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 was established June 8, 1962, by Reorganization plan No. 2 of 1962. Its 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.

2. Assessment of selected scientific and technical developments and programs in relation to their impact on national policies. 3. Review, integration, and coordination of major Federal activities in science and technology, giving due consideration to the effects of such activities on non-Federal resources and institutions.

4. Assuring that good and close relations exist with the Nation's scientific and engineering communities so as to further in every appropriate way their participation in strengthening science and technology in the United States and the free world. 5. Such other matters consonant with law as may be assigned by the President to the office.

The Director of the Office of Science and Technology is appointed by the President with the advice and consent of the Senate. He is assisted by a small full-time, high-caliber professional staff. The services of some 300 expert consultants in the fields of science and engineering are called upon to provide judgments and evaluations as required. Of these, 87 are life scientists.

The operation of the Office involve making studies and rendering advice on a wide variety of matters involving science and technology that require attention at the level of the Exectiuve Office of the President. In this work the Director draws on the capabilities of the President's Science Advisory Committee, the Federal Council for Science and Technology, the Federal departments and agencies engaged in research and development, and scientists and engineers outside of Government, particularly the National Academy of Sciences. Considering its broad scope of interest and the small size of its staff. the effectiveness of the Office depends on being selective in undertaking studies and in rendering evaluations and judgments. Thus major responsibility for initiation and development of programs as well as their implementation remains with the operating agencies.

Within the broad area of the life sciences, consultant panels to my office have considered many Federal problems related to health. Their investigations have necessarily cut across organizational structures within the Government, but they have been primarily directed to the scientific and technical issues rather than those related to organization and operation.

Some of these studies have involved research areas in which two or more agencies have an interest. In these cases, this Office has been concerned not only with the quality of the research programs themselves, but also with coordination between the agencies involved, and application of the knowledge used.

In each case, advisory panels working with the staff in my office, and with full cooperation of the agencies, have made extensive efforts to understand the broad implications of the current research programs, and therefore needs and opportunities as well as the immediate problems which precipitated the study. Many of these studies have highlighted the need for interagency coordination to avoid duplication or gaps in those research problems which involve more than one agency. To further this end, and to assure the highest quality research in programs involving a single agency as well, I have encouraged the agencies with substantial scientific programs to appoint assistant secretaries for science and technology. These positions have already been created in the Departments of Commerce, Defense, and Interior, and I have been extremely pleased with the results which these appointments have facilitated.

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 several 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

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.