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National Institutes of Health

The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late 1880s and is now part of the United States Department of Health and Human Services. The majority of NIH facilities are located in Bethesda, Maryland, and other nearby suburbs of the Washington metropolitan area, with other primary facilities in the Research Triangle Park in North Carolina and smaller satellite facilities located around the United States. The NIH conducts its own scientific research through the NIH Intramural Research Program (IRP) and provides major biomedical research funding to non-NIH research facilities through its Extramural Research Program.

National Institutes of Health (NIH)
National Institutes of Health logo

Aerial photo of the NIH Mark O. Hatfield Clinical Research Center, Bethesda, Maryland
Agency overview
FormedAugust 1887; 135 years ago (1887-08)
Preceding agency
  • Hygienic Laboratory
HeadquartersBethesda, Maryland, U.S.
39°00′09″N 77°06′16″W / 39.00250°N 77.10444°W / 39.00250; -77.10444Coordinates: 39°00′09″N 77°06′16″W / 39.00250°N 77.10444°W / 39.00250; -77.10444
Employees18,478 (2021), [1]
Annual budget$45 billion (2022)
Agency executive
Parent agencyDepartment of Health & Human Services
Child agencies
Websitenih.gov

As of 2013, the IRP had 1,200 principal investigators and more than 4,000 postdoctoral fellows in basic, translational, and clinical research, being the largest biomedical research institution in the world,[1] while, as of 2003, the extramural arm provided 28% of biomedical research funding spent annually in the U.S., or about US$26.4 billion.[2]

The NIH comprises 27 separate institutes and centers of different biomedical disciplines and is responsible for many scientific accomplishments, including the discovery of fluoride to prevent tooth decay, the use of lithium to manage bipolar disorder, and the creation of vaccines against hepatitis, Haemophilus influenzae (HIB), and human papillomavirus (HPV).[3]

In 2019, the NIH was ranked number two in the world, behind Harvard University, for biomedical sciences in the Nature Index, which measured the largest contributors to papers published in a subset of leading journals from 2015 to 2018.[4][5]

History

Origins

 
Ida A. Bengtson, a bacteriologist who in 1916 was the first woman hired to work in the Hygienic Laboratory[6]
Dedication of first six NIH buildings by President Franklin D. Roosevelt in 1940
 
NIH campus in Bethesda, Maryland, in 1945

In 1887, a laboratory for the study of bacteria, the Hygienic Laboratory, was established within the Marine Hospital Service, which at the time was expanding its functions beyond the system of Marine Hospitals into quarantine and research programs. It was initially located at the New York Marine Hospital on Staten Island.[7][8][9] In 1891, it moved to the top floor of the Butler Building in Washington, D.C. In 1904, it moved again to a new campus at the Old Naval Observatory, which grew to include five major buildings.[10]

In 1901, the Division of Scientific Research was formed, which included the Hygienic Laboratory as well as other research offices of the Marine Hospital Service.[11] In 1912, the Marine Hospital Service became the Public Health Service (PHS).[9] In 1922, PHS established a Special Cancer Investigations laboratory at Harvard Medical School. This marked the beginning of a partnership with universities.[9]

In 1930, the Hygienic Laboratory was re-designated as the National Institute of Health by the Ransdell Act, and was given $750,000 to construct two NIH buildings at the Old Naval Observatory campus.[9] In 1937, NIH absorbed the rest of the Division of Scientific Research, of which it was formerly part.[11][12]

In 1938, NIH moved to its current campus in Bethesda, Maryland.[9] Over the next few decades, Congress would markedly increase funding of the NIH, and various institutes and centers within the NIH were created for specific research programs.[9] In 1944, the Public Health Service Act was approved, and the National Cancer Institute became a division of NIH. In 1948, the name changed from National Institute of Health to National Institutes of Health.

Later history

In the 1960s, virologist and cancer researcher Chester M. Southam injected HeLa cancer cells into patients at the Jewish Chronic Disease Hospital.[13]: 130  When three doctors resigned after refusing to inject patients without their consent, the experiment gained considerable media attention.[13]: 133  The NIH was a major source of funding for Southam's research and had required all research involving human subjects to obtain their consent prior to any experimentation.[13]: 135  Upon investigating all of their grantee institutions, the NIH discovered that the majority of them did not protect the rights of human subjects. From then on, the NIH has required all grantee institutions to approve any research proposals involving human experimentation with review boards.[13]: 135 

In 1967, the Division of Regional Medical Programs was created to administer grants for research for heart disease, cancer, and strokes. That same year, the NIH director lobbied the White House for increased federal funding in order to increase research and the speed with which health benefits could be brought to the people. An advisory committee was formed to oversee the further development of the NIH and its research programs. By 1971 cancer research was in full force and President Nixon signed the National Cancer Act, initiating a National Cancer Program, President's Cancer Panel, National Cancer Advisory Board, and 15 new research, training, and demonstration centers.[14]

Funding for the NIH has often been a source of contention in Congress, serving as a proxy for the political currents of the time. In 1992, the NIH encompassed nearly 1 percent of the federal government's operating budget and controlled more than 50 percent of all funding for health research, and 85 percent of all funding for health studies in universities.[15] While government funding for research in other disciplines has been increasing at a rate similar to inflation since the 1970s, research funding for the NIH nearly tripled through the 1990s and early 2000s, but has remained relatively stagnant since then.[16]

By the 1990s, the NIH committee focus had shifted to DNA research and launched the Human Genome Project.[17]

Leadership

The NIH Office of the Director is the central office responsible for setting policy for NIH, and for planning, managing, and coordinating the programs and activities of all NIH components. The NIH Director plays an active role in shaping the agency's activities and outlook. The Director is responsible for providing leadership to the Institutes and Centers by identifying needs and opportunities, especially in efforts involving multiple Institutes.[18] Within the Director's Office is the Division of Program Coordination, Planning and Strategic Initiatives with 12 divisions including:

The Agency Intramural Research Integrity Officer "is directly responsible for overseeing the resolution of all research misconduct allegations involving intramural research, and for promoting research integrity within the NIH Office of Intramural Research (OIR)."[19] There is a Division of Extramural Activities, which has its own Director.[20] The Office of Ethics has its own Director,[21] as does the Office of Global Research.[22]

Locations and campuses

Intramural research is primarily conducted at the main campus in Bethesda, Maryland, and Rockville, Maryland, and the surrounding communities.

 
Clinical Research Center at NIH
 
Main Lobby Wall at the Clinical Research Center at NIH
 
Looking at the Main Lobby at the Clinical Research Center at NIH
 
Looking at the Main Lobby at the Clinical Research Center at NIH

The Bayview Campus in Baltimore, Maryland houses the research programs of the National Institute on Aging, National Institute on Drug Abuse, and National Human Genome Research Institute with nearly 1,000 scientists and support staff.[23] The Frederick National Laboratory in Frederick, MD and the nearby Riverside Research Park, houses many components of the National Cancer Institute, including the Center for Cancer Research, Office of Scientific Operations, Management Operations Support Branch, the division of Cancer Epidemiology and Genetics and the division of Cancer Treatment and Diagnosis.[24]

The National Institute of Environmental Health Sciences is located in the Research Triangle region of North Carolina.

Other ICs have satellite locations in addition to operations at the main campus. The National Institute of Allergy and Infectious Diseases maintains its Rocky Mountain Labs in Hamilton, Montana,[25] with an emphasis on BSL3 and BSL4 laboratory work. NIDDK operates the Phoenix Epidemiology and Clinical Research Branch in Phoenix, Arizona.

Research

 
Clinical Center – Building 10

As of 2017, 153 scientists receiving financial support from the NIH have been awarded a Nobel Prize and 195 have been awarded a Lasker Award.[26]

Intramural and extramural research

NIH devotes 10% of its funding to research within its own facilities (intramural research), and gives >80% of its funding in research grants to extramural (outside) researchers.[27] Of this extramural funding, a certain percentage (2.8% in 2014) must be granted to small businesses under the SBIR/STTR program.[28] As of 2011, the extramural funding consisted of about 50,000 grants to more than 325,000 researchers at more than 3000 institutions.[29] By 2018, this rate of granting remained reasonably steady, at 47,000 grants to 2,700 organizations.[27] In FY 2010, NIH spent US$10.7bn (not including temporary funding from the American Recovery and Reinvestment Act of 2009) on clinical research, US$7.4bn on genetics-related research, US$6.0bn on prevention research, US$5.8bn on cancer, and US$5.7bn on biotechnology.[30]

Public Access Policy

In 2008 a Congressional mandate called for investigators funded by the NIH to submit an electronic version of their final manuscripts to the National Library of Medicine's research repository, PubMed Central (PMC), no later than 12 months after the official date of publication.[31] The NIH Public Access Policy was the first public access mandate for a U.S. public funding agency.[32]

Economic return

In 2000, the Joint Economic Committee of Congress reported NIH research, which was funded at $16 billion a year in 2000, that some econometric studies had given a rate of return of 25 to 40 percent per year by reducing the economic cost of illness in the US. It found that of the 21 drugs with the highest therapeutic impact on society introduced between 1965 and 1992, public funding was "instrumental" for 15.[33] As of 2011 NIH-supported research helped to discover 153 new FDA-approved drugs, vaccines, and new indications for drugs in the 40 years prior.[34] One study found NIH funding aided either directly or indirectly in developing the drugs or drug targets for all of the 210 FDA-approved drugs from 2010 to 2016.[35] In 2015, Pierre Azoulay et al. estimated $10 million invested in research generated two to three new patents.[36]

Notable discoveries and developments

Since its inception, the NIH intramural research program has been a source of many pivotal scientific and medical discoveries. Some of these include:

  • 1908: George W. McCoy's discovery that rodents were a reservoir of bubonic plague.
  • 1911: George W. McCoy, Charles W. Chapin, William B. Wherry, and B. H. Lamb described the previously unknown tularemia.
  • 1924: Roscoe R. Spencer and Ralph R. Parker developed a vaccine against Rocky Mountain spotted fever.
  • 1930: Sanford M. Rosenthal developed a treatment for mercury poisoning used widely before the development of dimercaptoethanol.
  • 1943: Wilton R. Earle pioneered the cell culture process and published a paper describing the production of malignancy in vitro, Katherine K. Sanford developed the first clone from an isolated cancer cell, and Virginia J. Evans devised a medium that supported growth of cells in vitro.
  • 1940s–1950s: Bernard Horecker and colleagues described the pentose phosphate pathway.
  • 1950s: Julius Axelrod discovered a new class of enzymes, cytochrome P450 monooxygenases, a fundamental of drug metabolism.
  • 1950: Earl Stadtman discovered phosphotransacetylose, elucidating the role of acetyl CoA in fatty acid metabolism.
  • 1960s: Discovered the first human slow virus disease, kuru, which is a degenerative, fatal infection of the central nervous system. This discovery of a new mechanism for infectious diseases revolutionized thinking in microbiology and neurology.
  • 1960s: Defined the mechanisms that regulate noradrenaline, one of the most important neurotransmitters in the brain.
  • 1960s: Developed the first licensed rubella vaccine and the first test for rubella antibodies for large scale testing.
  • 1960s: Developed an effective combination drug regimen for Hodgkin's lymphoma.
  • 1960s: Discovery that tooth decay is caused by bacteria.
  • 1970s: Developed the assay for human chorionic gonadotropin that evolved into the home pregnancy tests.
  • 1970s: Described the hormonal cycle involved in menstruation.
  • 1980s: Determined the complete structure of the IgE receptor that is involved in allergic reactions.
  • 1990s: First trial of gene therapy in humans.

NIH Toolbox

In September 2006, the NIH Blueprint for Neuroscience Research started a contract for the NIH Toolbox for the Assessment of Neurological and Behavioral Function to develop a set of state-of-the-art measurement tools to enhance collection of data in large cohort studies. Scientists from more than 100 institutions nationwide contributed. In September 2012, the NIH Toolbox was rolled out to the research community. NIH Toolbox assessments are based, where possible, on Item Response Theory and adapted for testing by computer.[citation needed]

Database of Genotypes and Phenotypes

NIH sponsors the Database of Genotypes and Phenotypes (dbGap), a repository of information produced by studies investigating the interaction of genotype and phenotype. The information includes phenotypes, molecular assay data, analyses and documents. Summary-level data is available to the general public whereas the individual-level data is accessible to researchers.[37] According to the City Journal NIH denies access to such attributes as intelligence, education and health on the grounds that studying their genetic basis would be stigmatizing.[38]

Coronavirus vaccine

The NIH partnered with Moderna in 2020 during the COVID-19 pandemic to develop a vaccine. The final phase of testing began on July 27 with up to 30,000 volunteers assigned to one of two groups—one receiving the mRNA-1273 vaccine and the other receiving salt water injections—and continued until there had been approximately 100 cases of COVID-19 among the participants.[39][40] In 2021, the NIH contributed $4,395,399 towards the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) program.[41]

Collaboration with Wuhan Institute of Virology

Following the outbreak of the COVID-19 pandemic, NIH-funded EcoHealth Alliance has been the subject of controversy and increased scrutiny due to its ties to the Wuhan Institute of Virology (WIV)—which has been at the center of speculation since early 2020 that SARS-CoV-2 may have escaped in a lab incident.[42][43][44][45][46] Under political pressure, the NIH withdrew funding to EcoHealth Alliance in July 2020.[47]

NIH Interagency Pain Research Coordinating Committee

On February 13, 2012, the National Institutes of Health (NIH) announced a new group of individuals assigned to research pain. This committee is composed of researchers from different organizations and will focus to "coordinate pain research activities across the federal government with the goals of stimulating pain research collaboration… and providing an important avenue for public involvement" ("Members of new", 2012). With a committee such as this research will not be conducted by each individual organization or person but instead a collaborating group which will increase the information available. With this hopefully more pain management will be available including techniques for those with arthritis.[48] In 2020 Beth Darnall, American scientist and pain psychologist, was appointed as scientific member of the group.

Funding

Budget and politics

Historical NIH budget[49]
Year Budget (millions)
1938 0.5
1940 0.7
1945 2.8
1950 52.7
1955 81.2
1960 399.4
1965 959.2
1970 1,061.0
1975 2,092.9
1980 3,428.9
1985 5,149.5
1990 7,567.4
1995 11,299.5
2000 17,840.5
2005 28,594.4
2010 31,238.0
2015 30,311.4
2016 32,311.4
2017 34,300.9
2018 37,311.3
2019 39,000.0
2020 42,000.0

To allocate funds, the NIH must first obtain its budget from Congress. This process begins with institute and center (IC) leaders collaborating with scientists to determine the most important and promising research areas within their fields. IC leaders discuss research areas with NIH management who then develops a budget request for continuing projects, new research proposals, and new initiatives from the Director. NIH submits its budget request to the Department of Health and Human Services (HHS), and the HHS considers this request as a portion of its budget. Many adjustments and appeals occur between NIH and HHS before the agency submits NIH's budget request to the Office of Management and Budget (OMB). OMB determines what amounts and research areas are approved for incorporation into the President's final budget. The President then sends NIH's budget request to Congress in February for the next fiscal year's allocations.[50] The House and Senate Appropriations Subcommittees deliberate and by fall, Congress usually appropriates funding. This process takes approximately 18 months before the NIH can allocate any actual funds.[51]

When a government shutdown occurs, the NIH continues to treat people who are already enrolled in clinical trials, but does not start any new clinical trials and does not admit new patients who are not already enrolled in a clinical trial, except for the most critically ill, as determined by the NIH Director.[52][53][54][55]

Historical funding

Over the last century, the responsibility to allocate funding has shifted from the OD and Advisory Committee to the individual ICs and Congress increasingly set apart funding for particular causes. In the 1970s, Congress began to earmark funds specifically for cancer research, and in the 1980s there was a significant amount allocated for AIDS/HIV research.[56]

Funding for the NIH has often been a source of contention in Congress, serving as a proxy for the political currents of the time. During the 1980s, President Reagan repeatedly tried to cut funding for research, only to see Congress partly restore funding. The political contention over NIH funding slowed the nation's response to the AIDS epidemic; while AIDS was reported in newspaper articles from 1981, no funding was provided for research on the disease. In 1984 National Cancer Institute scientists found implications that "variants of a human cancer virus called HTLV-III are the primary cause of acquired immunodeficiency syndrome (AIDS)," a new epidemic that gripped the nation.[57]

In 1992, the NIH encompassed nearly 1 percent of the federal government's operating budget and controlled more than 50 percent of all funding for health research and 85 percent of all funding for health studies in universities.[15] From 1993 to 2001 the NIH budget doubled. For a time, funding essentially remained flat, and for seven years following the financial crisis, the NIH budget struggled to keep up with inflation.[58]

In 1999 Congress increased the NIH's budget by $2.3 billion[56] to $17.2 billion in 2000.[59] In 2009 Congress again increased the NIH budget to $31 billion in 2010.[59] In 2017 and 2018, Congress passed laws with bipartisan support that substantially increasing appropriations for NIH, which was 37.3 billion dollars annually in FY2018.[60][61]

Extramural research

Researchers at universities or other institutions outside of NIH can apply for research project grants (RPGs) from the NIH. There are numerous funding mechanisms for different project types (e.g., basic research, clinical research, etc.) and career stages (e.g., early career, postdoc fellowships, etc.). The NIH regularly issues "requests for applications" (RFAs), e.g., on specific programmatic priorities or timely medical problems (such as Zika virus research in early 2016). In addition, researchers can apply for "investigator-initiated grants" whose subject is determined by the scientist.

The total number of applicants has increased substantially, from about 60,000 investigators who had applied during the period from 1999 to 2003 to slightly less than 90,000 in who had applied during the period from 2011 to 2015.[62] Due to this, the "cumulative investigator rate", that is, the likelihood that unique investigators are funded over a 5-year window, has declined from 43% to 31%.[62]

R01 grants are the most common funding mechanism and include investigator-initiated projects. The roughly 27,000 to 29,000 R01 applications had a funding success of 17-19% during 2012 though 2014. Similarly, the 13,000 to 14,000 R21 applications had a funding success of 13-14% during the same period.[63] In FY 2016, the total number of grant applications received by the NIH was 54,220, with approximately 19% being awarded funding.[64] Institutes have varying funding rates. The National Cancer Institute awarded funding to 12% of applicants, while the National Institute for General Medical Science awarded funding to 30% of applicants.[64]

Funding criteria

NIH employs five broad decision criteria in its funding policy. First, ensure the highest quality of scientific research by employing an arduous peer review process. Second, seize opportunities that have the greatest potential to yield new knowledge and that will lead to better prevention and treatment of disease. Third, maintain a diverse research portfolio in order to capitalize on major discoveries in a variety of fields such as cell biology, genetics, physics, engineering, and computer science. Fourth, address public health needs according to the disease burden (e.g., prevalence and mortality). And fifth, construct and support the scientific infrastructure (e.g., well-equipped laboratories and safe research facilities) necessary to conduct research.[65]

Advisory committee members advise the institute on policy and procedures affecting the external research programs and provide a second level of review for all grant and cooperative agreement applications considered by the Institute for funding.[66]

Gender and sex bias

In 2014, it was announced that the NIH is directing scientists to perform their experiments with both female and male animals, or cells derived from females as well as males if they are studying cell cultures, and that the NIH would take the balance of each study design into consideration when awarding grants.[67] The announcement also stated that this rule would probably not apply when studying sex-specific diseases (for example, ovarian or testicular cancer).[67]

Stakeholders

General public

One of the goals of the NIH is to "expand the base in medical and associated sciences in order to ensure a continued high return on the public investment in research."[68] Taxpayer dollars funding NIH are from the taxpayers, making them the primary beneficiaries of advances in research. Thus, the general public is a key stakeholder in the decisions resulting from the NIH funding policy.[69][failed verification] However, some in the general public do not feel their interests are being represented, and individuals have formed patient advocacy groups to represent their own interests.[70]

Extramural researchers and scientists

Important stakeholders of the NIH funding policy include researchers and scientists. Extramural researchers differ from intramural researchers in that they are not employed by the NIH but may apply for funding. Throughout the history of the NIH, the amount of funding received has increased, but the proportion to each IC remains relatively constant. The individual ICs then decide who will receive the grant money and how much will be allotted.

Policy changes on who receives funding significantly affect researchers. For example, the NIH has recently attempted to approve more first-time NIH R01 applicants or the research grant applications of young scientists. To encourage the participation of young scientists, the application process has been shortened and made easier.[71] In addition, first-time applicants are being offered more funding for their research grants than those who have received grants in the past.[72]

Commercial partnerships

In 2011 and 2012, the Department of Health and Human Services Office of Inspector General published a series of audit reports revealing that throughout the fiscal years 2000–2010, institutes under the aegis of the NIH did not comply with the time and amount requirements specified in appropriations statutes, in awarding federal contracts to commercial partners, committing the federal government to tens of millions of dollars of expenditure ahead of appropriation of funds from Congress.[73]

Institutes and centers

The NIH is composed of 27 separate institutes and centers (ICs) that conduct and coordinate research across different disciplines of biomedical science. These are:

In addition, the National Center for Research Resources operated from April 13, 1962, to December 23, 2011.

Previous directors

See also

References

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External links

  • Official website  
  • National Institutes of Health in the Federal Register
  • Regional Medical Programs Collection of information on NIH's Regional Medical Programs, from the National Library of Medicine

national, institutes, health, redirects, here, other, uses, disambiguation, commonly, referred, with, each, letter, pronounced, individually, primary, agency, united, states, government, responsible, biomedical, public, health, research, founded, late, 1880s, . NIH redirects here For other uses see NIH disambiguation The National Institutes of Health commonly referred to as NIH with each letter pronounced individually is the primary agency of the United States government responsible for biomedical and public health research It was founded in the late 1880s and is now part of the United States Department of Health and Human Services The majority of NIH facilities are located in Bethesda Maryland and other nearby suburbs of the Washington metropolitan area with other primary facilities in the Research Triangle Park in North Carolina and smaller satellite facilities located around the United States The NIH conducts its own scientific research through the NIH Intramural Research Program IRP and provides major biomedical research funding to non NIH research facilities through its Extramural Research Program National Institutes of Health NIH National Institutes of Health logoAerial photo of the NIH Mark O Hatfield Clinical Research Center Bethesda MarylandAgency overviewFormedAugust 1887 135 years ago 1887 08 Preceding agencyHygienic LaboratoryHeadquartersBethesda Maryland U S 39 00 09 N 77 06 16 W 39 00250 N 77 10444 W 39 00250 77 10444 Coordinates 39 00 09 N 77 06 16 W 39 00250 N 77 10444 W 39 00250 77 10444Employees18 478 2021 1 Annual budget 45 billion 2022 Agency executiveLawrence A Tabak Acting DirectorParent agencyDepartment of Health amp Human ServicesChild agenciesNational Cancer InstituteNational Institute of Allergy and Infectious DiseasesNational Institute of Diabetes and Digestive and Kidney DiseasesNational Heart Lung and Blood InstituteNational Library of MedicineWebsitenih wbr govAs of 2013 update the IRP had 1 200 principal investigators and more than 4 000 postdoctoral fellows in basic translational and clinical research being the largest biomedical research institution in the world 1 while as of 2003 the extramural arm provided 28 of biomedical research funding spent annually in the U S or about US 26 4 billion 2 The NIH comprises 27 separate institutes and centers of different biomedical disciplines and is responsible for many scientific accomplishments including the discovery of fluoride to prevent tooth decay the use of lithium to manage bipolar disorder and the creation of vaccines against hepatitis Haemophilus influenzae HIB and human papillomavirus HPV 3 In 2019 the NIH was ranked number two in the world behind Harvard University for biomedical sciences in the Nature Index which measured the largest contributors to papers published in a subset of leading journals from 2015 to 2018 4 5 Contents 1 History 1 1 Origins 1 2 Later history 2 Leadership 3 Locations and campuses 4 Research 4 1 Intramural and extramural research 4 2 Public Access Policy 4 3 Economic return 4 4 Notable discoveries and developments 4 4 1 NIH Toolbox 4 4 2 Database of Genotypes and Phenotypes 4 4 3 Coronavirus vaccine 4 4 4 Collaboration with Wuhan Institute of Virology 4 4 5 NIH Interagency Pain Research Coordinating Committee 5 Funding 5 1 Budget and politics 5 1 1 Historical funding 5 2 Extramural research 5 3 Funding criteria 5 3 1 Gender and sex bias 5 4 Stakeholders 5 4 1 General public 5 4 2 Extramural researchers and scientists 6 Commercial partnerships 7 Institutes and centers 8 Previous directors 9 See also 10 References 11 External linksHistory EditOrigins Edit Ida A Bengtson a bacteriologist who in 1916 was the first woman hired to work in the Hygienic Laboratory 6 source source source source source source source source source source Dedication of first six NIH buildings by President Franklin D Roosevelt in 1940 NIH campus in Bethesda Maryland in 1945 In 1887 a laboratory for the study of bacteria the Hygienic Laboratory was established within the Marine Hospital Service which at the time was expanding its functions beyond the system of Marine Hospitals into quarantine and research programs It was initially located at the New York Marine Hospital on Staten Island 7 8 9 In 1891 it moved to the top floor of the Butler Building in Washington D C In 1904 it moved again to a new campus at the Old Naval Observatory which grew to include five major buildings 10 In 1901 the Division of Scientific Research was formed which included the Hygienic Laboratory as well as other research offices of the Marine Hospital Service 11 In 1912 the Marine Hospital Service became the Public Health Service PHS 9 In 1922 PHS established a Special Cancer Investigations laboratory at Harvard Medical School This marked the beginning of a partnership with universities 9 In 1930 the Hygienic Laboratory was re designated as the National Institute of Health by the Ransdell Act and was given 750 000 to construct two NIH buildings at the Old Naval Observatory campus 9 In 1937 NIH absorbed the rest of the Division of Scientific Research of which it was formerly part 11 12 In 1938 NIH moved to its current campus in Bethesda Maryland 9 Over the next few decades Congress would markedly increase funding of the NIH and various institutes and centers within the NIH were created for specific research programs 9 In 1944 the Public Health Service Act was approved and the National Cancer Institute became a division of NIH In 1948 the name changed from National Institute of Health to National Institutes of Health Later history Edit In the 1960s virologist and cancer researcher Chester M Southam injected HeLa cancer cells into patients at the Jewish Chronic Disease Hospital 13 130 When three doctors resigned after refusing to inject patients without their consent the experiment gained considerable media attention 13 133 The NIH was a major source of funding for Southam s research and had required all research involving human subjects to obtain their consent prior to any experimentation 13 135 Upon investigating all of their grantee institutions the NIH discovered that the majority of them did not protect the rights of human subjects From then on the NIH has required all grantee institutions to approve any research proposals involving human experimentation with review boards 13 135 In 1967 the Division of Regional Medical Programs was created to administer grants for research for heart disease cancer and strokes That same year the NIH director lobbied the White House for increased federal funding in order to increase research and the speed with which health benefits could be brought to the people An advisory committee was formed to oversee the further development of the NIH and its research programs By 1971 cancer research was in full force and President Nixon signed the National Cancer Act initiating a National Cancer Program President s Cancer Panel National Cancer Advisory Board and 15 new research training and demonstration centers 14 Funding for the NIH has often been a source of contention in Congress serving as a proxy for the political currents of the time In 1992 the NIH encompassed nearly 1 percent of the federal government s operating budget and controlled more than 50 percent of all funding for health research and 85 percent of all funding for health studies in universities 15 While government funding for research in other disciplines has been increasing at a rate similar to inflation since the 1970s research funding for the NIH nearly tripled through the 1990s and early 2000s but has remained relatively stagnant since then 16 By the 1990s the NIH committee focus had shifted to DNA research and launched the Human Genome Project 17 Leadership EditThe NIH Office of the Director is the central office responsible for setting policy for NIH and for planning managing and coordinating the programs and activities of all NIH components The NIH Director plays an active role in shaping the agency s activities and outlook The Director is responsible for providing leadership to the Institutes and Centers by identifying needs and opportunities especially in efforts involving multiple Institutes 18 Within the Director s Office is the Division of Program Coordination Planning and Strategic Initiatives with 12 divisions including Office of AIDS Research Office of Research on Women s Health Office of Disease Prevention Sexual and Gender Minority Research Office Tribal Health Research Office Office of Program Evaluation and PerformanceThe Agency Intramural Research Integrity Officer is directly responsible for overseeing the resolution of all research misconduct allegations involving intramural research and for promoting research integrity within the NIH Office of Intramural Research OIR 19 There is a Division of Extramural Activities which has its own Director 20 The Office of Ethics has its own Director 21 as does the Office of Global Research 22 Locations and campuses EditIntramural research is primarily conducted at the main campus in Bethesda Maryland and Rockville Maryland and the surrounding communities Clinical Research Center at NIH Main Lobby Wall at the Clinical Research Center at NIH Looking at the Main Lobby at the Clinical Research Center at NIH Looking at the Main Lobby at the Clinical Research Center at NIH The Bayview Campus in Baltimore Maryland houses the research programs of the National Institute on Aging National Institute on Drug Abuse and National Human Genome Research Institute with nearly 1 000 scientists and support staff 23 The Frederick National Laboratory in Frederick MD and the nearby Riverside Research Park houses many components of the National Cancer Institute including the Center for Cancer Research Office of Scientific Operations Management Operations Support Branch the division of Cancer Epidemiology and Genetics and the division of Cancer Treatment and Diagnosis 24 The National Institute of Environmental Health Sciences is located in the Research Triangle region of North Carolina Other ICs have satellite locations in addition to operations at the main campus The National Institute of Allergy and Infectious Diseases maintains its Rocky Mountain Labs in Hamilton Montana 25 with an emphasis on BSL3 and BSL4 laboratory work NIDDK operates the Phoenix Epidemiology and Clinical Research Branch in Phoenix Arizona Research Edit Clinical Center Building 10 As of 2017 153 scientists receiving financial support from the NIH have been awarded a Nobel Prize and 195 have been awarded a Lasker Award 26 Intramural and extramural research Edit NIH devotes 10 of its funding to research within its own facilities intramural research and gives gt 80 of its funding in research grants to extramural outside researchers 27 Of this extramural funding a certain percentage 2 8 in 2014 must be granted to small businesses under the SBIR STTR program 28 As of 2011 update the extramural funding consisted of about 50 000 grants to more than 325 000 researchers at more than 3000 institutions 29 By 2018 update this rate of granting remained reasonably steady at 47 000 grants to 2 700 organizations 27 In FY 2010 update NIH spent US 10 7bn not including temporary funding from the American Recovery and Reinvestment Act of 2009 on clinical research US 7 4bn on genetics related research US 6 0bn on prevention research US 5 8bn on cancer and US 5 7bn on biotechnology 30 Public Access Policy Edit Main article NIH Public Access Policy In 2008 a Congressional mandate called for investigators funded by the NIH to submit an electronic version of their final manuscripts to the National Library of Medicine s research repository PubMed Central PMC no later than 12 months after the official date of publication 31 The NIH Public Access Policy was the first public access mandate for a U S public funding agency 32 Economic return Edit In 2000 the Joint Economic Committee of Congress reported NIH research which was funded at 16 billion a year in 2000 that some econometric studies had given a rate of return of 25 to 40 percent per year by reducing the economic cost of illness in the US It found that of the 21 drugs with the highest therapeutic impact on society introduced between 1965 and 1992 public funding was instrumental for 15 33 As of 2011 NIH supported research helped to discover 153 new FDA approved drugs vaccines and new indications for drugs in the 40 years prior 34 One study found NIH funding aided either directly or indirectly in developing the drugs or drug targets for all of the 210 FDA approved drugs from 2010 to 2016 35 In 2015 Pierre Azoulay et al estimated 10 million invested in research generated two to three new patents 36 Notable discoveries and developments Edit Since its inception the NIH intramural research program has been a source of many pivotal scientific and medical discoveries Some of these include 1908 George W McCoy s discovery that rodents were a reservoir of bubonic plague 1911 George W McCoy Charles W Chapin William B Wherry and B H Lamb described the previously unknown tularemia 1924 Roscoe R Spencer and Ralph R Parker developed a vaccine against Rocky Mountain spotted fever 1930 Sanford M Rosenthal developed a treatment for mercury poisoning used widely before the development of dimercaptoethanol 1943 Wilton R Earle pioneered the cell culture process and published a paper describing the production of malignancy in vitro Katherine K Sanford developed the first clone from an isolated cancer cell and Virginia J Evans devised a medium that supported growth of cells in vitro 1940s 1950s Bernard Horecker and colleagues described the pentose phosphate pathway 1950s Julius Axelrod discovered a new class of enzymes cytochrome P450 monooxygenases a fundamental of drug metabolism 1950 Earl Stadtman discovered phosphotransacetylose elucidating the role of acetyl CoA in fatty acid metabolism 1960s Discovered the first human slow virus disease kuru which is a degenerative fatal infection of the central nervous system This discovery of a new mechanism for infectious diseases revolutionized thinking in microbiology and neurology 1960s Defined the mechanisms that regulate noradrenaline one of the most important neurotransmitters in the brain 1960s Developed the first licensed rubella vaccine and the first test for rubella antibodies for large scale testing 1960s Developed an effective combination drug regimen for Hodgkin s lymphoma 1960s Discovery that tooth decay is caused by bacteria 1970s Developed the assay for human chorionic gonadotropin that evolved into the home pregnancy tests 1970s Described the hormonal cycle involved in menstruation 1980s Determined the complete structure of the IgE receptor that is involved in allergic reactions 1990s First trial of gene therapy in humans NIH Toolbox Edit In September 2006 the NIH Blueprint for Neuroscience Research started a contract for the NIH Toolbox for the Assessment of Neurological and Behavioral Function to develop a set of state of the art measurement tools to enhance collection of data in large cohort studies Scientists from more than 100 institutions nationwide contributed In September 2012 the NIH Toolbox was rolled out to the research community NIH Toolbox assessments are based where possible on Item Response Theory and adapted for testing by computer citation needed Database of Genotypes and Phenotypes Edit NIH sponsors the Database of Genotypes and Phenotypes dbGap a repository of information produced by studies investigating the interaction of genotype and phenotype The information includes phenotypes molecular assay data analyses and documents Summary level data is available to the general public whereas the individual level data is accessible to researchers 37 According to the City Journal NIH denies access to such attributes as intelligence education and health on the grounds that studying their genetic basis would be stigmatizing 38 Coronavirus vaccine Edit The NIH partnered with Moderna in 2020 during the COVID 19 pandemic to develop a vaccine The final phase of testing began on July 27 with up to 30 000 volunteers assigned to one of two groups one receiving the mRNA 1273 vaccine and the other receiving salt water injections and continued until there had been approximately 100 cases of COVID 19 among the participants 39 40 In 2021 the NIH contributed 4 395 399 towards the Accelerating COVID 19 Therapeutic Interventions and Vaccines ACTIV program 41 Collaboration with Wuhan Institute of Virology Edit See also COVID 19 lab leak theory and Investigations into the origin of COVID 19 Following the outbreak of the COVID 19 pandemic NIH funded EcoHealth Alliance has been the subject of controversy and increased scrutiny due to its ties to the Wuhan Institute of Virology WIV which has been at the center of speculation since early 2020 that SARS CoV 2 may have escaped in a lab incident 42 43 44 45 46 Under political pressure the NIH withdrew funding to EcoHealth Alliance in July 2020 47 NIH Interagency Pain Research Coordinating Committee Edit On February 13 2012 the National Institutes of Health NIH announced a new group of individuals assigned to research pain This committee is composed of researchers from different organizations and will focus to coordinate pain research activities across the federal government with the goals of stimulating pain research collaboration and providing an important avenue for public involvement Members of new 2012 With a committee such as this research will not be conducted by each individual organization or person but instead a collaborating group which will increase the information available With this hopefully more pain management will be available including techniques for those with arthritis 48 In 2020 Beth Darnall American scientist and pain psychologist was appointed as scientific member of the group Funding EditBudget and politics Edit Historical NIH budget 49 Year Budget millions 1938 0 51940 0 71945 2 81950 52 71955 81 21960 399 41965 959 21970 1 061 01975 2 092 91980 3 428 91985 5 149 51990 7 567 41995 11 299 52000 17 840 52005 28 594 42010 31 238 02015 30 311 42016 32 311 42017 34 300 92018 37 311 32019 39 000 02020 42 000 0To allocate funds the NIH must first obtain its budget from Congress This process begins with institute and center IC leaders collaborating with scientists to determine the most important and promising research areas within their fields IC leaders discuss research areas with NIH management who then develops a budget request for continuing projects new research proposals and new initiatives from the Director NIH submits its budget request to the Department of Health and Human Services HHS and the HHS considers this request as a portion of its budget Many adjustments and appeals occur between NIH and HHS before the agency submits NIH s budget request to the Office of Management and Budget OMB OMB determines what amounts and research areas are approved for incorporation into the President s final budget The President then sends NIH s budget request to Congress in February for the next fiscal year s allocations 50 The House and Senate Appropriations Subcommittees deliberate and by fall Congress usually appropriates funding This process takes approximately 18 months before the NIH can allocate any actual funds 51 When a government shutdown occurs the NIH continues to treat people who are already enrolled in clinical trials but does not start any new clinical trials and does not admit new patients who are not already enrolled in a clinical trial except for the most critically ill as determined by the NIH Director 52 53 54 55 Historical funding Edit Over the last century the responsibility to allocate funding has shifted from the OD and Advisory Committee to the individual ICs and Congress increasingly set apart funding for particular causes In the 1970s Congress began to earmark funds specifically for cancer research and in the 1980s there was a significant amount allocated for AIDS HIV research 56 Funding for the NIH has often been a source of contention in Congress serving as a proxy for the political currents of the time During the 1980s President Reagan repeatedly tried to cut funding for research only to see Congress partly restore funding The political contention over NIH funding slowed the nation s response to the AIDS epidemic while AIDS was reported in newspaper articles from 1981 no funding was provided for research on the disease In 1984 National Cancer Institute scientists found implications that variants of a human cancer virus called HTLV III are the primary cause of acquired immunodeficiency syndrome AIDS a new epidemic that gripped the nation 57 In 1992 the NIH encompassed nearly 1 percent of the federal government s operating budget and controlled more than 50 percent of all funding for health research and 85 percent of all funding for health studies in universities 15 From 1993 to 2001 the NIH budget doubled For a time funding essentially remained flat and for seven years following the financial crisis the NIH budget struggled to keep up with inflation 58 In 1999 Congress increased the NIH s budget by 2 3 billion 56 to 17 2 billion in 2000 59 In 2009 Congress again increased the NIH budget to 31 billion in 2010 59 In 2017 and 2018 Congress passed laws with bipartisan support that substantially increasing appropriations for NIH which was 37 3 billion dollars annually in FY2018 60 61 Extramural research Edit Main article NIH grant Researchers at universities or other institutions outside of NIH can apply for research project grants RPGs from the NIH There are numerous funding mechanisms for different project types e g basic research clinical research etc and career stages e g early career postdoc fellowships etc The NIH regularly issues requests for applications RFAs e g on specific programmatic priorities or timely medical problems such as Zika virus research in early 2016 In addition researchers can apply for investigator initiated grants whose subject is determined by the scientist The total number of applicants has increased substantially from about 60 000 investigators who had applied during the period from 1999 to 2003 to slightly less than 90 000 in who had applied during the period from 2011 to 2015 62 Due to this the cumulative investigator rate that is the likelihood that unique investigators are funded over a 5 year window has declined from 43 to 31 62 R01 grants are the most common funding mechanism and include investigator initiated projects The roughly 27 000 to 29 000 R01 applications had a funding success of 17 19 during 2012 though 2014 Similarly the 13 000 to 14 000 R21 applications had a funding success of 13 14 during the same period 63 In FY 2016 the total number of grant applications received by the NIH was 54 220 with approximately 19 being awarded funding 64 Institutes have varying funding rates The National Cancer Institute awarded funding to 12 of applicants while the National Institute for General Medical Science awarded funding to 30 of applicants 64 Funding criteria Edit NIH employs five broad decision criteria in its funding policy First ensure the highest quality of scientific research by employing an arduous peer review process Second seize opportunities that have the greatest potential to yield new knowledge and that will lead to better prevention and treatment of disease Third maintain a diverse research portfolio in order to capitalize on major discoveries in a variety of fields such as cell biology genetics physics engineering and computer science Fourth address public health needs according to the disease burden e g prevalence and mortality And fifth construct and support the scientific infrastructure e g well equipped laboratories and safe research facilities necessary to conduct research 65 Advisory committee members advise the institute on policy and procedures affecting the external research programs and provide a second level of review for all grant and cooperative agreement applications considered by the Institute for funding 66 Gender and sex bias Edit In 2014 it was announced that the NIH is directing scientists to perform their experiments with both female and male animals or cells derived from females as well as males if they are studying cell cultures and that the NIH would take the balance of each study design into consideration when awarding grants 67 The announcement also stated that this rule would probably not apply when studying sex specific diseases for example ovarian or testicular cancer 67 Stakeholders Edit General public Edit One of the goals of the NIH is to expand the base in medical and associated sciences in order to ensure a continued high return on the public investment in research 68 Taxpayer dollars funding NIH are from the taxpayers making them the primary beneficiaries of advances in research Thus the general public is a key stakeholder in the decisions resulting from the NIH funding policy 69 failed verification However some in the general public do not feel their interests are being represented and individuals have formed patient advocacy groups to represent their own interests 70 Extramural researchers and scientists Edit Important stakeholders of the NIH funding policy include researchers and scientists Extramural researchers differ from intramural researchers in that they are not employed by the NIH but may apply for funding Throughout the history of the NIH the amount of funding received has increased but the proportion to each IC remains relatively constant The individual ICs then decide who will receive the grant money and how much will be allotted Policy changes on who receives funding significantly affect researchers For example the NIH has recently attempted to approve more first time NIH R01 applicants or the research grant applications of young scientists To encourage the participation of young scientists the application process has been shortened and made easier 71 In addition first time applicants are being offered more funding for their research grants than those who have received grants in the past 72 Commercial partnerships EditIn 2011 and 2012 the Department of Health and Human Services Office of Inspector General published a series of audit reports revealing that throughout the fiscal years 2000 2010 institutes under the aegis of the NIH did not comply with the time and amount requirements specified in appropriations statutes in awarding federal contracts to commercial partners committing the federal government to tens of millions of dollars of expenditure ahead of appropriation of funds from Congress 73 Institutes and centers EditMain article List of NIH ICs The NIH is composed of 27 separate institutes and centers ICs that conduct and coordinate research across different disciplines of biomedical science These are National Cancer Institute NCI National Eye Institute NEI National Heart Lung and Blood Institute NHLBI National Human Genome Research Institute NHGRI National Institute on Aging NIA National Institute on Alcohol Abuse and Alcoholism NIAAA National Institute of Allergy and Infectious Diseases NIAID National Institute of Arthritis and Musculoskeletal and Skin Diseases NIAMS National Institute of Biomedical Imaging and Bioengineering NIBIB National Institute of Child Health and Human Development NICHD 74 National Institute on Deafness and Other Communication Disorders NIDCD National Institute of Dental and Craniofacial Research NIDCR National Institute of Diabetes and Digestive and Kidney Diseases NIDDK National Institute on Drug Abuse NIDA National Institute of Environmental Health Sciences NIEHS National Institute of General Medical Sciences NIGMS National Institute of Mental Health NIMH National Institute on Minority Health and Health Disparities NIMHD National Institute of Neurological Disorders and Stroke NINDS National Institute of Nursing Research NINR National Library of Medicine NLM Center for Information Technology CIT Center for Scientific Review CSR Fogarty International Center FIC National Center for Advancing Translational Sciences NCATS National Center for Complementary and Integrative Health NCCIH NIH Clinical Center NIH CC In addition the National Center for Research Resources operated from April 13 1962 to December 23 2011 Previous directors EditJoseph J Kinyoun served August 1887 April 30 1899 Milton J Rosenau served May 1 1899 September 30 1909 John F Anderson served October 1 1909 November 19 1915 George W McCoy served November 20 1915 January 31 1937 Lewis R Thompson served February 1 1937 January 31 1942 Rolla Dyer served February 1 1942 September 30 1950 William H Sebrell Jr served October 1 1950 July 31 1955 James Augustine Shannon served August 1 1955 August 31 1968 Robert Q Marston served September 1 1968 January 21 1973 Robert Stone served May 29 1973 January 31 1975 Donald S Fredrickson served July 1 1975 June 30 1981 James B Wyngaarden served April 29 1982 July 31 1989 Bernadine Healy served April 9 1991 June 30 1993 Harold E Varmus served November 23 1993 December 31 1999 Elias A Zerhouni served May 2 2002 October 31 2008 Francis S Collins served August 17 2009 December 19 2021 75 See also EditList of institutes and centers of the National Institutes of Health United States Public Health Service Foundation for the National Institutes of Health National Institutes of Health Stroke Scale Heads of International Research Organizations NIH Toolbox National Institute of Food and Agriculture Biomedical Engineering and Instrumentation Program BEIP References Edit Organization and Leadership NIH Intramural Research Program Irp nih gov April 4 2011 Archived from the original on April 24 2013 Retrieved April 28 2013 Osterweil Neil September 20 2005 Medical Research Spending Doubled Over Past Decade MedPage Today Archived from the original on October 16 2015 Retrieved September 15 2015 NIH Sourcebook Archived copy PDF Archived from the original PDF on January 5 2012 Retrieved January 20 2012 a href Template Cite web html title Template Cite web cite web a CS1 maint archived copy as title link The top 10 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from websites or documents of the National Institutes of Health External links Edit Wikimedia Commons has media related to National Institutes of Health Official website National Institutes of Health in the Federal Register Regional Medical Programs Collection of information on NIH s Regional Medical Programs from the National Library of Medicine Retrieved from https en wikipedia org w index php title National Institutes of Health amp oldid 1136536644, wikipedia, wiki, book, books, library,

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