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FY 2012 Congressional Appropriations Testimony

Witness appearing before the
Senate Subcommittee on Labor-HHS-Education Appropriations

Jack Whitescarver, Ph.D., Director
Office of AIDS Research

May 11, 2011


Mr. Chairman and Members of the Committee:

I am pleased to present the Fiscal Year (FY) 2012 President's budget request for the trans-NIH AIDS research program, which is $3,159,531,000. This amount is an increase of $100,254,000 over the FY 2011 Enacted level. It includes the total NIH funding for research on HIV/AIDS and the wide spectrum of AIDS-associated malignancies, opportunistic infections, co-infections, and clinical complications; intramural and extramural research; research management support; research centers; and training. It also includes a transfer of approximately $27 million to the HHS Office of the Assistant Secretary of Health to foster collaborations across HHS agencies and finance high priority initiatives in support of the President’s National HIV/AIDS Strategy.

The AIDS Pandemic

Nearly 30 years since the recognition of AIDS and the identification of HIV as its causative agent, the HIV/AIDS pandemic remains a global scourge. UNAIDS reports that in 2009, more than 33 million people were estimated to be living with HIV/AIDS; 2.6 million were newly infected; and 1.8 million people died of AIDS-related illnesses. The majority of cases worldwide are the result of heterosexual transmission, and women represent more than 50% of HIV infections worldwide. More than 1,000 children become infected each day, most of them as newborns. More than 25 million men, women, and children worldwide have already died.

In the United States, CDC reports that more than 1.1 million people are estimated to be HIV-infected; approximately 56,300 new infections occur each year; and someone is infected with HIV every nine and a half minutes. HIV/AIDS continues to be an unrelenting public health crisis, disproportionately affecting racial and ethnic populations, women of color, young adults, and men who have sex with men. The number of individuals aged 50 years and older living with HIV/AIDS is increasing, due in part to antiretroviral therapy, which has made it possible for many HIV-infected persons to live longer, but also due to new infections in individuals over the age of 50.

NIH AIDS Research Program

To address this pandemic, NIH has established the most significant AIDS research program in the world, a comprehensive program of basic, clinical, translational, and behavioral research in domestic and international settings – a multi-disciplinary, global research program carried out by every NIH institute and center in accordance with their mission. This diverse research portfolio requires an unprecedented level of trans-NIH planning, scientific priority-setting, and resource management. The Office of AIDS Research (OAR) was authorized to plan, coordinate, evaluate, and budget all NIH AIDS research, functioning as an “institute without walls,” to identify the highest priority areas of scientific opportunity, enhance collaboration, minimize duplication, and ensure that precious research dollars are invested effectively and efficiently.

New Scientific Advances and Opportunities

The past year has been a significant one for AIDS research. The NIH investment in the priority areas of HIV prevention research and in basic science over the past several years has resulted in important progress in critical areas of the NIH AIDS research program. Recent research advances by NIH intramural and extramural investigators have opened doors for new and exciting research opportunities in the search for strategies to prevent, treat, and ultimately cure HIV infection. These advances include:

Trans-NIH Plan and Budget

These advances, while preliminary and incremental, provide the groundwork for further scientific investigation and the building blocks for the development of the trans-NIH AIDS strategic Plan, developed by OAR in collaboration with both government and non-government experts. The priorities of the strategic Plan guide the development of the trans-NIH AIDS research budget. OAR develops each IC’s AIDS research allocation based on the Plan, scientific opportunities, and the IC’s capacity to absorb and expend resources for the most meritorious science – not on a formula. This process reduces redundancy, promotes harmonization, and assures cross-Institute collaboration. The priorities of the Plan will establish the biomedical and behavioral research foundation necessary to implement the major goals of the President’s National HIV/AIDS Strategy and to implement the NIH Director’s themes.

FY 2012 Scientific Priorities

A growing proportion of patients receiving long-term antiretroviral therapy (ART) are demonstrating treatment failure, experiencing serious drug toxicities and side effects, and developing drug resistance. Recent studies have shown an increased incidence of malignancies, as well as cardiovascular and metabolic complications, and premature aging associated with long-term HIV disease and ART. NIH research will address the need to develop better, less toxic treatments and to investigate how genetic determinants, sex, gender, race, age, pregnancy status, nutritional status, and other factors interact to affect treatment success or failure and/or disease progression.

NIH-funded research is needed to address the causes of HIV-related health disparities, their role in disease transmission and acquisition, and their impact on treatment access and effectiveness. These include disparities among racial and ethnic populations in the U.S.; between developed and resource-constrained nations; between men and women; between youth and older individuals; and disparities based on sexual identity. In addition, specific FY 2012 research priorities include:


The OAR has utilized its authorities to shift AIDS research program priorities and resources to meet the changing epidemic and scientific opportunities. This investment in AIDS research has produced groundbreaking scientific advances. AIDS research also is helping to unravel the mysteries surrounding many other cardiovascular, malignant, neurologic, autoimmune, metabolic, and infectious diseases as well as the complex issues of aging and dementia. Despite these advances, however, AIDS has not been conquered, and serious challenges lie ahead. The HIV/AIDS pandemic will remain the most serious public health crisis of our time until better, more effective, and affordable prevention and treatment regimens are developed and universally available. NIH will continue its efforts to prevent, treat, and eventually cure AIDS.

Thank you for your continuing support for our efforts.

Jack E. Whitescarver, Ph.D.
Associate Director for AIDS Research and
Director, Office of AIDS Research

National Institutes of Health

Dr. Whitescarver received his doctorate in medical microbiology in 1974 from the University of Medicine and Dentistry of New Jersey (UMDNJ), Graduate School of Biomedical Sciences. He pursued his post-doctoral research at the Harvard School of Public Health, focusing on immunopathogenesis of rickettsia infection. In his position as a Research Associate at the Harvard School of Public Health and Medical School, Dr. Whitescarver’s research interests included obligate intracellular parasites. His published research results include in vitro studies on breast tumors, spirochetes, mycoplasmas, and rickettsia.

In 1977, Dr. Whitescarver completed a year in the Grants Associates Program at the National Institutes of Health (NIH) and became the Special Assistant to the Director of the National Institute of Allergy and Infectious Diseases (NIAID). In that position he was responsible for assisting the Director in policy, planning and budget issues. It was during this tenure that Dr. Whitescarver first reported to the NIAID on the possibility of the emergence of a new infectious disease, now known as AIDS, and he helped develop the initial federal response for research on AIDS.

From 1984 to 1988, Dr. Whitescarver held the positions of Associate Dean for Research Development and Assistant Professor of Pathology at Emory University School of Medicine. His duties as Associate Dean included directing the M.D. /Ph.D. training program and facilitating new research initiatives, particularly in AIDS.

In 1988, the new Office of AIDS Research (OAR) at the NIH was established, and Dr. Whitescarver was recruited as the Deputy Director. He served as Acting Director of the OAR from October 2000 until June 2002, when he was named permanent Director. Under his leadership, OAR has launched a number of innovative domestic and international initiatives. Dr. Whitescarver is a member of several professional societies including the American Academy of Allergy and Immunology, Infectious Diseases Society of America, the Royal Society of Medicine, and the International AIDS Society. He has received numerous honors and awards. Last year he was awarded the first International AIDS Society Presidential Award for his commitment to the global fight against HIV and his pioneering work in the field.

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