A substitute amendment to reauthorize the National Cancer Institute the National Heart, Lung, and Blood Institute of NIH for three years at the levels contained in the committee bill, including establishment of a new National Institute on Musculoskeletal Diseases and Arthritis and health promotion and disease prevention centers. It leaves NIH's general research authority intact, removes most of the line item authorizations, does not transfer any outside agencies to NIH and strikes NIH management changes. It contains the animal welfare guidelines, establishes the National Commission on Orphan Diseases, and mandates certain studies, including the animal welfare study.