The NATIONAL INSTITUTES OF HEALTH (NIH) is the primary agency of the
United States government
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, 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 , the use of lithium to manage bipolar disorder , and the creation of vaccines against hepatitis , Haemophilus influenzae (HIB), and human papillomavirus (HPV).
* 1 History * 2 Directors * 3 Locations and campuses
* 4 Research
* 4.1 Intramural research * 4.2 Public Access Policy * 4.3 NIH Interagency Pain Research Coordinating Committee * 4.4 Economic return
* 4.5 Notable discoveries and developments
* 4.5.1 NIH Toolbox
* 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 Government shutdown
* 5.5 Stakeholders
* 5.5.1 General public * 5.5.2 Extramural researchers and scientists
* 6 Commercial partnerships * 7 Institutes and centers * 8 See also * 9 References * 10 External links
The Laboratory of Hygiene in 1887
Ida A. Bengtson , a
bacteriologist who in 1916 was the first woman hired to work in the
Hygienic Laboratory. Dedication of first six NIH buildings by
Franklin D. Roosevelt
NIH's roots extend back to a Marine Hospital Service in the late 1790s that provided medical relief to sick and disabled men in the U.S. Navy. By 1870, a network of marine hospitals had developed and was placed under the charge of a medical officer within the Bureau of the Treasury Department. In the late 1870s, Congress allocated funds to investigate the causes of epidemics like cholera and yellow fever, and it created the National Board of Health, making medical research an official government initiative.
In 1887, a laboratory for the study of bacteria, the Hygienic
Laboratory, was established at the Marine Hospital in New York. In
the early 1900s, Congress began appropriating funds for the Marine
Hospital Service. By 1922, this organization changed its name to
Public Health Services and established a
In the 1960s, virologist and cancer researcher Chester M. Southam injected HeLa cancer cells into patients at the Jewish Chronic Disease Hospital. :130 When three doctors resigned after refusing to inject patients without their consent, the experiment gained considerable media attention. :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. :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. :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 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
In 2001, President Bush instituted a ban on federal funding for stem-cell research, which was revoked by President Obama in 2009.
* Joseph 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 – Present
LOCATIONS AND CAMPUSES
The Bayview Campus in
National Institute of Environmental Health Sciences is located in
Research Triangle region of
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 , with an emphasis on BSL3 and BSL4 laboratory work. NIDKK operates the Phoenix Epidemiology and Clinical Research Branch in Phoenix, AZ .
Clinical Center – Building 10
As of 2017, 153 scientists receiving financial support from the NIH
have been awarded a
NIH devotes 10% of its funding to research within its own facilities (intramural research). The institution gives 80% of its funding in research grants 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 consists of about 50,000 grants to more than 325,000 researchers at more than 3000 institutions. 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 .
PUBLIC ACCESS POLICY
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
National Library of Medicine 's research repository, PubMed
Central (PMC), no later than 12 months after the official date of
NIH Public Access Policy
NIH INTERAGENCY PAIN RESEARCH COORDINATING COMMITTEE
On February 13, 2012, the
National Institutes of Health
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. In 2015, the National Bureau of Economic Research 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 . * 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. * 1940's-50's – Bernard Horecker and colleagues described the pentose phosphate pathway . * 1950's – 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.
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.
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BUDGET AND POLITICS
Historical NIH budget YEAR BUDGET (MILLIONS)
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. 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.
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. Since then, funding essentially remained flat, and during the decade 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 March 2017, President Trump proposed to cut the 2018 budget by 18.3%, or about $5.8 billion to $25.9 billion. :26
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 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. 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.
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).
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.
Many groups are highly invested in NIH funding.
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
Other important stakeholders of the NIH funding policy are 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 affects 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.
In 2011 and 2012 the
Department of Health and Human Services
INSTITUTES AND CENTERS
Main 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
National Eye Institute
National Heart, Lung, and Blood Institute
National Human Genome Research Institute
National Institute on Aging
National Institute on Alcohol Abuse and Alcoholism
National Institute of Allergy and Infectious Diseases
* National Institute of Arthritis and Musculoskeletal and Skin
* National Institute of
* National Institute of Child Health and Human Development * National Institute on Deafness and Other Communication Disorders * National Institute of Dental and Craniofacial Research * National Institute of Diabetes and Digestive and Kidney Diseases * National Institute on Drug Abuse * National Institute of Environmental Health Sciences * National Institute of General Medical Sciences * National Institute of Mental Health * National Institute on Minority Health and Health Disparities
* National Institute of Neurological Disorders and Stroke * National Institute of Nursing Research * National Library of Medicine * Center for Information Technology * Center for Scientific Review * Fogarty International Center * National Center for Advancing Translational Sciences * National Center for Complementary and Integrative Health * NIH Clinical Center
In addition, the National Center for Research Resources operated from April 13, 1962 to December 23, 2011.
* 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
* ^ Washington Examiner
* ^ "Appropriations (Section 2)". The NIH Almanac (Report).
National Institutes of Health. February 25, 2011. Retrieved
* ^ "Organization and Leadership NIH Intramural Research
Program". Irp.nih.gov. Retrieved 2013-04-28.
* ^ Osterweil, Neil (September 20, 2005). "Medical Research
Spending Doubled Over Past Decade". MedPage Today. Retrieved
* ^ NIH Sourcebook
* ^ Harden, Victoria A. "WWI and the
Ransdell Act of 1930". A Short
History of the National Institutes of Health. Office Of History
National Institutes Of Health, United States National Institutes of
Health. Retrieved 2011-09-12.
* ^ NIH Almanac 2011 , History: Chronology of Events: 1800–
* ^ "A Short History of the
National Institutes of Health
* ^ "Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract N01-AI-15416 With the University of California at San Francisco Audit (A-03-10-03120)" (PDF). June 2011. Retrieved 2011-06-25. "Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract N01-AI-3-0052 With Avecia Biologics Limited" (PDF). September 2011. Retrieved 2011-10-09. "Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract HHSN266-2006-00015C With NexBio, Inc" (PDF). September 2011. Retrieved 2011-10-09. "Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract HHSN272-2008-00013C with the EMMES Corporation (A-03-10-03115)" (PDF). October 2011. Retrieved 2011-09-11. "Appropriations Funding for Eunice Kennedy Shriver National Institute of Child Health and Human Development Contract HHSN275-03-3345 With Westat, Inc. Audit (A-03-10-03106)" (PDF). October 2011. Retrieved 2011-11-20. "Appropriations Funding for National Institute on Drug Abuse Contract HHSN271-2007-00009C with Charles River Laboratories, Inc. (A-03-10-03104)" (PDF). October 2011. Retrieved 2011-11-22. "Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract HHSN266-2005-00022C With PPD Development, LP (Audit A-03-10-03118)" (PDF). September 2012. Retrieved 2012-09-26.
"Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract N01-AI-30068 With PPD Development, LP (Audit A-03-10-03116)" (PDF). September 2012. Retrieved 2011-09-26.
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