March, 2020
The Honorable Peter Visclosky The Honorable Ken Calvert
Chair Ranking Member
Subcommittee on Defense Subcommittee on Defense
Committee on Appropriations Committee on Appropriations
H-405 Capitol Building 1016 Longworth House Office Bldg
Washington, DC 20515 Washington, DC 20515
Dear Chairman Visclosky and Ranking Member Calvert:
As you continue your efforts to provide the investments needed to respond to the novel coronavirus pandemic, we thank you and encourage you to continue your support for the critical and highly successful defense health research programs funded through the Congressionally Directed Medical Research Programs (CDMRP) at the Department of Defense (DoD). Many of these programs are directly related to preparedness and response to global pandemics, while other equally important CDMRPs fund research to protect the men and women who serve in our Armed Forces, military families, veterans, and civilian populations from a wide range of medical conditions and health challenges. We therefore encourage you to increase funding for these critical programs by five percent plus inflation, to ensure that our country is prepared to meet current and future public health-related threats and challenges to our national security.
The highly innovative research portfolio supported by the CDMRP fuels scientific discovery by funding high impact research not sponsored by the National Institutes of Health (NIH), the Department of Veterans Affairs (VA) and other federal agencies. Many of the programs’ award mechanisms propel the exploration of revolutionary ideas and concepts. Programs focus on the potential of having a significant impact upon both their respective fields of research and support and treatment for members of the military. Defense health research programs are worthy of continued federal support for the following reasons:
Directly relevant to DoD-prevalent conditions: The medical research programs at DoD directly impact the health and lives of the U.S. military, their families, veterans and the public. Programs provide groundbreaking research on psychological health, Gulf War Illness, effects of burn pits and other airborne hazards, spinal cord injury, and hearing and vision loss (which comprise a significant portion of current battlefield injuries). Research also focuses on existing and emerging infectious diseases that may threaten operational readiness and health security, and why diseases like ALS and multiple sclerosis occur at greater rates in those who have served in the military. The DoD’s defense health research program has also funded the orthopedic research program that has resulted in new limb-sparing techniques to save injured extremities and preserve and restore the functions of injured extremities.
Equally important, this disease-specific approach includes important medical research programs related to several forms of cancer (breast, blood, colorectal, kidney, melanoma, pancreatic, brain tumors, lung, ovarian, prostate, stomach, liver, cancers related to
radiation exposure, rare and childhood cancers), autoimmune diseases and other disorders (like neurofibromatosis and tuberous sclerosis complex) that have led to breakthroughs on nerve regeneration, traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD).
Complementary – and not duplicative – of other federal research: Defense health research program grants neither duplicate nor supplant NIH or VA research efforts, but rather enhance those efforts. They fund highly innovative projects – support that is typically unavailable through other federal programs. For example, programmatically- related VA research funding is only available to VA employees (at least 0.625 full-time equivalent). CDMRP funds the best-qualified proposals from researchers and research teams at top research universities and medical centers. The NIH and DoD medical research portfolios have symbiotic relationships, allowing NIH-funded basic research to serve as a foundation for ground-breaking, disorder-targeted research at DoD. NIH and DoD program officers meet regularly to ensure collaboration and prevent duplication.
Cutting-edge and focused on cures: While the NIH funds high-quality basic biomedical research, the defense health research programs provide essential emphasis on and support for finding innovative cures or new therapies for medical conditions. For several disorders, DoD breakthroughs have led to new clinical trials, new drug products, and novel procedures that are making a difference in the everyday lives of affected patients and families. For example, research funded by DoD led to the development of the only treatment for tuberous sclerosis complex approved by Food and Drug Administration. The ALS Research Program is supporting translational research and has developed four potential treatments for the disease, for which an effective treatment currently does not exist. Enclosed is a detailed white paper providing many examples of breakthroughs that have benefitted active duty warfighters, veterans, military families and civilian populations.
Agile, adaptable, and collaborative: Each of the separate programs is guided by a specific vision and mission statement, which in addition to incorporating Congressional direction, reflect rapid change in knowledge, address research gaps, and prevent duplication. Annual funding prevents out-year budget commitments, which in turn further enhances programmatic flexibility. Many DoD programs identify, develop and fund collaborative and consortium-based research, helping to bring unique, interdisciplinary, inter-institutional, collaborative efforts to bear on complex medical research issues unlikely to be solved though the inherent limits of individual researchers.
Competitive and unique peer review process: While Congress allocates funding through the annual Defense Appropriations Act to specific medical conditions, it does not direct the programs’ dollars to specific researchers. These programs utilize an efficient multi-tiered process that includes multiple stages of peer review, including two levels of formal peer review of final proposals. Proposals are scored in a number of key areas such as scientific merit and impact for patients and the military, providing a robust comparative basis for helping accomplish the program’s mission of finding and funding the best research related to these important medical conditions.
Consumer review: All defense health research programs incorporate the full and equal participation of consumer reviewers at every stage of the multi-tiered review process – a novel and valuable practice in medical research funding. Consumers – people actually affected by the disease or medical condition – help ensure the program’s funded research will have the greatest impact on those who are affected. Consumer reviewers also help inform and educate their disease advocacy communities and others.
Generating economic growth across the United States: Research activities promote job growth and encourage long-term economic development through innovation. It has been estimated that for every dollar awarded in biomedical research grants, more than $2 of additional business activity is created. Defense health research grants are awarded to universities and institutes in every state in the country.
In short, the well-executed and efficient programs within the defense health research programs demonstrate responsible government stewardship of taxpayer dollars and benefit current and former military service members, the general patient population, and our nation’s economy.
Perhaps most importantly, DoD’s innovative approaches to funding biomedical research have led to several significant breakthroughs and achievements, contributing to national security and the health and welfare of U.S. Armed Forces personnel and their dependents. Continued federal funding will only build on these successes.
Lastly, we encourage timely enactment of the fiscal year 2021 Defense Appropriations Act, to ensure continuity in the defense health research programs. We recognize the challenges that the current pandemic has placed on your ability to move appropriations bills through the “regular order” process. However, we must continue to maintain continuity in investment in this important research to ensure that our nation is prepared for future pandemics and other public health challenges that threaten our current military populations and their families, as well as veterans and the general civilian population.
Therefore, the undersigned respectfully request your support increasing the appropriation for defense health research programs by five percent plus inflation in the FY 2021 Defense Appropriations Act.
Sincerely,
Enclosure
cc: Members, House Appropriations Committee
