country's federally-supported dedicated clinical research beds. Each year, 

 there are about 9000 in-patients from all over the world, and in addition, 

 145,000 out-patient visitors who participate in clinical trials at the Clinical 

 Center. 



The Clinical Center's design places laboratory research side-by-side with 

 patient-care activities. Because of this, the NIH continues to be a world 

 leader in biotechnology transfer; that is, the ability to rapidly take an idea 

 from the laboratory directly to clinical trials. 



For example, NIH scientists were the first worldwide to use gene therapy 

 to treat human disease. The first little girl who received the therapy just cele- 

 brated her third year of healthy life. 



Additionally, the successful use of taxol to treat ovarian and breast cancer, 

 gene therapy protocols for drug-resistant breast cancer, and new treatments 

 for approaches to Alzheimer's Disease have all emanated from research in 

 NIH's intramural program. 



Having been built in 1950, the original Clinical Center is over 40 years. 

 Medical research has advanced astronomically. To begin to address changing 

 medical research needs, modernization improvement programs have been un- 

 dertaken to attempt to repair and upgrade the hospital's infrastructure. These 

 include: the essential maintenance and safety program, undertaken as a meas- 

 ure to improve conditions and address the most critical safety issues in the 

 Clinical Center complex; construction of the ambulatory-care research facility; 

 and construction of the A-wing of the Clinical Center to address the national 

 epidemic of AIDS. 



The Clinical Center, however, was not designed to accommodate future 

 expansion. Additions have been based on available space rather than on 

 functional efficiencies, and, as a result, serious functional inefficiencies have 

 occurred. 



Additionally, the major utility infrastructure systems within the original 

 building that provide critical electrical power, lighting, air conditioning, venti- 

 lation and plumbing are outmoded and do not have the flexibility or capacity 

 to meet current research demands. 



For example, because deficiencies in the building's air-handling system 

 pose potential risks to researchers and patients, NIH has had to impose a 

 moratorium on adding fume hoods in individual laboratories, impeding im- 

 portant research activities. And the laboratory located next to one of the sur- 

 gery units was intended to be used for an expedited program on drug-resistant 

 tuberculosis, but due to incorrect airflow, it cannot be used for this or any 

 other infectious disease research. 



In 1987, NIH initiated studies to examine the extent and severity of defi- 

 ciencies in the Clinical Center's infrastructure systems. These studies indi- 

 cated that the deficiencies were indeed severe and widespread. Upgrading of 

 the Clinical Center's infrastructure, in terms of essential safety and health 

 needs, has been included in the budget presentations and an upgrade was in- 

 cluded in the 1991 Presidential budget submission. 



In response to the proposed upgrade, the House Committee on Appropria- 

 tions requested that the Secretary of Health and Human Services conduct a 

 review of these needs in cooperation with other federal agencies. 



The U.S. Army Corps of Engineers agreed to assess NIH's facilities revitali- 

 zation program. In their 1991 report, the Army Corps of Engineers review 



