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 USDepartment 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.