>> GOOD AFTERNOON, EVERYONE. I'M JOHN BURKLOW, COMMUNICATIONS DIRECTOR AT NIH. THIS IS THE PRESS BRIEFING. ON THE IMPACT OF IMPENDING SEQUESTRATION ON NIH ON THE BROADER BIOMEDICAL RESEARCH COMMUNITY AND ON PATIENTS AND THEIR FAMILIES. FOLLOWING OUR SPEAKERS REMARKS I'LL MODERATE A Q&A WITH MEMBERS OF MEDIA. I'LL INTRODUCE OUR FIRST SPEAKER DR. FRANCIS COLLINS, DIRECTOR OF NIH WHO WILL INTRODUCE OUR GUESTS. DR. COLLINS. >> AT THIS TIME'S JOHN. GOOD AFTERNOON TO THE ALL OF YOU. THANK YOU FOR BEING HERE FOR WHAT IS A VERY IMPORTANT CONVERSATION ABOUT THE POTENTIAL IMPACT OF THE SEQUESTERS ON THE NATIONAL INSTITUTES OF HEALTH THE WORLD'S LARGEST SUPPORTER OF BIOMEDICAL RESEARCH. I WANT TO ECHO JOHN'S WELCOME TO YOU AND SAY HOW DELIGHTED WE ARE TO HAVE WITH US TODAY SENATOR BARBARA MIKULSKI WHO REPS THE GREAT STATE OF -- REPRESENTS THE STATE OF MARYLAND WHERE WE ARE THIS AFTERNOON. SENATOR MIKULSKI AND I JUST TOURED A LAB AT THE NIH AND MET WITH SCIENTISTS AND REVIEWED DEVELOPMENTS IN BRAIN RESEARCH, WE TALKED ABOUT MULTIPLE SCLEROSIS, ALZHEIMER'S DISEASE, AN AREA OF SPECIAL EMPHASIS FOR THE SENATOR IN TERMS OF HER PROMOTION OF THE NEED FOR MORE MEDICAL ER SEARCH. WE WILL ALSO BE JOINED BY DR. CAROL GREIDER FROM JOHNS HOPKINS WHO ALSO HAPPENS TO BE A NOBEL PRIZE WINNER AND A REMARKABLE RESEARCHER. SHE WILL GIVE US THE VIEW FROM THE NIH SUPPORTED RESEARCH ABOUT WHAT IT'S LIKE TO BE IN THIS CURRENTER RA OF UNCERTAINTY IN TERMS OF SUPPORT FOR THE ENTERPRISES THAT WE ALL CARE ABOUT. WE'RE PARTICULARLY DELIGHTED TO BE JOINED BY FELICIA SANCHEZ, A PATIENT HERE AT THE CLINICAL CENTER AND SHE WILL TELL US HOW MEDICAL RESEARCH HAS MADE A DIFFERENCE IN HER LIFE. SO WE'RE HERE TODAY THE TALK ABOUT THE IMPORTANCE OF BIOMEDICAL RESEARCH, HOW IT ADVANCES OUR KNOWLEDGE ABOUT HEALTH AND HOW TO OVERCOME DISEASE AND ALSO HOW THE NIH INVESTMENT IS A POWERFUL ECONOMIC ENGINE IN ADDITION TO AN ENGINE OF DISCOVERY. AND HOW POSSIBLE CUTS FROM SEQUESTRATION WILL HAVE FAR-REACHING NEGATIVE EFFECTS ON ALL THOSE THINGS. WHEN IT COMES TO NIH WE HAVE BOTH A LOCAL AND A NATIONAL IMPACT. RIGHT NOW YOU'RE IN THE LARGEST RESEARCH HOSPITAL IN THE WORLD DEVOTED ENTIRELY TO RESEARCH. WE TREATED THOUSANDS OF PATIENTS OVER THE YEARS THIS HAS BEEN THE SITE FOR MANY GROUND BREAKING ADVANCES. THE FIRST CHEMOTHERAPY FOR CANCER HAPPENED HERE. THE CRACKING OF THE GENETIC CODE BY MARSHALL NEREMBURG HAPPENED HERE. FIGURING HOW TO MAKE THE BLOOD SUPPLY SAFE FROM HEPATITIS AND HIV WHICH WE TAKE FOR GRANTED HAPPENED HERE AND WE CONTINUE TO MAKE DISCOVERIES LIKE THIS EVERY DAY. BUT THIS IS JUST A SMALL FRACTION OF NIH'S INVESTMENT. BECAUSE MORE THAN 80% OF THE DOLLARS THAT COME TO NIH THROUGH THE TAX PAYERS GO TO RESEARCH INSTITUTIONS AROUND THE COUNTRY SUCH AS JOHNS HOPKINS. TO SUPPORT NEARLY 400,000 -- STAFF WORKING ON HUNDREDS OF DISEASES. COMMON AND RARE. SO WHEN NIH FUNDING IS CUT, IT'S NOT JUST FELT HERE IN BETHESDA, IT'S FELT IN EVERY STATE AROUND THE COUNTRY. AND EVEN AROUND THE WORLD. SO WHO WILL PAY THE PRICE THEN FOR THIS LENDING ACROSS THE BOARD CUT KNOWN AS SEQUESTERS? ULTIMATELY PATIENTS AND FAMILIES WHO ARE COUNTING ON US TO FIND THOSE NEXT PROMISSION CURES AND TREATMENTS. CUTS WILL RESULT IN SLOWER PROGRESS AGAINST OUR MOST COMMON DISEASES SUCH AS ALZHEIMER'S, CANCER, AIDS, DIABETES AND HEART DISEASE. AND TO THOSE RARE DISEASES TOO WHICH OFTEN GIVE WINDOWS HOW TO TREAT MORE COMMON ONES. CUTS MEAN DELAY IN FINDING REVOLUTIONIZED TREATMENT. CUTS WILL MEAN A DELAY FOR INSTANCE IN DEVELOPING A UNIVERSEAL VACCINE AGAINST INFLEW WHEN, A PROJECT GOING EXTREMELY WELL BUT WILL BE SLOWED BY THIS ENTERPRISE. SO WHEN IT COMES TO FINDING CURES AND TREATMENTS, TIME IS OF THE ESSENCE AND WE FEAR THAT TIMES WILL BE SLOW IN TERMS OF PROGRESS ABOVE THESE CUTS. SO IT'S A VERY SERIOUS TIME WE'RE GATHERED HERE WITH JUST DAYS BEFORE THAT MARCH 1st DEADLINE AND I VERY MUCH NOW LIKE TO ASK YOU TO WELCOME SENATOR BARBARA MIKULSKI WHO HAS BEEN SUCH A STRONG VOICE FOR NIH AND I LEARNED TODAY SHE WAS PREVIOUSLY SUPPORTED BY AN NIH GRANT HERSELF IN HER SOCIAL WORK GRADUATE PROGRAM AND WE'RE PROUD OF THAT. SO PLEASE I WOULD LIKE TO INTRODUCE THE SENIOR SENATOR FROM THE STATE OF MARYLAND, SENATOR BARBARA MIKULSKI. [APPLAUSE] >> GOOD MORNING, EVERYBODY. I'M ONCE AGAIN DELIGHTED TO BE HERE AT THE NATIONAL INSTITUTES OF HEALTH. TO SEE THE WONDERFUL WORK THAT THEY'RE DOING, TO SAVE LIVES, HELP PEOPLE WHO TURN TO LIVELIHOODS AND BE ABLE TO DEVELOP CURES OR HELPING DRUGS, THROUGH INTERVENTIONS THAT ENABLE PEOPLE TO LIVE PRODUCTIVE LIVES AND GO ABOUT THE ACTIVITIES OF DAILY LIVING. I A YEAR AGO TODAY NOT MANY MY CAPACITOR, WHICH MANY VISITING (INDISCERNIBLE) I'M HERE TODAY AS CHAIRPERSON OF THE SENATE APPROPRIATIONS COMMITTEE. THAT COMMITTEE THAT PUTS MONEY IN THE FEDERAL CHECKBOOK TO MAKE SURE THE AMERICAN GOVERNMENT DOES THE JOB THE AMERICAN PEOPLE WANT THEM TO DO. I'M HERE WITH REPRESENTING BOTH MYSELF, MEMBERS OF THE APPROPRIATIONS COMMITTEE, AND WE HAVE A BIPARTISAN GROUP OF STAFFERS WITH US TO LISTEN AND TO LEARN TO FIND OUT WHAT DOES THIS SEQUESTER MEAN TO THE NATIONAL INSTITUTES OF HEALTH? SEQUESTER IS A WASHINGTON SPEAK WORD THAT NOBODY UNDERSTANDS. NOBODY KNOWS THE MEANING, NOBODY KNOWS THE CONSEQUENCES. THAT IN PLAIN ENGLISH STRAIGHT TALK SEQUESTER MEANS THAT ON MARCH 1st THERE WILL BE ACROSS-THE-BOARD CUTS IN EVERY SINGLE PROGRAM WITH EXCEPTION OF MEN AND WOMEN IN MILITARY UNIFORM AND VETERANS. IT MEANS IN THE NATIONAL INSTITUTES OF HEALTH THERE WILL BE A 5% ACROSS-THE-BOARD CUT IN EVERY SINGLE PROGRAM, EVERY SINGLE RESEARCH ENDEAVOR AND ALSO IN EDUCATION AND TRAINING AND PROMISING NEW IDEAS TO BE EXPLORED AGAIN TO HELP PEOPLE. TODAY I'M SURROUNDED BY PEOPLE WHO HAVE EITHER WON THE NOBEL PRIZE OR WHO OUGHT TO WIN THE NOBEL PRIZE. BUT THEY NOT ONLY SEEK TO WIN THAT PRIZE, THEY SEEK TO RUN THE RATES TO FIND A CURE FOR ALZHEIMER'S, AUTISM, EVEN IF WE STUCK WITH THE A WORDS, ARTHRITIS, AIDS, BREAST CANCER, THE RACE FOR THE CURE SO WE SHOULD RACE TO END SEQUESTER. I WANT TO HEAR FIRSTHAND WHAT IT WOULD MEAN. WELL FIRST, IT WOULD BE AN IMPACT IN 15,000 MARYLANDERS WHO WORK EITHER AT NIH OR WHO BENEFIT FROM THE RESEARCH FUNDING AT OTHER MARYLAND INSTITUTIONS, WHETHER IT IS JOHNS HOPKINS, THE UNIVERSITY OF MARYLAND, NEARBY INSTITUTES, IT WILL ALSO HAVE A DIRECT IMPACT ON MARYLAND'S VIBRANT"D=Q BUT FOR THE NATION IT MEANS THOSE 15,000 MARYLANDERS COULD EITHER FACE CUTS IN THEIR RESEARCH AND IN CERTAIN AREAS OF ENDEAVOR MIGHT EVEN BE THOROUGH. SO INSTEAD OF THE WORLD WANTS THE GIVE PRIZES, THE WORLD BEAT THE DOOR TO THAT ARE DOOR, WHAT DO WE DO? WE TALK ABOUT THREATS TO THE UNITED STATES, WE FORE FOREIGN PREDATORS AND TERRORISM, WE FEAR FOREIGN COMPETITION, WHAT ARE THE CHINESE DOING, BUT WE'RE ABOUT TO INFLICT UPON US A SELF-INFLICTED WOUND. SO I LOOKED AT THE NUMBERS. EVERYBODY TALKED ABOUT YOU KNOW, IT'S MAP. I'M LOOKING AT THE MAP. GUESS WHAT, NIH THE RECEIVE QUESTER CUT MEANS $1.5 BILLION. $1.5 BILLION. NOW, THE FUNDING FOR NIH FOR -- IS $30 BILLION. $30 BILLION. THERE'S A LOT OF MONEY. LOOK WHAT ITS IMPACT IS ON OUR SOCIETY. OVER TEN YEARS AGO THE UNITED STATES CONGRESS AND BIPARTISAN RACES BEGAN TO DOUBLE THE FUNDING AT NIH WE KNEW THAT WE WERE IN A RACE TO THE FUTURE, FOR THE INNOVATION ECONOMY, TO COME UP WITH NEW IDEAS AND NEW RESEARCH, NEW OPPORTUNITIES TO HELP PEOPLE HELP PEOPLE IN OUR OWN COUNTRY AND DEVELOP THE PRODUCTS, FDA APPROVED, THAT WE COULD SELL AROUND THE WORLD. WE WERE THE TURBO ENGINE OF THE INNOVATION ECONOMY. WE WENT FROM 13 BILLION TO 27 BILLION IN 2003. BUT AS THE IRAQ WAR WENT OFF OUR WAR AGAINST DISEASE BEGAN TO SLOW DOWN. SO NOW YES, WE HAVE $30 BILLION BUT WE KNOW THAT THAT IS MEANT A CUT OF OVER 20% IN PURCHASING POWER, WHETHER IT'S IN NUMBER OF RESEARCH GRANTS THAT CAN BE AWARDED BASED ON PEER REVIEW, OR WHETHER IT'S THE NUMBER OF PETRI DISHES WE BUY FROM THE PRIVATE SECTOR ECONOMY. AND WHAT HAVE WE BE DOING WITH ALL THE MONEY THAT WE GAVE NIH? GUESS WHAT? JUST WHEN WE KNEW SEQUESTER WAS GOING TO HAPPEN, NIH ANNOUNCED IT HAS CUT CANCER DEATH RATES BY 11%. 11% IN WOMEN AND 19% IN MEN. WHAT ARE WE FINDING? AT HIV AIDS UNDER THE LEADERSHIP OF DR. FAUCI, NO LONGER A DEATH SENTENCE. WE LEARNED THAT AROUND THE WORLD WE LOVE WHAT BILL GATES IS DOING BUT BILL GATES COULDN'T HAVE DONE WHAT HE'S DOING WITHOUT NIH AND WE HAVE ERADICATED POLIO AND SMALLPOX IN OUR OWN COUNTRY AND WE'RE DOING IT AROUND THE WORLD UNDER THE AMERICAN FLAG, UNDER THE FLAG OF INTERNATIONAL PUBLIC HEALTH, THE WORLD LOVES AMERICA BECAUSE WE ARE HELPING THEM IN EVERY VILLAGE AROUND THE WORLD. THESE BREAK THROUGHS OCCURRED BECAUSE OF GOVERNMENT SPONSORED RESEARCH. WELL, RIGHT NOW, WE'RE ON OUR WAY TO THESE CUTS. I FEAR THAT THE $1.5 BILLION CUT AT NIH WILL DELAY SCIENTIFIC PROJECTS, WILL MAKE HUNDREDS FEWER RESEARCH AWARDS, THEREFORE JEOPARDIZING THOUSANDS OF JOBS. IT WILL DELAY PROGRESS IN RESEARCH IN DEBILITATING CONDITIONS LIKE PARKINSON'S OR LOU GEHRIG'S DISEASE THAT TOOK MY FATHER'S LIFE, THE CONSEQUENCES OF ALZHEIMER'S. IT ALSO MEANS COMMUNITY, STATES THAT, A STATE GOVERNMENT THAT RECEIVES NIH, IT'S USUALLY THE ICONIC MEDICAL INSTITUTION THAT RECEIVES NIH FUNDING. MY OWN STATE, IT'S HOPKINS IN MARYLAND. SENATOR MOREAN, VICE CHAIRMAN OF LABOR HHS AND CANCERS AT THE UNIVERSITY OF KANSAS. SO RESEARCH IS GOING ON IN EVERY COMMUNITY, EVERY MEDICAL SCHOOL. WORKING WITH PUBLIC HEALTH, MEDICINE, NURSING, SOCIAL WORK TO SEE WHAT ARE THE BREAK THROUGHS. JOHNS HOPKINS ANTICIPATES THE DEFENSE CUTS COULD RESULT IN OVER $60 MILLION IN REDUCTION THAT, WILL HAVE A DIRECT IMPACT ON JOBS, ON THE PROGRESS OF RESEARCH AND QUITE FRANKLY, IN HEALTH. THE NATIONAL INSTITUTES OF HEALTH STANDS FOR HEALTH, IT COULD BE THE NATIONAL INSTITUTE OF HOPE. HOPE THAT YOU'LL FIND THAT CURE. THAT YOU'LL FIND THAT HELP, THAT YOU'LL GET A HELPING HAND WHEN YOU FACE A DRACONIAN OR EVEN ORPHAN SITUATION. IF YOcfsebm A YOUNG PERSON WHO HAS BEEN GOOD AT MATH, GOOD AT SCIENCE, EVERYTHING THE PRESIDENT SAYS HE WANTS YOU TO BE, BUT THEN WHEN YOU WANT TO GO AHEAD AND STUDY THE MONEY TO HELP YOU WITH GRANTS AND FELLOWSHIPS SHRINKS AND SHRINKS AND SHRINKS. IF YOU GO INTO QUESTION THAT TO GET THAT M.D. OR Ph.D., WHAT HAPPENS TO YOU, YOU STAND IN LINE TO GET YOUR RESEARCH. IT MEANS THAT THERE'S AUDACIOUS GRANTS COULD BE CUT. I WAS STUNNED LAST WEEK WHEN I READ THAT UNDER DR. COLLINS' LEADERSHIP THERE WERE 22 GRANTS IN OPHTHALMOLOGY, CALLED THE AUDACIOUS GRANTS, THEY WERE MEANT TO FIND THOSE YOUNG PEOPLE WITH OUT OF THE BOX IDEAS TO COME UP WITH NEW IDEAS FOR DISEASES THAT AFFECT THE EYE FROM GENETICS TO CELLULAR REGENERATION, TO BUY I DON'T KNOWIC PROSTHETICS THAT COULD RESTORE SIGHT, RESTORE VISION AT THE NATIONAL INSTITUTES OF HOPE. IF WE DO THAT, THAT'S GOING TO BE CUT, WHAT'S GOING TO HAPPEN TO THOSE 22 GRANTS? AND JUST THE OTHER DAY FDA APPROVED A BUYIONIC PROSTHETIC DEVICE TO IMPROVE EYE SIGHT AND ELIMINATE BLINDNESS. THIS IS WHY I CALL IT THE NATIONAL INSTITUTES OF HOPE T. NATIONAL INSTITUTES OF HEALTH. SO WE HAVE TO STOP SEQUESTER. I'M GOING TO WORK ON A BIOPARTISAN BASIS, HANDS ACROSS THE AISLE, HANDS ACROSS THE DOME TO COME UP WITH A SOLUTION. WE HAVE A PLAN. I HAVE A PLAN WORKING WITH THE DEMOCRATIC LEADERSHIP FOR A BALANCED APPROACH FINDING REVENUES, STRATEGIC CUTS, UNNEEDED PROGRAMS, AND WE CAN DO IT. THE PROGRAM THAT I'M ADVANCING WITH MY DEMOCRATIC COLLEAGUES WE WILL HAVE 50% IN REVENUE PLUGGING LOP HOLES THROUGH SENDING JOBS OVERSEAS, IMPLEMENTING THE WARREN BUFFET RULE THAT SAYS PAY AS MUCH TAXES AS YOUR SECRETARY. AND WE WILL HAVE STRATEGIC CUTS IN FORM SUBSIDY, $27 BILLION AND ANOTHER 20 BILLION CUTS IN DEFENSE THAT WILL START IN 2015 WHEN OUR TROOPS COME BACK HOME. I HAVE A PLAN FOR $86 BILLION TO END SEQUESTER FOR CAST TODAY WE CAN ALL BREATHE EASIER TOMORROW. SO KNOW THAT I WILL FIGHT TO END SEQUESTER, TO END DOUBT AND UNCERTAINTY IN THIS DRACONIAN APPROACH TO DEALING WITH THE BUDGET. I AM SO PLEASED THAT MY VICE CHAIRMAN SENATOR SHELBY SENDS TOP STAFF HERE TO HEAR WHAT I HEAR. I'M SO PLEASED SENATOR MORAN RANKING MEMBER OF SUBCOMITTEE HHS ALSO SENT HIS STAFF. WE MIGHT NOT AGREE ON THE EXACT POLICY BUT WE DO AGREE THAT WE MUST END SEQUESTER, COME UP WITH COMMON SENSE BUDGET AND LET THE BRILLIANT PEOPLE IN OUR COUNTRY CONTINUE TO BE THE NATIONAL INSTITUTE OF HOPE. I LOOK FORWARD TO WORKING WITH MY COLLEAGUES TO END SEQUESTER AND MAKE SURE THE VITALITY, VIBRANCY AND VISION CONTINUE AT THIS GREAT INSTITUTION. [APPLAUSE] >> THANK YOU, SENATOR. IT IS INDEED A PRIVILEGE TO HAVE YOU HERE WITH US AND HEAR SUCH STIRRING WORDS AND WORDS OF SOME ENCOURAGEMENT IN THE MIDST OF WHAT HAS CERTAINLY BEEN A VERY ANXIOUS TIME FOR ANYBODY INVOLVED IN BIOMEDICAL RESEARCH. I WOULD ALSO LIKE TO EXTEND A SPECIAL WELCOME TO STAFFERS WHO JOINED US HERE, MENTIONED FROM VERY IMPORTANT PARTS OF THE APPROPRIATIONS PROCESS, STAFFERS, ARE CRITICAL TO ALMOST EVERYTHING THAT GETS DONE AND OFTEN ARE THE UNSUNG HEROES WHEN DIFFICULTIES ARISE AND SOLUTIONS NEED TO BE FOUND. WE APPRECIATE ALL THE THINGS THAT Y'ALL ARE DOING AND THANK YOU FOR BEING HERE. I WOULD LIKE NOW LIKE TO INTRODUCE DR. CAROL GREIDER WHO IS THE DANIEL NATHANS DIRECTOR AND DIRECTOR OF DEPARTMENT OF MOLECULAR BIOLOGY AND GENETICS AT JOHNS HOPKINS AND NOBEL LAUREATE, DR. GREIDER CAN GIVE US A SNAP SHOT OF WHAT IT'S LIKE BEING A MARYLAND SCIENTIST IN THE MIDST OF ALL THIS. DR. GREIDER. >> THANK YOU. I WOULD LIKE TO THANK THE SENATOR VERY MUCH FOR HER LEADERSHIP. CERTAINLY BY HER WORDS HAVE GIVEN ME SOME HOPE. I'M CHAIR OF DEPARTMENT OF BIOLOGY GENETICS JOHNS HOPKINS SCHOOL OF MEDICINE. I'M PROUD TO SAY MY RESEARCH IS FUNDED BY THE NIH FOR THE PAST 23 YEARS. IN MY DEPARTMENT AT HOPKINS WE HAVE 15 OWING FACULTY EACH ALSO HAVE BEEN FUNDED ON AVERAGE FOR OVER 20 YEARS. THESE OUTSTANDING SCIENTISTS HAVE MADE SOME OF THE FUNDAMENTAL DISCOVERIES IN MODERN BIOLOGY. INCLUDING IN THE AREAS OF AGING, STEM CELL RESEARCH, VISION, NEUROSCIENCE, INFECTIOUS DISEASE, THE IMMUNE SYSTEM, AND CANCER. FIVE OF US ARE MEMBERS OF THE NATIONAL ACADEMY OF SCIENCES. WE HAVE BEEN HIGHLY SUCCESSFUL AT COMPETING FOR NIH GRANTS OVER THE PAST TEN OR MORE YEARS. IN THE DEPARTMENT WE HAVE OVER 16 MILLION IN NIH FUNDING. WHEN PEOPLE TALK ABOUT FUNDING FOR RESEARCH WHAT COMES TO MIND AND IS OFTEN ASSUMED, IS WHAT WE'RE TALKING ABOUT IS DOLLARS SPENT BUYING EQUIPMENT, TEST TUBES, REAGENTS, THAT STUFF. IN FACT, THE BULK OF THE FUNDS FROM MY RESEARCH GRANT GOES TO SUPPORTING YOUNG PEOPLE WHO WORK IN THE LAB. YOUNG PEOPLE WHO I'M TRAINING TO BE THE NEXT GENERATION OF SCIENTIFIC LEADERS. NOW I SEE THE TRAINING OF THESE BRIGHT YOUNG STUDENTS AS TRULY BEING IN JEOPARDY IF NIH FUNDING FURTHER DECLINES. IN 1985, WHEN I WAS DOING WORK THAT LED TO THE NOBEL PRIZE, THE SUCCESS RATE GETTING A GRANT WAS 33%. TODAY THAT RATE IS 17% AND UNDER CURRENT PROPOSALS IF THE SEQUESTER GOES THROUGH IT MAY GO LOW AS 15%. THIS MEANS THAT MANY OF THE GREAT YOUNG SCIENTISTS TODAY WHO WOULD HAVE BEEN FUNDED WHEN I WAS FUNDED ONLY HALF OF THEM WILL ACTUALLY GET THEIR GRANTS. GIVEN THAT OUR WORK IN MY LAB ON TELOMERES AT THE TIME WAS REALLY FAR FROM OUTSIDE MAINSTREAM RESEARCH, I'M NOT SURE IN THE CURRENT CLIMATE WE HAVE FOR RESEARCH FUNDING THAT I WOULD HAVE RECEIVED FUNDING TO BE ABLE TO DO THE WORK THAT LED TO THE NOBEL PRIZE. IT'S WELL ESTABLISHED THAT WORK THAT LEADS TO NOBEL PRIZE IS USUALLY DONE BY PEOPLE AT THE BEGINNING OF THEIR CAREER. BREAK THROUGHS COME FROM YOUNG SCIENTISTS. THIS GROUP IS IN JEOPARDY TODAY. IN MY DEPARTMENT WE HAVE ALREADY BEEN FEELING THE EFFECTS OF THE VERY TIGHT NIH BUDGET BECAUSE OF THE FLAT NIH BUDGET WHICH IS ACTUALLY DECREASING IF YOU COUNT INFLATION. IN THE LAST TWO YEARS THE GRANTS WE BRING IN ARE NOT SUFFICIENT TO PAY FOR THE TRAINEES WHO WE SUPPORT. FOR THE FIRST TIME IN THIS YEAR IN ALL THE YEARS I HAVE BEEN CHAIR OF THE DEPARTMENT WE HAVE A PROJECTED BUDGET DEFICIT AND THIS DEFICIT IS DUE ENTIRELY DUE TO THE LOW PERCENTAGE OF GRANTS THAT ARE BEING FUNDED. THIS DOWNTURN AFFECTED MY LAB DIRECTLY. OVER THE PAST 15 YEARS I HAVE TYPICALLY TRAINED AND SUPPORTED 8 TO 10 YOUNG TRAINEES. IN THE LAST YEAR THAT NUMBER HAS DROPPED TO FOUR. SO EVEN BEFORE THE TALK OF SEQUESTRATION, THINGS HAVE BEEN HARD. WITH AN ADDITIONAL 5% DECREASE IN NIH BUDGET IT'S PROJECTED THAT THERE WILL BE OVER 20,000 FEWER JOBS. WITH THE LOOMING SEQUESTER IN MIND, I RECENTLY REVIEWED MY OWN BUDGET PROJECTIONS AND REALIZED I COULD NOT MAKE AN OFFER TO A PROANYTHING PROMISSION YOUNG RESEARCHER I JUST INTERVIEWED FOR A POSITION. IN ADDITION TO THE NEXT GENERATION OF SCIENTISTS FACULTY AT HOPKINS ARE VERY ENTREPRENEURIAL. USING CREATIVE ENERGY TO START A NUMBER OF NEW COMPANIES AN PROVIDING ADVICE AND GUIDANCE TO MANY IN THE BIOTECHNOLOGY AND PHARMACEUTICAL COMPANIES. WE HEARD LAST WEEK FROM PRESIDENT OBAMA THAT THE 4 BILLION INVESTMENT THAT WENT INTO THE HUMAN GENOME PROJECT SPURRED ALMOST 800 MILLION IN ECONOMIC GROWTH. WHICH IS 140 FOLD RETURN ON INVESTMENT. BY HIRING THE BEST MOST CREATIVE YOUNG FACULTY WE CAN NURTURE AND TRAIN ENTREPRENEURIAL SCIENTISTS OF TOMORROW WHO WILL NO DOUBT BRING SIMILAR SPECTACULAR RETURNS ON INVESTMENT TO THE U.S. ECONOMY. HOWEVER WITH DECLINE IN NIH FUNDING MY DEPARTMENT WILL NOT BE ABLE TO HIRE OR SUPPORT CREATIVE YOUNG SCIENTISTS AND A GENERATION OF INNOVATORS MAY BE MISSING. THE U.S. HAS BEEN A LEADING INNOVATOR IN SCIENCE AND TECHNOLOGY IN THE PAST MANY DECADES. HOWEVER, GIVEN LARGE INVESTMENTS IN RESEARCH AND DEVELOPMENT NOW BEING MADE BY OTHER COUNTRIES ESPECIALLY CHINA, WE STAND TO LOSE OUR STATUS AS A PLACE TO GO, TO INNOVATE IF WE DON'T SUPPORT OUR YOUNG SCIENTISTS. WE CAN SURELY DO BETTER THAT THAT AND WE MUST. THANK YOU. [APPLAUSE] >> THANK YOU, DR. GREIDER. IN ALL OF OUR DISCUSSIONS TODAY, KEEP IN MIND THOSE WHO ARE REALLY THREATENED BY CUTS IN BIOMEDICAL RESEARCH ARE ULTIMATELY THE PATIENTS AND ALL OF US WILL AT SOME POINT BE PATIENTS, OUR FAMILY MEMBERS MAY BE NOW. HERE AT THE NATIONAL INSTITUTES OF HOPE, CURES AND THERAPIES DELAYED, OUR HOPE DENIED. TO OFFER PATIENT'S PERSPECTIVE ON THE IMPORTANCE OF WHAT THE NATIONAL INSTITUTES OF HEALTH SUPPORTS I WOULD LIKE TO INTRODUCE MY FELICIA SANCHEZ WHO WILL TELL YOU HER STORY. FELICIA. >> HI, EVERYONE. MY NAME IS FELICIA. I HAVE BEEN COMING TO THE NIH FOR THREE YEARS. I CAME HERE FROM -- I CAME IN 2009 FROM THE UNIVERSITY OF (INAUDIBLE) IN ARIZONA. WHERE MY DOCTOR TOLD ME THERE IS NOTHING I CAN DO FOR YOU. WE DON'T KNOW WHAT IT IS OR WHY AND IN THE NEXT FEW MONTHS YOU'LL PROBABLY DIE AND HE TOLD ME THAT AT THE AGE OF 21. HE TOLD ME AT THE AGE OF 21 AND THEN I REMEMBER THINKING AND ASKING MYSELF WHAT AM I SUPPOSED TO DO, GO HOME AND WAIT TO DIAL -- DIE? HE SAID NO, GO TO NIH. AND THEN SO I CAME HERE TWO YEARS FROM THE SMALL DUSTY TOWN GROWING UP IN THE COTTONS, AND THEN I SAW THIS BUILDINGi-[ AND I WAS LIKE WOW, MY WHOLE TOWN COULD WORK IN JUST THIS BUILDING. THEY CAN EVEN LIVE COMFORTABLY AND THAT WAS ONE BUILDING IN THIS WHOLE BIG GREAT CITY. I THOUGHT ALL THE POSSIBILITIES, THAT IS WHAT NIH GAVE ME. AND THEN NIH GAVE ME MEDICINES AND TREATMENTS, INSURANCE DIDN'T COVER THE HOSPITALS BACK AT HOME COULDN'T GIVE ME. THEY JUST SUMMONED THEM UP AND ALONG WITH RESEARCH MEDICINE AND WITHIN A MONTH THEY MADE ME BETTER AND I GOT TO GO HOME AND ENJOY LIFE, FAMILY AND FRIENDS. AND LAUGHTER. VERY HAPPY THAT I COULD BE THERE THAT YEAR. AND THEN I WAS FOR TWO YEARS AND SADLY AT THE AGE OF 23 MY NEUROSURGEON IN PHOENIX TOLD ME YOU WILL BE PARALYZED FROM YOUR WAIST DOWN, YOU'LL NEVER WALK AGAIN IF YOU DONE GET THIS SURGERY. HE SAID WORD FOR WORD, IT WILL BE A MIRACLE TO FIX THIS. AND THE ONLY THING I CAN THINK OF, I NEED TO GO TO THE NIH. I CAME TO THE NIH AND I WAS WALKING PERFECTLY WITHOUT THE SURGERY. AND (INAUDIBLE) AT NIGHT AFTER THAT VISIT AND TO A GIRL WHO HAS NEVER FLOWN BEFORE BESIDES -- FOR THE FIRST TIME, I REMEMBER LOOKING DOWN AT TEXAS AND LIKE BUILDINGS FOR MILES AND MILES AND THAT NIGHT, FLY OVER IT, HUGE, IT GOES ON FOREVER. AND WE DO ALL THE PEOPLE IN THE STORES, ALL THE PEOPLE IN THEIR CARS, ALL THE PEOPLE IN NIH, ALL THE PEOPLE IN MARYLAND, AND EVEN ALL THE PEOPLE IN CHINA, I WAS IN THIS LITTLE BITTY TOWN AND I WAS ONE GIRL OF BILLIONS ALL OVER THE WORLD. AND LIKE HOW DO I HAVE TIME TO HEAR -- GOD HAVE TIME TO HEAR ALL OF OUR PRAYERS? HE MUST HAVE ANGELS WORKING HERE ON EARTH BECAUSE I HAVE MET PEOPLE AND THEY HAVE ANSWERED MY PRAYERS. I WOULDN'T KNOW WHAT I WILL DO WITHOUT DOCTORS, RESEARCHERS AND SCIENTISTS HERE. I'M ONLY HERE TODAY BECAUSE OF THEM. I HAVE WOULD BE IN A LONELY EMPTY GRAVE, BONES AND DUST. AND A YOUNG GIRL'S LIFE CUT SHORT BECAUSE OF THE UNKNOWN. AND I THANK ALL THOSE PEOPLE BECAUSE THEY GAVE ME BACK SOMETHING I THOUGHT I HAD LOST. AND LIKE THE SENATOR SAID, HOPE. AND IF THE SENATOR (INDISCERNIBLE) THERAPY ON BEHALF OF MYSELF AND THE NIH FOR YOUR APPRECIATION AND SUPPORTING THIS FACILITY IN THE PAST AND THE PRESENT AND P THE FUTURE. [APPLAUSE] >> IT SAYS MARYLAND AND IT'S A BEAUTIFUL PICTURE OF ME IN A DOWNTON ABBEY COSTUME. IT'S A BEAUTIFUL PICTURE AND I THINK THOSE HAVE DEEPLY -- THANK YOU VERY MUCH. AND WE WISH YOU GOOD HEALTH. THANK YOU FOR YOUR INSPIRATIONAL WORDS AND YOUR INSPIRATIONAL LIFE. >> THANK YOU VERY MUCH. I WILL NOW GO TO THE Q&A AND IF YOU COULD IDENTIFY YOURSELF AND YOUR AFFILIATION. >> PAUL BASKIN WITH CHRONICLES OF HIGHER EDUCATION. AT THE AAAS CONFERENCE IN BOSTON THIS PAST WEEKEND THERE WAS TALK ABOUT ENCOURAGING TRANSFORMATIVE RESEARCH THAT WE'RE HEARING ABOUT HERE AND THERE WAS CONCERN THAT ALREADY THE EXISTING REVIEW PROCESS AT THE NIH AND OTHER AGENCIES FOR THAT MATTER DON'T DO ENOUGH TO HELP ENSURE GET THE MOST TRANSFORMATIVE RESEARCH THAT IT ENCOURAGES MORE STICK TO THE MORE CONSERVATIVE TRIED AND TRUE MECHANISMS THAT THERE'S A LOT OF CONCERN WITH THE SEQUESTER OF BUDGET CUTS GO THROUGH IT WILL MAKE THE PROBLEM WORSE. SO I WANT TO HEAR WHETHER DIRECTOR ON YOUR SENSE OF THAT PROBLEM, SIZE OF THAT PROBLEM, DEGREE TO WHICH SEQUESTER AND OTHER BUDGET SHORE FALLS MAKE THAT THE PROBLEM OF BREAK THROUGH TRANSFORMATIVE RESEARCH MORE DIFFICULT TO ACHIEVE. >> THANKS FOR THE QUESTION, PAUL. SO WE DO EVERYTHING WE CAN EVEN IN THIS DIFFICULT BUDGET SITUATION TO BE SURE WE'RE ENCOURAGING INNOVATION. YET IT IS CHALLENGING. IMAGINE YOURSELF AS REVIEWER LOOKING AT A PILE OF 50 GRANTS THAT HAVE COME IN THAT CYCLE, TRYING TO DECIDE WHICH ONE OR TWO YOU MIGHT BE ABLE TO FUND. AMONG THEM ARE SOLID IMPRESSIVE PROPOSALS FROM INDIVIDUALS WITH WITH A LONG AND IMPRESSIVE TRACK RECORD PROPOSING REALLY SOLID RESEARCH THAT WILL PUSH BACK THE FRONTIERS. THEN ALSO THE HERE AND THERE OF SOMEWHAT REALLY OUT OF THE BOX IDEAS FROM PERHAPS YOUNGER INVESTIGATORS WHO AREN'T ADS WELL KNOWN, DON'T HAVE AS MUCH TRACK RECORD. YOU HAVE TO SOMEHOW DECIDE THE PROBLEM IS NOT THAT WE DON'T FAVOR INNOVATION. THE PROBLEM IS RESOURCES ARE SUFFICIENTLY LIMITED THAT WE DON'T FAVOR EITHER TYPES OF THOSE RESEARCH IN WAY WE LIKE TO. WE HAVE SPECIAL PROGRAMS AT NIH WHERE YOU CAN ONLY APPLY. IF YOU HAVE AN OUT OF THE BOX IDEA, THE PIONEER AWARDS, NEW INNOVATORS, I WOULD LOVE TO SEE THOSE EXPANDED. FRANKLY, WE CAN'T DO ANY OF THAT UNLESS WE GET BEYOND THE CURRENT CIRCUMSTANCE OR ON THE AVERAGE ONLY ONE IN SIX APPLICATIONS GET FUNDED AND UNFORTUNATELY THE SEQUESTERS KICK IN, THAT WILL DROP EVEN FURTHER. >> LET'S BE CLEAR. DR. COLLINS HAS NO FLEXIBILITY, IT'S NOT LIKE YOU CAN SAY I'M GOING TO GO THROUGH THIS AND THAT. SEQUESTER IS AN ACROSS-THE-BOARD APPROACH. IT IS A MUTE ACT APPROACH. IT IS NOT SURGICAL AND SPECIFIC. SO IT'S 5% ACROSS EVERY SINGLE THING IN EXACTLY THE SAME WAY. SO SO 2014, THE GOOD DOCTOR AND OTHER FEDERAL AGENCIES TO HAVE FLEXIBILITY. NIH IS TO HAVE A 1% FLEXIBILITY WHERE THEY COULD MOVE SOMETHING THAT'S PROMISING. SO WHERE IS THE RIGHT MANAGEMENT DIRECTIVE, GO WHERE THERE'S OPPORTUNITY, AND THERE'S THE PROMISE MAYBE EVEN ACCELERATE BUT HE WILL HAVE NO FLEXIBILITY I WANT TO POINT THAT OUT BECAUSE MUCH IS SAID BY SOME PEOPLE LET'S GIVE THEM FLEXIBILITY SO THEY CAN MANAGE IT BETTER. WELL, THAT'S THE ONLY (INAUDIBLE) PERFECT THAT IDEA AND IN DEFENSE OF THE AMERICAN PEOPLE LIES IN WHAT WE JUST HEARD. SO WE HAVE TO STOP SEQUESTER AND TROY TO MAKE SEQUESTER BETTER. WE HAVE TO STOP IT, WE HAVE TO COME UP WITH $86 BILLION THIS YEAR. I BELIEVE THAT WE CAN DO IT. WE MIGHT DISAGREE ON POLICY BUT WE AGREE ON OUTCOME. REMEMBER UNDER THE BUDGET CONTROL ACT OF 2011, THAT MANDATES THESE CUTS, SEQUESTER WILL HAPPEN EVERY YEAR FOR NINE YEARS SO IT'S JUST NOT WE SOLVE THIS PROBLEM THIS YEAR. THIS IS WHY WE WOULD HOPE THERE WOULD BE A SOLUTION FOR THIS YEAR AND THEN THE RESOLUTION FOR FUNDING A TRILLION DOLLARS. CERTAINLY IN OUR COUNTRY WITH GOOD WILL, GOOD THINKING, AND GOOD LEADERSHIP WE CAN GET THROUGH IT. IS THAT A MICROPHONE? >> CHAIRMAN (INAUDIBLE) ON THE TAX SIDE PUS SOME GROUPS ON TAX REFORM TAKING UPWARDS OF A YEAR. DO YOU THINK THROUGH THE TAX CODE IS GOING TO BE THE BEST WAY THE DIVERT THESE? AND THAT WILL TAKE A LONG TIME SO THERE'S NOTHING FOR NEXT WEEK'S DEADLINE, WHAT DO YOU THINK NEEDS TO HAPPEN IN THE SHORT AND LONG TERM? >> I THINK THAT WE NEED A BALANCED APPROACH, THIS IS WHAT THE PRESIDENT HAS SAID, AND ECONOMIC LEADERS HAVE OFTEN SAID. THAT MEANS MORE REVENUE, MORE REVENUE COMES FROM PERFORMING THE TAX CODE AND LOCKING UP LOOP HOLES, IT COMES FROM LOOK AT MAPPED BTORY SPENDING AND SEEING WHERE WE CAN GATHER THE FORMS THERE AND LOOKING AT ADDITIONAL STRATEGIC CUTS. I USE THE ONE THAT WAS -- REPORTING FOR FOR THIS YEAR, $27 BILLION IN AS A CULTURAL SUBSIDY THAT AUTHORIZERS HAVE ALREADY BEEN AGREED TO BUT HASN'T BEEN IMPLEMENTED. SO PAYING PEOPLE $27 BILLION NOT TO DO ANYTHING COULD GO BETTER TO PUT IN $27 BILLION TO SOLVING A PROBLEM SO THEY CAN CONTINUE DOING WHAT LEADS TO JOBS TODAY, SAVING LIVES, AND GIVING THIS PRODUCT AROUND THE WORLD THAT MAKES US PROUD. (OFF MIC) >> TOM BURTON, WALL STREET JOURNAL. I UNDERSTAND THE RELUCTANCE TO BE TOO SPECIFIC ABOUT WHAT CUTS AND WHAT GRANTS MAY GET CUT AND SO ON. BUT IN OUR EFFORT TO TRY TO MAKE VIVID TO READERS WHAT REALLY THIS WILL MEAN, DR. COLLINS, CAN YOU OR OTHERS EXPLAIN, WHAT ARE SOME OF THE SPECIFIC GRANTS YOU MAY NOT BE ABLE TO FUND? WHAT -- ON FRIDAY DO YOU START THINKING ABOUT FURLOUGHS? ON MONDAY AFTER THAT DO YOU START THINKING ABOUT LAY OFFS? WHAT'S THE TIMING DAY BY DAY? >> SO IF THIS $1.5 BILLION CUT HITS US ON MARCH 1st, THAT TRANSLATES INTO HUNDREDS OF GRANTS THAT WOULD HAVE BEEN FUNDED IN THIS FISCAL YEAR THAT SIMPLY WILL NOT GET PAID. THE WAY WHICH THE SEQUESTER HITS NIH, EACH ONE OF OUR 27 INSTITUTES AND CENTERS HAS TO TAKE AN EQUIVALENT CUT OF 5.1%. SO THAT MEANS THIS WILL HIT CANCER, IT WILL HIT HEART DISEASE, IT WILL HIT DIABETES, HIV AIDS, IT WILL HIT ALZHEIMERS, IT WILL HIT ALL THOSE AREAS. WE DON'T EVEN HAVE THE FLEXIBILITY TO MAKE THOSE DIFFICULT CHOICES AMONGST THOSE. I CAN'T TELL YOU OF THE HUNDREDS OF GRANTS THAT DON'T GET FUNDED EXACTLY WHICH ONES THOSE WILL BE. WE WILL HAVE A VERY DIFFICULT TIME DECIDING AMONG OUR FAVORITE CHILDREN BECAUSE THAT'S WHAT IT'S GOING TO FEEL LIKE. AND AGAIN, I WANT TO ECHO WHAT CAROL GREIDER SAID IN TERMS OF PERHAPS THE GREATEST CONCERN THAT ALL OF US HAVE ABOUT THE IMPLICATION AND THAT IS WHAT DOES THIS DO TO YOUNG SCIENTISTS? AMONG THE OTHER THINGS THAT WILL HAPPEN IS, OUR TRAINING GRANTS WILL BE CUT. INDIVIDUALS WHO ARE MAYBE GOING TO BE OFFERED POSITIONS TO COME AND WORK IN TRAINING PROGRAMS WON'T GET THOSE OFFERS. CAROL TALKED ABOUT A YOUNG SCIENTIST SHE WAS GOING TO BRING ON BOARD NOW SHE'S NOT SURE SHE CAN DO. THAT PARTICULAR PART OSTEOGENS QUESTIONSES -- OF THE CONSEQUENCES HAS TO BE LOOKED AT. THIS IS NOT A SPIGGOT YOU TURN OFF AND TURN IT BACK ON LATER F. WE LOSE THE TALENTS OF THIS UP AND -- TALENTS OF THIS UP AND COMING GENERATION WITH DREAMS AN VISIONS, THEY'RE NOT COMING BACK. ALL OF US ADVISING YOUNG PEOPLE IN COLLEGE OR STARTING GRADUATE SCHOOL ABOUT CAREERS ARE HAVING A HARDER AND HARDER TIME TELLING THEM THAT THE OPPORTUNITIES ARE LIMITLESS, RIGHT NOW THEY DON'T SEEM LIMITLESS, RIGHT NOW WE HAVE A HARD TIME CONVINCING PEOPLE WHO ARE GETTING INTO THIS FIELD THAT THERE'S A CAREER PATH FOR THEM. BIOMEDICAL RESEARCH DESPERATELY NEEDS A STABLE TRAJECTORY. WHAT WE HAVE HAD INSTEAD IS A ROLLER COASTER OF UPS AN DOWNS AN UPS AN DOWNS. WHAT WE HAVE HAD IS THIS CONSTANT UNCERTAINTY FROM MONTH TO MONTH ABOUT WHAT THAT TRAJECTORY IS GOING TO LOOK LIKE. HEAVENS, WE'RE HERE IN FEBRUARY TALKING ABOUT MARCH, THE FISCAL YEAR BEGAN IN OCTOBER OF LAST YEAR AND WE'RE STILL IN THIS TERRIBLY UNCERTAIN SPACE WHERE WE DON'T ACTUALLY KNOW HOW TO MAKE THE INVESTMENTS THAT WE'D LIKE TO MAKE. THAT'S ABOUT AS CONCRETE AS I CAN GET. I CAN'T TELL YOU ANY SPECIFIC GRANT THAT MAY NOT GET SUPPORTED BECAUSE THOSE ARE ALL STILL UNDER CONSIDERATION BUT I CAN TELL YOU ACROSS THE BOARD IN EVERY DISEASE, THERE WILL BE CONSEQUENCES. RESEARCH WILL NOT HAPPEN, THINGS THAT WERE EXCITELING GO SLOWER THAN THEY SHOULD. >> >> DR. DR. COLLINS YOU MENTION 5% CUTS IN THE INSTITUTES. WOULD THERE BE FLEXIBILITY WITHIN THE INSTITUTE TO BURY THOSE CUTS AND HOW WOULD THAT BE DONE IF SO? >> INSTITUTE DIRECTORS FACED WITH THAT HAVE TO FIGURE OUT THOUSAND DISTRIBUTE THAT AMONG THE MANY KINDS OF MECHANISMS IN TERMS OF GRANTS AND CENTERS, IN TERMS OF INTRAMURAL PROGRAM AND SO ON. EVERYTHING WILL TAKE A HIT. AT LEAST SOME FLEXIBILITY WITHIN THE INSTITUTES. >> HOW TO FEEL ABOUT FLEXIBILITY FLEXIBILITY, SEQUESTER IS LIKE THE TITANIC HITTING AN ICEBERG. FLEXIBILITY ESSENTIALLY SAYS YOU'RE ON A SHIP SINKING, WHICH DECK DO YOU WANT, AS YOU GO DOWN DO YOU WANT TO BE CLOSER TO THE KITCHEN, CLOSER TO THE BEND, ALL YOU'RE GOING TO DO IS BE ON A DIFFERENT DECK BUT YOU'RE STILL HEADING DOWN. WHAT WE NEED TO DO IS NOT HIT THE ICEBERG. WE HAVE UNTIL NEXT FRIDAY, WE COULD PASS LEGISLATION, WE CAN MOVE TO DO IT. WHEN THERE IS A WILL TO DO IT. AND ALSO THOUGH WORKING ON A BIPARTISAN BASIS ACROSS THE DOME, WE ALSO ARE LOOKING AT MARCH 27th WHEN THE FISCAL YEAR, CONTINUING RESOLUTION EXPEERS. WE'RE ALSO LOOKING AT DEALING WITH THAT SO WE WOULD HAVE A LEGISLATIVE VEHICLE TO SOLVE THE PROBLEM OF SEQUESTER TO GET US INTO BEYOND THE CR AND REALLY THEN FOCUS, GIVE CERTAINTY FOR THIS YEAR AND FOCUS IN THE FISCAL YEAR FOR TWO APPROPRIATIONS WHILE THE PRESIDENT HOPES TO SEEK OTHER LEADERSHIP GRAND BARGAIN. >> JOCELIN (INAUDIBLE) SCIENCE MAGAZINE. >> DID YOU SAY SCIENCE MAGAZINE? >> YEAH. OTHER GRANTS THAT ARE ON HOLD RIGHT NOW BECAUSE OF THE SEQUESTRATION THAT YOU -- HAVE BEEN THROUGH COUNSELING JUST CAN'T FUND THEM YET? AND ALSO, CAN YOU ADDRESS THE QUESTION ABOUT INTRAMURAL FURLOUGHS? ESPECIALLY LIKE IN THE CLINICAL CENTER, ARE THERE PEOPLE WHO WILL BE PRESERVED BECAUSE YOU GOT PATIENTS HERE? >> SO IN TERMS OF WHERE WE ARE WITH CURRENT PLAN, WE'RE UNDER CONTINUING RESOLUTION, OCTOBER 1st, AS YOU JUST HEARD, EXPIRING MARCH 27, WITHOUT CLEAR UNDERSTANDING OF WHERE THAT'S GOING, WE HAVE NOT FELT IT WAS APPROPRIATE TO EVEN FUND GRANTS WHERE WE'D ALREADY MADE A MULTI-YEAR AWARD AT 100% OF THEIR LEVEL. SO PEOPLE WHO ARE IN THAT CIRCUMSTANCE OF GETTING FUNDED AT 90% SINCE OCTOBER 1st, TO ARE CONTINUING GRANTS AWARDED IN A PREVIOUS YEAR. FOR GRANTS THAT HAVE BEEN REVIEWED THIS YEAR, EVEN THOSE THAT ARE SCORING EXTREMELY HIGH IN OUR RIGOROUS PEER REVIEW PROCESS, WE HAVE BEEN VERY RELUCTANT TO MAKE THE NUMBER OF AWARDS THAT WE NORMALLY WOULD AT THIS TIME OF YEAR BECAUSE WE DON'T KNOW WHAT WE'RE GOING9D TO HAVE TO WORK WITH. SO SOME OF THAT SCIENCE IS BEING HELD UP. AS WE TRY TO FIGURE OUT WHAT ARE THE RESOURCESES THAT WE HAVE IN FY 13 AND OF COURSE WE'RE STILL TRYING TO FIGURE THAT OUT. SO YOU'RE QUITE RIGHT. THE CONSEQUENCES EVEN BEFORE THE SEQUESTER HAVE TO SLOW DOWN THE PROCESS BECAUSE OF LIVING UNDER CR WITH ALL THE THREATS OF WHAT MIGHT HAPPEN NEXT. >> TOM. >> TOM, DID YOU HAVE ANOTHER QUESTION? DID YOU HAVE A FOLLOW-UP? (OFF MIC) >> WHEN WOULD LAY OFFS START? >> HOW SENSITIVE OF THE WALL STREET JOURNAL. >> WELL, AGAIN, WE WILL DO EVERYTHING WE CAN TO TRY NOT TO FURLOUGH, TO LAY OFF EMPLOYEES. WE'RE ALREADY WORKING WITH MANY OF THEM WELL BEYOND WHAT YOU WOULD EXPECT A FEDERAL EMPLOYEE IN A PLACE LIKE THIS TO TRY TO SHOULDER BECAUSE WE HAVE BEEN UNDER SIGNIFICANT STRESS FOR A WHILE. BUT OF COURSE WE CAN'T MAKE ANY PROMISES GIVEN THE UNCERTAINTIES OF WHAT WE'RE ACTUALLY GOING TO HAVE TO LIVE WITH. MUCH OF THIS IS STILL IN FLUX. >> SONDRA YOUNG, CNN. DR. COLLINS, WE HAVE HEARD FELICIA SANCHEZ TALK ABOUT WHAT NIH MEANT TO HER. CAN YOU TALK TO THE IMPACT THESE CUTS WILL HAVE ON PATIENTS LIKE FELICIA? NUMBER ONE, AND NUMBER 2, AGAINST THIS DISCUSSION OF BUDGET CUTS WE HAVE ALSO HEARD THE PRESIDENT ANNOUNCE HIS ADMINISTRATION NEW BRAIN MAPPING PROJECT. IN FACT, YOU TWEETED OBAMA MENTIONED THE NIH BRAIN -- COULD YOU JUST TELL US -- (OFF MIC) >> WE GOT THE PART ABOUT THE BRAIN INITIATIVE AND AND TWEETED ABOUT IT. >> I WOULD LIKE HIM TO TELL US A LITTLE BIT ABOUT THE PROJECT BECAUSE IT'S ESTIMATED TO MEAN SOME $3 BILLION OVER THE NEXT TEN YEARS FOR NIH. WE'RE TALKING ABOUT THIS IN BUDGET CUTS TO OTHER AREAS OF PUBLIC HEALTH. HOW DO YOU RECONCILE THAT? >> WHAT DOES THIS MEAN TO PATIENT? I THINK FELICIA TELLS THAT SORRY MUCH BETTER THAN I POSSIBLY COULD BY RELATING IT TO HER OWN CIRCUMSTANCE, SOMEBODY WHO TOLD HER CHANCE OF SURVIVAL WAS EXTREMELY LIMITED AND WHO IS HERE NOW STANDENING FRONT OF YOU BECAUSE OF THE EXISTENCE OF THIS CLINICAL CENTER. I CAN TELL YOU DOZENS AND DOZENS AN DOZENS OF STORIES LIKE THAT. YET THE CLINICAL CENTER IS SUPPORTED BY THE NIH BUDGET, 240 BED RESEARCH HOSPITAL PLACE WHERE MIRACLES ARE HAPPENING EVERY DAY IS PART OF THE THREAT OF THE SEQUESTER, THE CONSEQUENCES OF THAT WILL BE PATIENTS WHO WANTED TO COME HERE TO BE PART OF CLINICAL TRIALS WILL NOT BE ABLE TO COME. THAT INVESTIGATOR WHOSE WANTED TO START A NEW PROGRAM TO TRY TO FIND A CURE FOR A DISEASE THAT'S CURRENTLY DOESN'T HAVE ONE WILL HAVE TO WAIT PERHAPS PUT THOSE IDEAS PERMANENTLY ON HOLD. THIS IS NOT JUST ABOUT ADMINISTRATIVE TASKS, THIS IS ABOUT REAL PATIENT, REAL CLINICAL OPPORTUNITIES THAT ARE GOING TO BE LOST. THE BRAIN ACTIVITY MAP WHICH YOU MENTIONED WHICH THE PRESIDENT ALSO MENTIONED IN THIS STATE OF THE UNION MESSAGE AND WHICH WAS HIGHLIGHTED IN THE NEW YORK TIMES ON MONDAY IN THE FRONT PAGE STORY, IS A VERY EXCITING POTENTIAL OPPORTUNITY TO BRING TOGETHER SOME VERY HIGH-TECH APPROACHES TO UNDERSTANDING HOW THE BRAIN WORKS IN A INTERDISCIPLINARY MULTI-INSTITUTIONAL WAY THAT WILL PROBABLY STRETCH OUT OVER MANY YEARS, AT LEAST A DECADE. YOU MENTIONED THE BUDGET, WE DO NOT HAVE A BUDGET FIGURE, THIS IS ACTUALLY A CIRCUMSTANCE WHERE ONLY IN THE LAST YEAR OR SO HAS THE MOMENTUM BEHIND THIS BEING EVEN POSSIBLE, BEGUN TO BUILD. THE NOTION IS TO BRING TOGETHER THE DEVELOPERS, TECHNOLOGIES, TOGETHER WITH NEUROSCIENTISTS, TOGETHER WITH COMPUTER SCIENTISTS TO TRY TO REALLY UNDERSTAND NOT HOW HAO A SINGLE ONE WORKS BUT HOW THOUSANDS, MAYBE MILLIONS OF NEURONS WORK TOGETHER TO ACTUALLY ALLOW THE BRAIN TO DO WHAT IT DOES, WHETHER ACTIVATING A PHYSICAL MOTION, WHETHER IT'S VISION OR CONSCIOUSNESS. AND TO BE ABLE TO DO THAT WHERE EMERGENT PROPERTIES OF THE BRAIN WHICH YOU CANNOT DISCERN BY STUDYING ONE NEURON AT A TIME BEGIN THE APPEAR, FIGURING OUT THE LANGUAGE THAT THE BRAIN USES TO DO THESE THINGS. SO THIS IS POTENTIALLY THE FOUNDATION FOR ALL OF NEUROSCIENCE GOING FORWARD. IF SUCCESSFUL, I BELIEVE IT ULTIMATELY WILL BE, IT WILL TEACH US ALL THE THINGS WE NEED TO KNOW TO GET TO ANSWERS TO ALZHEIMER'S AND AUTISM AND TRAUMATIC BRAIN INJURY AND MANY OTHER CONDITIONS. BUT IT IS STILL A NASCENT CONVERSATION AT THE MOMENT. STAY TUNED. THERE WILL BE MORE TO SAY ABOUT THIS. (OFF MIC) >> THANK YOU. DR. COLLINS TALKEDDED A LOT ABOUT THE PROBLEMS WITH OPERATING UNDER A CR. SENATOR MIKULSKI IS THERE A CHANCE THAT CR THAT HALL ROGERS IS WORKING ON AND TURN IT INTO AN OMNIBUS FOR THE END OF YEAR? >> YES. WE HAVE HAD VERY PRODUCTIVE TALKS WITH CONGRESSMAN ROGERS AN CONGRESSMAN WILLIE. THE WAY OUR PROCESSES WORK IS THAT ONCE THE HOUSE ALL APPROPRIATIONS AND REVENUE GOALS MUST STAR IN THE HOUSE. SO BY PUTTING VEHICLE IN PLAY THAT CAN BE AMENDED IN THE SENATE AND YOU CAN HAVE A BACK AND FORTH TO THAT. SO THAT COULD BE THE VEHICLE FOR SOLVING BOTH SEQUESTER, CR AND OMNIBUS IN A METHOD FOR SOLVING THE PROBLEM AND ALSO CAN WE SAY POLICY DISPUTES ABOUT WHERE TO GO. AND I THINK THE HOUSE IS REALLY TRYING TO TAKE LEADERSHIP, HOPE THAT CONGRESSMAN ROGERS CAN PASS A BILL SO SENATE CAN GO TO WORK ON IT. (OFF MIC) >> HOUSING VOUCHERS AND ASSISTANCE FOR MEDICAL AND FOOD ASSISTANCE, WHAT WOULD YOU SAY TO THOSE PEOPLE? >> FIRST OFF SEQUESTER WAS NEVER MEN TO HAPPEN. SEQUESTER WAS MEANT TO BE SUCH AN AWFUL IMPACT APPROACH THAT IT WOULD FORCE MEMBERS OF CONGRESS TO COME TO THE TABLE AND SOLVE CUTTING A TRILLION DOLLARS OVER A TEN YEAR PERIOD IN A WAY THAT WAS A BALANCED APPROACH. REVENUE, MANDATORY SPENDING REFORM, AND STRATEGIC CUTS. AND WE SAY TO THOSE PEOPLE YOU ARE GOING TO BE AFFECTED BY SEQUESTER. IT IS ESTIMATED THAT THE CUTS IN EDUCATION BECAUSE LISTENING TO SEAN DONOVAN WILL BE SIGNIFICANT. IT WILL BE THE LOSS OF SECTION 8 VOUCHERS, IT WILL BE SHRINKING THE AVAILABILITY FOR HOMELESS PROGRAMS. AND PARTICULARLY COMMUNITY DEVELOPMENT GRANTS WHICH LOCAL COMMUNITIES USE TO RENOVATE HOUSING OR PUT MODEST PRICE HOUSING IN THE MARKET. AND THOSE ARE ALSO JOBS IN CONSTRUCTION. EVERY MEMBER, EVERY SINGLE PROGRAM FROM NATIONAL SECURITY TO DOMESTICS WILL BE AFFECTED BY IT. THAT'S WHY IT WAS MEANT NEVER TO HAPPEN BUT NOW IT'S INTENDING SO YOU GOT TO STOP PENDING AND GETTING ON WITH ENDING SEQUESTER FOR THIS YEAR. IT WILL REQUIRE $86 BILLION. CERTAINLY WE CAN COME UP WITH THAT. AND ALSO THEN RESOLVING THE CR, CONTINUING RESOLUTION, GETTING THE FUNDING STRAIGHT FOR 2013 AND LOOKING AT WHAT WE NEED TO DO IN THE FUTURE. IN THE AMERICAN BUSINESS COMMUNITY THEY NEED CERTAINTY. THEY NEED TO HAVE CERTAINTY TO KNOW WHAT TO DO. THEY NEED CERTAINTY OVER WHAT SPENDING REGULATORY AND TAX POLICIES SHOULD BE. I AGREE WITH THAT. BUT ALSO HELP US MANAGERS IN CHARGE WITH PUBLIC FUNDS AND PUBLIC TRUST HAVE TO ARE HAVE CERTAINTY SO THAT THEY CAN PLANT DR. COLLINS'S ENERGY NEED TO GO INTO SAVING LIVES AN HELP L PEOPLE KEEP THEIR LIVELIHOOD. MANAGING THIS AND MANAGING THAT AND HOLDING BREATH OVER THIS. SO MUCH ENORMOUS EFFORT WILL GO INTO LOST PRODUCTIVITY AND LOST TIME AND LOST OPPORTUNITY IN TERMS OF JOBS, RESEARCH, SCIENCE AND SO ON, THAT SEQUESTER WILL BE AN ENORMOUS COST TO THE COUNTRY AND NOT ONLY MONETARILY. SO THIS IS WHY I'M GOING TO USE WHATEVER I CAN WORKING AGAIN ON A BIPARTISAN BASIS, GIVE OR TAKE AN COMPROMISE TO STOP SEQUESTER. THANK YOU VERY MUCH. STAY IN TOUCH WITH US. WE'LL BE HAPPY TO TALK TO YOU LATER ON IN THE WEEK. [APPLAUSE] >> PROVIDER AND PHYSICIAN SO BRAVE AND REALLY COMING TO THE MICROPHONE AND SPOKE ELOQUENTLY. [APPLAUSE] >> LET'S GIVE THEM A ROUND OF APPLAUSE. [APPLAUSE]