What Is the National Institution Of Health?

The National Institutes of Health, abbreviated as NIH (with each letter pronounced separately), is the primary government agency in the United States responsible for biomedical and public health research. It was established in the late 1880s and is now a component of the US Department of Health and Human Services. The majority of NIH facilities are in Bethesda, Maryland, and other nearby suburbs of the Washington metropolitan area, with other primary facilities in North Carolina's Research Triangle Park and smaller satellite facilities scattered across the country. The National Institutes of Health (NIH) conducts its own scientific research through the Intramural Research Program (IRP) and provides significant biomedical research funding to non-NIH research facilities through the Extramural Research Program.

As of 2013, the IRP had 1,200 principal investigators and over 4,000 postdoctoral fellows in basic, translational, and clinical research, making it the world's largest biomedical research institution, while the extramural arm provided 28% of biomedical research funding spent annually in the United States, or approximately $26.4 billion. 

The National Institutes of Health (NIH) is made up of 27 separate institutes and centers that specialize in various biomedical disciplines. It is responsible for many scientific achievements, such as the discovery of fluoride to prevent tooth decay, the use of lithium to treat bipolar disorder, and the development of vaccines against hepatitis, Haemophilus influenzae (HIB), and human papillomavirus (HPV).

In 2019, the NIH was ranked second in the world for biomedical sciences, trailing only Harvard University, according to the Nature Index, which measured the largest contributors to papers published in a subset of leading journals from 2015 to 2018.

The National Institutes of Health (NIH) is the primary federal biomedical research agency in the United States, with the mission of improving national health through discovery and innovation, fostering resources to prevent disease, expanding the biomedical knowledge base, and promoting high-level scientific conduct. These objectives support the National Institutes of Health's mission to "enhance health, lengthen life, and reduce the burdens of illness and disability" by funding and conducting scientific research.

The National Institutes of Health (NIH) began in 1887 as a small laboratory within the Marine Hospital Service (MHS) in response to advances in microbiology and subsequent efforts to better understand infectious diseases such as cholera.

In 1902, Congress established the Division of Pathology and Bacteriology, which, along with the newly established Divisions of Chemistry, Pharmacology, and Zoology, was housed in the MHS, which was reorganized as the Public Health and Marine Hospital Service (PH-MHS, eventually shorted to Public Health Service). This legislation was significant in that it allowed the PH-MHS to hire scientist researchers in addition to physicians to carry out the Service's mission of public health research. The Hygienic Laboratory was renamed the National Institutes of Health in 1930 as a result of the Ransdell Act, and its research focus was expanded to include general biomedical research. Between 1937 and 1998, the organization grew to include the 27 institutes and centers that make up the National Institutes of Health today.

The majority of NIH grants are "investigator initiated," which means that the principal investigator is in charge of developing the project's ideas, concepts, methods, and approaches. The grantee submits a yearly progress report, but NIH personnel are not involved in the work. Cooperative agreements, like grants, are intended to aid and support research or related activities. They do, however, include a significant scientific and/or technical role by NIH staff, such as coordination of awardee activities or approval of project phases or processes. Applications for cooperative agreements are typically solicited through a specific Request for Applications (RFA), which describes the activities that will be supported as well as NIH staff involvement.

Is The National Institute of Health A Government Agency?

The US Department of Health and Human Services oversees the National Institutes of Health (NIH), which is funded by the US government. The NIH must first obtain a budget from Congress before allocating funds. They are also supported by donors.

The NIH is made up of several Institutes and Centers. These Institutes and Centers represent the NIH's program activities.

Some of the top ten institutes, along with a brief description of their primary missions, are as follows:

• The mission of the National Cancer Institute (NCI) is to "lead a national effort to reduce cancer morbidity and mortality and, eventually, to prevent the disease NCI conducts and supports programs to understand the causes of cancer, prevent, detect, diagnose, treat, and control cancer, and disseminate information to practitioners, patients, and the general public through basic and clinical biomedical research and training."
• The National Center for Research Resources' (NCRR) objective is to "Through cooperative research programs and shared resources that establish, develop, and supply a wide range of human, annual, technological, and other resources, biomedical research is advanced and human health is improved. The NCRR concentrates on four research fields: comparative medicine, clinical research, biomedical technology, and research infrastructure."
• According to its mission statement, the National Eye Institute's (NEI) goal is to "conduct and support research, training, health information dissemination, and other programs relating to blinding eye diseases, visual disorders, mechanisms of visual function, sight preservation, and the special health issues and needs of the blind."
• The mission of the National Heart, Lung, and Blood Institute (NHLBI) is to "provide leadership for a national research program in diseases of the heart, blood vessels, lungs, and blood, as well as in transfusion medicine, by supporting innovative basic, clinical, population-based, and health education research."
• The National Human Genome Research Institute's (NHGRI) objective is to "support the Human Genome Project's National Institutes of Health section. The Human Genome Project is an international research initiative that aims to analyze the structure of human DNA and locate the estimated 100,000 human genes. Technology is developed and used by the NHGRI Intramural Research Program to better comprehend, recognize, and cure genetic disorders."
• The National Institute of Allergy and Infectious Diseases (NIAID) is responsible for "supporting and conducting research and research training that aims to understand, treat, and ultimately prevent the myriad infectious, immunologic, and allergic diseases that threaten the lives of millions of people."
• The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is to "conduct and support a wide range of research on the normal structure and function of bones, muscles, and skin, as well as the many and varied diseases that affect these tissues NIAMS also conducts research training, epidemiologic studies, and information dissemination."
• The mission of the National Institute of Child Health and Human Development (NICHD) is to support and conduct "research on fertility, pregnancy, growth, development, and medical rehabilitation, with the goal of ensuring that every child is born healthy and wanted, and grows up free from disease and disability."
• The mission of the National Institute of Dental and Craniofacial Research (NIDCR), formerly known as the National Institute of Dental Research (NIDR), is to "provide leadership for a national research program designed to understand, treat, and eventually prevent the infectious and inherited craniofacial-oral-dental diseases and disorders that endanger millions of human lives."
• The mission of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is to "conduct and support basic and applied research, and serve as the national program's leader in diabetes, endocrinology, and metabolic diseases; digestive diseases and nutrition; and kidney, urologic, and hematologic diseases Several of these diseases are among the leading causes of disability and death, and they all have a negative impact on the quality of life of those who suffer from them."

Where Is National Institute of Health Located?

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

The Bayview Campus in Baltimore, Maryland, is home to nearly 1,000 scientists and support staff from the National Institute on Aging, the National Institute on Drug Abuse, and the National Human Genome Research Institute.

 Many components of the National Cancer Institute are housed at the Frederick National Laboratory in Frederick, MD, and the nearby Riverside Research Park, including the Center for Cancer Research, Office of Scientific Operations, Management Operations Support Branch, Cancer Epidemiology and Genetics division, and Cancer Treatment and Diagnosis division.

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

Other ICs have satellite locations in addition to main campus operations. The Rocky Mountain Labs of the National Institute of Allergy and Infectious Diseases are located in Hamilton, Montana, and specialize in BSL3 and BSL4 laboratory work. In Phoenix, Arizona, the NIDDK runs the Phoenix Epidemiology and Clinical Research Branch.

Who Funds National Institute of Health?

Politics and the Budget

The NIH must first obtain a budget from Congress before allocating funds. This process begins with institute and center (IC) leaders working with scientists to identify the most important and promising research areas in their respective fields. IC leaders discuss research areas with NIH management, who then develops a budget request from the Director for ongoing projects, new research proposals, and new initiatives. The National Institutes of Health (NIH) submits its budget request to the Department of Health and Human Services (HHS), which considers it as part of its budget. Before the agency submits NIH's budget request to the Office of Management and Budget, many adjustments and appeals take place between NIH and HHS (OMB).

OMB decides which amounts and research areas are included in the President's final budget. In February, the President sends the NIH budget request to Congress for the following fiscal year's allocations. The House and Senate Appropriations Subcommittees deliberate, and Congress usually appropriates funds by the fall. Before the NIH can allocate any actual funds, this process takes about 18 months.

When the government shuts down, the NIH continues to treat people who are already enrolled in clinical trials, but no new clinical trials are started, and no new patients who are not already enrolled in a clinical trial are admitted, except for the most critically ill, as determined by the NIH Director.

Funding from the past

Over the last century, the responsibility for allocating funding has shifted from the OD and Advisory Committee to individual ICs, and Congress has increasingly set aside funds for specific causes. Congress began to earmark funds specifically for cancer research in the 1970s, and AIDS/HIV research received significant funding in the 1980s.

Funding for the NIH has frequently been a source of contention in Congress, serving as a proxy for current political currents. During the 1980s, President Reagan repeatedly attempted to cut research funding, only to have Congress partially restore it.

Political wrangling over NIH funding slowed the nation's response to the AIDS epidemic; while AIDS was reported in newspaper articles beginning in 1981, no funding was provided for disease research. In 1984, scientists at the National Cancer Institute discovered 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 country.

In 1992, the NIH controlled nearly 1% of the federal government's operating budget and over 50% of all funding for health research and 85% of all funding for health studies in universities. The NIH budget more than doubled between 1993 and 2001.

For a time, funding was essentially flat, and the NIH budget struggled to keep up with inflation for seven years following the financial crisis.

Congress increased the NIH budget by $2.3 billion in 1999, bringing it to $17.2 billion in 2000. The NIH budget was increased by Congress in 2009 to $31 billion in 2010. In 2017 and 2018, Congress passed bipartisan legislation significantly increasing NIH appropriations, which were 37.3 billion dollars in FY2018.

Criteria for funding

In its funding policy, the NIH uses five broad decision criteria. First, use a rigorous peer review process to ensure the highest quality of scientific research. Second, seize opportunities that have the greatest potential for yielding new knowledge and leading to better disease prevention and treatment. Third, keep a diverse research portfolio in order to capitalize on major breakthroughs in fields such as cell biology, genetics, physics, engineering, and computer science. Fourth, prioritize public health needs based on disease burden (e.g., prevalence and mortality). Fifth, build and support the scientific infrastructure required for research (e.g., well-equipped laboratories and secure research facilities).

Members of the advisory committee advise the Institute on policy and procedures affecting external research programs and provide a second level of review for all grant and cooperative agreement applications considered for funding by the Institute.