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ORGANIZATION OF PUBLIC HEALTH SERVICE

MONDAY, JUNE 10, 1963

HOUSE OF REPRESENTATIVES,
SUBCOMMITTEE ON PUBLIC HEALTH AND SAFETY
OF THE COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE,

Washington, D.C. The subcommittee met at 10 a.m., pursuant to recess, in room 1334, Longworth Building, Hon. Paul G. Rogers of Florida presiding.

Mr. ROGERS of Florida. The Subcommittee on Public Health and Safety will come to order, please.

We are very pleased to have as our witness today Dr. Jerome Wiesner, Director of the Office of Science and Technology and special assistant to the President.

Dr. Wiesner, we are delighted to have you and are very anxious to hear your testimony. STATEMENT OF DR. JEROME B. WIESNER, DIRECTOR, OFFICE OF

SCIENCE AND TECHNOLOGY, AND SPECIAL ASSISTANT TO THE
PRESIDENT
Dr. WIESNER. Thank you very much.

There is little disagreement on the high priority which we, as a nation, accord to the goal of a healthy citizenry. There have been, and will continue to be, differences of opinion on how that goal can best be achieved.

I am very pleased to accept the committee's invitation to discuss with you the role which the Office of Science and Technology can play in aiding and coordinating the Government's participation in health research and training.

I would like to tell you a little bit about the Office since it is quite new.

The Office of Science and Technology as established June 8, 1962, by Reorganization plan No. 2 of 1962. Is primary purpose is to provide the President with permanent staff resources capable of advising and assisting him on matters of national policy affected by or pertaining to science and technology.

More particularly, the Director of the Office of Science and Technology advises and assists the President as the President may request with respect to

1. Major policies, plans, and programs of science and technology of the various agencies of the Federal Government, giving appropriate emphasis to the relationship of science and technology to national security and foreign policy, and measures for furthering science and technology in the Nation.

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ably also aware, that has a large built-in factor of continuations and supplementals so that, in looking at it for any succeeding year, something over 90 percent of a particular figure is essentially a built-in factor since NIH is making these grants on a 3. to 5-year basis.

Our concerns, then, in that area, are primarily on the dollar figures which the agency. would wish to devote to new research projects comparing this with the factors that Mr. Staats has already talked Uso about ; what are likely to be the demands, are there capable researchers thi available to take on this level of new projects over and above the level that was achieved the year before, and then the judgmental factor as to the marginal return and how far we are to go in that area.

I have just one or two other comments.

Biologic standards, for instance, happens to appear first the left-hand side of the NIH chart.

That activity has a specific appropriation and is an activity that pretty much stands on its own; we attempt to review that one by the or itself year in and year out.

We also try to shift our program review emphasis to meet emerging problems. This year, for instance, the mental health activities and the the activities of the Institute of Mental Health received special attention because of the President's special message and special program for mental health and mental retardation, and in succeeding senen years perhaps other parts of the National Institutes would receive some special attention. But as the appropriations have grown, approaching the billion dollar level, with one staff member to concentrate fer in the area, we have had to more and more take the summary approach that you find on the right-hand column of the chart and try to deal in large pieces of this very large and growing activity.

Mr. ROBERTS. Thank you, sir.

Do you have any other suggestion as to how the Congress can be placed in a better position to evaluate these programs other than on the project by project basis which, of course, is impossible?

Mr. Staats. I would like to say one or two things on that and there may be others here one could add.

As part of the study which Mr. Sutton referred to a while ago, we want to give particular attention to the impact of various programs on the universities because we do not think that you can separate out one research program from all of the other programs that the Federal Government carries on that may be affecting a single institution.

Institutions are, all of them, interested in strengthening their programs, they are interested in finding a way to cooperate with the Government, but in many cases this has resulted in a large number of different programs, different approaches dealing with the same university which has caused very serious problems for that institution

So that, one factor, it seems to me, that we need to give greater consideration to, is to what all of this adds up to as to the effect on our institutions of higher learning. That is a matter of emphasis.

I would think, additionally, that we would agree that, as to the categories of the kind in the right-hand column here which are more by functions or components, such as research training programs, er tramural research, collaborative studies, and so on, that we would feel that this is a more useful approach in evaluating what the agencies are doing.

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In other studies the reports have provided, for the first time, a compilation of the results available from completed research, and have thus served as a vehicle for the distribution of scientific information. For example, our study of the technical aspects of drug abuse, which provided the substantive background for the White House Conference on Narcotics and Drug Abuse, compiled information previously available only from separate sources. Additionally, it revealed that much of the information commonly taken for granted was either incorrect or could not be substantiated. In other cases, such as the studies of behavioral sciences and of the application of new technologies to life sciences research, an effort was made to delineate the opportunities in growing and rapidly changing scientific fields related to health.

The difficulties of initiating extensive research programs in a previously undeveloped area are exemplified by the current efforts of the Public Health Service to establish a center for the study of environmental pollutants. Toxicology has received little support in past years, and consequently the number of trained scientists available to the field is limited. An officer of Science and Technology Panel tried to determine the best way to meet the immediate needs for toxicological evaluation and at the same time establish a broad base of research competence and training to meet the inevitable pollution problems of the future. Their recommendations for a center in Washington to house administrative support and certain research activities and for strong, university-based centers not only for research and education, but also to help in the solution of local environmental health problems, have provided guidelines for administration policy.

In furtherance of health through environmental control, my office has also concerned itself with possible hazards from radioactive fallout and from pesticide use. In the case of fallout protection, we attempted to gain further insight into the nature of the radiation hazards associated with testing, through work with the Federal Radiation Council and the Committee on Biological Effects of Atomic Radiation of the National Academy of Sciences. The Federal Radiation Council publication on health implications of fallout summarized available information. In addition to providing judgments of the possible biologic effects of fallout, it was necessary to insure the integration of a national monitoring network. This was accomplished by coordination of the resources of the Departments of Health, Education, and Welfare and Defense with those of the Atomic Energy Commission and the Weather Bureau.

The other study related to environmental health—the report on the use of pesticides-was just completed and released 3 weeks ago. The recommendations made by our distinguished advisory Panel should provide a framework for the design of both an effective Federal control program which will remain flexible enough to adapt to new pesticide types and formulations, and a significantly improved research capability to assess the hazards of currently used methods and devise better ones for the future.

During the past 2 years, I have had repeated briefings on the program activities of the sereral Institutes which make up the National Institutes of Health. Additionally, the Cancer Institute has presented a detailed briefing to the President's Science Advisory Committee. In cooperation with the Bureau of the Budget, we have re

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reviewed the National Institutes of Health budgetary requests each year.

I understand that you are concerned, as are other people, about the size of the National Institutes of Health activity. It has been surprising to me to learn that, although the total budget of the Institutes appears to be very large, health problems are so diverse that the amount which can be devoted to research on any one is quite small. I have appended a National Institutes of Health budget breakdown which illustrates this point, and which also gives the committee a picture of the spectrum of efforts in which the Institutes are currently involved. In view of their importance to the health of our population, I have fully supported the administration's budget requests for the Institutes.

It will also be of interest to your subcommittee to know that the President has approved a major study of the research programs of the National Institutes of Health, My office will initiate the study this summer. From this, we hope to gain a clearer insight into the nature of the biological and medical research needs of our Nation and to be in a much better position to to make judgments of the adequacy,

with which the National Institutes of Health programs fulfill our needs.

In conclusion, several thoughts seem pertinent. First, like activities we see in other fields, health problems will never disappear; they will simply change. As the currently important threats such as heart disease and cancer are conquered, other causes of illness and death will take their place. Thus, there is no prospect that efforts to deal with health problems can ever end. Second, it seems clear that health problems generated by alterations in man's environment will become steadily more acute. Third, as the rate of change in all of man's affairs increases, the strain thrown upon the capacity of people and institutes to adapt will increase. One consequence is that problems of social adjustment and of various kinds of personality disorders will probably become more extensive.

There is one other surprising fact that examination has indicated. Quantitatively, the amounts spent for medical research in this country have not increased relative to overall increases in funding of research and development. This we have seen in our recent review of the budget. Dr. Shannon has pointed out to the subcommittee that medical research has traditionally occupied between 5 and 8 percent of the total research and development expenditures. Mr. Staats has noted that, although Federal expenditures constituted 44 percent of public funds expended for health, they amounted to only 11 percent of the total national expenditures for health. However, these relatively small research expenditures which I talked about previously provided nearly two-thirds of health research in this country.

It is thus of paramount importance that the Federal Government, carrying the greater burden of responsibility for health research, insure that these funds produce maximal results both in terms of the solution of specific health problems, and in terms of increasing the numbers and quality investigators available to work in this area.

Thank you, sir.
Mr. ROGERS of Florida. Thank you, Dr. Wiesner.
I see you have attached to your statement certain charts.

Dr. WIESNER. Yes. You might be interested in looking at them now or later.

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