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June 12, 2018 The Honorable Roy Blunt The Honorable Tom Cole Chair Chair Subcommittee on Labor, Health and Human Subcommittee on Labor, Health and Human Services, Education, and Related Agencies Services, Education, and Related Agencies Senate Committee on Appropriations House Committee on Appropriations Washington, DC 20510 Washington, DC 20515 The Honorable Patty Murray The Honorable Rosa DeLauro Ranking Member Ranking Member Subcommittee on Labor, Health and Human Subcommittee on Labor, Health and Human Services, Education, and Related Agencies Services, Education, and Related Agencies Senate Committee on Appropriations House Committee on Appropriations Washington, DC 20510 Washington, DC 20515 Dear Chairmen Blunt and Cole, and Ranking Members Murray and DeLauro: As you prepare to mark up the Fiscal Year 2019 Labor, Health and Human Services, and Education Appropriations bill, we ask you to consider our coalition s support for funding the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institutes of Health (NIH). The Friends of NICHD are very grateful for the strong, bipartisan support your subcommittees have given the NIH and NICHD. Thanks to your leadership, NIH received a historic $3 billion increase in FY 2018, while NICHD received an impressive $71 million increase. In testimony we ve submitted to your subcommittees, the Friends of NICHD have urged you to continue supporting NIH and NICHD in FY 2019. Specifically, we ve endorsed the Ad Hoc group for Medical Research FY 2019 funding recommendation, which would give the NIH $39.3 billion, a $2.2 billion increase over the agency s FY 2018 level, and NICHD a proportionate increase bringing its funding to $1.531 billion in Fiscal Year (FY) 2019, an increase of $79 million over FY 2018. The Friends of NICHD is a coalition of over 100 organizations representing scientists, physicians, health care providers, patients, and parents concerned with the health and welfare of women, children, and families, and people with disabilities. A complete list of the Friends of NICHD is attached. All of these organizations are pleased to support the extraordinary work of NICHD.

Since its establishment in 1963, NICHD has achieved great success in meeting the objectives of its broad biomedical, behavioral, and social research mission, which includes research on child development before and after birth; women s health throughout the life cycle; maternal, child, and family health; learning and language development; reproductive biology; population health; and medical rehabilitation. With sufficient resources, NICHD can build upon the promising initiatives it has undertaken over the last 50 years, produce new insights into human development, and develop solutions to health and developmental problems throughout the world, including those individuals and families in your districts and states, and expand efforts, including: Increasing investment in longitudinal behavioral and biobehavioral work on child developmental trajectories, across infancy, childhood, and adolescence, in both normative and at-risk environments, across diverse contexts (school, home, and community) and including underrepresented and vulnerable groups; Improving survival rates, neurological outcomes, and birth defects rates for preterm infants; Supporting research to address unique effects of the opioid epidemic on newborns, children, and their families; Training the next generation of pediatric clinical investigators; Developing effective prevention, treatment, and intervention strategies for children and adults with developmental disabilities; Encouraging research to better understand the mechanisms of disparities, to include social determinants of health and genetic factors that adversely affect pregnancy outcomes; Better evaluating the health outcomes of spinal cord injuries; Using robotics to improve technologies for prosthetic limb production; Investing in large-scale longitudinal studies to understand how social, environmental and genetic factors affect the long-term health and well-being of children and adults; and, Facilitating research regarding the causes and implications of the increasing rates of maternal mortality in the U.S. With sustained support in FY 2019, NICHD will be able to continue funding research and research training activities to fulfill its mission of improving the health and well-being of mothers, children, and families. We thank you for your longstanding support of the NIH and encourage you to make NICHD a top priority as you work on the FY 2019 Labor-HHS appropriations bill. Sincerely, Mary Jo Hoeksema Joseph Laakso 2018 Chair 2018 Vice-Chair Friends of NICHD Friends of NICHD

Attachment Friends of NICHD Organizational List Advocates for Youth Ambulatory Pediatric Association American Academy of Child and Adolescent Psychiatry American Academy of Orthopaedic Surgeons American Academy of Orthotists and Prosthetists American Academy of Pediatrics American Academy of Physical Medicine & Rehabilitation American Anthropological Association American Association of University Affiliated Programs American Association on Mental Retardation American Chemistry Council American College of Medical Genetics American College of Nurse Midwives American College of Obstetricians & Gynecologists American Congress of Rehabilitation Medicine American Educational Research Association American Federation for Medical Research American Kidney Fund American Medical Student Association American Nurses Association American Orthotic & Prosthetic Association American Pediatric Society American Pediatric Society & Society for Pediatric Research American Physical Therapy Association American Psychiatric Association American Psychological Association American Public Health Association American Society of Bone and Mineral Research American Society for Cell Biology American Society for Clinical Nutrition American Society for Microbiology American Society for Nutritional Sciences American Society for Parenteral & Enteral Nutrition American Society for Reproductive Immunology American Society for Reproductive Medicine American Society of Pediatric Nephrology American Sociological Association American Speech-Language-Hearing Association American Urogynecologic Society Amputee Coalition of America Association for Health Services Research Association for Human Genetics Association of American Medical Colleges

Association of Maternal and Child Health Programs Association of Medical School Pediatric Department Chairmen Association of Population Centers Association for Psychological Science Association of Reproductive Health Professionals Association of SIDS & Infant Mortality Programs Association of University Centers on Disabilities Association of Women s Health, Obstetric, & Neonatal Nurses Autism Coalition Autism Society of America Center for Injury Research and Policy at the Research Institute at Nationwide Children's Hospital Cerebral Palsy International Research Foundation Child Welfare League of America Children's Defense Fund CJ Foundation for SIDS Coalition for American Trauma Care Consortium of Family Organizations Consortium of Social Science Associations Council for Exceptional Children Elizabeth Glaser Pediatric AIDS Foundation Epilepsy Foundation Federation of American Societies for Experimental Biology Federation of Behavioral, Psychological and Cognitive Sciences First Candle/SIDS Alliance FRAXA Research Foundation Global Alliance to Prevent Prematurity and Stillbirth Hydrocephalus Association Institute for the Advancement of Social Work Research International Rett Syndrome Association Jeffrey Modell Foundation Joseph P. Kennedy, Jr. Foundation Juvenile Diabetes Foundation International Kids TLC Learning Disabilities Association of America March of Dimes Birth Defects Foundation Mental Health America Muscular Dystrophy Association National Alliance for Autism Research National Association of Children s Hospitals National Association of Pediatric Nurse Practitioners National Association of Social Workers National Black Child Development Institute National Center for Learning Disabilities National Council on Family Relations National Down Syndrome Society National Down Syndrome Congress

National Easter Seal Society National Family Planning & Reproductive Health Association National Fragile X Foundation National Osteoporosis Foundation National Partnership for Women and Families National Pediatric and Family HIV Resource Center National Safe Kids Campaign National SIDS and Infant Death Project IMPACT National Women s Health Network National Women s Law Center Nemours, Inc. Osteogenesis Imperfecta Foundation Pediatrix Medical Group Physicians for Reproductive Health Planned Parenthood Federation of America Population Association of America/Association of Population Centers Population Resource Center Preeclampsia Foundation Premature Ovarian Failure Support Group Resolve, Inc. Reproductive Health Technologies Project Society for Advancement of Violence and Injury Research Society for Gynecologic Investigation Society for Gynecologic Oncologists Society for Maternal-Fetal Medicine Society for Neuroscience Society for Pediatric Research Society for Research in Child Development Society for Research on Adolescence Society for Women s Health Research Society for the Psychological Study of Social Issues Society for the Study of Reproduction Society of Behavioral Medicine Spina Bifida Association of America Teratology Society The Alan Guttmacher Institute The Alliance of Genetic Support Groups The Arc The Chromosome 18 Registry and Research Society The Endocrine Society The International Dyslexia Association The Pediatric Trauma Society Trisomy 18 Foundation UCSF Bixby Center for Global Reproductive Health United Mitochondrial Disease Foundation