Senator EAGLETON. Is it good scientific management for the administration to have said this year that you are not going to renew a whole series of programs in the aging field. Here is one of 15 years duration that appeared to me as a layman to be highly useful, and in the words of your own department, if it is canceled it will have a crippling effect on progress in aging research. Is that good scientific management? Dr. MARSTON. This is one of the centers that was established back under the Heart Institute when it was carrying on research in aging, and was transferred to Child Health and Human Development when it received this mandate. It is one of the few centers of its type in the country, and it is in an important area. If in fact after studying all aspects of the renewal request, and after the 1972 budget is settled if this is in fact closed, it will be on the basis of making the very difficult type of judgment that one has to make between varying useful activities. I could have no enthusiasm for closing down an activity that has been important and does seem to be important in the future. We have to make this type of decision with 12,000 grants at any one time. We have to make this type of decision almost every day, and it is not an easy decision to make. Senator EAGLETON. I am not going to pick at you, because I know the difficult decisions, and I very much appreciate the dilemma you face, and I hold no special brief for this one. I had not met the doctor, nor heard of the program until he testified on June 1, but it just appears to me again, identifying myself as a total layman in this field, that the program in which he invested 16 years and frankly, I think you will agree with me, that the information gathered becomes even more valuable as the program goes on, to scrub it, and to lose all the background that has been laid, 15 or more years worth, and break up the team that is working on it and at a point where it is just about reaching, maybe, its maximum potential for useful information, to me does not seem to be the useful expenditure of money. Either NIH has been wrong for 15 years, and that is possible, or it is very wrong in its 16th year when it sees fit to discontinue this program. I don't know. I just get the feeling from all that I have read and from the presentation today, Doctor, that there just is not enough clout, call it political clout, call it budgetary clout, for aging in NIH as I would like to see. I presume Senator Percy and maybe many other Senators would like to see that as well. If I am remotely correct in that feeling of lack of budgetary clout, then just as I sympathize with you and the dilemma you face in approving or disapproving 12,000 applications, grants, renewals, et cetera, you in turn have to sympathize with Congress in terms of its desire to see that there is greater emphasis placed in this area. How do we do it? We know this much, and that is what motivates us to talk in terms of a new Institute of Gerontology-if a new institute is established and we take into account the other requests that Mr. Kurzman mentioned for other institutes, we do know if we elevate it to a new institute status it will have greater budgetary clout. So what alternative do you leave us, if we are correct in our feeling that we want greater emphasis placed on this, we don't want you to cut your budget $1.4 million. Indeed, we would like you to increase your budget. We don't want you do leave the center in Baltimore under half utilized; what other mechanism is at our disposal, short of a new Institute of Gerontology, to strongly persuade you that is what we want done? Dr. MARSTON. I think today it is obvious that I am listening very hard on this, and I say this very seriously. I would comment that whereas in the past, historically it would bear to the fact that when there have been new institutes, these have been followed by increased funding. This is not necessarily true in the future. I have been Director of NIH during the launching of two new Institutes, the Eye Institute at the direction of Congress, and the Environmental Health Sciences Institute at my own recommendation. I can tell you that in both of these instances, the creation of a new institute at NIH with the buildup of the whole logistical and support background, has carried a cost. I am not saying that in either of these instances a mistake was made, but I am saying that it is not as it was 5 or 10 years ago when creation of a new institute was followed by markedly increased resources because it had been named an institute. I hope that the alternative ways of achieving the goals of Congress in terms of emphasis, other than what I view as an overly simplistic assumption that perhaps if it had something to go for it demonstrably in a different environment-by the time one adds a half million dollars or more just in the minimum overhead of setting up a new Institute at my own recommendation. In passing-I don't want to focus on this point-but I don't think it is true that if NIH supports something for 15 years that the only two conclusions are that we either made a mistake or that we should continue to support it. This is important in this context, because, particularly people interested in the aging field have testified to the need for longer commitments. Some have even suggested 10 to 20 years. I think that it is reasonable to relook, and relook in a competitive fashion at long-term major investments in research, and I think that we will get better research if we have this type of evaluation. It may be that for 10 years one had an effective program, but for the next 10 years one would have a more effective program doing things a different way or even with a different group. Again I am not talking about the Duke program specifically. I have reviewed it to some extent, but not enough to want to make any public comment other than that it has been one of our more effective pro grams. Senator EAGLETON. I am going to ask you to do me a favor, Doctor, and I won't extract any public commitment from you at this time, but, to use your own words, you have been listening to what I have been saying, and let me say that what I have said with respect to emphasis on aging research, this is not just one of a hundred Senators that has rest. It is shared in significant measure by many Members of the SenateI dare say a substantial majority, and especially those who serve on this subcommittee and Senator Church's special committee, and in both parties, including Senator Percy of Illinois. I think that you and the administration showed remarkable cooperation in the recent give and take, for instance, in the war on cancer situation. It was originally the proposal of Senator Kennedy, and there was a dialog back and forth and a bill seems to be emerging that, to use L.B.J.'s favorite word, establishes a "consensus" that is apparently successful and utilitarian from the administration's point of view and the committee's point of view. I think that was a very fruitful and meaningful process of give and take. Could you think out for us, think long and hard, as to how we could establish some viable rapport on the question of greater emphasis on the problems of aging? What mechanisms, what procedures, et cetera, would in your judgment be workable within the framework of NIH and yet give some satisfaction-not complete satisfaction, because I don't think anything is ever complete-but reasonable satisfaction to this committee that a greater awareness and greater attention will be paid in the future to research relating to the aged? It is a tough question I am posing to you, but it is not an impossible one, because the cancer example proves something can be worked out in that area. Let's see if we can put our heads together and see what might be possible in this area that would be compatible with the numerous responsibilities you have as head of NIH and yet would be responsive to our desires that greater emphasis be placed on this subject matter. Dr. MARSTON. Would you like to have some type of document forwarded to you? Senator EAGLETON. Yes. After you have thought it out for awhile, we might sit down and talk it over amongst ourselves or something in rough form document form. I would like you to put your good mind to work on it, and I don't question your sincerity, Doctor, because you are dedicated in this whole field of research. So I would be very interested in having your best ideas as to how we could place greater emphasis on this so that there-it would not be totally submerged as a sort of after thought, a footnote on the research activities of NIH. Dr. MARSTON. We will be pleased to do that. (NIH had not responded to this request when this hearing went to press.) Senator EAGLETON. We will talk about it further. A column on aging research by Charles Bartlett, nationally syndicated columnist, which appeared in the periodicals on June 11, 1971, I would like to put that into the record. (The following was subsequently supplied for the record :) NEWS FOCUS (By Charles Bartlett) SLOWING THE CLOCK WASHINGTON.-As lobby pressures go in Washington, the young make the noise but the aged have the clout. By sheer growth of members, they have drawn politicians to their cause. One in ten Americans is now over 65 and this is one reason why polite ears will be turned when the National Council of Senior Citizens meets here this weekend to assail the reluctance of the Nixon administration to expand Social Security benefits beyond what is necessary to match the rise in living costs. The Congressional Record reflects this shift in concern. Twenty years ago, when the aged were less numerous, few legislators made proposals to ease their problems. Even the famous Townsend Plan of 1934, promising an annuity to every person over 60, was defended as a way to correct all the ills of the economy, not merely the poverty of the elderly. Now the Congressional scene is bubbling with ideas on how to assist the aged. Pressures for reduced air fares, various tax exemptions, community centers, lowcost meals, and other accommodations persuaded President Nixon to summon a White House Conference on Aging in October. It will be, as one official said, a search for "a national philosophy" on a phase of life with many gaps. Mr. Nixon made an interesting point in announcing the Conference. He said that several hundred thousand Americans of advanced age had written government officials to say that what they need most is some way to play a continuing role in the society. They are dissatisfied at being shunted off to wind up their days in "second childishness and mere oblivion." The antidote for this malaise is research aimed at the biology of aging, the effort to discover how to maintain functional capability, mental and physical, to make life worth living for as long as possible. This is the goal of slowing the biological clock which guides the degenerative process. "Aging may be a process," wrote one biologist, Dr. Frederic Ludwig, "in which the body slowly grows more and more allergic to itself." The discovery of DNA or "genetic material" has excited fresh hopes of finding ways to resist the decline in functional efficiency. The emphasis of this research is less on extending life than on enabling people to feel well and happy until they die at a ripe age. As Thomas Jefferson wrote John Adams in 1816, "Bodily decay is gloomy in prospect but of all human contemplations the most abhorrent is body without mind." Dr. Marrott Sinex of Boston University's School of Medicine maintains that a single breakthrough in the delay of senile dimentia could save vast amounts of medical costs and human anguish. The focus of government-financed research has been on the killing diseases. But success against them will merely extend the enfeeblement of the aging process. If degeneration can be delayed however, the body will retain its resistance and make the onslaught of cancer, arthritis and heart trouble less probable. This point has been lost in the rush to find cures and while the Nixon administration is pushing the annual subsidy for cancer research towards $400 million a year, the budget has shaved the mere $8 million committed to research on aging. It languishes as a stepchild in the vast complex of the National Institutes of Health. But a move is afoot in Congress, led by Sen. Thomas Eagleton (D-Mo.), to create a special institute for these studies. This is the best hope for Benjamin Franklin's vision of a time in which "all would live long but none would be old." Senator EAGLETON. Mr. Kurzman, Commissioner Martin, and Dr. Marston, we appropriate your appearance here, and the contribution you have made. (Whereupon, at 12:15 p.m., the subcommittee adjourned, subject to call of the Chair.) NATIONAL SCIENCE FOUNDATION ref HEARING BEFORE THE SPECIAL SUBCOMMITTEE ON OF THE COMMITTEE ON LABOR AND PUBLIC WELFARE NINETY-SECOND CONGRESS FIRST SESSION ON S. 1968 TO AUTHORIZE APPROPRIATIONS FOR ACTIVITIES OF S. 1168 TO AUTHORIZE APPROPRIATIONS FOR ACTIVITIES OF JUNE 2, 1971 Printed for the use of the Committee on Labor and Publica UNITED STATES OF AMERICA |