°®¶¹´«Ã½

March 22, 2023
 
Submitted on behalf of: Allen Segal, Chief Advocacy Officer
1752 N Street, NW, Washington, DC 20036  

°®¶¹´«Ã½ (ASM) is the one of the largest life science societies, composed of more than 30,000 scientists and health professionals. Our mission is to promote and advance the microbial sciences. ASM respectfully requests that Congress provide at least $50.924 billion for the National Institutes of Health (NIH) and $11.58 billion for the Centers for Disease Control and Prevention (CDC) in fiscal year (FY) 2024. Within the CDC budget, we request $175 million for the Advanced Molecular Detection (AMD) program in the National Center for Emerging and Zoonotic Infectious Diseases. 

Continuing to Lead Through a Strong Investment in the NIH
We thank Congress for its longstanding, bipartisan support for the NIH and for its commitment to basic, translational and clinical microbial research funded through multiple institutes and centers, particularly through the National Institute of Allergy and Infectious Diseases (NIAID). We especially thank Chair Aderholt, Ranking Member DeLauro and members of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies for their unwavering support for the NIH and leadership over the past several years, during which they and their Senate counterparts have worked in a bipartisan manner to place the NIH budget back on the path of meaningful growth above inflation. 

Thanks to a renewed commitment to NIH, researchers were able to pivot when SARS-CoV-2 emerged and the race to develop tests, vaccines and therapeutics commenced. Researchers built on decades of federally funded basic science and technological advances to develop safe and effective vaccines at record speed. Now, as we move past the pandemic, we must maintain the momentum and continue to provide robust, sustained and predictable funding for the NIH. The U.S. continues to face threats—known and unknown—and sustaining our investments is the only way we will seize the unparalleled scientific opportunities in microbial research that lie before us, and the only way we will be equipped to address the demands that future infectious disease outbreaks will place on our society.

NIH Funding has Transformed the Microbial Sciences  
Beyond the remarkable achievements in COVID-19 diagnostics, vaccines and therapeutics that NIH funding enabled, investments in microbial research led to great strides in protecting and improving human health as illustrated by the following advances:  

•  A young person diagnosed with Human Immunodeficiency Virus (HIV) today who receives treatment will have a near normal life expectancy. The AIDS death rate has dropped 80% from its peak in 1995.
• Routine childhood vaccinations prevent millions of cases of illness. An estimated $82 billion in costs will be saved and 20 million cases, including 42,000 early deaths, will be prevented for children vaccinated in 2009. The introduction of a vaccine for rotavirus—the most common cause of childhood diarrhea worldwide—has resulted in the prevention of up to 50,000 child hospitalizations per year.
• NIH research played a major role in the discovery of the hepatitis C virus, which affects millions of people in the U.S. and around the world. The discovery and fundamental research resulted in the development of drugs that can cure almost all infected individuals, and as a result, blood donor screening programs have decreased the incidence of transfusion-transmitted hepatitis to near zero.
• The NIH has been on the forefront of supporting microbiome research since 2007, with the Common Fund’s Human Microbiome Project (HMP), which was formed to develop research resources to study of microbial communities and how they impact human health and disease. Microbiome research has increased over 40 times since the inception of the HMP, and the work engages over 20 NIH Institutes and Centers. This important research has had implications for our understanding of microbiome interactions in pregnancy and preterm birth, inflammatory bowel disease and diabetes, among other topics.

Continued Progress Requires Sustained Funding and Support for Investigators
Even in the face of the promise and progress highlighted above, well known pathogens and pathogen resistance threaten our nation’s health with serious economic and social ramifications. Seasonal flu continues to cost the U.S. billions annually in direct medical costs and lost productivity due to illness that claims the lives of thousands of Americans each year. Through sustained funding to NIAID, scientists continue the quest for a universal flu vaccine. Antimicrobial resistance (AMR) is a daunting public health challenge and considered a global crisis by the World Health Organization, the G20 and the °®¶¹´«Ã½ Nations. Continued investment in research to better understand how microbes become resistant and develop more precise clinical diagnostics, novel therapeutics and vaccines is greatly needed.

CDC’s Indispensable Role in Preventing and Controlling Infectious Disease
The programs and activities supported by CDC are instrumental in protecting the health of the American people. We applaud the CDC Moving Forward initiative, which will enable the agency to focus more on readiness and response to the American public. In particular, we are pleased to see the Office of Laboratory Science and Safety elevated to report to the Office of the Director. ASM appreciates the extraordinary emergency funding Congress provided to the agency since early 2020 to meet the needs presented by the pandemic. However, had Congress provided necessary support for CDC and public health infrastructure over time, our country would have been in a better position to address the public health crisis more effectively from the start. With this in mind, we urge Congress in FY 2024 to build on the infrastructure that has been bolstered in recent years, including robust funding for the Data Modernization Initiative and the Prevention and Public Health Fund. CDC aids in surveillance, detection and prevention of global and domestic outbreaks from novel viruses to foodborne illness, to Ebola, to the measles, to seasonal flu. CDC is the nation’s expert resource and response center, coordinating communications and action and serving as the laboratory reference center. As we learned during the pandemic, states, communities and international partners rely on CDC for accurate information, direction and resources to ensure they continue to be prepared in a crisis or outbreak.

Three areas that ASM would like to highlight under CDC are: (1) advanced molecular detection technology; (2) antimicrobial resistance; and (3) laboratory capacity. 

• The Advanced Molecular Detection (AMD) program brings cutting edge genomic sequencing technology to the front lines of public health by harnessing the power of next-generation sequencing and high-performance computing with bioinformatics and epidemiology expertise to study pathogens. The program has played an indispensable role by leading genomic surveillance efforts and sequencing of SARS-CoV-2 samples, especially aimed at getting in front of emerging variants. We thank Congress for passing the Tracking Pathogens Act in late 2022 that supports this program, for providing transformational funding for AMD in the American Rescue Plan Act, and for providing 2 consecutive years of meaningful increases in base funding. With a stronger base, the AMD program can continue to promote innovation, expand workforce development, sustain the newly established Pathogen Genomics Centers of Excellence and enter into productive partnerships with academic research institutions and state/local public health agencies. ASM requests $175 million for AMD in FY 2024.
• Multiple programs support antimicrobial resistance, one of the most daunting health challenges we face today. ASM requests funding for the Antibiotic Resistance Solutions Initiative at $400 million, the National Healthcare Safety Network at $100 million and the Division of Global Health Protection at $842.8 million, which will ensure that we have the resources across multiple programs to address this urgent public health challenge.
• Support for laboratory capacity is paramount, and the Emerging and Zoonotic Infectious Disease labs are the world’s reference labs. But maintaining labs costs more each year, from quality and safety initiatives to the cost of shipments and supplies, to recruiting and retaining specialized and highly trained staff. We urge you to consider additional funding for resources to this area, particularly as we consider ways to bolster lab capacity in times of public health emergency.

ASM looks forward to working with you to ensure that researchers and public health professionals have the resources they need to apply fundamental microbial science research to meet 21st Century challenges in public health promotion, the prevention, detection and treatment of infectious diseases and the prevention of outbreaks.