Sexual Health Research Once Again an Issue;
Rogers, Waxman Defend NIH Research
On October 2, the House Energy and Commerce Committee and the Senate Health, Education, Labor and Pensions (HELP) Committee held a joint hearing to discuss the recently released National Academies report, Enhancing the Vitality of National Institutes of Health: Organizational Change to Meet New Challenges. (See Update, August 11, 2003). Testifying before the Committees were Elias Zerhouni, Director, National Institutes of Health (NIH), Harold Varmus, Memorial Sloan- Kettering Cancer Center and former NIH director, and Harold Shapiro, Princeton University and Chair of the Academies Committee on the Organizational Structure of the NIH.
Opening the hearing, HELP Chairman Judd Gregg (R-NH) explained that its purpose was to obtain background on how the NIH is handling the major increase in its funding as a result of the five-year doubling commitment of Congress. Gregg further explained that he recognizes that the agency is an “extraordinary resource doing exceptional research.” The question is, he continued, are the resources being effectively used and how can the Congress assist NIH in attaining its goal to improve health care in the U.S.?
Three issues dominated the discussion by Members: sexual behavior and function research, stem cell research, and the outsourcing (OMB Circular A-76) of Federal jobs.
Rep. Joseph Pitts (R-PA) initiated the discussion regarding the NIH’s support of the grants cited in the Toomey amendment to the House Labor-HHS appropriations bill. (See Update, July 14, 2003). Mischaracterizing the grant to the Kinsey Institute on how to study how decision-making regarding sexual risk taking was affected by sexual arousal and emotional state, Pitts questioned why the NIH was paying people to drink alcohol and then watch pornography. In actuality, the grant to the Institute does not involve alcohol in any way. Apparently, Pitts read from two separate parts of the application. One section of the application cited as background a previous study that examined the effects of alcohol on sexual risk-taking intentions and did involve alcohol. The grant to the Kinsey Institute did not.
Answering that the NIH took this question seriously, Zerhouni replied that “one has to look at the balance between science, society and health.” There is a “scientific justification” for support of this research and there is a “definite public health connection.” The NIH “clearly” has a transparent process when it comes to funding, Zerhouni maintained, adding that it would be “detrimental if a small percentage of the [NIH] portfolio was opaque.”
What mechanism does the NIH have in place “to stop this research,” even if the peer review process approves it, Pitts asked. Expressing his understanding of “how one could be concerned,” Zerhouni explained that the peer review process has integrity and is made up of two-thirds scientists and one-third public members. “We have to believe that these processes are working. We need to look at the total balance of the portfolio,” Zerhouni argued.
Aligning himself with Pitts, Rep. Michael Ferguson (R-NJ) noted that research that could be construed as “provocative” when discussed in an open forum is problematic. This research is “difficult to comprehend and hard to justify,” he asserted. He asked the NIH to provide him with a written explanation of the medical benefits hoped to be derived from this research.
Applauding the members who voted against the Toomey amendment when it was considered by the House because of their support for NIH, Rep. John Shimkus (R-IL), explained that he voted for the amendment because “in this case I had to let ideology or politics ... intervene. I had to make a statement (to my constituents).” It is “stuff like this” that will cause my constituents to say ‘don’t fund anything.’ He inquired whether or not the NIH is directing, conducting, or advising applicants to stay away from certain buzzwords that will cause concern for some Members of Congress or people that oppose certain types of spending. Zerhouni said no.
Noting that he voted against the Toomey amendment because he wanted to make sure the NIH had the authority to make the decisions with regard to research, Rep. Michael Rogers (R-MI) noted that a grant by Michigan State, which was included in the Toomey amendment, was doing research that did not sound good but “once you got down below the surface, it made a lot sense.” Rogers explained that he did not want to micromanage the NIH; the powerful things that NIH can accomplish are great if the Congress would get out of the agency’s way and let them do it, he reasoned.
Rogers, a former FBI agent, observed that he thought “Some of those sexual behaviors could be translated into rape cases, pedophile cases, and other valuable research for law enforcement. We don’t know that and by reading the application, you can’t even come close to that. You can help us by being very clear and very transparent to allow us to make good decisions so that we are not climbing in your knickers,” he told Zerhouni.
Rep. Henry Waxman (D-CA) emphasized his desire “to make sure that NIH’s scientific mission is protected from political interference.” Remarking that he has a sense that NIH is suffering from increased political interference, Waxman cited as examples the questions raised at the hearing by members of the Committee. “What has been raised has been a question of political correctness. I don’t think your decisions on research should be based on somebody else’s view of political correctness. I think it ought to be based on the validity of the scientific research.” He commended the merit review process used by the NIH to fund research.
Finally, he noted that there seems to be a theme to the objections – a theme based on sex and sexual research. “It appears to me,” Waxman emphasized, “that sexuality and sexual relationships are a very important part of the lives of most adults.” Agreeing with Rogers, he noted that he saw the benefits of this research when he looked below the surface.