this research. And this was the case across the NIH. The National Institutes on Aging, the primary funder of Alzheimer's disease research, funded 438 or 33% fewer grants last year. That's not creating stability for researchers. It's kicking the chair out from under them. I pushed hard to limit multi-year funding in our fiscal year 2026 bill. And although we included a provision that prevented the administration from doing even worse damage, I was disappointed that we weren't able to do more to stop it. This chaos has ramifications across the country. Hiring freezes are hollowing out research labs and forcing institutions to rescind job offers to young scientists. Clinical trials are being canceled or postponed. For decades, NIH funding decisions were guided by scientific expertise and independent peer review, as they should be. Now, political appointees and ideological screening decide which grants get funded. Researchers are spending more time trying to decipher shifting political priorities than finding treatments and cures. Groundbreaking research is being stifled. Notices of funding opportunities that NIH uses to solicit research on specific topics are down by 90%. These specialized funding calls are necessary for type 1 diabetes research, expanded access for ALS, and cancer and HIV research. Even after this committee provided 415 million dollars in increased funds for NIH in this fiscal year, the White House delayed getting that money out the door and left NIH unable to fund research for 40 days. I can't comprehend why this administration is so hell-bent on sabotaging the life-saving research NIH supports, but they are doing so at every turn. What concerns me most is that this damage will take years, if not decades to undo, because the cost is so much higher than lab closures, canceled clinical trials, or young investigators leaving science. The cost will be fewer treatments and cures, lost loved ones, and an entire generation of scientists gone. Congress should do more to stop this administration from what they're doing to our biomedical research enterprise. I've certainly been pushing to do that, but Congress also needs to get serious again about running a budget and appropriations process that truly allows us to prioritize biomedical research. From meaningful increases for NIH, NIH awarded more grants each of those years. But that progress has stalled. Republicans' insistence on squeezing and cutting non-defense funding has meant NIH funding hasn't kept up with rising research costs. This, combined with misguided administration policies like multi-year funding, will mean that NIH will award fewer research grants this year than any year since 2017. Meanwhile, the president is asking for $1.5 trillion, an increase of $450 billion, or 42% for defense spending. If we can find additional funding for bombs, we should be able to find additional funding for cancer research. We need meaningful increases in non-defense funding to be able to do that, and that's what I will be pushing for during the fiscal year 2027 appropriations process so that scientists can discover the next breakthrough and families can have hope for new treatments and cures.
Thank you. Welcome, Dr. Bhattacharya. We will welcome you for your 5-minute opening statements before we go to questions. Thank you.
Chairwoman Capito, Ranking Member Baldwin, and distinguished members of the subcommittee, it's an honor to appear before you again to discuss the work that's being done at the National Institutes of Health. NIH's mission is to turn scientific discovery into better health outcomes and longer life for the American people. It's central to the Make America Healthy Again initiative. The NIH plays a leading role in confronting the chronic disease crisis, advancing rigorous nutrition science, prioritizing prevention, and so much more. Chronic disease remains the leading cause of death and disability in the United States, driving most health care costs, and affecting millions of Americans. NIH is intensifying investment in research that identifies the root cause of these conditions, enables earlier, more effective interventions, including studies that integrate genetics, behavior, environment, and diet. Diet is a major driver of chronic disease risk, yet critical gaps remain in understanding how specific foods affect health. Ultra-processed foods now account for about 60% of daily caloric intake with growing links with obesity and metabolic conditions. To address this, NIH is supporting multidisciplinary research, advancing targeted interventions to address chronic disease at its source so we can make America healthy again. The NIH continues to deliver measurable progress by building on decades of foundational science. Our sustained investment in basic research is resulting in transformative clinical advances across multiple areas of medicine. In 2019, President Trump announced the Ending the HIV Epidemic Initiative, predicting that we could essentially eliminate HIV in the United States by 2030. Decades of NIH investments in basic science laid the groundwork for drugs like lenacapavir, a long-acting antiretroviral agent. A single injection lasting 6 to 12 months offers near total protection against HIV acquisition. Together with other antiretrovirals also supported by NIH research, this provides a credible pathway for ending HIV transmission in the United States in coming years. Gene-based therapies have never shown more promise than they do now. CRISPR-based gene editing has led to not just one, but two treatments that can cure sickle cell anemia, a disease long thought untreatable. NIH-funded researchers built on this same platform to deliver personalized therapy to an infant with a rare and previously fatal condition, baby KJ. Enabled by the NIH Common Fund, this treatment edited his genes directly in the liver to correct a lethal mutation so that baby KJ will live a long and healthy life. NIH is harnessing advances in artificial intelligence and data science. For example, NIH-supported researchers recently developed AI tools to match patients to clinical trials more efficiently, reducing the barriers to participation and accelerating access to potentially life-saving therapies. NIH is advancing partnerships to expand the frontiers of biomedical science. We're proud to work with NASA on the Artemis 2 mission through the Avatar project, which uses cells from astronauts to create organ-on-a-chip biosystems. I think my colleagues have brought an example for you to show around how to model how deep space radiation and microgravity affect human biology. You may be asking how this helps the average American. Well, microgravity reveals aging-related changes in cardiovascular, immune, and musculoskeletal systems, and this work informs treatment for chronic diseases here on Earth. While innovation is critical, affordability remains essential. Drug repurposing is a powerful lever to reduce the cost and accelerate access to this new technology. Testing FDA-approved drugs for new indications can happen faster and with less risk than for new drugs. Research suggests a shingles vaccine called Zostavax may reduce dementia risk, and my colleagues at the National Institute of Aging are organizing a round table on this. Terazosin, long used for benign prostatic hyperplasia, shows potential on Parkinson's disease. While more research is needed, this approach allows us to deliver interventions more cost-effectively while maintaining scientific rigor. We're improving how science is conducted and funded. NIH is advancing a coordinated agency-wide effort to improve rigor, replication, and reproducibility, including the Common Fund Replication Initiative and new investments of approximately $100 million to validate key findings. I'm grateful to Congress for making that possible. These efforts ensure the NIH-supported science is reliable, generalizable, and ready to inform clinical care. The NIH fosters innovation by supporting a balanced research portfolio. Through a unified funding strategy, the NIH is strengthening its ability to curate portfolios that span the full spectrum of scientific approaches and align with national priorities. We're working to broaden the geographic scope of funding, strengthening research capacity in institutions across the country, while expanding the use of human-based research models to improve translatability, responsibly reducing animal use when appropriate. Let me just finish with a bit. The strength of American biomedical research relies on its rigor, transparency, and its early-stage investigators. Its ability to deliver durable results, our role as careful stewards of resources entrusted to us ensures that every taxpayer dollar produces reliable knowledge, produces measurable health gains, and has a lasting public benefit. We remain committed to scientific excellence and to improving the health of all Americans. Thank you, and I look forward to your questions.
Thank you very much. I will now turn to the chair of the full committee, Senator Collins, for several minutes for her statement or questions or whatever she wants.
Just remember I'm the one who said it.
Thank you so much, Madam Chair. First of all, let me welcome all of you this morning. I have worked so closely with many of the members of this panel and admire your dedication to improving the health of the American people. There are however some budget issues that I find to be inexplicable in some ways and I do want to discuss some of those with you today. In fiscal year 2025 the NIH awarded more than 120 million dollars in grants and contracts to entities in my home state of Maine. This funding directly supported 1,378 jobs and more than 280 million dollars in economic activity. I mentioned that because there is an economic impact to the research that we're doing as well as an impact on the health and well-being of Americans. This funding has also led to very exciting developments such as a clinical trial for a new Lyme disease vaccine and another clinical trial investigating how GLP-1 drugs could be used to treat long COVID. Really exciting developments. Breakthroughs like these can only be sustained if research institutions are able to cover this cost. Yet, the administration's budget request once again proposes a 15% arbitrary across-the-board cap for indirect research costs after Congress specifically blocked a similar proposal last year. Such a cap would negatively affect cutting-edge research happening at universities, nonprofit laboratories, medical centers around the country, and undermine the foundation of our nation's global leadership in biomedical research and technological innovation. Doctor, we discussed the FA model and other alternatives last year to have more accountability, increase transparency on indirect costs that are funded with taxpayer dollars. I would like to ask you whether you have a specific proposal for improving the current indirect cost system without adopting this one-size-fits-all, arbitrary, very harmful cap across the board.
Senator, we absolutely remain committed to making sure that the research institutions of this country receive the support that they need to have the success that you described. I'm really grateful that you started with the examples of potential vaccine for Lyme disease, GLP-1s for so many different uses, and so much more. I'm sure you could have gone on for a very long time. The key thing that I'd love to have happen and we — I'm going to convene a committee of my advisory committee of directors so that we can discuss this openly — is a proposal to delink, to allow competition, free and open competition for these facilities money the NIH has for institutions. The key idea is that right now in order for Maine and other places to win the facilities support you have to have excellent scientists that win the grants and linked to that is the facilities money. But in order to have people win the grants in the first place you have to attract the great scientists to your facility. You have to have great facilities. This Catch-22 guarantees that our investments in institutions will be concentrated. 20 institutions get about a third of our facilities support. We need to fix that and I'd love to work with you all, and I know we had such great conversations about this, to delink this connection and then allow there to be more open competition for the facilities money by places like Maine, like Kansas, like I visited so many of these great institutions across the country where there are so many great scientists. We need to make it easier to build up facilities. NIH is like seed money for these places. Once we invest, you get other foundations investing as well and I want to work with you to launch essentially a renaissance in biomedical research across the country where we won't just have a couple of super biomedical hubs but everywhere across the country where there are amazing scientific ideas, people should be able to get support for it.
Thank you, Dr. Rodgers. It's great to see you again. Although I don't think this hearing will be quite as moving and inspiring as the Children's Congress hearing at which you testified last summer. Seeing all those delegates with type 1 diabetes from across the country including little 6-year-old Carolina from the state of Maine who traveled to share her story was truly moving. Recent type 1 diabetes research funded by NIH has led to some exciting developments. And clinical trial data resulting from NIH funding — the clinical islet transplantation consortium has contributed to FDA's approval of the first-ever stem cell treatment for type 1 diabetes. And I realize the clinical trials have been small so far, but it is so exciting that after receiving this treatment 10 out of 12 patients in clinical trials no longer needed insulin. That is extraordinary. Therefore for the life of me I cannot understand why the budget would propose a $167 million cut for your institute, the National Institute of Diabetes and Digestive and Kidney Diseases. By contrast, we have increased funding for the special diabetes program. But this is the last point at which we should be cutting funding for biomedical research period, but your institute, given that we're finally seeing real progress. Could you please comment on this?
Sure, Senator Collins. First of all, thank you for your ongoing support for the special diabetes program and yours and your colleagues'. This has really led to some major breakthroughs in the way that people in this country with type 1 diabetes have enjoyed long and — the quality of life has changed dramatically. You mentioned the first ever FDA approved stem cell treatment transplantation, but also the first drug under your watch, Teplizumab, which can delay the onset of type 1 diabetes by at least 3 or more years. And also it was SDP support that's responsible for five of the six commercially available artificial pancreas technologies. And these are now being applied in many other areas. A reduction in funding will have consequences, of course. We'd have to either delay or postpone many of our efforts, including our TrialNet effort, which was actually the vehicle which led to this approval ultimately of the first drug to delay the onset. And we're right on the cusp of understanding what the environmental determinants of diabetes in youth are, the so-called TEDDY study. We're right at that point where we're in an intense data analysis phase. This could certainly delay that to some extent. Nonetheless, we're very thankful for what we get and we'll make the appropriate adjustments as necessary to ensure that all of our funding goes out as required by the law. Thank you.
Thank you. Thank you, Madam Chair. I know I've gone over my time. I will submit for the record questions on Alzheimer's disease, which is also one of our top priorities, and women's health care grants.
Thank you. Thank you. Senator Baldwin.
Thank you. The current Ebola outbreak highlights the potential use of mRNA technology to respond rapidly to viral threats, especially ones we don't have vaccines or treatments for, like the Ebola strain that is emerging in Central Africa. But last year, Health and Human Services terminated $500 million in contracts for cutting-edge mRNA vaccine development and then redirected that funding to 80-year-old vaccine technology. Experts have expressed serious concerns that this technology is outdated and inferior and that the way the funding was awarded circumvented the scientific review process. Dr. Bhattacharya, that awarded that funding.
Senator, so first I should say that the Bunia virus, that Ebola virus that's now in the DRC, we don't have a vaccine for it. But we do have an NIH —
So, I'm raising an issue that there was $500 million in contracts for mRNA research vaccine development that was cut off and then redirected. And so I was wondering — what I asked was, will you commit to providing this committee with the contracts that awarded that funding?
So first, those are BARDA contracts, not NIH contracts. So you can ask HHS specifically. As far as NIH contracts, absolutely. We're an open book for that.
Was there an open, fair, transparent call for proposals for this funding?
For the funding for the universal flu vaccine, you mean?
For the funding that was taken from the mRNA contracts and redirected.
So, the universal flu vaccine that the NIH is investing in for research purposes followed our normal processes for identifying intramural research opportunities. So, the answer is yes.
Was there a peer review of that process?
The standard process that we use for all our intramural researchers. This is a very promising vaccine platform. So the idea that we can get a single vaccine —
It essentially bypassed the standard peer review competitive process.
No, that's not accurate, Senator.
$100 million internally to two NIH researchers, one of whom is your deputy director.
Senator, that's just not accurate. It followed the normal process for determining how — intramural NIH has a tremendous number of amazing scientists, some of whom you see here at the table with me. There's a normal process for deciding which projects get funded.
$500 million in contracts were terminated, 100 million redirected to 80-year-old technology without competition. And the researcher, one of them is best known for being a COVID vaccine skeptic, had his lab's annual operating budget increased by more than 50 times. Did Secretary Kennedy or his special assistant direct NIH to award this funding to these two investigators?
Senator, the project you're talking about is a tremendously promising project that could end HIV and save — NIH followed normal processes for deciding whether to invest in this universal flu vaccine platform. If the project works out and the early results look very promising, we could have a single injection so you don't have to get annual flu shots.
I'm very concerned about the process, a lack of competition, lack of peer review. This funding was appropriated in the American Rescue Plan. Congress agreed in our fiscal year 2026 Labor HHS Appropriations bill to rescind that funding. That bill was made public on January 20th. NIH obligated this funding on January 31st, well after the bill was public but 3 days before it was enacted into law and would have been rescinded.
January, did anyone at NIH discuss needing to award this funding before Congress rescinded it?
Senator, we followed the law on allocating the funding and we've allocated it to a very promising project that promises to end the need for annual flu vaccines with a single injection that can protect people from the flu forever.
My understanding is that those discussions did happen and to be clear, the Trump administration rushed out American Rescue Plan funding before Congress could rescind it as we tried to do in our bill. Secretary Kennedy has his own narrative about the effectiveness or lack thereof of mRNA vaccine technology and hiding studies to show their effectiveness is something that I'm deeply disturbed about. And meanwhile, NIH is bypassing its actual gold standard scientific review process to unilaterally award more than $100 million to two NIH researchers, one of whom is best known for being a COVID vaccine skeptic and the other who reportedly just stepped down as NIAID director without any public explanation.
Forgive me, those researchers you're talking about are among the most important flu vaccine researchers in the world. They've had a tremendous track record of success in infectious diseases for flu and particularly flu vaccination research. They're NIH-funded researchers, NIH researchers that have been here for decades. They're among the world's leaders in flu vaccine research.
I expect to see those contracts. Thank you.
Well, I was going to start my question with Dr. Lotte, but I have to respond a little bit. Senator Baldwin and I get along really well, but the insinuation — we're sitting in front of six incredible scientists for our country that are trying to solve some of the most devastating problems — that it's being done on the lam or done illegally or done suspiciously is very offensive to me. And so I just wanted to say that before I ask Dr. [Bhattacharya]. He knows what I'm going to ask him, I think. I am from a rural state, as we know, and I'm very interested in the NCI Cancer Center designations. I've seen several projects where it talks about the concentration of cancers in rural areas such as mine, such as many of our states here. And some of the states that bear the highest cancer incidence and mortality rates remain largely without access to NCI designated care where it's proven the care is better, more successful, and has better rates of cure. So, you know, we have the IDEA program which has great success. And to help get some of that biomedical research out to our rural areas, what I would like to see is this NCI Cancer designation branch sort of an alternative designation pathway or something so that the structural barriers that are preventing our eligible institutes in states such as mine from getting — and I know mine's working towards this, and I know you're working with them, and I appreciate that — will you continue to keep looking at this comprehensive review of cancer center support? And maybe you could give us just like a 30-second: how much more successful the rates are around cancer center designations for the patients that are being served in those immediate or regional areas?
Thank you, Senator. First, I'd like to say that I think the undercurrent of your question — that we can reach all Americans with this — and the NCI wholeheartedly agree with you on that. With respect to West Virginia, we are working closely with Dr. Hazard Jenkins to make sure that when an application is submitted, it will be a successful application. As you may know, NCI designated cancer centers are specifically designated because of their devotion to research as well as clinical and basic research, if they are a comprehensive cancer center. And I think that's a very laudable goal and I agree with you that our cancer centers, not only in providing clinical care but also advancing the standard of care, our NCI designated cancer centers have been essential to that function. And we look forward to cancer centers from rural states joining that group. I also want to make the point though that NCI designated cancer centers aren't the only way that we bring top quality care to the more rural areas of America. We also have NCORP sites as well as NCTN sites throughout the country where people can enroll in NCI-supported cancer clinical trials. And that's a way of getting cutting-edge clinical research to people whether they're in rural environments or urban environments. And we look forward to continuing that. Thank you.
Thank you very much. Dr. Volkow, you know, in your visit to West Virginia and your many years of working in your area of expertise, we still got a big problem. So, we're having breakthroughs also in your area. Some exciting opioid research results from a NIDA intramural research team — and I'm not even going to try to say his last name, so I'm just going to say Dr. Mike and his team — identified a novel highly potent opioid that shows potential therapy for pain and opioid use disorder. Could you describe that research, please?
