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The National Institutes of Health (NIH ) is the primary agency of the
United States government The federal government of the United States (U.S. federal government or U.S. government) is the national government of the United States The United States of America (USA), commonly known as the United States (U.S. or US), or Ameri ...
responsible for
biomedical Biomedicine (also referred to as Western medicine, mainstream medicine or conventional medicine)
and
public health Public health has been defined as "the science and art of Preventive healthcare, preventing disease", prolonging life and improving quality of life through organized efforts and informed choices of society, organizations (public and private), C ...

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 United States Department of Health and Human Services (HHS), is a cabinet-level executive branch The executive is the branch of government exercising authority in and holding Moral responsibility, responsibility for the governance of a ...
. The majority of NIH facilities are located in
Bethesda, Maryland Bethesda is an unincorporatedUnincorporated may refer to: * Unincorporated area, land not governed by a local municipality * Unincorporated entity, a type of organization * Unincorporated territories of the United States, territories under U.S. j ...
, and other nearby suburbs of the
Washington metropolitan area#REDIRECT Washington metropolitan area The Washington metropolitan area (also known as the National Capital Region and colloquially as the DMV for "D.C., Maryland, Virginia") is the metropolitan area centered on Washington, D.C., the capital of ...
, with other primary facilities in the
Research Triangle Park Research Triangle Park (RTP) is the largest research park The following is a list of science park, technology parks and biomedical parks of the world, organized by continent. Asia ASEAN Economic Community Report listing all the Economic Z ...
in
North Carolina North Carolina () is a state State may refer to: Arts, entertainment, and media Literature * ''State Magazine'', a monthly magazine published by the U.S. Department of State * The State (newspaper), ''The State'' (newspaper), a daily newsp ...

North Carolina
and smaller satellite facilities located around the United States. The NIH conducts its own scientific research through its Intramural Research Program (IRP) and provides major biomedical research funding to non-NIH research facilities through its Extramural Research Program. , the Intramural Research Program (IRP) had 1,200
principal investigator In Canada and the United States, the term principal investigator (PI) refers to the holder of an independent grant and the lead researcher for the grant project, usually in the sciences, such as a laboratory study or a clinical trial. The phrase is ...
s and more than 4,000
postdoctoral A postdoctoral researcher or postdoc is a person professionally conducting research after the completion of their doctoral studies (typically a PhD). The ultimate goal of a postdoctoral research position is to pursue additional research, train ...
fellows in basic, translational, and clinical research, being the largest biomedical research institution in the world, 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. 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 Tooth decay, also known as dental caries or cavities, is the breakdown of teeth A tooth (plural teeth) is a hard, calcification, calcified structure found in the jaws (or mouths) of many vertebrates and used to Mastication, break down food. ...
, the use of
lithium Lithium (from el, λίθος, lithos, lit=stone) is a chemical element Image:Simple Periodic Table Chart-blocks.svg, 400px, Periodic table, The periodic table of the chemical elements In chemistry, an element is a pure substance consist ...
to manage
bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of pe ...

bipolar disorder
, and the creation of
vaccines A vaccine is a biological preparation that provides active to a particular . A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or o ...
against
hepatitis Hepatitis is inflammation Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a prot ...

hepatitis
, ''
Haemophilus influenzae ''Haemophilus influenzae'' (formerly called Pfeiffer's bacillus or ''Bacillus influenzae'') is a , , of the family . ''H. influenzae'' was first described in 1892 by during an influenza . He incorrectly described ''Haemophilus influenzae' ...

Haemophilus influenzae
'' (HIB), and
human papillomavirus Human papillomavirus infection (HPV infection) is an infection An infection is the invasion of an organism's body Tissue (biology), tissues by Pathogen, disease-causing agents, their multiplication, and the reaction of host (biology), host t ...
(HPV). In 2019, the NIH was ranked number two in the world, behind
Harvard University Harvard University is a private Private or privates may refer to: Music * "In Private "In Private" was the third single in a row to be a charting success for United Kingdom, British singer Dusty Springfield, after an absence of nearly tw ...

Harvard University
, for biomedical sciences in the
Nature IndexThe Nature Index is a database, that tracks institutions and countries and their scientific output since its introduction in 2016. Each year, Nature Index ranks the leading institutions (which can be companies, universities, government agencies, rese ...
, which measured the largest contributors to papers published in a subset of leading journals from 2015 to 2018.


History


Origins

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 The Marine Hospital Service was an organization of Marine Hospitals dedicated to the care of ill and disabled seamen in the United States Merchant Marine, the U.S. Coast Guard and other federal beneficiaries. The Marine Hospital Service evolved ...
, 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 New is an adjective referring to something recently made, discovered, or created. New or NEW may refer to: Music * New, singer of K-pop group The Boyz (South Korean band), The Boyz Albums and EPs * New (album), ''New'' (album), by Paul McCartne ...

New York Marine Hospital
on
Staten Island Staten Island () is a borough A borough is an administrative division in various English language, English-speaking countries. In principle, the term ''borough'' designates a self-governing walled town, although in practice, official use o ...

Staten Island
. In 1891, it moved to the top floor of the
Butler Building The Butler Building was a mansion in Washington, D.C., constructed by Benjamin Butler, Benjamin Franklin Butler. It served as the headquarters of the U.S. Marine Hospital Service, and its successor the United States Public Health Service, Public ...
in
Washington, D.C. ) , image_skyline = , image_caption = Clockwise from top left: the Washington Monument The Washington Monument is an obelisk within the National Mall The National Mall is a Landscape architecture, landscaped ...
In 1904, it moved again to a new campus at the
Old Naval Observatory The Old Naval Observatory is a historic site at 23rd and E Street in Northwest, Washington, D.C.. It is where the United States Naval Observatory The United States Naval Observatory (USNO) is one of the oldest scientific agencies in the Unite ...
, which grew to include five major buildings. 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. In 1912, the Marine Hospital Service became the
Public Health Service The United States Public Health Service (USPHS or PHS) is a collection of agencies of the Department of Health and Human Services concerned with public health, containing eight out of the department's eleven operating divisions. The Assistant Se ...
(PHS). In 1922, PHS established a Special Cancer Investigations laboratory at
Harvard Medical School Harvard Medical School (HMS) is the graduate medical school A medical school is a tertiary educational institution, or part of such an institution, that teaches medicine, and awards a professional degree for physicians and surgeons. Such med ...
. This marked the beginning of a partnership with universities. In 1930, the Hygienic Laboratory was re-designated as the National Institute of Health by the
Ransdell Act The Ransdell Act (ch. 251, , codified as amended at , , ), reorganized, expanded and redesignated the ''Laboratory of Hygiene'' (created in 1887) as the National Institute of Health. Congress appropriated $750,000 in the bill for construction of f ...
, and was given $750,000 to construct two NIH buildings at the Old Naval Observatory campus. In 1937, NIH absorbed the rest of the Division of Scientific Research, of which it was formerly part. In 1938, NIH moved to its current campus in
Bethesda, Maryland Bethesda is an unincorporatedUnincorporated may refer to: * Unincorporated area, land not governed by a local municipality * Unincorporated entity, a type of organization * Unincorporated territories of the United States, territories under U.S. j ...
. 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. In 1944, the
Public Health Service Act The Public Health Service Act is a United States federal law The law of the United States comprises many levels of codified and uncodified forms of law, of which the most important is the nation's Constitution of the United States, Constitution ...
was approved, and the
National Cancer Institute The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health The National Institutes of Health (NIH) () is the primary agency of the United States government respons ...
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 Immunofluorescence image of HeLa cells grown in tissue culture and stained with antibody to actin in green, vimentin in red and DNA in blue HeLa (; also Hela or hela) is an Immortalised cell line, immortal cell line used in scientific researc ...
cancer cells into patients at the Jewish Chronic Disease Hospital. When three doctors resigned after refusing to inject patients without their consent, the experiment gained considerable media attention. 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. 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. 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. 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. 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. By the 1990s, the NIH committee focus had shifted to DNA research and launched the
Human Genome Project The Human Genome Project (HGP) was an international scientific research project with the goal of determining the base pairs that make up human DNA, and of identifying and mapping all of the genes of the human genome from both a physical and a f ...
.


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. 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 The National Institutes of Health (NIH) is an agency of the United States Department of Health and Human Services and is the primary agency of the United States government responsible for biomedical and health-related research. It comprises 27 sepa ...
* Office of Disease Prevention * Sexual and Gender Minority Research Office * Tribal Health Research Office * Office of Program Evaluation and Performance 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)." There is a Division of Extramural Activities, which has its own Director. The Office of Ethics has its own Director, as does the Office of Global Research.


Locations and campuses

Intramural research is primarily conducted at the main campus in
Bethesda, Maryland Bethesda is an unincorporatedUnincorporated may refer to: * Unincorporated area, land not governed by a local municipality * Unincorporated entity, a type of organization * Unincorporated territories of the United States, territories under U.S. j ...
, and
Rockville, Maryland Rockville is a city that serves as the county seat of Montgomery County, Maryland, Montgomery County, Maryland, United States, part of the Baltimore–Washington metropolitan area. The 2020 United States Census, 2020 census tabulated Rockville's p ...
, and the surrounding communities. The Bayview Campus in
Baltimore Baltimore ( , locally: ) is the most populous city The United Nations uses three definitions for what constitutes a city, as not all cities in all jurisdictions are classified using the same criteria. Cities may be defined as the city prop ...

Baltimore
, Maryland houses the research programs of the
National Institute on Aging The National Institute on Aging (NIA) is a division of the U.S. National Institutes of Health The National Institutes of Health (NIH ) is the primary agency of the United States government The federal government of the United States ...
,
National Institute on Drug Abuse The National Institute on Drug Abuse (NIDA) is a United States The United States of America (USA), commonly known as the United States (U.S. or US), or America, is a country Contiguous United States, primarily located in North America. It c ...
, and
National Human Genome Research Institute The National Human Genome Research Institute (NHGRI) is an institute of the National Institutes of Health The National Institutes of Health (NIH ) is the primary agency of the United States government The federal government of the Unit ...
with nearly 1,000 scientists and support staff. The Frederick National Laboratory in
Frederick, MD Frederick is a city in, and the county seat, of Frederick County, Maryland. It is part of the Baltimore–Washington metropolitan area, Baltimore–Washington Metropolitan Area. Frederick has long been an important crossroads, located at the inte ...
and the nearby Riverside Research Park, houses many components of the
National Cancer Institute The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health The National Institutes of Health (NIH) () is the primary agency of the United States government respons ...
, 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. The
National Institute of Environmental Health Sciences The National Institute of Environmental Health Sciences (NIEHS) conducts research into the effects of the environment on human disease, as one of the 27 institutes and centers of the National Institutes of Health The National Institutes of Healt ...
is located in the
Research Triangle The Research Triangle, or simply The Triangle, are both common nicknames for a metropolitan area in the Piedmont it, Piemontese , population_note = , population_blank1_title = , population_blank1 = , demographics_type1 ...
region of
North Carolina North Carolina () is a state State may refer to: Arts, entertainment, and media Literature * ''State Magazine'', a monthly magazine published by the U.S. Department of State * The State (newspaper), ''The State'' (newspaper), a daily newsp ...

North Carolina
. Other ICs have satellite locations in addition to operations at the main campus. The
National Institute of Allergy and Infectious Diseases The National Institute of Allergy and Infectious Diseases (NIAID, sometimes pronounced "NYE-ad") is one of the 27 institutes and centers that make up the National Institutes of Health The National Institutes of Health (NIH) () is the primary ag ...
maintains its Rocky Mountain Labs in
Hamilton, Montana Hamilton ( fla, čɫc̓lc̓lé) is a city in and the county seat A county seat is an administrative center, seat of government, or capital city of a county or Parish (administrative division), civil parish. The term is used in Canada, China, Rom ...
, with an emphasis on BSL3 and BSL4 laboratory work. NIDDK operates the Phoenix Epidemiology and Clinical Research Branch in
Phoenix, Arizona Phoenix ( ; nv, Hoozdo; es, Fénix or ) is the List of capitals in the United States, capital and List of cities and towns in Arizona#List of cities and towns, most populous city in the American state of Arizona, with 1,608,139 residents as o ...

Phoenix, Arizona
.


Research

As of 2017, 153 scientists receiving financial support from the NIH have been awarded a
Nobel Prize The Nobel Prizes ( ; sv, Nobelpriset ; no, Nobelprisen ) are five separate prizes that, according to Alfred Nobel Alfred Bernhard Nobel ( , ; 21 October 1833 – 10 December 1896) was a Swedish chemist, engineer, inventor, busines ...
and 195 have been awarded a
Lasker Award The Lasker Awards have been awarded annually since 1945 to living persons who have made major contributions to medical science or who have performed public service on behalf of medicine. They are administered by the Lasker Foundation, founded by ...
.


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 grant Grant are funds given by an entity – frequently, a public body A statutory corporation is a corporation A corporation is an organization—usually a group of people or a company—authorized by the state to act as a single entity (a le ...
s to extramural (outside) researchers. Of this extramural funding, a certain percentage (2.8% in 2014) must be granted to small businesses under the SBIR/STTR program. , the extramural funding consisted of about 50,000 grants to more than 325,000 researchers at more than 3000 institutions. , this rate of granting remained reasonably steady, at 47,000 grants to 2,700 organizations. , NIH spent (not including temporary funding from the
American Recovery and Reinvestment Act of 2009 The American Recovery and Reinvestment Act of 2009 (ARRA) (), nicknamed the Recovery Act, was a Stimulus (economics), stimulus package enacted by the 111th U.S. Congress and signed into law by President Barack Obama in February 2009. Developed ...
) on
clinical research Clinical research is a branch of healthcare science The following outline is provided as an overview of and topical guide to health sciences: Health sciences – are those sciences which focus on health Health is a state of physical ...
, on
genetics Genetics is a branch of biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical processes, Molecular biology, molecular interactions, Physiology, ...

genetics
-related research, on prevention research, on cancer, and on
biotechnology Biotechnology is a broad area of biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical processes, Molecular biology, molecular interactions, Phy ...

biotechnology
.


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 The United States National Library of Medicine (NLM), operated by the United States federal government The federal government of the United States (U.S. federal government or U.S. government) is the national government of the United Sta ...
's research repository,
PubMed Central PubMed Central (PMC) is a free digital repository that archives open access Open access (OA) is a set of principles and a range of practices through which research Research is "creative and systematic work undertaken to increase ...
(PMC), no later than 12 months after the official date of publication. The
NIH Public Access PolicyThe NIH Public Access Policy is an open access mandate, drafted in 2004 and mandated in 2008,National Institutes of Health"Request for Information: NIH Public Access Policy" available at https://publicaccess.nih.gov/comments.htm. ("NIH implemented ...
was the first public access mandate for a U.S. public funding agency.


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 arthritis sufferers. In 2020 Beth Darnall, American scientist and pain psychologist, was appointed as scientific member of the group.


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. 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. 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. In 2015, Pierre Azoulay et al. estimated $10 million invested in research generated two to three new patents.


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 Bubonic plague is one of three types of plague caused by the plague bacterium Bacteria (; common noun bacteria, singular bacterium) are a type of biological cell The cell (from Latin ''cella'', meaning "small room") is the basic ...
. * 1911: George W. McCoy, Charles W. Chapin, William B. Wherry, and B. H. Lamb described the previously unknown
tularemia Tularemia, also known as rabbit fever, is an infectious disease caused by the bacterium Bacteria (; common noun bacteria, singular bacterium) are a type of Cell (biology), biological cell. They constitute a large domain (biology), domain ...
. * 1924: Roscoe R. Spencer and Ralph R. Parker developed a vaccine against
Rocky Mountain spotted fever Rocky Mountain spotted fever (RMSF) is a bacterial disease spread by ticks Ticks (suborder Ixodida) are parasitic arachnids that are part of the superorder Parasitiformes. Along with mites, they constitute the subclass Acari. Adult ticks are ...

Rocky Mountain spotted fever
. * 1930: Sanford M. Rosenthal developed a treatment for
mercury poisoning Mercury poisoning is a type of metal poisoning due to exposure to mercury. Symptoms depend upon the type, dose, method, and duration of exposure. They may include muscle weakness, poor coordination, numbness in the hands and feet, skin rashes, ...
used widely before the development of dimercaptoethanol. * 1943: Wilton R. Earle pioneered the
cell culture Cell culture is the process by which cells Cell most often refers to: * Cell (biology), the functional basic unit of life Cell may also refer to: Closed spaces * Monastic cell, a small room, hut, or cave in which a monk or religious recluse ...

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 In chemistry Chemistry is the scientific Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity or awareness, of someone or something, such as facts A fact is an occurrence in the ...

pentose phosphate pathway
. * 1950s:
Julius Axelrod Julius Axelrod (May 30, 1912 – December 29, 2004) was an American Biochemistry, biochemist. He won a share of the Nobel Prize in Physiology or Medicine in 1970 along with Bernard Katz and Ulf von Euler. The Nobel Committee honored him for his w ...

Julius Axelrod
discovered a new class of enzymes,
cytochrome P450 Cytochromes P450 (CYPs) are a Protein superfamily, superfamily of enzymes containing heme as a cofactor (biochemistry), cofactor that functions as monooxygenases. In mammals, these proteins oxidize steroids, fatty acids, and xenobiotics, and are ...
monooxygenases, a fundamental of drug metabolism. * 1950:
Earl Stadtman Earl Reece Stadtman (November 15, 1919 – January 7, 2008) was an American biochemist, notable for his research of enzymes and anaerobic bacteria. Stadtman received the National Medal of Science from President Jimmy Carter in 1979 "for seminal cont ...
discovered phosphotransacetylose, elucidating the role of
acetyl CoA Acetyl-CoA (acetyl coenzyme A) is a molecule that participates in many biochemical reaction Biochemistry or biological chemistry, is the study of chemical processes within and relating to living organism In biology, an organism (from ...

acetyl CoA
in
fatty acid metabolism Fatty acid metabolism consists of various metabolism, metabolic processes involving or closely related to fatty acids, a family of molecules classified within the lipid macronutrient category. These processes can mainly be divided into (1) cataboli ...

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 Hodgkin lymphoma (HL) is a type of lymphoma Lymphoma is a group of blood cancer, blood malignancies that develop from lymphocytes (a type of white blood cell). The name often refers to just the cancerous versions rather than all such tumours. ...
. * 1960s: Discovery that tooth decay is caused by bacteria. * 1970s: Developed the assay for
human chorionic gonadotropin Human chorionic gonadotropin (hCG) is a hormone for the maternal recognition of pregnancy produced by trophoblast cells that are surrounding a growing embryo (syncytiotrophoblast initially), which eventually forms the placenta after implantatio ...
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 Gene therapy is a medical Medicine is the science Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity, awareness, or understanding of someone or something, such as facts ( descri ...

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 In psychometrics Psychometrics is a field of study within concerned with the theory and technique of . Psychometrics generally refers to specialized fields within psychology and education devoted to testing, measurement, assessment, and rel ...
and adapted for testing by computer.


Coronavirus vaccine

The NIH partnered with
Moderna Moderna, Inc., ( ) is an American pharmaceutical and biotechnology Biotechnology is a broad area of biology, involving the use of living systems and organisms to develop or make products. Depending on the tools and applications, it often o ...

Moderna
in 2020 during the
COVID-19 pandemic The COVID-19 pandemic is an ongoing global pandemic A pandemic (from , , "all" and , , "local people" the 'crowd') is an of an that has spread across a large region, for instance multiple or worldwide, affecting a substantial numbe ...

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 The Moderna COVID‑19 vaccine (INN Inns are generally establishments or buildings where travelers can seek lodging Lodging refers to the use of a short-term dwelling In law, a dwelling (also known as a residence or an abo ...
vaccine and the other receiving salt water injections—and continued until there had been approximately 100 cases of COVID-19 among the participants.


Collaboration with Wuhan Institute of Virology

Following the outbreak of the
COVID-19 pandemic The COVID-19 pandemic is an ongoing global pandemic A pandemic (from , , "all" and , , "local people" the 'crowd') is an of an that has spread across a large region, for instance multiple or worldwide, affecting a substantial numbe ...

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. Under political pressure, the NIH withdrew funding to EcoHealth Alliance in July 2020.


Funding


Budget and politics

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 The United States Department of Health and Human Services (HHS), is a cabinet-level executive branch The executive is the branch of government exercising authority in and holding Moral responsibility, responsibility for the governance of ...
(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 The Office of Management and Budget (OMB) is the largest office within the Executive Office of the President of the United States (EOP). OMB's most prominent function is to produce the president's budget, but it also examines agency programs, poli ...
(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. 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. When a
government shutdown Government shutdowns occur when the government refuses passage of key bills, resulting in the cessation of some or all operations by the government. Government shutdowns in the United States have occurred periodically since 1980, and are the res ...
occurs, the NIH continues to treat people who are already enrolled in
clinical trial Clinical trials are experiments or observations done in . Such prospective biomedical or behavioral research studies on are designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as no ...

clinical trial
s, 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.


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. 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. 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. 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. In 1999 Congress increased the NIH's budget by $2.3 billion to $17.2 billion in 2000. In 2009 Congress again increased the NIH budget to $31 billion in 2010. 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.


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
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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. 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%. 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. In FY 2016, the total number of grant applications received by the NIH was 54,220, with approximately 19% being awarded funding. 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.


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. 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.


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. The announcement also stated that this rule would probably not apply when studying sex-specific diseases (for example, ovarian or testicular cancer).


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." 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. 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.


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. In addition, first-time applicants are being offered more funding for their research grants than those who have received grants in the past.


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.


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: *
National Cancer Institute The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health The National Institutes of Health (NIH) () is the primary agency of the United States government respons ...
(NCI) *
National Eye Institute The National Eye Institute (NEI) was established in 1968 and is located in Bethesda, Maryland. The NEI is one of 27 institutes and centers of the US National Institutes of Health (NIH), an agency of the US Department of Health and Human Services. ...
(NEI) *
National Heart, Lung, and Blood Institute The National Heart, Lung, and Blood Institute (NHLBI) is the third largest Institute of the National Institutes of Health The National Institutes of Health (NIH ) is the primary agency of the United States government The federal go ...
(NHLBI) *
National Human Genome Research Institute The National Human Genome Research Institute (NHGRI) is an institute of the National Institutes of Health The National Institutes of Health (NIH ) is the primary agency of the United States government The federal government of the Unit ...
(NHGRI) *
National Institute on Aging The National Institute on Aging (NIA) is a division of the U.S. National Institutes of Health The National Institutes of Health (NIH ) is the primary agency of the United States government The federal government of the United States ...
(NIA) *
National Institute on Alcohol Abuse and Alcoholism Former logo. The National Institute on Alcohol Abuse and Alcoholism (NIAAA), as part of the U.S. National Institutes of Health The National Institutes of Health (NIH) () is the primary agency of the United States government responsible for biom ...
(NIAAA) *
National Institute of Allergy and Infectious Diseases The National Institute of Allergy and Infectious Diseases (NIAID, sometimes pronounced "NYE-ad") is one of the 27 institutes and centers that make up the National Institutes of Health The National Institutes of Health (NIH) () is the primary ag ...
(NIAID) *
National Institute of Arthritis and Musculoskeletal and Skin Diseases The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is one of the institutes and centers that make up the National Institutes of Health, an agency of the United States Department of Health and Human Services (HHS). ...
(NIAMS) * National Institute of Biomedical Imaging and Bioengineering (NIBIB) *
National Institute of Child Health and Human Development The ''Eunice Kennedy Shriver'' National Institute of Child Health and Human Development (NICHD) is one of the National Institutes of Health The National Institutes of Health (NIH) () is the primary agency of the United States government respons ...
(NICHDDo a Google search for "NICHHD" (there are none) site:https://www.nichd.nih.gov/) *
National Institute on Deafness and Other Communication Disorders 200px The National Institute on Deafness and Other Communication Disorders (NIDCD), a member of the U.S. National Institutes of Health, is mandated to conduct and support biomedical and behavioral research and research training in the normal and d ...
(NIDCD) *
National Institute of Dental and Craniofacial Research The National Institute of Dental and Craniofacial Research (NIDCR) is a branch of the National Institutes of Health, U.S. National Institutes of Health. The institute aims to improve the oral, dental, and craniofacial health through research and th ...
(NIDCR) *
National Institute of Diabetes and Digestive and Kidney Diseases The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is part of the United States National Institutes of Health, which in turn is part of the Department of Health and Human Services. NIDDK is approximately the fifth-largest ...

National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK) *
National Institute on Drug Abuse The National Institute on Drug Abuse (NIDA) is a United States The United States of America (USA), commonly known as the United States (U.S. or US), or America, is a country Contiguous United States, primarily located in North America. It c ...
(NIDA) *
National Institute of Environmental Health Sciences The National Institute of Environmental Health Sciences (NIEHS) conducts research into the effects of the environment on human disease, as one of the 27 institutes and centers of the National Institutes of Health The National Institutes of Healt ...
(NIEHS) *
National Institute of General Medical Sciences The National Institute of General Medical Sciences (NIGMS) supports basic research Research is "creativity, creative and systematic work undertaken to increase the stock of knowledge". It involves the collection, organization, and analysi ...
(NIGMS) *
National Institute of Mental Health The National Institute of Mental Health (NIMH) is one of 27 institutes and centers that make up the National Institutes of Health (NIH). The NIH, in turn, is an agency of the United States Department of Health and Human Services and is the prima ...
(NIMH) *
National Institute on Minority Health and Health Disparities The National Institute on Minority Health and Health Disparities (NIMHD) is an American government health institute. It is part of the National Institutes of Health The National Institutes of Health (NIH) () is the primary agency of the United S ...
(NIMHD) * National Institute of Neurological Disorders and Stroke (NINDS) * National Institute of Nursing Research (NINR) *
National Library of Medicine The United States National Library of Medicine (NLM), operated by the United States federal government The federal government of the United States (U.S. federal government or U.S. government) is the national government of the United Sta ...
(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

*Joseph J. Kinyoun, served August 1887 – April 30, 1899 *Milton J. Rosenau, served May 1, 1899 – September 30, 1909 *John Fleetezelle Anderson, 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 (scientist), 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 – present


See also

* List of institutes and centers of the National Institutes of Health * United States Public Health Service * 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


External links

*
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 {{Authority control National Institutes of Health, Medical research institutes in the United States International research institutes Life sciences industry Nursing research Cancer organizations based in the United States Buildings and structures in Bethesda, Maryland Hospitals in Maryland Research institutes in Maryland Science and technology in Maryland Government agencies established in 1887 Hospitals established in 1887 1887 establishments in Maryland Tourist attractions in Montgomery County, Maryland