shall establish a program to enhance the competitiveness
of such entities in obtaining funds from the national re-
search institutes for conducting biomedical and behavioral
research.
‘‘(B) The entities referred to in subparagraph (A) are
entities that conduct biomedical and behavioral research
and are located in a State in which the aggregate success
rate for applications to the national research institutes for
assistance for such research by the entities in the State
has historically constituted a low success rate of obtaining
such funds, relative to such aggregate rate for such enti-
ties in other States.
‘‘(C) With respect to enhancing competitiveness for
purposes of subparagraph (A), the Director of NIH, in
carrying out the program established under such subpara-
graph, may—
‘‘(i) provide technical assistance to the entities
involved, including technical assistance in the prepa-
ration of applications for obtaining funds from the
national research institutes;
‘‘(ii) assist the entities in developing a plan for
biomedical or behavioral research proposals; and
‘‘(iii) assist the entities in implementing such
plan.
‘‘(2) The Director of NIH shall establish a program
of supporting projects of biomedical or behavioral research
whose principal researchers are individuals who have not
previously served as the principal researchers of such
projects supported by the Director.’’.
SEC. 203. CHILDREN’S VACCINE INITIATIVE.
Part A of title IV of the Public Health Service Act
(42 U.S.C. 281 et seq.) is amended by adding at the end
the following new section:
‘‘CHILDREN’S VACCINE INITIATIVE
‘‘SEC. 404. (a) DEVELOPMENT OF NEW VACCINES.—
The Secretary, in consultation with the Director of the
National Vaccine Program under title XXI and acting
through the Directors of the National Institute for Allergy
and Infectious Diseases, the National Institute for Child
Health and Human Development, the National Institute
for Aging, and other public and private programs, shall
carry out activities, which shall be consistent with the
global Children’s Vaccine Initiative, to develop affordable
new and improved vaccines to be used in the United States
and in the developing world that will increase the efficacy
and efficiency of the prevention of infectious diseases. In
carrying out such activities, the Secretary shall, to the ex-
tent practicable, develop and make available vaccines that
require fewer contacts to deliver, that can be given early
in life, that provide long lasting protection, that obviate
refrigeration, needles and syringes, and that protect
against a larger number of diseases.
‘‘(b) REPORT.—In the report required in section
2104, the Secretary, acting through the Director of the
National Vaccine Program under title XXI, shall include
information with respect to activities and the progress
made in implementing the provisions of this section and
achieving its goals.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—In ad-
dition to any other amounts authorized to be appropriated
for activities of the type described in this section, there
are authorized to be appropriated to carry out this section
$50,000,000 for fiscal year 1994, and such sums as may
be necessary for each of the fiscal years 1995 and 1996.’’.
SEC. 204. PLAN FOR USE OF ANIMALS IN RESEARCH.
(a) IN GENERAL.—Part A of title IV of the Public
Health Service Act, as amended by section 203 of this Act,
is amended by adding at the end the following new section:
‘‘PLAN FOR USE OF ANIMALS IN RESEARCH
‘‘SEC. 404A. (a) The Director of NIH, after consulta-
tion with the committee established under subsection (e),
shall prepare a plan—
‘‘(1) for the National Institutes of Health to
conduct or support research into—
‘‘(A) methods of biomedical research and
experimentation that do not require the use of
animals;
‘‘(B) methods of such research and experi-
mentation that reduce the number of animals
used in such research; and
‘‘(C) methods of such research and experi-
mentation that produce less pain and distress in
such animals;
‘‘(2) for establishing the validity and reliability
of the methods described in paragraph (1);
‘‘(3) for encouraging the acceptance by the sci-
entific community of such methods that have been
found to be valid and reliable; and
‘‘(4) for training scientists in the use of such
methods that have been found to be valid and reli-
able.
‘‘(b) Not later than October 1, 1993, the Director
of NIH shall submit to the Committee on Energy and
Commerce of the House of Representatives, and to the
Committee on Labor and Human Resources of the Senate,
the plan required in subsection (a) and shall begin imple-
mentation of the plan.
‘‘(c) The Director of NIH shall periodically review,
and as appropriate, make revisions in the plan required
under subsection (a). A description of any revision made
in the plan shall be included in the first biennial report
under section 403 that is submitted after the revision is
made.
‘‘(d) The Director of NIH shall take such actions as
may be appropriate to convey to scientists and others who
use animals in biomedical or behavioral research or experi-
mentation information respecting the methods found to be
valid and reliable under subsection (a)(2).
‘‘(e)(1) The Director of NIH shall establish within
the National Institutes of Health a committee to be known
as the Interagency Coordinating Committee on the Use
of Animals in Research (hereafter in this subsection re-
ferred to as the ‘Committee’).
‘‘(2) The Committee shall provide advice to the Direc-
tor of NIH on the preparation of the plan required in sub-
section (a).
‘‘(3) The Committee shall be composed of—
‘‘(A) the Directors of each of the national re-
search institutes and the Director of the Center for
Research Resources (or the designees of such Direc-
tors); and
‘‘(B) representatives of the Environmental Pro-
tection Agency, the Food and Drug Administration,
the Consumer Product Safety Commission, the Na-
tional Science Foundation, and such additional agen-
cies as the Director of NIH determines to be appro-
priate.’’.
(b) CONFORMING AMENDMENT.—Section 4 of the
Health Research Extension Act of 1985 (Public Law 99–
158; 99 Stat. 880) is repealed.
SEC. 205. INCREASED PARTICIPATION OF WOMEN AND DIS-
ADVANTAGED INDIVIDUALS IN FIELDS OF
BIOMEDICAL AND BEHAVIORAL RESEARCH.
Section 402 of the Public Health Service Act, as
amended by section 202 of this Act, is amended by adding
at the end the following new subsection:
‘‘(h) The Secretary, acting through the Director of
NIH and the Directors of the agencies of the National
Institutes of Health, may conduct and support programs
for research, research training, recruitment, and other ac-
tivities to provide for an increase in the number of women
and individuals from disadvantaged backgrounds in the
fields of biomedical and behavioral research.’’.
SEC. 206. REQUIREMENTS REGARDING SURVEYS OF SEX-
UAL BEHAVIOR.
Part A of title IV of the Public Health Service Act,
as amended by section 204 of this Act, is amended by add-
ing at the end the following new section:
‘‘REQUIREMENTS REGARDING SURVEYS OF SEXUAL
BEHAVIOR
‘‘SEC. 404B. With respect to any survey of human
sexual behavior proposed to be conducted or supported
through the National Institutes of Health, the survey may
not be carried out unless—
‘‘(1) the proposal has undergone review in ac-
cordance with any applicable requirements of sec-
tions 491 and 492; and
‘‘(2) the Secretary, in accordance with section
492A, makes a determination that the information
expected to be obtained through the survey will as-
sist—
‘‘(A) in reducing the incidence of sexually
transmitted diseases, the incidence of infection
with the human immunodeficiency virus, or the
incidence of any other infectious disease; or
‘‘(B) in improving reproductive health or
other conditions of health.’’.
SEC. 207. DISCRETIONARY FUND OF DIRECTOR OF NA-
TIONAL INSTITUTES OF HEALTH.
Section 402 of the Public Health Service Act, as
amended by section 205 of this Act, is amended by adding
at the end the following new subsection:
‘‘(i)(1) There is established a fund, consisting of
amounts appropriated under paragraph (3) and made
available for the fund, for use by the Director of NIH to
carry out the activities authorized in this Act for the Na-
tional Institutes of Health. The purposes for which such
fund may be expended include—
‘‘(A) providing for research on matters that
have not received significant funding relative to
other matters, responding to new issues and sci-
entific emergencies, and acting on research opportu-
nities of high priority;
‘‘(B) supporting research that is not exclusively
within the authority of any single agency of such In-
stitutes; and
‘‘(C) purchasing or renting equipment and
quarters for activities of such Institutes.
‘‘(2) Not later than February 10 of each fiscal year,
the Secretary shall submit to the Committee on Energy
and Commerce of the House of Representatives, and to
the Committee on Labor and Human Resources of the
Senate, a report describing the activities undertaken and
expenditures made under this section during the preceding
fiscal year. The report may contain such comments of the
Secretary regarding this section as the Secretary deter-
mines to be appropriate.
‘‘(3) For the purpose of carrying out this subsection,
there are authorized to be appropriated $25,000,000 for
fiscal year 1994, and such sums as may be necessary for
each of the fiscal years 1995 and 1996.’’.
SEC. 208. MISCELLANEOUS PROVISIONS.
(a) TERM OF OFFICE FOR MEMBERS OF ADVISORY
COUNCILS.—Section 406(c) of the Public Health Service
Act (42 U.S.C. 284a(c)) is amended in the second sen-
tence by striking ‘‘until a successor has been appointed’’
and inserting the following: ‘‘for 180 days after the date
of such expiration’’.
(b) LITERACY REQUIREMENTS.—Section 402(e) of
the Public Health Service Act (42 U.S.C. 282(e)) is
amended—
(1) in paragraph (3), by striking ‘‘and’’ at the
end;
(2) in paragraph (4), by striking the period and
inserting ‘‘; and’’; and
(3) by adding at the end thereof the following
new paragraph:
‘‘(5) ensure that, after January 1, 1994, at
least one-half of all new or revised health education
and promotion materials developed or funded by the
National Institutes of Health is in a form that does
not exceed a level of functional literacy, as defined
in the National Literacy Act of 1991 (Public Law
102–73).’’.
(c) DAY CARE REGARDING CHILDREN OF EMPLOY-
EES.—Section 402 of the Public Health Service Act, as
amended by section 207 of this Act, is amended by adding
at the end the following new subsection:
‘‘(i)(1) The Director of NIH may establish a program
to provide day care service for the employees of the Na-
tional Institutes of Health similar to those services pro-
vided by other Federal agencies (including the availability
of day care service on a 24-hour-a-day basis).
‘‘(2) Any day care provider at the National Institutes
of Health shall establish a sliding scale of fees that takes
into consideration the income and needs of the employee.
‘‘(3) For purposes regarding the provision of day care
service, the Director of NIH may enter into rental or lease
purchase agreements.’’.
TITLE 
III—GENERAL 
PROVI-
SIONS 
RESPECTING 
NA-
TIONAL 
RESEARCH 
INSTI-
TUTES
SEC. 301. APPOINTMENT AND AUTHORITY OF DIRECTORS
OF NATIONAL RESEARCH INSTITUTES.
(a) ESTABLISHMENT OF GENERAL AUTHORITY RE-
GARDING DIRECT FUNDING.—
(1) IN
GENERAL.—Section 405(b)(2) of the
Public Health Service Act (42 U.S.C. 284(b)(2)) is
amended—
(A) in subparagraph (A), by striking
‘‘and’’ after the semicolon at the end;
(B) in subparagraph (B), by striking the
period at the end and inserting ‘‘; and’’; and
(C) by adding at the end the following new
subparagraph:
‘‘(C) shall receive from the President and the
Office of Management and Budget directly all funds
appropriated by the Congress for obligation and ex-
penditure by the Institute.’’.
(2) 
CONFORMING
AMENDMENT.—Section
413(b)(9) of the Public Health Service Act (42
U.S.C. 285a–2(b)(9)) is amended—
(A) by striking ‘‘(A)’’ after ‘‘(9)’’; and
(B) by striking ‘‘advisory council;’’ and all
that follows and inserting ‘‘advisory council.’’.
(b) APPOINTMENT AND DURATION OF TECHNICAL
AND SCIENTIFIC PEER REVIEW GROUPS.—Section 405(c)
of the Public Health Service Act (42 U.S.C. 284(c)) is
amended—
(1) by amending paragraph (3) to read as fol-
lows:
‘‘(3) may, in consultation with the advisory
council for the Institute and with the approval of the
Director of NIH—
‘‘(A) establish technical and scientific peer
review groups in addition to those appointed
under section 402(b)(6); and
‘‘(B) appoint the members of peer review
groups established under subparagraph (A);
and’’; and
(2) by adding after and below paragraph (4)
the following:
‘‘The Federal Advisory Committee Act shall not apply to
the duration of a peer review group appointed under para-
graph (3).’’.
SEC. 302. PROGRAM OF RESEARCH ON OSTEOPOROSIS,
PAGET’S DISEASE, AND RELATED BONE DIS-
ORDERS.
Part B of title IV of the Public Health Service Act
(42 U.S.C. 284 et seq.), as amended by section 121(b)
of Public Law 102-321 (106 Stat. 358), is amended by
adding at the end the following new section:
‘‘RESEARCH ON OSTEOPOROSIS, PAGET’S DISEASE, AND
RELATED BONE DISORDERS
‘‘SEC. 410. (a) ESTABLISHMENT.—The Directors of
the National Institute of Arthritis and Musculoskeletal
and Skin Diseases, the National Institute on Aging, and
the National Institute of Diabetes, Digestive and Kidney
Diseases, shall expand and intensify the programs of such
Institutes with respect to research and related activities
concerning osteoporosis, Paget’s disease, and related bone
disorders.
‘‘(b) COORDINATION.—The Directors referred to in
subsection (a) shall jointly coordinate the programs re-
ferred to in such subsection and consult with the Arthritis
and Musculoskeletal Diseases Interagency Coordinating
Committee and the Interagency Task Force on Aging Re-
search.
‘‘(c) INFORMATION CLEARINGHOUSE.—
‘‘(1) IN GENERAL.—In order to assist in carry-
ing out the purpose described in subsection (a), the
Director of NIH shall provide for the establishment
of an information clearinghouse on osteoporosis and
related bone disorders to facilitate and enhance
knowledge and understanding on the part of health
professionals, patients, and the public through the
effective dissemination of information.
‘‘(2) ESTABLISHMENT
THROUGH
GRANT
OR
CONTRACT.—For the purpose of carrying out para-
graph (1), the Director of NIH shall enter into a
grant, cooperative agreement, or contract with a
nonprofit private entity involved in activities regard-
ing the prevention and control of osteoporosis and
related bone disorders.
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated $40,000,000 for fiscal year 1994, and
such sums as may be necessary for each of the fiscal years
1995 and 1996.’’.
SEC. 303. ESTABLISHMENT OF INTERAGENCY PROGRAM
FOR TRAUMA RESEARCH.
(a) IN GENERAL.—Title XII of the Public Health
Service Act (42 U.S.C. 300d et seq.) is amended by adding
at the end the following part:
‘‘PART E—INTERAGENCY PROGRAM FOR TRAUMA
RESEARCH
‘‘SEC. 1251. ESTABLISHMENT OF PROGRAM.
‘‘(a) IN GENERAL.—The Secretary, acting through
the Director of the National Institutes of Health (here-
after in this section referred to as the ‘Director’), shall
establish a comprehensive program of conducting basic
and clinical research on trauma (hereafter in this section
referred to as the ‘Program’). The Program shall include
research regarding the diagnosis, treatment, rehabilita-
tion, and general management of trauma.
(b) PLAN FOR PROGRAM.—
‘‘(1) IN GENERAL.—The Director, in consulta-
tion with the Trauma Research Interagency Coordi-
nating Committee established under subsection (g),
shall establish and implement a plan for carrying
out the activities of the Program, including the ac-
tivities described in subsection (d). All such activities
shall be carried out in accordance with the plan. The
plan shall be periodically reviewed, and revised as
appropriate.
‘‘(2) SUBMISSION
TO
CONGRESS.—Not later
than June 1, 1993, the Director shall submit the
plan required in paragraph (1) to the Committee on
Energy and Commerce of the House of Representa-
tives, and to the Committee on Labor and Human
Resources of the Senate, together with an estimate
of the funds needed for each of the fiscal years 1994
through 1996 to implement the plan.
‘‘(c) PARTICIPATING AGENCIES; COORDINATION AND
COLLABORATION.—The Director—
‘‘(1) shall provide for the conduct of activities
under the Program by the Directors of the agencies
of the National Institutes of Health involved in re-
search with respect to trauma;
‘‘(2) shall ensure that the activities of the Pro-
gram are coordinated among such agencies; and
‘‘(b) BREAST CANCER AND GYNECOLOGICAL CAN-
CERS.—
‘‘(1) BREAST CANCER.—
‘‘(A) For the purpose of carrying out sub-
paragraph (A) of section 417(c)(1), there are
authorized to be appropriated $225,000,000 for
fiscal year 1994, and such sums as may be nec-
essary for each of the fiscal years 1995 and
1996. Such authorizations of appropriations are
in addition to the authorizations of appropria-
tions established in subsection (a) with respect
to such purpose.
‘‘(B) For the purpose of carrying out sub-
paragraphs 
(B) 
through 
(E) 
of 
section
417(c)(1), there are authorized to be appro-
priated $100,000,000 for fiscal year 1994, and
such sums as may be necessary for each of the
fiscal years 1995 and 1996. Such authoriza-
tions of appropriations are in addition to the
authorizations of appropriations established in
subsection (a) with respect to such purpose.
‘‘(2) OTHER
CANCERS.—For the purpose of
carrying out subsection (d) of section 417, there are
authorized to be appropriated $75,000,000 for fiscal
year 1994, and such sums as are necessary for each