course and genetics are progressing. In addition, research into possible viral causes of ALS continues as well as into the immunological response of ALS patients to infection. HUNTINGTON'S DISEASE CENTERS Question: Have you opened any Centers Without Walls for those suffering from Huntington's? Answer: Research grants to support two Huntington's Disease Research Centers Without Walls were awarded in July 1980, one to Johns Hopkins University and one to a consortium of investigators in the Boston area with administrative focus at the Massachusetts General Hospital. REYE'S SYNDROME Question: What progress are you making against Reye's Syndrome, a frequently fatal disease in children? Answer: The NINCDS, in co-sponsorship with other NIH institutes, published a Program Announcement requesting research grant applications related to Reye's Syndrome on May 16, 1980 in the NIH Guide to Grants and Contracts, Vol. 9, No. 7. Responses to this Announcement in the form of applications are presently undergoing NIH peer review. The NINCDS is the lead institute in sponsoring a Consensus Development Conference on the "Diagnosis and Treatment of Reye's Syndrome" to be held March 2-4, 1981 at the National Institutes of Health. Currently the NINCDS is supporting research on metabolic profiles and amino acid disorders in Reye's syndrome and on its neuropsychological consequences. Over the last several years, mortality rates for Reye's Syndrome reported by medical centers treating the syndrome have dropped considerably. This change is due in part to earlier detection and treatment, increased knowledge and experience, and more aggressive treatment. Most of the surviving children seem to have full recovery, but there is suggestive evidence of emotional and personality changes in some survivors, short-term memory problems in others, and in some of the most severe cases clear evidence of varying degrees of brain damage. Question: research? How much is in the Carter budget for Reye's Answer: The budget amount for this program is currently under discussion within the Reagan Administration. After the revised budget is forwarded to the Congress, we will provide an appropriate answer to this question. AUTISM Question: What advances have you made against autism, a complex learning and personality disorder in children? Answer: Research on intonation and timing of speech production has shown characteristic differences between autistic and normal children. These findings suggest new approaches for speech training in autistic children. Research continues on the acquisition of language and communicative skills by speech and sign in autistic children. A search for early predictive signs of autism in neonates and infants is underway. As autism is a complex disorder of unknown etiology and pathology and as there as yet have been no major research leads, emphasis continues to be placed on basic neuroscience research in order to identify approaches for targeted studies. [CLERK'S NOTE.-The following is the administration's response to those questions in the record that were under review by the Secretary at the time the Department submitted earlier responses.] MAINTAINING NEW RESEARCH GRANTS Question: The Fiscal Year 1982 Budget continues to emphasize the stabilization of new, investigator-initiated research grants at 5,000. How much funding will you need in Fiscal Year 1982 to maintain your share of the NIH goal of 5,000 new and competing research grants? Answer: The revised budget request, proposed by President Reagan provides for the funding of approximately 4,900 new and competing research project grants for $571,621,000. The NINCDS share of that amount is $52,837,000 and 472 grants. Question: How is inflation impacting--or how will it impact--on this goal? What inflator are you using? Answer: An inflation factor of 9.5 percent was taken into account in developing the cost of funding the 4,900 new and competing research project grants. Question: Why is it so important to stabilize new Research Grants regardless of other budget priorities within NIH? Answer: The award of new grants provides the opportunity to capitalize on new information as it evolves from the research. It also provides for the support of a continuing group of bright, young investigators and investigators from other fields with new ideas and new technology relevent to NINCDS areas of responsibility. Question: What happens if, in a particular year, the quality of new research proposals declines? To what extent would you then want to fund fewer new grants and put greater emphasis on research contracts or intramural research? Answer: Past and present experience demonstrates it is highly improbable that this would occur. However, if it should occur, the funds would be utilized in meeting additional needs in other areas of priority which have been restrained because of fiscal constraints, such as support of clinical trials and full utilization of intramural research opportunities. Question: To what "Payline" will you fund new and competing grants in fiscal 1981--and if you can estimate it--in FY 1982? Answer: We estimate that new and competing research project grants will be funded through a priority score payline of 200 for 1981 and 200 for 1982. years? Question: What percentage of grants will you fund in both Answer: In 1981, we estimate that 37 percent of approved new and competing research project grants will be funded. 1982, the estimate is 39 percent of approved grants. WHERE TO CUT In Question: If faced with a major budget cutback, what are your priorities? Where could cuts be made without impairing essential research? Answer: In making reductions from the budget submitted to you in January we have attempted to develop a budget which maintains a viable research program for FY 1982 and strikes a balance among research grants, intramural activities and training. While these reductions will not impair essential research, further cuts may alter this balance as well as our research capability. Question: How much can be saved through more efficient management, less official travel and fewer consultant contracts? Answer: In 1981 cuts were made in travel, consultant services, procurement contracts and personnel compensation because of the hiring freeze. Further reductions in consultant services were made in 1982. Additional cuts in these areas in FY 1982 could not be absorbed without affecting essential research activities. Question: Please provide for the record the effects of various levels of funding reduction on your major activities. Answer: The budget justification recently submitted to the Congress has attempted to depict the effects of reductions made from the budget proposals submitted in January. These justifications show the levels of funding reductions by budget mechanism and major disease category. BUDGET Question: Will you give us some idea of how your Institute plans to adjust to the overriding demands of the inflationary economy that we are currently burdened with? Answer: The NINCDS is reevaluating the competing priorities among its several research responsibilities and adjusting the emphasis to be given to its targeted efforts in relation to public need and research opportunity. In addition, both its personnel needs and procedural methods are being reviewed to assure even greater economies and efficiencies commensurate with program adequacy. Question: To what extent will you have to make substantial cuts in various programs in order to fund others of higher priority? Answer: The NINCDS will continue to give primary emphasis to its research project grant program, intramural research program and research training and career development programs. This will decrease the resources to be made available to other activities. STROKE Question: If we are to witness a continued decline in stroke incidence as we have over the past decade, what specific course of action should be followed to achieve such dramatic results? Answer: A continued decline in the incidence of stroke will depend in part upon the widespread understanding and control of the all-important risk factors related to stroke. Additional impact on stroke incidence and mortality will be accomplished by current stroke research which is addressing itself to more specific diagnosis of stroke type (hemorrhage vs. arterial occlusion), more aggressive management of stroke, therapeutic trials to determine the efficacy of new treatments and a multidisciplinary understanding of the biochemical and physiologic mechanisms which precede and follow a stroke. REYE'S SYNDROME Question: How much is in the Carter budget for Reye's research? Answer: The NINCDS budget for research directly related to Reye's syndrome is estimated for FY 1981 at $360,000 and for FY 1982 at $400,000. This includes $15,000 for intramural research projects in each year. President Reagan's revised budget provides · for the same level of funding for Reye's syndrome as the Carter budget. In addition, the NINCDS supports a broad program of research on the consequences of infectious and metabolic insults to the nervous system and neuroimmunological responses to these factors. These studies provide for the basic research necessary to identify specific factors which will be of importance to understanding the basis of Reye's syndrome. NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES STATEMENT OF DR. RICHARD M. KRAUSE, DIRECTOR ACCOMPANIED BY: DR. DONALD S. FREDRICKSON, DIRECTOR, NATIONAL INSTITUTES OF HEALTH DR. JOHN R. SEAL, DEPUTY DIRECTOR CHARLES E. LEASURE, JR., EXECUTIVE OFFICER NORMAN D. MANSFIELD, DIRECTOR, DIVISION OF FINANCIAL MAN AGEMENT, NATIONAL INSTITUTES OF HEALTH ANTHONY BUDGET ITTEILAG, ACTING DEPUTY ASSISTANT PREPARED STATEMENT SECRETARY, Senator ANDREWS. Our next witness is Dr. Richard M. Krause, Director of the National Institute of Allergy and Infectious Diseases. I understand, Dr. Krause, the mission of your Institute is to conduct and support research on all infectious diseases of men and on diseases caused by disorders of the immune system, such as asthma and other allergies. And we welcome you and would ask that you very briefly highlight your opening statement, which will be printed in full in the record. so that we can move quickly to questions from the subcommittee. And I would appreciate it if you could, first, introduce your associates and then proceed. [The statement follows:] |