°®¶¹´«Ã½

     
May 3, 2024
Submitted on behalf of: Amalia Corby, Federal Affairs Director, American Society for °®¶¹´«Ã½  

°®¶¹´«Ã½ (ASM) urges Congress to increase funding for the National Institutes of Health (NIH) to $51.3 billion in fiscal year (FY) 2025, consistent with the Ad Hoc Group for Medical Research. We also propose $7.151 billion for the National Institute of Allergy and Infectious Diseases (NIAID) within NIH. This includes $608 million in AMR research at NIAID. ASM also requests at least $11.6 billion for the Centers for Disease Control and Prevention (CDC), consistent with the CDC Coalition. The Biden Administration's FY25 Budget Request proposed $780.8 million for the National Center for Emerging and Zoonotic Diseases (NCEZID) within the CDC. ASM requests that Congress allocate at least $780.8 million for the NCEZID, including $175 million for the Advanced Molecular Detection (AMD) program and $20 million for wastewater surveillance. 

ASM appreciates the opportunity to submit outside witness testimony for the Fiscal Year 2025 Labor, Health and Human Services, Education, and Related Agencies appropriations bill. Established in 1899, ASM is the home for microbial scientists from around the globe to connect, learn, discover and prepare for the future. ASM is one of the oldest and largest single life science societies with 36,000 members in the U.S. and around the world, whose mission is to promote and advance the microbial sciences. We connect with millions of experts and harness their science to serve humanity to solve the world's most pressing problems, including climate change and antimicrobial resistance.

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 NIAID. 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 NIH. The U.S. continues to face threats, known and unknown, and sustaining our investments at NIH 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. It is of utmost importance to prepare for and respond rapidly and effectively to future pandemics and other high-consequence biological threats. 

The requested appropriation for the NIH base budget of at least $51.3 billion would expand NIH’s capacity to support promising science in biomedical research. This would build on Congress’ recent investments in NIH that have allowed for advances toward promising therapies and diagnostics, supported current and new scientists nationwide and advanced the potential of medical research. Funding to support the Advanced Research Projects Agency for Health (ARPA-H) should supplement, not supplant, funding for the NIH base.

Institutes within NIH have a tremendous impact on the microbial sciences. NIAID funding supports research to overcome threats such as Valley fever, antimicrobial resistance and many other pressing health concerns. Infections frequently complicate other types of medical care, including organ transplantation, cancer treatment, cesarean sections, joint replacements and other surgeries, making infectious disease research essential to the very foundation of health care.

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. 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 microbial communities and how they impact human health and disease. Thanks to NIH’s cross-cutting work that the Common Fund enabled, we now have a foundational understanding of how microbial communities interact with humans, especially the human gut microbiome, and the world around us. 

In an analysis by the NIH Human Microbiome Portfolio Analysis Team published in 2019, the initial $215 million HMP investment at NIH catalyzed microbiome research, with NIH support for human microbiome research outside of the HMP eclipsing the annual HMP investment and reached or exceeded $100 million per year by FY2012. 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 and many other diseases. We ask that Congress continue and build on the great work regarding the microbiome to harness its power to enhance human, environmental and animal health. 

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. Robust AMR research funding at NIAID would support the training of new investigators; enhance basic, translational and clinical research on mechanisms of resistance, therapeutics, vaccines and diagnostics; and support the development of a clinical trials network to reduce barriers to research on difficult-to-treat infections.

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. ASM appreciates the extraordinary emergency funding Congress provided to the agency since early 2020 to meet the needs presented by the pandemic. With this in mind, we urge Congress in FY 2025 to build on the infrastructure that has been bolstered in recent years. CDC aids in detection and prevention of domestic and global outbreaks from novel viruses to foodborne illness, to Ebola, measles, seasonal flu, antimicrobial resistance and other infectious diseases. CDC is the nation’s expert resource and response center, coordinating communications and action and serving as the laboratory reference center. 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 advanced molecular detection technology, antimicrobial resistance and enhancing 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 and for providing transformational funding for AMD in the American Rescue Plan Act. With stronger base funding, the AMD program can continue to promote innovation, expand workforce development, sustain the newly established Pathogen Genomics Centers of Excellence and enter productive partnerships with academic research institutions and state/local public health agencies. ASM requests the following report language be included in the final FY25 Labor-H report for AMD:

• Advanced Molecular Detection—The Committee provides $175 million for the Advanced Molecular Detection program to align with the proposed authorized level in the Tracking Pathogens Act. The Committee believes it is critical to boost U.S. genetic surveillance and viral sequencing to effectively respond to future public health challenges associated with novel and evolving infectious diseases, as well as seasonal threats, antimicrobial resistance and foodborne pathogens. The increase in funding will sustain existing work made possible through supplemental appropriations including the 5 Centers of Excellence that aim to better prevent, control and respond to microbial threats of public health importance. It will also increase program capacity to take on multiple threats at a time, improve disease detection tools and embed this expertise at the state level.

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 $60 million and the Division of Global Health Protection at $456.4 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. The U.S. must continue investing in programs that strengthen health systems and build laboratory capacity. Funding from the Centers for Disease Control and Prevention's Global AR Lab & Response Network improves the detection of antimicrobial resistance threats and identifying risk factors that drive the emergence and spread of resistance across health care, the community and the environment. This global network also responds to these threats and informs global prevention strategies for antimicrobial resistance.

ASM also supports $20 million for wastewater surveillance, consistent with the FY25 Budget Request. This investment will allow CDC to support the National Wastewater Surveillance System (NWSS), which to this point has been supported solely with COVID-19 supplemental resources. NWSS has been an invaluable tool to track COVID-19 hotspots and has the potential to detect and combat various other infectious diseases, including influenza. New base funding will allow CDC to support wastewater surveillance activities in select locations, such as major metropolitan areas and areas of high social vulnerability.

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.