dr. rodgers. and also one of those folks who is being honored this evening at the sammy's awards because he's one of the nominees for this year's awards for public service. and over on the far end, dr. volkow, highly educated in addiction science and highly recognized by the press because she's often in front of them talking about addiction, the national institute of drug abuse. that's my team. i would like you to start the clock and i'd like to tell you a few things by way of an opening statement. it's a great day for my colleagues and i to be before you to discuss how nih is investing in a healthier future for all americans. longevity, you can see what has happened, breakthroughs by nih-supported research. for example, cardiovascular diseases, death rates have fallen by more than 70% in the last 60 years. cancer death rates are now dropping by 1 or 2% annually. likewise, hiv/aids, when first being written about as a death sentence, greatly extends lives and an increasing potential of a vaccine a

dr. rodgers, i believe you mentioned the young investigators.folks who were partway into their career, they have gone through their postgraduate work, they are in a laboratory and then the grants don't come through and then they have this incredible specialty about some form of nerve communication or chemistry deep within the cell that may be the key but who knows, but suddenly they are going, well, what do i do now? does this continue to be a problem and to what degree should we be deeply concerned about the loss of this -- we expend a huge amount of resources to develop that talent and then suddenly its ability to be applied is cut short. >> well, i think we should be deeply concerned. we do put a great deal of resources into the training of this generation of young scientists. the talents and the skills that they possess are incredibly impressive and yet if you, as i often do, go and visit universities across this country and meet with graduate students, postdoctoral fellows t used to be when i made those visits they wanted to tell me about t

dr. rodgers: i would just expand upon that. the three areas i would focus on are the young investigators. we know that there are two critical points in which an investigator is likely to stay in research or exit. one is on their first application to get a grant. the second is getting that renewed. and they get that through that second hurdle it's likely that they will be with us a long time. so we would like to encourage them by making incentives for both the first application as well as the first renewal. the other point i would make is with expanded funds we would be able to allow for expansion of some of our existing clinical studies which are very expensive because of the curtail that we would have to do. and one way to amplify the investment in infrastructures in these clinical trials is by using -- by having ancillary studies of these trials. so i would expand existing trials as well as ancillary studies of these trials. lowy: the question of young people we at nci are in the process of trying to develop new approaches to

dr. rodgers, you spoke earlier about the 29 million americans who have diabetes and the 86 million who are prediabetic. that sounds to me like we have a crisis on your hands as the number of americans with that disease continues to grow. you mentioned the work your institute has been on prevention programs that include regular exercise and reduce fat intake and the huge difference it makes. the cdcs program which our bill has forced to cut helped force programs like one in my state that supported community health efforts through the ymca and other organizations that promote healthier living. what might taking that preventive program to scale mean for this country's diabetic epidemic? >> thank you, senator, for that question. the ymca that you are referring to and their ability to develop what we did in the clinical trial, the diabetes prevention program which is counseling this lifestyle intervention on an individual basis, they were able to take it to scale by doing the same lifestyle intervention but providing it in a group setting and in fact their results after the first year or two we

dr. rodgers: thank you, senator, for that question. the ymca you are referring to and their ability to develop what we did in the clinical trial which is a lifestyle intervention on an individual basis, they took it to scale by doing the same lifestyle intervention but providing it in a group setting. their results after the first year or two are quite similar to what we achieved in the individual program in terms of weight loss, etc. more interestingly, the cost per patient involved in the clinical trial with the initial instructions and the follow-up was about $6,000 per patient. in the group setting at the ymca, that cost was cut down to about $400. in terms of scaling this, we could expand this. we have not done economic analysis on this but there is a private group called the urban institute that has recently looked at what happens if you scale this. they estimate that given those numbers, about $191 billion over 10 years if this -- with some very conservative assessments or assumptions if this could go to scale. sen. murray: that