we now call our special research resource program, through which we hope to provide in some part for the highly specialized research services and facilities essential to persent-day medical research. In the current year, $6 million will be expended for this purpose. Mr. ROGERS of Florida. Excuse me just one moment, if I may interrupt. Mr. ROBERTS. The gentleman from Florida. Mr. ROGERS of Florida. Did you say the $6 million covers your seven primate research facilities, or is that just for the present research resource program? Dr. SHANNON. That is for the special resources program, exclusive of the primates. We would be glad to give you a detailed breakdown of those dollars, Mr. Rogers. Mr. ROGERS of Florida. On the primates? Dr. SHANNON. Well, we will break the resources dollarwise into its various components for you. I can give them to you now. Mr. ROGERS of Florida. That is all right. Dr. SHANNON. The regional primate research center program this year up to the present time amounts to $4,300,000. The remainder of the program amounts to $6 million. Mr. ROGERS of Florida. Thank you. Dr. SHANNON. Yes, sir. EXTENSION INTO THE INTERNATIONAL SCENE Growth of medical knowledge in the United States up to World War II depended to a large extent on the flow of basic knowledge from Europe. In the postwar period, with the vigorous growth of American science, this situation has been reversed. However, during the period when the United States was coming into a position of world leadership in medical research, the basic interdependence between America and the rest of the scientific world for stimulation of ideas and interchange of skills came to be clearly understood as essential for the rapid progress of the medical sciences, both nationally and internationally. Explicit legislative recognition of the importance of international medical resaerch activities to the progress of the health sciences in the United States came through the International Health Research Act of 1960, Public Law 86-610, whose terms were developed, for the most part, by this committee. This act authorized the Surgeon General of the Public Health Service to carry on "cooperative endeavors with other countries in health research and research training." In the same act, Congress recognized a permanent U.S. interest in international cooperation to further the "international status of the health sciences," an interest which had previously been manifested mainly through the various foreign aid programs. Authority to act in respect to this latter objective, however, was reserved to the President. The National Institutes of Health have in recent years greatly increased the use of foreign scientific resources to carry forward their medical research objectives. By selecting appropriate projects among the many foreign opportunities offered abroad, the Institutes are supplementing domestic resources both in quantity and scope. Thus, the productivity of our supply of highly trained scientists in certain fields is being reinforced by grants affording partial support for outstanding foreign scientists working on projects of mutual interest and concern. Use of foreign scientific resources and environments not only adds unusual talent, unique research opportunities, and the stimulation of other ideas, but it affords a greater variety of techniques and approaches to solve problems related to causation, prevention, and treatment of diseases of importance to the American people as well as those of other nations. In recent years, NIH international activities have grown both in scope and magnitude under the impetus of the International Health Research Act. Grants for the support of research by foreign investigators and institutions, including international scientific organizations, now number around 1,200. These involved an annual expenditure of about $16 million. An additional $4 million will be spent in the form of U.S.-owned local currencies under our Public Law 480 program. Support is also provided for the training of U.S. scientists abroad, and a limited number of foreign scientists are supported in study in the United States under the NIH international postdoctoral fellowship program. A special aspect of our international activities has been the support of U.S. university-based international centers for medical research and training. These centers provide for collaborative health research and research training relationships between American medical schools and foreign research institutions. THE CURRENT STATUS OF NIH PROGRAMS In the foregoing, I have tried to portray to the committee the major program components of the National Institutes of Health and how they have emerged in the context of the needs and forces which shaped them. As the chart now before you shows (chart 4), these developments took place in a period of rapidly increasing appropriations and represent the adaptation of existing and the forging of new mechanisms of operation within the statutory framework of the Public Health Service Act and its subsequent amendments. (Chart 4 follows:) Stete control programs, biologics control, prof. & tech. asst., training, administration, review & approval. CHART 4 Dr. SHANNON. I think it important for the committee to understand that this process of growth in medical research, although led by Federal programs, has been accompanied by a susbtantial expansion of medical research funds from private sources. The next chart (5) shows these trends quite clearly. The role of non-Federal funds in the expansion of national medical research activity is quite in contrast to most other fields of national scientific activity. In aerodynamics, the space sciences, and other branches of the physical sciences, Federal funds support most, if not all, the research now underway. (Chart 5 follows:) MILLIONS $1000 900 SOURCES OF MEDICAL RESEARCH FUNDS NONFEDERAL $577 800 700 600 500 400 300 200 100 Industry ($390) * Data not strictly comparable with those for prior years, since coverage has been improved. CHART 5 Dr. SHANNON. The relationship of NIH support to other sources of support for medical research is shown in the next chart (6). (Chart 6 follows:) NIH FUNDS AS A PROPORTION OF NATION'S MEDICAL RESEARCH SUPPORT Dr. SHANNON. The magnitude of the national program in medical research and its rate of growth has been the subject of considerable "viewing with alarm." It is frequently overlooked, however, that medical research has shared in the general expansion in national research activity in the postwar period. In relation to overall research and development expenditures, the proportion going to medical research has changed relatively little over the past decade, as shown by the next chart (7). (Chart 7 follows:) MEDICAL RESEARCH AS A PROPORTION OF ALL RESEARCH AND DEVELOPMENT Dr. SHANNON. To add to this perspective, I should like to emphasize that the great preponderance of sums for medical research will be expended for the acquisition of knowledge for the well-being of man-not the application of known principles in major developmental and hardware efforts. ACCOMPLISHMENTS At this point, I should like to refer the committee to the review of progress in the health sciences contained in the fuller statement which I am submitting for the record. In reviewing this record of accomplishment, I believe it would be difficult to dispute that over the past 15 years this Nation through public and private effort has brought into being an enormously productive research effort in the medical and health sciences. This development has had a revolutionary influence upon the health sciences, the practice of medicine, and indeed the state of the Nation's health. Open-heart surgery, extension of survival rates in cancer, advances in the understanding and control of metabolic disease, reduction in the patient census of mental hospitals, nearly absolute control over many infectious diseases, and a major extension of knowledge into the basic life processes are significant reflections of this accomplishment. There is a promise of even more profound advances in the next decade. To me and this is a point I would urge the committee to ponder—the most profoundly important aspect of this postwar development of medical research is the probability that this rate of growth has advanced by at least 10 years the base of our scientific knowledge in the biomedical sciences and in our capability to deal with disease and disability. We know and can do now what, under the circumstances of growth such as obtained during the early 1950's, would probably not have been feasible until the 1970's. It is this base that augurs further major gains in the next 10-year period. In addition, this growth has made possible a broad program, encompassing support for fundamental scientific effort relevant to health and disease, strengthening the health research environment and capability of institutions, and enlarging the resources in manpower and facilities for the future. QUALITY I believe the qualitative character of our programs and the research being conducted under them is both reflective of and the measure of the general capability of American biomedical science. It is no better and no worse than that. By virtue of our non-Federal review and advisory system, the overall character of our scientific activities and the specific projects supported are the consequence of the best this Nation has to offer in the way of scientific evaluation and advice. I think this argues well for the general scientific soundness of our activities. ADMINISTRATION While there has been little question raised about the scientific aspects of our research program some have critized their adminis |