Mr. Chairman, thank you for scheduling this hearing on the National Institutes of Health (NIH). I hope this hearing is the first of many. The NIH is the crown jewel of biomedical research. This magnificent collection of resources, talent, devotion, and energy is the envy of the world, and more importantly, it is the source of hope for millions of people who suffer and die unnecessarily because techniques to prevent, treat, or cure their ailments are not currently available. Major changes in its structure and operation should be taken with great care.

We have a distinguished panel with us today. I first welcome Harold Shapiro. Under his leadership the Institute of Medicine recently published a report "Enhancing the Vitality of the National Institutes of Health: Organizational Change to Meet New Challenges." This is a thoughtful and extensive analysis of key challenges facing the NIH. I also welcome Dr. Harold Varmus, who has made a tremendous contribution to the success of NIH. And, I am, of course, pleased that Dr. Zerhouni is here to share with us his plans, his "road map," for the future of NIH.

I have grave concerns about part of that road map -- the program, now under way, for outsourcing many of the jobs currently held by NIH employees. This program has caused great concern among NIH employees and many of its key stakeholders, such as academic health centers that actually conduct much of the research supported with NIH dollars, as well as the patients whose hopes and fears are directly tied to the success or failure of NIH.

Why is outsourcing necessary? Are we serving science, or are we serving a privatization ideology? What jobs will be outsourced, and which ones will not be outsourced? What is the time frame for completing this process and what criteria are being applied? Outsourcing is an instrument of fear, and successful organizations do not use fear as their primary management tool. It is also a very blunt instrument, and can cause much collateral damage. We need candid assessments of the damage it has done and will continue to do to the human fabric of NIH.

Another subject that I hope our witnesses will address is the persistence of major health disparities. There are numerous articles and studies that document the fact that disparities persist, including two important books published by the Institute of Medicine. Why have these disparities continued? What should Congress be doing about them? Is the organization and management of NIH geared to identify and respond to disparities throughout the NIH program portfolio? This is a critical challenge for Congress and NIH, and one we must address quickly and successfully.

I look forward to our witnesses' testimony on these subjects.