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Mr Chairman, I have recently returned from the Soviet Union where I was an unofficial observer of the national referendum on independence in the Republic of Georgia, and where with
colleagues from my Foundation I helped with seminars in shared decision-making for members of the newly elected parliament of the Republic of Armenia. I carried out these tasks, and seized related opportunities to assist both Republics in strengthening their new systems of democratic governance, with greater knowledge and greater confidence, and to greater effect, because I was fortunate enough to be able to participate in programs of the U.S Institute of Peace. And I had digested relevant papers and reports prepared by scholars, fellows, and grantees of the Institute. So I can attest to the practical and immediate usage of a variety of products of the Institute's work. Thank goodness, in its plans for 1991 and 1992, the Institute will continue to devote a considerable amount of its resources to the prospects for peace and for ameliorating continuing conflicts in Eastern Europe and the Soviet Union. I feel certain, based on the high quality work that I personally benefitted from this year, that the projected enterprises will be equally valuable and relevant.
Mr. Chairman, my board of directors has asked me especially to commend to your attention the special Middle East program already described to you by Ambassador Lewis, which will be a major feature of the Institute's agenda in the present calendar year and the next fiscal year. National elation about the U.S. and U.N. military success in the Persian Gulf is giving way to new feelings of dismay about the chances for lasting peace in the Middle East. I perhaps should not say but will-- that we at the Foundation are not surprised that wartime success has not produced peaceful results. For we who work in this field know that peace building is infinitely more difficult that war making. But, while we are not all together surprised by the new tragic turn of events in Iraq, or the persistent and seemingly intractable dilemma of the Palestinians, and the continuing difficult relations between Israel and its Arab neighbors, we and our friends at the Institute are determined to show how it might be possible to move from the psychology of fear and mistrust to a sense of common problems and opportunities which could finally yield to jointly forged solutions.
Over the last two months, we have heard from a great many of our members on the subject of Middle East peace. Almost to a person, they have urged us to urge Congress and the President to keep peace building in the Middle East at the top of the foreign policy agenda. And so our members, and my board, are very
impressed with what the U.S. Institute of Peace proposes to do in this difficult but critically important area in 1991 and 1992.
We devoutly hope you will approve this full appropriation request for this proposed program, and for the other programs with activities of the Institute. The Institute's role is more important than ever, its capacity is stronger than ever. With your approval of their request for $11,918,000 for Fiscal Year 1992, the Institute will be able to do more and better work for the good of our nation and the world.
THE NATIONAL PEACE INSTITUTE FOUNDATION
All people share a vision of a peaceful, just and secure world. The National Peace Institute Foundation links this vision with the growing knowledge and practice of the peaceful resolution of conflict.
We take pride in the fact that our National Peace Academy Campaign mobilized 45,000 citizens to secure the establishment of the United States Institute of Peace. Campaign affirmed our belief in the power of concerned citizens working together to make a difference. We have a special commitment to the further growth of the Institute.
The Foundation's wider purpose is to promote peacebuilding and peacemaking throughout our own country and in the world. We seek to empower citizens and governments with the perspectives and skills required to avoid violent conflict and to convert potentially destructive tensions into positive energies for progress. Our objective is to integrate conflict resolution into the mainstream of national and international life.
Through the network of our Regional Councils, we work cooperatively with local groups to promote the United States Institute of Peace and to sponsor events on peacemaking and conflict resolution. Our newsletter, the Peace Reporter, serves as a national forum for peace educators and institutions. As a non-governmental member of the United nations and in other ways, we participate in a global community of peacemakers.
An active, involved membership is key to the Foundation's past and future achievements. We welcome as members both individuals and institutions who share this vision for our common future.
Senator HARKIN. Thank you very much, Dr. Strickland. And this subcommittee has been a strong supporter of the Peace_Institute and the work that it has been doing, and especially the fine work, as you said, that the Ambassador has done.
Dr. STRICKLAND. Yes, sir.
Senator HARKIN. The request this year is much too low, and we will see what we can do about some substantial support for the Peace Institute next year.
Dr. STRICKLAND. That is a welcome word, sir. Thank you very much.
Senator HARKIN. Thank you very much, Dr. Strickland.
STATEMENT OF DR. JAMES N. CLARK, TRUSTEE, AMERICAN DENTAL ASSOCIATION
Senator HARKIN. I am going to go out of order. I understand someone has a bit of a medical problem here, and I wanted to bring Dr. Jim Clark of the American Dental Association forward at this time. We will proceed a bit out of order here.
Dr. CLARK. Mr. Chairman and members of the subcommittee, I am Dr. James Clark, a trustee of the American Dental Association and a private practitioner in Dubuque, IA. On behalf of the 150,000 association members, thank you for this opportunity to testify in support of Federal funding for dental research, education, and disease prevention.
While research into the treatment and prevention of tooth decay and gum disease continues, the successes at the National Institute of Dental Research over the past four decades, now allows NIDR to expand its focus. It has embarked on two major initiatives: research addressing the oral health needs and treatment of special care patients such as victims of lupus, cystic fibrosis, birth defects, and oral cancers; the research and action program for improving oral health of adults and older Americans, whose goal include eliminating toothlessness in future generations.
To continue NIDR's traditional disease research, and to advance these two initiatives, the association recommends that $126,500,000 be appropriated for research grants. To accelerate the transfer of new technology to dental practice, seven additional research centers are needed. To fund their establishment and the 23 centers currently studying such areas as Carries periodontal disease, and aging research, an appropriation of $30 million is requested.
The association strongly supports additional research into the safety and ethicacy of water fluoridation as recommended by a special public health committee and by NIDR. For this purpose, an appropriation of $5 million is requested.
The recent controversy over the possible harmful effects of dental amalgam fillings heightens the need for the acceleration of NIDR's research on this subject. Such research would concentrate on neurological effects of amalgams, the effects on kidney function and metabolism of elemental mercury, as well as the safety and ethicacy of new alternative materials. The association recommends
that $6 million in additional contract funds be appropriated for this end.
The needs of special care patients, including those affected with AIDS and the elderly will be met only if enough dentists develop the necessary clinical and management skills to treat them in the coming decades. General practice residencies, geriatric training, and the geriatric education center programs are critical to the training of faculty and the development of curriculum that will prepare dentists to meet the needs of these patients. The association recommends that general dentist residencies be funded at $8 million for fiscal year 1992, and the geriatric training and education programs be funded at $26 million.
Disease prevention activity at the Centers for Disease Control focuses on the control and the prevention of oral diseases. As you know, DDPA has become the national leader in water fluoridation, the most effective means for preventing tooth decay. However, its most recent efforts have also addressed infectious control in dentistry. DDPA is responsible for investigating the transmission of infectious diseases such as AIDS and hepatitis B in dental settings.
Following such investigations, DDPA works with State and local governments and private organizations in implementing and evaluating dental infection control programs. For fiscal year 1992 it is requested that the DDPA be funded at $2.3 million. This funding level will also allow DDPA to work with the National Institute of Dental Research on the adult oral health initiatives noted earlier.
This completes my statement. Thank you, Mr. Chairman. [The statement follows:]
STATEMENT OF DR. JAMES N. CLARK
Mr. Chairman and Members of the Subcommittee:
I am Dr. James N. Clark, a trustee of the American Dental Association and a private practitioner in Dubuque, Iowa. behalf of the 150,000 Association members, thank you for this opportunity to testify in support of federal funding for dental research, education and disease prevention.
Dental Research: The improved oral health status of today's citizens is principally a factor of dental research. advanced technology and expanded knowledge of disease, which have made American dentistry the world standard, derive from research
research traditionally funded by the federal government through the National Institute of Dental Research.
NIDR's most significant achievements over the past four decades in instrumentation, restorative materials development and preventative measures have been in research directed largely to the treatment and ultimate elimination of caries and periodontal diseases. Control of the incidence of caries, especially in young people, and reduction of the severity of periodontal diseases once the primary cause of tooth loss in adults realizes an estimated savings in treatment costs of $5 billion annually.
These successes do not obviate the need for continued research in caries and periodontal diseases, but they have allowed an expansion of the research focus of NIDR. As described to the Committee last year, NIDR has embarked on two new major initiatives:
Research addressing the needs of special care patients, the victims of systemic diseases, and systemic treatments, that adversely affect their oral health, and
The Research and Action Program for Improving Oral Health of Adults and Older Americans.
Prominent in these initiatives is increased exploration of oral cancers, acute and chronic pain, and disorders affecting taste, smell and swallowing, as well as continued AIDS research. With respect to the latter effort, NIDR seeks identification of a factor in saliva that appears to inhibit the AIDS virus from infecting cells.
To continue NIDR's traditional disease research and to advance these two new initiatives, the Association recommends that $126,500,000 be appropriated for research grants.
To accelerate the transfer of new technology to dental practice, seven additional research centers are needed. To fund their establishment and the 23 centers currently operational, an appropriation of $30 million is requested.
The Association strongly supports the additional research into the safety and efficacy of water fluoridation recommended in the NIDR Long-Range Research Plan, and in the report of the special subcommittee of the Committee to Coordinate Environmental Health and Related Programs. For this purpose, an appropriation of $5 million is requested.
The recent controversy over the possible harmful effects of dental amalgam on health heightens the need for acceleration of NIDR's research into the neurological effects and the effects on kidney function and metabolism of elemental mercury, as well as