the then-known fact that approximately some 1.5 million people suffered from this condition and many of them were institutionalized at great cost because of it. AD could not be diagnosed, prevented, treated, or cured and, therefore, there was a paucity of interest in researching it. Because of the interest generated by the Institute under the FY 80 revised budget, the Public Health Service will support $53.9 million in AD research, $32.1 million of it by the NIA. Although this ten-year research effort has not answered all of the earlier questions, we do now have better diagnostic methods and theories abound on ways to prevent, treat, or cure it. the development of improved neuropsychological test batteries, the detection of abnormal proteins in the blood, and the finding of specific genetic markers in familial cases are examples of advances in the diagnostic screening techniques for AD; modern molecular biology techniques hold great promise for helping find the causes of AD by determing what causes the formation of abnormal proteins in the blood, for example; and research in animals suggests that lost brain function may be restored through the transplantation of brain cells.

These are exciting findings, ones which were unthinkable just ten short years ago. These and many more developed through NIA-supported research illustrated the degree to which we can overcome what appear to be insurmountable problems if we have the will to commit the necessary resources.

The Alzheimer's Disease Research Centers Program provides an unparalleled opportunity in the field of AD research to translate research findings in improved care and diagnosis for Alzheimer's patients. This program was initiated just two years ago, and despite restricted and reduced funding which has caused delays in initiating some approved projects, is already contributing tremendously to the knowledge base related to this disease. But we must expand beyond the ten centers which now exist if we are not to lose momentum. Currently, approximately 2-3 million suffer from AD and it is estimated that this number will double by the year 2000. The Nation must be willing to pay now to overcome the problem or we are destined to pay later to care for the individuals who, without the intervention of our scientific community, will surely become victims.

To summarize my views upon Alzheimer's disease support, we should bring the present ten national Alzheimer's Disease Research Centers to full funding. This would require $2.3 million.

We should make available an additional $10 million for general funding of Alzheimer's disease research through investigator-initiated research projects and program projects.

We should also support five additional Alzheimer's Disease Research Centers at $1 million each which should be a total of $5 million.

Another important research area which must be conducted and expanded is that related to osteoporosis. Ostoeporosis is a condition that affects as many as 15-20 million individuals in the Nation and costs approximately $2 billion a year to treat. One of its many sequalae is hip fractures with approximately two hundred thousand of them occurring each year. This condition, which affects primarily women, often occurs postmenopausally. The genesis of osteoporosis appears to relate to age-related bone thinning, diet (calcium and vitamin K), exercise and hormonal balance among other factors. I urge that the National Institute on Aging in coordination with the New National Institute of Arthritis, Muscular Skeletal and Skin Diseases create programs of excellence which focus attention upon this major condition. At the minimum, funding should be in the range of $7 million.

It would be impossible to continue the important agenda of research on aging without a continuing investment in research training. I urge a minimum of $200,000 devoted to support of fellows to work in the NIA intramural program. $1.1 million should go for career awards and $1.4 million should go for NRSA. This would bring the total for research training to $2.7 million.

It is of great importance that centers and clinical trials be supported not only at the National Institute on Aging but throughout the National Institutes of Health. The ultimate application of new knowledge must be tested. The systolic hypertention in the elderly patient program (SHEP) is a case in point. This program by the National Heart Lung and Blood Institute (NHLBIO and the NIA must be supported. The result will be the further effective reduction of death from heart disease and stroke.

I am pleased to have had this opportunity to present the case for the National Institute on Aging this morning. This Institute was born shortly after the impact of the OPEC rise in oil prices. This was the beginning of the era of austerity. The new National Institute

on Aging was never adequately capitalized. It never received an adequate supply of personnel to appropriately monitor the financial aspects of the grant program and to spearhead new initiatives. There should be a minimum of 20 additional FTE personnel provided to the Institute. This would cost $700,000.

As we move towards the end of the 20th century we must be mindful of the remarkable numbers of baby boomers born between 1946 and 1964 who would soon be among the ranks of those over 65. We cannot wait until they reach their maximum, roughly between 2020 and 2030, to develop the kind of new knowledge required to prevent and effectively treat the variety of diseases that afflict older people. From that perspective research on aging is the ultimate service and the ultimate cost containment.

STATEMENT OF DR. ROGER GUILLEMIN, WINNER OF THE NOBEL PRIZE FOR MEDICINE

Senator WEICKER. Dr. Guillemin.

Dr. GUILLEMIN. Senator, I am a physician, but I have worked in basic research all of my life. The last 30 years have been devoted to work in the laboratory. I received a Nobel Prize, as you indicated earlier, in 1977 for the research which has led us to understand that our brain makes hormones. We can now talk of brain hormones like for years we have been talking of sex hormones, hormones of the pancreas involving diabetes.

I would like to make some remarks around the written statement that was submitted to your committee.

I am also the incoming president of the Endocrine Society. The eradication of infectious diseases, medication involved with endocrinology, those have probably been the two aspects of modern medicine which have touched more hundreds of millions of people than any other aspects of medicine.

Probably the most important point I would like to make as a basic science man is that the public must understand that all the funding of basic medical research in this country, with the exception of the research conducted in industry and whatever parts of budgets come from private foundations, all of the budget, 95 percent of the budget of medical research, comes from Federal funding.

In other words, we are not asking, when we are concerned with the possible cuts of the budgets of research laboratories, we are not concerned with some sort of subsidies to make our life easier, or our equipment fancier, or our laboratories easier to live in. We are talking about the actual existence of biomedical research in this country.

This concept has to be emphasized over and over again so that the public understands. I will use the same words again, we are not looking for subsidies, we are looking for the problems involved in the survival of biomedical research.

Biomedical research is expensive. The first of these brain hormones, which I characterized with my collaborator, when I was still on the staff of Baylor College of Medicine in Houston, 18 or 20 years ago—the first of these molecules, making simple assumptions from what I read in the Houston Post in those days, meant that weight per weight the first kilogram of that new brain hormone was five times more expensive than a kilogram of Moon rock-a lot of money.

Nowadays, this same molecule, which is used, by the way, all over the world in hundreds of thousands of clinical tests all the time, is, through the efforts of pharmaceutical industry, available for fractions of a cent per active dose.

All of this is to say that biomedical research is expensive, but also can be brought to the public in unquestionable ways through the efforts of the pharmaceutical industry.

One of the important points that I want to mention here also has already been mentioned in more detail by Dr. Thier, and it is the extreme importance in the existence and future of biomedical research, and of all science, actually, of the stability of funding.

We are not trying to be unreasonable about it, but it is absolutely impossible to train people, and just lose them, see them disappear because we don't have the moneys to keep them in some position in a research laboratory, or in an institute.

It takes 5 to 7 years to train young people to become efficient in one aspect of research right now. Molecular biology, at this moment in particular, is probably the best example of this. We simply cannot consider an efficient series of programs in centers and in research institutions unless there is some modicum of stability in these research budgets.

It has also been mentioned that in the future, for these programs, which are being proposed, NIH may not have, the institutes of the NIH may not have the possibility of designing their own areas of emphasis. This, I think, would be a capital mistake. The institutes must be left to be responsible for what areas they want to put their money in.

The problem of the appraisal, the peer committee, and the appraisal of the various research proposals is still the best way to characterize the quality of science in this country.

I mentioned earlier that the basic research in this country is funded essentially by the Federal Government. One fine example to close here. I work at the Salk Institute where a laboratory around myself is about 30 people. When polio was eradicated after the arrival of the first polio vaccine from Jonas Salk, the Salk Institute was created, with Dr. Salk as its first director, as evidence of the gratitude of the people in this country through the March of Dimes.

The Salk Institute receives no money from patents on the polio vaccine. Neither Dr. Salk nor the March of Dimes ever took any patent on the polio vaccine. We receive nothing out of all of that.

With probably 8 percent of moneys coming from the efforts of our administration as endowment, all of the research of an institution like the Salk Institute, all of it, comes exclusively from the NIH. Any reduc

tion of that budget means an equivalent reduction immediately of whatever research is going on in an institution like the Salk Institute. The significance of that for the future is exponential.

Thank you very much.

PREPARED STATEMENT

Senator WEICKER. Thank you, Dr. Guillemin. Your statement in its entirety will be inserted in the record.

[The statement follows:]

STATEMENT OF ROGER GUILLEMIN

While I am a physician I have spent the last 30 years of my life working in the laboratory as a physiologist and biologist. I have studied the mechanisms whereby the brain controls all the functions of our endocrine glands. Indeed, we know now that it is a specialized part of the brain that controls the function of the thyroid gland, the adrenal glands in response to stress, the sex glands both in terms of sexual behavior and of reproductive functions. The same region of the brain controls also thirst, hunger, as well as the general growth of the organism leading to our normal height and body size. This work has lead to the discovery of a series of brain hormones controlling all these functions. The molecules are now synthesized by chemistry and are used throughout the world to study and treat several types of disorders ranging from bleeding gastric ulcers, tumors of the pancreas. to fertility problems. For instance, one of these hormones is the cure for a problem in children which is called precocious puberty. While these children were freaks in society until recently, they can now be cured in a few weeks and will resume a normal puberty and life. Another of these molecules is the treatment for these children of very short stature which are called pituitary dwarfs. Senator, the original cost of the first of these hormones when my laboratory isolated it in Houston, TX, in 1969 was weight per weight, five times the cost of the same weight of Moon rock. This same molecule is now produced by industry for a few cents per dose to a patient. It shows right here that both basic research is very expensive and that technology can bring these discoveries for the benefit of the public at some reasonable cost through the efforts of pharmaceutical industry.

The message that I want to bring here is very simple. All basic research in modern medicine and the related biology in the United States and all the advances in medicine that have come from it conducted in universities or research institutes is entirely and exclusively funded by Federal sources. The only exception to that is the research conducted in industry and the small part of university budgets coming from private foundations. What I am saying is that Federal funding for basic research in medicine is not a sort of subsidy for people, the biomedical researchers, who have a source of funding for their research and who just want more money and go to the Federal Government. This is fundamental difference that must be understood. Federal support for basic research through the NIH or the National Science Foundation [NSF] is really and genuinely the only source of funding for basic research in the medical sciences in the USA.

I am working at the Salk Institute in San Diego in California. The Salk Institute was created and built by the National Foundation March of Dimes for Dr. Jonas Salk to be its first director after the Salk vaccine had eradicated polio not only from this country but practically from the rest of the world. No patents were ever taken by Dr. Salk on his discovery of the polio vaccine. The Salk Institute does not receive royalties for the polio vaccine. With the exception of a small endowment our administration has gathered over the years the total budget of the Salk Institute for all the research going on in the fields of cancer, diabetes, neurosciences, endocrinology, comes exclusively and entirely from Federal sources. Thus it must be clearly understood that if the Federal support for biomedical research disappears or is reduced automatically, then by that percentage number, biomedical research will disappear or be reduced in this country. This is not a matter of having less fancy laboratory facilities, it is a matter of conducting research or not conducting research in the years to come.