The Association's more general recommendations also require some

additional comment and discussion.

General Contract Research Authority

The general contract authority for biomedical research and investigation is contained in Section 301 (h) of the Public Health Service Act. This authorization will expire on June 30, the same day as expiration of current cancer authorizations. The Association believes that the present legislation would be a most appropriate vehicle for the extension of this important contract authority, which provides authority for all the research institutes and divisions of the NIH, not solely for the Cancer Institute.

The Association recommends the following language:

"Section 301 (h) of the Public Health Service Act is amended to
read as follows:

(h) Enter into contracts, including contracts for research in accordance with and subject to the provisions of law applicable to contracts entered into by the military departments under title 10, United States Code, sections 2353 and 2354, except that determination, approval, and certification required thereby shall be by the Secretary of Health, Education, and Welfare; and ".

Availability of Funds

In order to insure that funds appropriated by Congress for cancer and other related health activities will be made available for expenditure and obligation, the Association recommends that the following language be included in the pending legislation:

"Notwithstanding any other provision of law, funds appropriated
for any fiscal year to carry out any program for which appropriations
are authorized by the Public Health Service Act (Public Law 410,
Seventy-eighth Congress, as amended) or the Mental Retardation
Facilities and Community Mental Health Centers Construction Act of
1963 (Public Law 88-164, as amended) shall be made available for
obligation and expenditure no later than the end of such fiscal
year."

Similar language is presently contained in Section 601 of PL 91-296, and is to expire on June 30, the same day that the current cancer authorities expire. This language has been used frequently in recent months to secure the availability of funds appropriated by Congress but not released for obligation and expenditure, including funds for cancer research.

legislation because it deals with cancer research

This

is a most appropriate

vehicle for the continuation of this Congressional directive that appropriated health funds, and the priorities which they reflect, are not to be tampered with. The importance of this language to the federal investment in health cannot be overemphasized. The Association therefore urges the subcommittee

to take this opportunity to extend this crucial statutory protection.

Statutory Term for NIH Director

The Association believes that the establishment of a statutory term of office for the Director of the National Institutes of Health is essential to

the continuity of leadership in biomedical research. Federal support of this research is a nonpartisan activity, and its leadership should be equally nonpartisan. It is imperative that the director of the federal biomedical research effort be a highly qualified individual, with a background and training in biomedical research and administration, who is selected without regard to political affiliation. The administration of the research effort

will be best served by the nonpolitical transition from one director to

the next, with careful Congressional review of the scientific qualifications of proposed directors.

In order to meet these goals, the Association strongly urges the subcommittee to provide a statutory term of seven years for the Director of the NIH and to make appointment subject to Senate confirmation.

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The Association therefore recommends that Section 454 of the Public

Health Service Act be amended to read as follows:

"(a) The Director of the National Institutes of Health shall be
appointed by the President with the advice and consent of the
Senate, to serve for a term of seven years; he or she shall be
eligible for reappointment. Before any person is appointed
Director, the President shall afford the National Academy of
Sciences an opportunity to make recommendations to the President
with respect to such appointment.

(b) The Director of the National Cancer Institute shall be appointed by the President. Except as provided in section 407 (b) (9), the Director of the National Cancer Institute shall report directly to the Director of the National Institutes of Health."

Additional Association Comment

The Association has repeatedly stressed that the basic causes and nature of the cancerous process are unknown. The nature of cancer is deeply embedded in the most elemental life processes and is an obscure and complex part of the life cycle. Major further progress in the conquest of cancer is, in the final analysis, dependent upon greater understanding of the intricate working of the basic life cell and its responses to both internal and external forces.

It is important to realize that the new leads which seem to offer promise for advances in cancer have emerged in scientific fields which at the same time were far removed from the mainstream of scientific effort in cancer. These new efforts are derived from, and are dependent upon, scientific achievements in the fields of virology, immunology, genetics, and cell biology. No one can predict with certainty the fields from which will come the findings that will provide further insights into the nature of cancer. All bioscientists, however, will agree that real progress in understanding cancer can only come through greater understanding of the fundamental life processes of which it is a part.

The national attack upon cancer cannot be fought exclusively with programs sponsored by the National Cancer Institute. Cancer research is also dependent, in part, upon advances in the various biosciences which

are sponsored by the other institutes at the NIH

particularly the general

basic research programs of the National Institute of General Medical Sciences. The Administration's failure to perceive the importance of the other NIH disciplines in the national attack against cancer is evident not only in the lowered budgets of these institutes, but also in the distribution of staff positions within the NIH. Over the past several years, the NIH

as a whole has suffered an outright loss of approximately 600 permanent fulltime staff positions. In addition, over 350 more positions have been transferred from the other institutes of the NIH to the NCI and the National Heart and Lung Institute. The net result has been a loss of approximately 950 staff positions within the other institutes of the NIH a loss which has seriously compromised the ability of the NIH staff to administer the programs under

its direction.

The impact of the Administration's decisions on the morale and effectiveness of NIH administrators is clear. The national biomedical research program established by the Congress has been stymied by administrative fiat. The repeated attempts to terminate research training programs, abolish peer review, and reorganize staffing patterns indicate all too clearly that biomedical research and the nation's health do not hold a high priority within this

Administration.

Such an attitude cannot be allowed to stand unchallenged.

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. Senator KENNEDY. Our final witness is the American Cancer Society, represented by Dr. A. Hamblin Letton.

He is chairman of the Society's Legislative Committee and its national chairman.

We welcome you to the committee this morning, and apologize for the late hour.

STATEMENT OF A. HAMBLIN LETTON, M.D., CHAIRMAN, LEGISLATIVE COMMITTEE, AND PAST PRESIDENT, AMERICAN CANCER SOCIETY

Dr. LETTON. Thank you, Mr. Chairman.

I am Dr. A. Hamblin Letton of Atlanta, Ga. I am in the private practice of surgery.

I am the former chief-of-staff of the Georgia Baptist Hospital, the largest private hospital in Georgia, and am president of the Atlanta Medical Center.

I am the chairman of the Patient Care and Research Committee for Cancer of the American College of Surgeons, and am a member of the Professional Education Committee of the International Union Against Cancer.

I am a volunteer of the American Cancer Society and have held the chairmanship of almost every important committee of the American Cancer Society, as well as being national president in 1972.

I am here today to present to you the views of the American. Cancer Society on the renewal of the Cancer Act legislation.

The American Cancer Society has been very pleased with the progress of the National Cancer Institute under the leadership of Dr. Frank Rauscher and the President's Cancer Panel, operating within Public Law 92–218, the National Cancer Act of 1971.

We, without hesitation, endorse and encourage the passing of the proposed amendments to Public Law 92-218, which we believe will make the national cancer program more effective. We strongly support the increase in funding authorizations for the next 2 years, both in the budget of the National Cancer Institute and the cancer control

program.

We strongly support the special authorities and initiatives the National Cancer Act gives to the National Cancer Institute, including direct budget submission to the President with reasonable opportunity for comment, but without change by the Secretary of HEW, and the Director of the National Institutes of Health. This has been one of the healthiest changes in the history of the National Cancer Institute. We would strongly oppose any action that would return the control of the National Cancer Institute to the National Institutes of Health.

We support the increase in the number of experts or consultants as defined in section 401 (1). We urge the deletion of the word "fifteen" in section 408 (A).

We support the increase in funding authorization as has been suggested by the National Cancer Advisory Board; that is, for the cancer control program $50 million for fiscal 1975, $65 million for fiscal 1976, and $85 million for fiscal year 1977.