The National Institutes of Health (NIH)

The National Institutes of Health (NIH) is a biomedical research facility primarily located in Bethesda, Maryland. An agency of the United States Department of Health and Human Services, it is the primary agency of the United States government responsible for bio medical and health-related research. The NIH both conducts its own scientific research through its Intramural Research Program(IRP) and provides major bio medical research funding to non-NIH research facilities through its Extramural Research Program.

With 1,200 principal investigators and more than 4,000 postdoctoral fellows in basic, transnational, and clinical research, the IRP is 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 US, or about US$26.4 billion.

The NIH comprises 27 separate institutes and centers that conduct research in different disciplines of biomedical science. The IRP 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)

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 Special Cancer Investigations laboratory at Harvard Medical School. This marked the beginning of a partnership with universities. In 1930, the Hygienic Laboratory was re-designated as the National Institutes of Health by the Ransdell Act and was given $750,000 to construct two NIH buildings. Over the next few decades, Congress would increase its funding tremendously to the NIH, and various institutes and centers within the NIH were created for specific research programs.

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.

The funding of NIH has often been a source of contention in Congress, serving as a proxy for the political currents of the time. This contention was seen most dramatically during the 1980s, when 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. But it was not until July 1987, as NIH celebrated its 100th anniversary, that President Reagan announced a committee to research the HIV epidemic.

By the 1990s, the focus of the NIH committee had shifted to DNA research, and the Human Genome Project was launched. In 2009, President Obama reinstated federally funded stem-cell research, revoking the ban imposed by President Bush in 2001.

From logistical restructuring, to funding increases, to research prioritization, to government expansion and political influence, the history of the National Institutes of Health is extensive and full of change. The NIH has grown to encompass nearly 1 percent of the federal government's operating budget. The NIH now controls more than 50 percent of all funding for health research, and 85 percent of all funding for health studies in universities.