“During the period of such appointment," what would be your opinion about the addition of the words "and for 2 years thereafter"? Mr. JONES. This is in the bill.

Mr. Chairman, we have with us Mr. Sidney Saperstein, from our General Counsel's Office, who has been directly involved in this particular area of concern for some years. He can respond to that.

Mr. SAPERSTEIN. The existing provision of law, Mr. Chairman, which prohibits an individual from prosecuting a claim against the Government for 2 years after his connection with the Government has ended, in any particular matter with which he was directly concerned, would not be changed by the bill.

That would continue to be applicable to the individual, so there is no need for us to provide for its applicability.

Mr. ROGERS of Florida. Would the gentleman yield?

The CHAIRMAN. I yield.

Mr. ROGERS of Florida. If that is a provision of law, rather than to confuse anyone who might read this particular provision, would it be hurtful just to include that provision? You have no objection, I presume?

Mr. SAPERSTEIN. No, sir.

I may say that the general subject of conflict of interest is under study now over in the Senate. The House has already passed a general bill. Because of the great confusion that has arisen over the interpretation of these various provisions, many of which were passed, I think, before 1873, and which overlap, the Congress is going into the question of which should continue to be applicable in their present form and which should be modified. I would like, if we were going to include such a provision, to make sure that it would not be inconsistent with what is being done there.

Mr. ROGERS of Florida. I understood that that would be the present law now anyhow.

Mr. SAPERSTEIN. Yes, that is the present law, and we do not propose to change it.

Mr. ROGERS of Florida. So if we added it here, that would continue the present situation?

Mr. SAPERSTEIN. Yes, sir.

Mr. ROGERS of Florida. Thank you.

The CHAIRMAN. Now, going back to the statement that you would transfer some functions from, I believe the Division of Medical Services-is that correct?

Mr. JONES. Yes, sir, the Division of General Medical Sciences. The CHAIRMAN (continuing). How would you determine which activities would be transferred and which would remain?

Mr. JONES. To the new Institute of Child Health and Human Development?

The CHAIRMAN. Yes.

Mr. JONES. There would be two activities that would be obviously subject to transfer. These are the Center for Aging and the Center for Child Health, which are already administratively established. The decisions as to other activities would be along the lines generally referred to in my statement, as to whether or not the job could best be done or related more specifically to a disease category than to the process of human growth and development. This would then be a matter for study by the Institute staff under Dr. Shannon, as

Director, in collaboration with the staff of the particular categorical Institutes concerned.

I think it would not be very difficult for the scientists to make the distinction along the lines generally presented in my statement.

The CHAIRMAN. I believe, also, you mentioned there would be no conflict in the creation of this new Institute with the Children's Bureau?

Mr. JONES. Yes, sir.

We have been very aware that there might be duplication or even jurisdictional disagreement. We have anticipated this to the point that we now have worked out a basis of operation that prevents this problem, and, as a matter of fact, have a specific agreement between the Children's Bureau and the National Institutes of Health that guards against this.

One other thing, we do plan to have a member of the Children's Bureau staff serve ex-officio on the Council for the new Institute to avoid duplication or jurisdictional overlapping.

The CHAIRMAN. The Chair might state that that certainly seems. to be borne out by the fact that the Labor Department has submitted a favorable report on this particular legislation.

Mr. JONES. Yes.

The CHAIRMAN. Now, how does the Government program for adults that is, in health research, research training compare with what we have been doing in the children's field?

Mr. JONES. These bills relate, Mr. Chairman, to the research activity alone, as you indicate. The research on the aging process has been promoted through the Division of General Medical Sciences at NIH in recent years through the Center for Aging.

I think the program how involves some $4 to $5 million, about $5 million of research support, most of which is in extramural grants to universities having a broadly conceived research interest in problems of the aging.

These universities have proposed and are now supporting a broad, interdisciplinary attack on the various problems dealing with the aging process, so that we have a collaboration among the disciplines involved. This is a major activity in the research field in aging as of

now.

The CHAIRMAN. I am not sure that we understand each other. I know that you could not name, percentagewise, either by amount of money or by number of grants. But in the seven categorical Institutes such as Heart, Mental Health, Arthritis, and Tuberculosis and the others, is it not true that throughout the years, since the beginning of the National Institutes of Health, we have done considerably more weeks in the middle-aged and older groups than we have ever done in the field of children?

Mr. JONES. I think that would be a fair statement.

Dr. Shannon has the figures, Mr. Chairman, if you would like to have them by way of comparison.

The CHAIRMAN. I would.

Dr. SHANNON. Mr. Chairman, first, in extension of your comment, I think that in their development over the past 15 years, the programs of the National Institutes of Health have emphasized diseases that are called killing or crippling, such as problems of heart, cancer, mental illness, and the like.

Beginning about 3 or 4 years ago, there was an attempt to increase our investigations in more basic areas. That is, there were more activities aimed at the less specific, the less applied and more broadly inquiring, and this was accomplished primarily through the Division of General Medical Sciences.

At the same time, a beginning was made in the study of problems of the aged.

I think we have reached a point now at which we must inquire into some of the very serious problems suffered by our children, many of whom carry through into adult life. We must recognize that we have not paid sufficient attention to these disorders in the past.

For example, of approximately $462 million spent on grants, direct research, and training in 1961, some $40.4 million supported activities related to the health of children and questions of human development. About half of this is related to problems of infancy and childhood, about half to the more general problems of the developing and aging adult.

In planning the development of the proposed institute we would expect to transfer to an Institute of Child Health and Human Development approximately half of this $40 million.

Of the $40 million, about $4 million was expended for research grants in the field of aging. We have proposed to transfer essentially all of this to the new Institute.

One must differentiate here between those disorders to which the aging individual is more susceptible and those problems which result from advanced age itself. We would not propose to transfer to the new Institute the broad problems of atherosclerosis, arthritis, cancer and the like diseases to which the older individual is more susceptible. It may seem a little peculiar to combine investigations of the very young child with those of the very old person in one research setting, but, basically, the foundation of the total effort would be an appreciation that life is a continuum. Aging starts at birth or before birth; the same factors, genetic or otherwise, that relate to the capabilities of the child also relate to the capabilities of the older individual; the type of experimental support that will be required are total life studies, rather than studies of short periods, examining specific segments of life.

Although on the surface it may appear illogical to group the young with the old, the concept of human development is the continuing thread that really ties these two together.

The CHAIRMAN. Doctor, why, in your opinion, have we dropped from 6th to 10th place among advanced nations in the saving of infant lives?

Dr. SHANNON. Sir, we have more or less remained static in terms of the absolute statistics, and we would be glad to furnish what the absolute

The CHAIRMAN. You mean as far as numbers?

Dr. SHANNON. Yes, sir.

I believe it is due to the fact that we have not dealt as adequately with some of the lower income groups as obtains in certain of the other countries that have more favorable figures to show. I would say that this is not due primarily to lack of medical knowledge, but, rather, due to the lack of mechanics for the application of medical

knowledge. It probably results from socioeconomic rather than medical factors.

The CHAIRMAN. What would be some of the work that would be done in this area of the 400,000 who are born with congenital malformations and with disorders of the nervous system?

Dr. SHANNON. What could be done?

The CHAIRMAN. What would be some of the type of research that would be done in this that is not being done at the present time?

Dr. SHANNON. Well, the first thing that one would want to investigate is the actual causation of certain of these congenital disorders. We have a few specific examples, such as the effect of German measles during an early stage of pregnancy. We know that this frequently results in anomalies of one sort or another in the infant. But when we have said that, we have said almost all we know about influences on the mother during pregnancy as they may affect the child.

During a 9-month period the mother is subjected to a wide variety of infections, a wide variety of physiological strains. The consequences to the child are not known.

This is particularly pertinent with reference to labor itself, when, due to the severe and upsetting physiological changes that take place, the final product-that is, the child has been subjected to what would amount to a rather severe physical beating, I would say. These factors-in terms of adequate oxygenation, in terms of adequate nutrition, perhaps a wide variety of things must have serious implications for the postnatal condition of the child.

Then there are a host of things that we are only now becoming aware of relating to immunological incompatibilities between the parent and the child. The child actually becomes an immunological aggressor as far as the mother is concerned.

We now know of only a few examples of what we suspect must be many, many complicating factors relating to the development of the infant in the uterus and the processes of his birth.

We used to think in terms of a "normal pregnancy." It is now apparent that we really do not know today what a "normal pregnancy" is, particularly, in terms of the birth of a child with full capabilities for development, emotionally, intellectually, and physically.

Studies encouraged by the proposed Institute would inquire into the fundamentals of uterine development, beginning with the initial, genetic processes and continuing through the very complex circumstances of early human development. Some studies might be conducted with humans, and others, for comparative purposes, with experimental animals.

The CHAIRMAN. How does our population growth compare with the other advanced nations?

Dr. SHANNON. The population growth, sir?

The CHAIRMAN. Yes, the birth rate.

Dr. SHANNON. I do not have the figures, but I would gather from recollection that it is not too different from that of other advanced countries. But these figures can be furnished for the record. I just do not have them.

The CHAIRMAN. The Chair would like to ask you to furnish those for the record.

Dr. SHANNON. Yes, sir.