clearance process in the Department. It is delayed because I asked for some refinements to be made in it before it went forward.

The thrust of the plan is as follows. It begins by recognizing the solid experience of the EPSCoR program in NSF as well as our own experience with a complementary program that we call AREA, Academic Research Enhancement Awards. This latter program, developed several years ago, is aimed at individual scientists in institutions that for one reason or another have not been traditionally a major recipient of our funding.

Many of those institutions are in the States you identify, but others can be in States where the overall funding is very high, but where these institutions have not been major participants. We now have $13 to $14 million supporting more than 100 project grants in this AREA program.

The approach we are proposing in response to your request is a hybrid that combines what we think are the best features of the AREA program and the EPSCoR. The general idea is to identify some number of States, up to 20, that have not traditionally been major recipients of NIH research funding. Academic institutions from within those States will be invited to apply for a 1-year planning grant. This will give the institutions, interacting with the governor's office and whatever other mechanism the State chooses, an opportunity to plan and develop a strategy. The next phase will provide an opportunity for 3-year institutional development awards that would enable institutions to implement their plans and to position themselves to be better competitors for the wide array of funding mechanisms available from the NIH, including the AŘEA program and our regular grant system.

We have suggested State matching funds on a one-to-two ratio, one part from the State and two from NIH. All of this is clearly negotiable, and we look forward to receiving the views of this subcommittee and others as to the elements in that plan.

DISTRIBUTION OF RESEARCH FUNDS

Senator COCHRAN. I really appreciate your being able to give us that report. I am encouraged by it, and I think that it certainly meets the challenge that we laid out in the language in our report last year.

Let me follow up with just this question and that is whether or not in this budget request there is room for us to make an appropriation available to support this new initiative. And if that is true, could you tell us how much money we need to put in this bill in order to give you a chance to carry out this planning grant program?

Dr. RAUB. There is not an explicit item in the 1992 budget for that plan since it had not been developed when the budget was completed. We have identified it as one of the items eligible for funding consideration from the director's discretionary fund requested for 1992, should the Congress agree to provide that. And, of course, it would also be considered for the 1993 budget which is being developed now. We estimate that a level of about $2 million would start this program.

Senator COCHRAN. Well, I hope we can find a way to provide those funds in our appropriation for NIH so that you can get this

new program started. I think it is interesting that you are building on the AREA program that you had started several years ago. If I am not mistaken, I think some of the scientists and physicians at the University of Mississippi Medical Center may have qualified for some of these funds, as a matter of fact. In the physiology department specifically, I think we have seen some funds come to the university for research by individual scientists.

The 20 States that will be invited for participation in this planning grant-can you tell us if you have identified them or not? I would recommend very strongly you include Iowa and Mississippi. [Laughter.]

Dr. RAUB. It might be hard to include Iowa. I think we can include Mississippi.

Senator COCHRAN. Well, I appreciate that. That would be helpful. Dr. RAUB. May I just add, sir, we have not agreed yet on a particular list. What we have done is develop criteria. For example, research funding for almost one-half of the States in the country accounts for only about 5 percent of total NIH funding, which is how we arrived at approximately 20 States. If we broaden that very far, we will diffuse the program and create too intense a competition. So, part of the further planning will be to select a number of States that we would all recognize as the most appropriate targets, but have funding adequate to provide reasonable opportunity to achieve what you have identified as, and what we agree is, an important goal.

Senator COCHRAN. I think it may be helpful to the committee just for our records and information if we could have a table that would show us the funding of these research activities in each State during the last fiscal year.

Dr. RAUB. We have such tables and listings included in the report that is under review now and I will be pleased to provide that now. We will be glad to supplement that with any more specific information you would find helpful.

[The information follows:]

FISCAL YEAR 1990 NIH AWARDS TO STATES/TERRITORIES BY DESCENDING
TOTAL DOLLAR AMOUNT

FISCAL YEAR 1990 NIH AWARDS TO STATES/TERRITORIES BY DESCENDING
TOTAL DOLLAR AMOUNT-Continued

Senator COCHRAN. And we will receive, as I understand it, a copy

of your report in due course so we can have that before we begin our markup session.

Dr. RAUB. Yes; I would hope within a few weeks.

Senator COCHRAN. I appreciate that very much, Dr. Raub.

Thank you, Mr. Chairman.

Dr. RAUB. Thank you, sir.

NONTRADITIONAL MEDICAL TREATMENTS

Senator HARKIN. Dr. Raub, we have to move along. I just wanted to personally thank you for seeing and spending time with our former colleague, Congressman Berkley Bedell, when he was up to see you recently regarding treatment that he had undergone for prostate cancer I guess.

I have been following this. I asked some questions last week of different people in the Department of Health and Human Services, and I propound the same question I will ask Dr. Broder when he

is up at the table here about looking at nontraditional approaches toward treating some of the more deadly illnesses and diseases we have in this country such as cancer. I am the first to admit that there are a lot of quacks out there preying on people's emotions, willing to use the emotions that people have to either enrich themselves or to make a quick buck. I understand all that. But I also understand there are people out there that may not be in the traditional mode. They have ingenious ideas and different ways of approaching things.

One of the things I am going to be focusing on for the next couple of years or so I am going to be here for at least 6 years. [Laughter.]

I am going to focus on a system whereby some of these nontraditional approaches are really looked at in a scientific manner and delved into and not just dismissed. I was looking at an article here that my staff had gotten for me where it said that cancer patients were helped by therapy, a study found, a study done by the OTA on unconventional cancer treatments. It said that psychotherapy had not only improved the quality of the lives but extended the lives of cancer patients. While psychotherapy in cancer treatment was once considered quackery, "the atmosphere has changed," said Mr. Spiegel, a psychiatrist at Stanford University. Here comes Stanford again. [Laughter.]

That is sort of the thing I am talking about, to try to look into some of these nontraditional approaches. And I know that you are setting up something to look at this, Doctor. I have never met this guy. I don't know anything about him other than some of the things I have read. And since I have gotten involved in this, I have gotten more incoming fires, you might say, on this doctor's microscope and things like that.

Do you have a team that is going to go and look at this up in Canada?

Dr. RAUB. We have not completed the arrangements for that yet, but I have had a series of discussions with Mr. Bedell as well as with some potential participants in it. We have sought some information from the Canadian side that we are still waiting for, especially from the equivalent of our FDA, which we think will be helpful to us.

Senator HARKIN. Why do you have to do that?

Dr. RAUB. Because there has been a major controversy between that particular scientist and the regulatory authorities in Canada, and we would like to understand at least what the differences between them are.

Senator HARKIN. Well, that is simple. Go write them and tell them to send you all the information they have on this guy. Dr. RAUB. That is exactly what we are doing.

Senator HARKIN. Well, that should not take more than 1 day. Dr. RAUB. We are moving ahead on that. But we did not want to insert ourselves prematurely into another government's regulation.

Senator HARKIN. Well, it seems to me Canada is a pretty free country. If you want to go up and talk to a doctor that has some way of treating cancer or has a microscope that he has invented or says that he can do certain things with, I do not see why you really

have to go to the government. If you want to get information from the government, that's fine, but I don't know why you need to seek permission.

Dr. RAUB. No; we were not seeking permission. It was more to be sure we were fully informed and as a courtesy to Canadian officials.

Senator HARKIN. I have no problem with that.

Dr. RAUB. But your point is well-taken.

NONTRADITIONAL MEDICAL TREATMENTS

Senator HARKIN. Again, obviously, there has been some controversy with the Canadian Government with this individual that I have heard about. But I am concerned in short-circuiting all of that and getting people up there to look at it, competent, scientific individuals who can make a judgment on this.

Dr. RAUB. The view we have taken with Mr. Bedell is that, while we are paid to be skeptical, we are not paid to be close-minded. So, on this topic and on others in cancer research and in AIDS research, we feel an obligation to identify and try to understand the factual basis, if there is one, on these various claims for treatment. In general, the approach we have taken is to request the data, patient information or other types of data, that would give an independent, objective third party reason to conclude what the advocate concludes.

Senator HARKIN. A lot of times in these nontraditional approaches, the data is not cohesive. It is not data that has been pulled together. A lot of it is anecdotal. A lot of it is sparse, and that is why you have to kind of cut through it and go to the source of this and take a look at the source. And that is really what I am requesting that you do in an expeditious a manner as possibleDr. RAUB. Yes, sir.

Senator HARKIN [continuing]. With all the competent, scientific individuals you can find to really give it an objective look.

QUESTIONS SUBMITTED BY THE SUBCOMMITTEE

Thank you very much, Dr. Raub. Thank you all. I am going to have to move to our next panel here for the individuals. Thank you, Dr. Raub.

There will be some additional questions from various Senators which we will submit to you for your response.

[The following questions were not asked at the hearing, but were submitted to the Institute for response subsequent to the hearing:]