Dear Chairmen Inouye and Rogers and Ranking Members Cochran and Dicks:

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April 4, 2011 The Honorable Daniel Inouye Chairman Senate Appropriations Committee Washington, DC 20510 The Honorable Hal Rogers Chairman House Appropriations Committee Washington, DC 20515 The Honorable Thad Cochran Vice Chairman Senate Appropriations Committee Washington, DC 20510 The Honorable Norm Dicks Ranking Member House Appropriations Committee Washington, DC 20515 Dear Chairmen Inouye and Rogers and Ranking Members Cochran and Dicks: The undersigned organizations, which represent research universities and institutions, medical schools and teaching hospitals, scientists, patients, and other supporters of medical research, strongly oppose the statutory mandates in H.R.1 that dictate the number and size of grant awards to be funded by the National Institutes of Health (NIH). We have grave concerns about the restrictions H.R. 1 places on NIH s ability to distribute funding effectively based on the best science and public health. In addition, we believe these mandates will exacerbate the negative consequences of the $1.6 billion funding cut included in H.R. 1. That cut will result in devastating consequences for the millions of patients awaiting the treatment or cure that only federally supported medical research can provide, as well as to the progress of scientists across the nation who compete for NIH funds. The extraordinary improvements in health that have resulted from NIH-funded research are a credit to the efficient and competitive award system that is the envy of the world. NIH Institutes and Centers have the flexibility to make the type and size of awards that are best suited to meeting our current health challenges and scientific opportunities, based on the merit of the science, input from the research community, and health needs of the nation. This allows NIH to respond quickly to emerging infectious diseases, such as SARS or H1N1 influenza, to seek out the best and the brightest individual investigators to foster breakthrough discoveries, and to invest wisely and thoughtfully in the most promising areas of cutting-edge science. If NIH is to continue to fund the highest quality research and the next generation of talented researchers in the most effective manner possible, Congress should not tie the hands of the agency by setting arbitrary boundaries on the number and size of awards. NIH plays an enormous role in our nation s health and economic security, forms the cornerstone of our biodefense, and is the foundation of our global dominance in biomedical innovation. Crippling this critical agency by cutting its funding while at the same time reducing its flexibility with wellintended but ill-conceived mandates will ultimately harm the search for cures and treatments intended to benefit the American people. As you complete the appropriations process for fiscal year 2011, we urge you to neither cut NIH funding nor prevent NIH from using its resources efficiently. Sincerely,

Academic Pediatric Association AIDS Action Baltimore AIDS Foundation of Chicago AIDS Policy Project Alliance for Academic Internal Medicine (AAIM) Alpha-1 Association American Academy of Pediatrics American Association for Cancer Research American Association for the Study of Liver Diseases American Association of Colleges of Nursing American Cancer Society Cancer Action Network American College of Radiology (ACR) American Gastroenterological Association American Heart Association American Lung Association American Pediatric Society American Society for Bone and Mineral Research American Society for Gastrointestinal Endoscopy American Society for Microbiology (ASM) American Society of Hematology American Statistical Association amfar, The Foundation for AIDS Research Anschutz Medical Campus, University of Colorado Associated Medical Schools of New York (AMSNY) Association for Psychological Science Association for Research in Vision & Ophthalmology (ARVO) Association of American Medical Colleges Association of American Universities Association of Independent Research Institutes Association of Medical School Pediatric Department Chairs Association of Public and Land-grant Universities AVAC: Global Advocacy for HIV Prevention Biophysical Society Brown University Cedars-Sinai Health System City of Hope

Cleveland Clinic Coalition for Health Services Research Coalition of Urban Serving Universities Columbia University Conference of Boston teaching Hospitals Cornell University Council on Governmental Relations (COGR) Creighton University Creighton University School of Medicine Cystic Fibrosis Foundation Duke University School of Medicine Georgia Health Sciences University HIV Prevention Justice Alliance (HIV PJA) Indiana University Infectious Diseases Society of America (IDSA) International Rectal Microbicide Advocates (IRMA) Johns Hopkins University Life Technologies Loyola University Medical Center Lung Cancer Circle of Hope Lupus Research Institute Medical College of Wisconsin Michigan State University Mount Sinai School of Medicine National Alliance for Eye and Vision (NAEVR) National Coalition for Osteoporosis and Related Bone Diseases National Osteoporosis Foundation National Patient Advocate Foundation New York University Northwestern University Feinberg School of Medicine Oregon Health & Science University Oregon State University Osteogenesis Imperfecta Foundation Pancreatic Cancer Action Network Penn Medicine Penn State College of Medicine

Princeton University Research!America Rutgers, The State University of New Jersey Saint Louis University Society for Pediatric Research Society of General Internal Medicine Society of Hospital Medicine South Dakota State University Stanford University Stony Brook University, State University of New York Texas Tech University The AIDS Institute The American Brain Coalition The Endocrine Society The Ohio State University The Paget Foundation The University of North Carolina at Chapel Hill The University of North Carolina at Greensboro The University of Vermont Treatment Action Group Tulane University University at Buffalo, The State University of New York University of California System: University of California Berkeley University of California Davis University of California Irvine University of California Los Angeles University of California Merced University of California Riverside University of California San Diego University of California San Francisco University of California Santa Barbara University of California Santa Cruz University of Cincinnati University of the District of Columbia University of Houston System

University of Idaho University of Illinois University of Kansas University of Kansas Medical Center University of Kentucky University of Maryland, Baltimore University of Massachusetts Medical School University of Michigan University of Minnesota University of Nebraska Medical Center University of Oregon University of Pennsylvania University of Pittsburgh University of Rochester University of South Alabama College of Medicine University of South Florida Health College of Medicine University of Southern California University of Texas at San Antonio University of Texas Health Science Center at San Antonio University of Texas Health Science Center at Tyler University of Texas Medical Branch University of Texas Southwestern Medical Center University of Virginia University of Washington University of Wisconsin-Madison Vanderbilt University Washington University in St. Louis Wayne State University West Virginia University ZERO The Project to End Prostate Cancer