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DEPARTMENTS OF LABOR, HEALTH AND

HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS FOR FISCAL YEAR 1992

TUESDAY, APRIL 23, 1991

U.S. SENATE,
SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS,

Washington, DC The subcommittee met at 9:30 a.m., in room SD-192, Dirksen Senate Office Building, Hon. Tom Harkin (chairman) presiding.

Present: Senators Harkin, Burdick, Specter, and Gorton.
Also present: Senator Thurmond.

NONDEPARTMENTAL WITNESSES

OPENING REMARKS OF SENATOR HARKIN

Senator HARKIN. The subcommittee will come to order today. The subcommittee will continue with its fourth day of testimony from approximately 150 congressional and public witnesses. We have scheduled six special sessions to hear this testimony. This year we had requests from 307 individuals and organizations to testify before the subcommittee.

Unfortunately, because of the limitations of time we were only able to schedule the first 150 organizations who contacted us. I regret that we cannot hear everyone, but we have made it known to those who did not make the cutoff that we would be pleased to publish their statements in the hearing record.

In order to keep on schedule we are going to use this red light/ green light system and give each witness 3 minutes to summarize the key points of their statement. All of your statements will be made a part of the record in their entirety. I would appreciate your keeping it within that 3-minute time limit. This will give us some time to ask a few questions and to be sure that everyone gets a fair and equal chance to address the subcommittee.

Today we will hear testimony on a wide range of subjects, including education, biomedical research, Alzheimer's disease, and a wide range of diseases of the skin, just to mention a few. I have noticed that a number of the statements have suggested increases of well over $1 billion, well over 50 percent increases for just a handful of programs. Needless to say, the Budget Enforcement Act has given us all a very difficult situation this year. From that act we expect a growth of from 4 to 5 percent over last year's level. We are barely keeping up with inflation.

While I am sure that we will agree on the importance of the several programs we will discuss this morning, the amount of funding increases that we will be able to provide by necessity because of that budget act last year will be limited. So I look forward to the advice of each one of you in making the many difficult decisions that face us this year in the allocations of the scarce dollars that we have available to us. STATEMENT OF HON. STROM THURMOND, U.S. SENATOR FROM SOUTH

CAROLINA ACCOMPANIED BY:

LEE DUCAT, PRESIDENT, NATIONAL DISEASE RESEARCH INTER

CHANGE MARK McCLENDON, SR. SIMONE MCCLENDON MARK McCLENDON, JR. Senator HARKIN. At this point I would welcome to the subcommittee our distinguished colleague and good friend from South Carolina, the distinguished Senator from South Carolina, Senator Strom Thurmond.

Senator Thurmond, welcome to the subcommittee.

Senator THURMOND. Thank you, Mr. Chairman. I am somewhat hoarse, so I hope you can hear me.

Mr. Chairman and members of the subcommittee, it is a pleasure to again have the opportunity to appear before this subcommittee to testify in support of diabetes research funding. As you know, I appeared before you 1 year ago with my wife and daughter, Julie, to urge increased funding for diabetes research and the search for the diabetes genes. I am back before you today to say thank you and to reemphasize this important and most beneficial endeavor.

Sitting beside me today is my good friend, Lee Ducat, a distinguished leader in the diabetes community. Lee is a woman of action. More than 20 years ago she founded the Juvenile Diabetes Foundation and today is working hand in hand with the foundation to help find a cure for diabetes. Lee and the foundation have made the search for the diabetes genes their top priority in fiscal year 1992. I join her in urging you to consider making it a top priority as well.

As a military man and veteran of World War II, I know what it means to spend a few extra dollars to defend freedom and to save lives. We proved it in the 1940's, and we proved it again this year in Kuwait. Today I want to challenge you to spend a few extra dollars on a noble effort to save lives right here in this country.

The Federal Government has demonstrated a commitment to diabetes research through the work of the National Institute of Diabetes, Digestive, and Kidney Diseases, which I am pleased received an appropriation of $617 million last year. Much progress has been made in treating diabetes and reducing the severity of some of the complications that are associated wit this disease. Recent breakthroughs such as new insulin delivery systems, self-administered blood glucose monitoring products, oral medications, and laser therapy techniques for treating diabetes-related eye disorders have all contributed greatly to improve lifestyles for diabetics.

Certainly these advances are remarkable. However, the cause of this disease still eludes scientists. We must find the cause, and the search for the diabetes genes will help us do just that.

Mr. Chairman, your interest in this important issue is much appreciated by the families of those who have diabetes. As a parent of a daughter with juvenile diabetes I am especially appreciative of the support of the subcommittee in this area. Mr. Chairman, I am sure you are familiar with the facts of this disease which, taken as a whole, help point out the reasons why we need to do more. Three facts bear mentioning:

One, more than 14 millon Americans suffer from diabetes and its complications. To put this in perspective, this amounts to over four times the population of my home State of South Carolina;

Second, annual diabetes-related costs amount to over $25 billion; and

Third, diabetes is a leading cause of death in this country, and it has been shown to reduce life expectancy by up to 30 percent.

PREPARED STATEMENT In closing, I wish to thank you for the opportunity to testify and urge the members of the subcommittee to consider an additionalI repeat, an additional-$30 million over 2 years to fund the search for the diabetes genes. Thank you very much.

STATEMENT OF SENATOR STROM THURMOND Mr. Chairman and members of the subcommittee, it is a pleasure to again have the opportunity to appear before the subcommittee to testify in support of diabetes research funding. As you know, I appeared before you one year ago with my wife and daughter Julie, to urge increased funding for diabetes research and the “Search for the Biabetes Genes". I am back before you today to say thank you and to reemphasize this important and most beneficial endeavor.

Sitting beside me today is my good friend, Lee Ducat, a distinguished leader in the diabetes community. Tee is a woman of action. More than 20 years ago she founded the Juvenile Diabetes Foundation and today is working hand-in-hand with the Foundation to help find the cure for diabetes. Lee and the Foundation have made the “Search for the Diabetes Genes” their top priority in fiscal year 1992. I join her in urging you to consider making it a top priority as well.

As a military man and veteran of World War 1, I know what it means to spend a few extra dollars to defend freedom and to save lives. We proved it in the 1940's, and we proved it again this year in Kuwait. Today, I want to challenge you to spend a few extra dollars on a noble effort to save lives right here in this country.

The Federal government has demonstrated a commitment to diabetes research through the work of the National Institute of Diabetes, Digestive, and Kidney Diseases, which I am pleased received an appropriation of $617 million last year. Much progress has been made in treating diabetes and reducing the severity of some of the complications that are associated with this disease. Recent breakthroughs such as new insulin delivery systems, self-administered blood glucose monitoring products, oral medications, and laser therapy techniques for treating diabetes-related eye disorders have all contributed greatly to improved lifestyles for diabetics.

Certainly these advances are remarkable. However, the cause of this disease still eludes scientists. We must find the cause, and the “Search for the Diabetes Genes” will help us do just that.

Mr. Chairman, your interest in this important issue is much appreciated by the families of those who have diabetes. As a parent of a daughter with juvenile diabetes, I am especially appreciative of the support of the Subcommittee in this area.

Mr. Chairman, I am sure you are familiar with the facts of his disease, which taken as a whole, help point out the reasons why we need to do more. Three facts bear mentioning: (1) More than 14 million Americans suffer from diabetes and its complications to put this in perspective, this amounts to over four times the popu. lation of my home state of South Carolina. (2) Annual diabetes-related costs amount

o over $25 billion; and (3) Diabetes is a leading cause of death in this country and t has been shown to reduce life expectancy by up to 30 percent.

In closing, I wish to thank you for the opportunity to testify, and I urge the members of the Subcommittee to consider an additional $30 million over two years to und the “Search for the Diabetes Genes”.

Senator HARKIN. Senator Thurmond, thank you again for appearng before the subcommittee as you did last year and for your very excellent testimony.

The budget request for diabetes this year is for about 7 percent more, Strom, which is a little bit more than the average increase hat we got for all of our budget. So that is the good news.

Of course, the bad news is it is probably not as much as people want, but it is higher than what the average increase for all of our programs is.

Senator THURMOND. We will appreciate every extra dollar you put into it.

Senator HARKIN. We will do our best.

Senator THURMOND. As I say, the people in this country who have diabetes is four times the population of my entire State, and we must take steps to find the cause of this disease.

Senator HARKIN. Thank you very much.

STATEMENT OF LEE DUCAT

Who are the other people here at the table you have with you?

Ms. DUCAT. These are the McClendons, Mr. and Mrs. McClendon and Mark, who is 2 years old and has had diabetes since he was 3 months old. They are parents who would just like to say a few words as part of the testimony.

Senator Harkin, I am really honored that we are able to talk to you personally today. There is a great research project at the University of Iowa which we hope will cure diabetes, the beta cell cransplant.

We started the search for the diabetes genes last year, and we are here to ask you for $30 million over a 2-year period to find the genes which cause diabetes. We need to know the genetic cause of his in order to find the cause to get some new treatment and to progress toward the cure.

We have done a lot. In fact, in the last 2 months there have been wo new genes found. We started this mission right here last year co find the genes which cause diabetes. As Senator Thurmond has said, there is an enormous constituency out there, 14 million diapetics across our country; 2 million are little ones, young people with insulin-dependent diabetes like Mark, Junior. We need to get che funds to find the cause and the cure for diabetes.

We are suggesting $30 million over 2 years to NIDDK. We are also suggesting to NIH $9.7 million. We are suggesting to NIDDK $835 million, and we are suggesting for the diabetes budget $385 million. Diabetes is the third leading cause of death in the country besides cancer and heart disease. Cancer is up here in funding (indicating), heart disease is here [indicating], and diabetes at $385 million would still be way down at the bottom.

We have a huge constituency. We have a massive united effort this year to search for the diabetes genes: NDRI, with 1,000 researchers; the Juvenile Diabetes Foundation International with

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