“The impact of Fogarty training has been extraordinary, and we really need to continue”

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On a day when partisan rancor over domestic health policy escalated with the release of the Senate version of a plan to replace the Affordable Care Act, members of the Senate Appropriations Subcommittee on Labor Health and Human Services found themselves on comfortable common ground once again as they considered the Trump Administration proposal to slash funding to the National Institutes of Health.

It is a plan that would reduce the NIH budget by 22 percent of its present level, and return its resources to a level not seen in 15 years, Subcommittee Chair Roy Blunt noted, as he opened a hearing today with witnesses that included NIH Director Dr. Francis Collins and National Institute of Allergy and Infectious Diseases Director Anthony Fauci. It also is a plane, he said, that “proposes cuts that you can rest assured this committee will find unacceptable.”

What the committee will do, however, remains an open question, particularly as it considers reorganization plans within the Trump budget proposal to eliminate the NIH global research Fogarty International Center, and bring the Agency for Health Care Research and Quality into the NIH as a new institute. Legislation passed more than a decade ago allows the NIH to have no more than the present number of 27 institutes.

Sen. Blunt raised the future of the Fogarty Center first, asking how it has contributed to American health security in the course of threats that in recent years have included international Zika and Ebola outbreaks.

“The Fogarty Center is truly integral to all that we do, both directly and indirectly, internationally and domestically,” Dr. Fauci said. Almost all HIV clinical trials in Africa, he said are led by scientists trained with Fogarty grants, as has much of the work to control Ebola and Zika.

He described the potentially disastrous turning point during the 2014 West Africa Ebola crisis when travelers infected with the virus arrived in Mali, and in Nigeria, the most populous country in Africa. “The investigators in those countries were able to handle, identify, isolate, contact trace, and stop it in those countries before it started,” he said. “Each of those individuals were people who were trained at the Fogarty International Center. So we look at them as our true colleagues. I’ve referred to them, and I mean it sincerely, as our brothers and sisters in the battle against infectious diseases.”

In that battle, he added, “they are our closest allies . . . The impact of Fogarty training has been extraordinary and we need to continue it.”

Sen. Blunt then asked Collins about the Trump proposal to bring the AHRQ into the NIH as a new institute. “Are there alternative ways for those things to be moved into the NIH?” he asked.

There are, Collins said, and they could be looked into. But with diabetes research, advances against Alzheimers disease, answers to an opioid epidemic also under threat, there was much to cover.

“This is where we can excel,” as Sen. Leahy put it, “Were we can lead the world. Not only that but we can make life so much better.”

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