Testimony on Veterans Affairs Research Funding

Testimony submitted on behalf of the American Physiological Society, Dennis Brown, PhD, Chief Science Officer.

The American Physiological Society (APS) thanks the committee for its ongoing support of Medical and Prosthetic Research at the Department of Veterans Affairs (VA). VA medical research facilities across the country provide veterans access to state-of-the-art health care and conduct research that specifically addresses the medical needs of veterans. The APS urges you to make every effort to fund the VA Medical and Prosthetic Research Program at a level of $860 million in FY 2021.

Challenges for VA Research and Medical Care

The VA research program specifically addresses the medical needs of veterans. Nevertheless, new technologies and treatments developed at VA medical centers lead to healthcare improvements for all Americans. VA scientists have done seminal research into rehabilitation following traumatic injury, development of state of the art prosthetic devices to recover functionality, and treatment for post-traumatic stress disorder, traumatic brain injury, and mental health issues including suicide. These medical problems are more prevalent among veterans but are also common in the general population. VA research also explores other conditions such as dementia, diabetes, pain, addiction and cancer and offers hope for the veteran and non-veteran alike. The research carried out in these areas and their resulting innovations will be particularly important in the coming decades as an aging population brings new challenges to the American health care system.

Congress included language in the FY 2020 VA appropriations bill mandating specific approval criteria and processes for VA research involving canines, felines, and non-human primates. The APS was aware that concerns had been raised about VA research with animals, but the agency has strong animal welfare protections in place, and it took prompt action to address the problems that arose—which it identified on its own. The VA conducts relatively little research with canines, felines, and non-human primates, and the agency has multiple reviews in place to ensure that such studies are designed and conducted with priority given to the welfare of the animals. We believe that the VA has an excellent framework in place to ensure animal welfare while seeking to give hope to those with serious health problems due to combat-related illnesses and injuries. Under the VA’s oversight framework, research with these animals is only allowed to go forward if the only way to answer an important scientific question is to study them.

Bringing Innovation to Health Care

Because most VA researchers are also clinicians caring for patients, the VA research system is ideally situated to foster the translation of basic biomedical research findings into clinically relevant diagnostics and treatment modalities. The VA has developed a number of programs that facilitate the translation of knowledge gained in the lab to use in a clinical setting. One example is the Million Veteran Program (MVP) which collects genetic samples and general health information from one million veterans and tracks them over five years, creating a wealth of information that will inform research and efforts to improve health care. Using the data collected through the MVP and electronic health records, the VA is engaging in efforts to make data available to researchers both within and outside of the VA to ensure that this program investment is maximized. In addition, in December of 2019 the VA announced a new institute, the National Artificial Intelligence Institute, which will utilize artificial intelligence applications to analyze large amounts of data with the goal of improving health care outcomes.

Another example of the VA’s innovative approach to bringing research to bear on clinical outcomes involves the agency’s efforts to reduce the amount of time required to set up a clinical trial. By looking for ways to reduce administrative burden for multi-site trials, the VA hopes to reduce the average time required to establish a clinical trial by 100 days.

Finally, in addition to focusing on research and patient care, VA medical researchers also play a critical role in educating the next generation of physician-scientists. Currently, more than half of all practicing physicians in the US receive some of their training at a VA facility.

Investing in The Future

In recent years, Congress has increased funding for the VA Medical and Prosthetic Research Program, allowing clinicians and researchers to pursue new ideas that would otherwise go unexplored and expand research in promising areas of science. In order to build on this investment in the VA research enterprise, the APS joins our colleagues at the Federation of American Societies for Experimental Biology in urging you to appropriate $860 million for VA Research in FY 2021. This level of investment will allow the VA to maintain their current research program while pursuing new directions to address the needs of the veteran population.

The APS is a nonprofit devoted to fostering education, scientific research and dissemination of information in the physiological sciences. The Society was founded in 1887 with 28 members and now has over 8,000 members, most of whom hold doctoral degrees in physiology, medicine and/or other health professions. Our members conduct research at colleges, universities, medical schools, and other public and private research institutions across the U.S., including VA facilities.