Speeches & Floor Statements

Floor Speech: 21st Century Cures

Posted on May 25, 2016

While the Senator from Connecticut is still here, I want to say to him that I'm glad I had a chance to hear his remarks. I agree with him that there is a mental health crisis, and I congratulate him for his leadership, especially with the Senator from Louisiana, Senator Cassidy, in focusing the Senate's attention on dealing with it this year. I think he has, in a very passionate but practical way, made the argument that while there may not be a consensus on what we do about guns, there is a consensus, I believe, in this body, on what we do about mental health; or at least an important step in the direction of dealing with the crisis.

Senator Cassidy and Senator Murphy will deserve great credit for that happening. I plan to attend for a while the summit tomorrow that Senator Murphy and Cassidy are hosting. It will help to draw attention to the efforts that the Senate has made.

Last year, the full Senate passed the Mental Health Awareness and Improvement Act. This year, working with the Senators from Connecticut and Louisiana, and the Senator from Washington, Senator Murray, we've incorporated that into the Mental Health Reform Act. We're very hopeful that we can pass that legislation on the Senate floor in June and work with the House to turn it into a law this year. No doubt we'll have more to do on the mental health crisis after that. And we'll have more debates on this floor about what the Senator from Connecticut called the gun crisis. But there's no reason we cannot move ahead with what we already have a consensus on in mental health. I’m committed and I know Senator Murray is committed to doing that.

So are other Senators on this side as well as that one. I know that Senator Blunt from Missouri feels passionately about mental health needs. Senator Cornyn is working on helping us resolve this legislation, and Senator McConnell has said that if we can find a consensus among ourselves and reduce the amount of time it takes to put it on the floor, that he will interrupt the appropriations process, put it on the floor, and try to get a result this year. So I'm glad I had a chance to hear the Senator, and I pledge to continue to work with him to get a result on the Mental Health Reform Act that he's played such a key role in fashioning.

Now, I'd like to speak of another issue that the Senator from Connecticut has also played a role in because he is an important member of our health care committee in the Senate. That is what we call the “21st Century Cures” legislation: legislation that has already passed the House in which President Obama is interested, and in which we have mostly finished in terms of our committee work in the Senate.

A little over a week ago, The New York Times Magazine published a special health issue on the new frontier in cancer treatment, how doctors and researchers are trying new tests, new drugs, and even new ways of thinking about cancer. And the photographer Brandon Stanton in his popular photography blog “Humans of New York,” turned his lens on the pediatric department of the Memorial Sloan Kettering hospital in New York City to help raise money there. Also this month, two former United States Senators, both of them physicians, and one a cancer survivor, Dr. Bill Frist, Dr. Tom Coburn, wrote an op-ed in The Wall Street Journal about what the Senate is doing to help bring safe treatments and cures to doctors' offices and medicine cabinets more quickly.

In The New York Times Magazine, one oncologist writes, “For patients for whom the usual treatments fail to work, oncologists must use their knowledge, wit, and imagination to devise individualized therapies. Increasingly, we are approaching each patient as a unique problem to solve. Toxic, indiscriminate, cell-killing drugs have given way to nimbler, finer-fingered molecules that can activate or deactivate complex pathways in cells, cut off growth factors, accelerate or decelerate the immune response, or choke the supply of nutrients and oxygen. More and we must come up with ways to use drugs as precision tools to jam cogs and turn off selective switches in particular cancer cells, trained to follow rules, oncologists are now being asked to reinvent them.”

The article continues, “Cancer and its treatment, once seemed simpler. A breakthrough came in the 2000's, soon after the human genome project when scientists learned to sequence the genomes of cancer cells. Gene sequencing allows us to identify the genetic changes that are particular to a given cancer. We can use that information to guide cancer treatment in effect matching the treatment to an individual patient's cancer.”

In yet another “Times” story the reporter writes, “Today, a better understanding of cancer's workings is transforming treatment as oncologists learn to attack tumors not according to their place of origin but by the mutations that drive deeper. The dream is to go much deeper, to give oncologists a listing of all the tumor's key mutations and their biological significance, making it able to put aside the rough typology that it currently takes to understand each patient's personal cancer. Every patient in this future situation could then be matched to the ideal treatment and with luck all responses would be exceptional. The idea more broadly has been called “Precision Medicine,” the hope that doctors will be able to come to a far more exact understanding of each patient's disease informed by genetics and treat it accordingly.”

I am here today to insert these important stories from The New York Times and the “Humans of New York” blog and Dr. Frist's and Dr. Coburn's op-ed into the record and to remind everyone that the United States Senate health committee has passed 19 bipartisan bills this year that will help drive medical innovation. And I'm working today with Senator Patty Murray of Washington, the senior Democrat on the committee, on an agreement that will give the National Institutes of Health a surge of funding for the President's Precision Medicine Initiative, which will map 1 million genomes and give researchers a giant boost in their efforts to tailor treatments to a patient's individual genome. It will also provide funding for the Cancer Moonshot, which the Vice President is heading to try to set us on faster course to a cure or to cures.

To raise money for cancer researchers at Sloan Kettering hospital, Brandon Stanton used photos on his blog, “Humans of New York,” Facebook, and Instagram accounts. He writes, “The study of rare cancers involves small and relentless teams of researchers. Lifesaving breakthroughs are made on very tight budgets, so your donations will make a difference. They may save a life.” The fundraiser wrapped up this past weekend. More than 103,000 people donated more than $3.8 million to help fight pediatric cancer. More than $1 million of these dollars were donated in last day of the campaign in honor of a young boy named Max to help research and cure the brain tumor that ended his short life. Stanton shared photos and stories of Sloan Kettering patients and their parents, as well as the doctors and researchers working to treat and cure them—many stories hopeful, all difficult to read. As Stanton put it, “These are war stories.”

In one post, a researcher at the pediatric center says “In the movies, scientists are portrayed as having a ‘eureka’ moment, that singular moment in time when their faces change and they find the answer. It's hard to say what a ‘eureka’ moment would look like in my research. Maybe it is when I'm finally able to look patients and parents in the eye and say with confidence that we have what's needed to cure them.” Another doctor says “it's been 12 hours a day, six days a week for the last 30 years. My goal during these years was to help all I could. I’ve given transplants to over 1,200 kids. I’ve published as many papers as I could. I'm almost finished. It's time for young people to be out there and finish the job. They're going to be smarter than us, he said. They'll know more. They'll unzip the D.N.A. And find the type. They'll invent targeted therapies so we don't have to use all this radiation.”

How do we make good on these dollars? How do we make sure these remarkable new discoveries of targeted therapies are able to reach the patients that need to be reached? We must give the FDA tools and the authority it needs to review these innovations and ensure that they're safe and effective, that they get to the patients who need them in a timely way. And that is exactly the goal of our Senate Cures initiative that I'm committed to seeing through to a result.

Dr. Francis Collins, Director of the National Institutes of Health – he calls it the National Institutes of Hope – a federal agency that this year funds $32 billion in biomedical research, offered what he called “bold predictions” in a Senate hearing last month about major advances to expect if there is a sustained commitment to such research. Listen to what he said: One prediction is that science will find ways to identify Alzheimer's before symptoms appear, as well as how to slow or even to prevent the disease. Today, Alzheimer's causes untold family grief. It costs $236 billion a year. And left unchecked, the cost in 2050 would be more than our nation spends on national defense. Dr. Collins other predictions are breath taking. Using pluripotent stem cells doctors could use a patient’s own cells to rebuild his or her own heart. This personalized rebuilt heart, Dr. Collins says, would make transplant waiting lists and anti-rejection drugs obsolete.

I had a phone call from Doug Oliver of Nashville, a medical technician. Last August, Vanderbilt eye institute pronounced him legally blind. They said to him, “no treatment, no cure, but check the internet.” He went to Florida and found a clinical trial. The doctors in an FDA-approved procedure took cells from his hipbone, put them through a centrifuge, and injected them into his retinas in both eyes. Within three days he was beginning to see. He now has his driver's license back. He is ready to go back to work, and he's sending us emails about our legislation urging us to pass it and give more Americans a chance to have the kind of treatments he had that have restored his sight.

Continuing with Dr. Collins' predictions for the next ten years, he expects the development of an artificial pancreas to help diabetes patients by tracking blood glucose levels and by creating precise doses of insulin. He says a Zika vaccine should be widely available by 2018, with a universal flu vaccine – the flu killed 30,000 people last year – and an HIV-AIDS vaccine available within a decade. Dr. Collins says that to relieve suffering and deal with the epidemic of opioid addiction that led to 28,000 overdose deaths in America in 2014, there will be new non-addictive medicines to manage pain.

Our Senate health committee approved 50 bipartisan strategies designed to make predictions like those of Dr. Collins come true. These include faster approval of breakthrough medical devices like the highly successful breakthrough paths of medicine in 2012 and make making the electronic health care system interoperable and less burdensome for doctors and more available to patients. We would make it easier for the National Institutes of Health and the Food and Drug Administration to hire experts needed to supervise research and evaluate safety and effectiveness. We approved measures to target rare diseases and runaway superbugs.

As Doctors Frist and Coburn wrote in The Wall Street Journal, this 21st Century Cures legislation “touches every American and millions of patients, and the medical community are counting on Congress.” The House has already passed by a vote of 344-77, companion legislation called 21st Century Cures, including a surge of funding for the National Institutes of Health. The President has his Precision Medicine Initiative. The Vice President started his Moonshot to cure cancer. The Senate health committee passed 19 bipartisan bills, as I said, either unanimously or by a wide margin. There is no excuse whatever for us not to get a result this year. And it would be extraordinarily disappointing to millions of Americans if we did not.

If the Senate finishes its work and passes these bipartisan biomedical innovation bills as well as a surge of funding for the National Institutes of Health, and takes advantage of these advancements in science, we can help more patients live longer and healthier lives and help more researchers who want to look the parent of a small child in the eye and say “we found a cure.”

I notice that the Senator from Pennsylvania has come to the floor, and I'm ready to yield my time. I see the Senator from Missouri as well. I want to say of both of them, the Senator from Pennsylvania has been a critical component of the 21st Century Cures committee work in the Senate. Several of the 19 bills that our committee approved were sponsored by him, and I thank him for his work. And the Senator from Missouri – I spoke a little earlier about the mental health focus and consensus that we're developing and how we hope to get a result this year on mental health in the Senate as well as 21st Century Cures – the Senator from Missouri has been key in both of them. Last year working with Senator Murray, he was the principal architect of a boost of $2 billion in funding to the National Institutes of Health. And this year he's pushing hard for advances in mental health. So, with this kind of bipartisan cooperation, we ought to be able to get a result in June or early July, and I’m pledging to try to do that.