U.S. National Institutes of Health
The NIH mission is to uncover new knowledge that will lead to better health for everyone. NIH works toward that mission by: conducting research in its own laboratories; supporting the research of non-Federal scientists in universities, medical schools, hospitals, and research institutions throughout the country and abroad; helping in the training of research investigators; and fostering communication of biomedical information.
The NIH is one of eight health agencies of the Public Health Service which, in turn, is part of the U.S. Department of Health and Human Services. Comprised of 24 separate Institutes, Centers, and Divisions, NIH has 75 buildings on more than 300 acres in Bethesda, MD. From a total of about $300 in 1887, the NIH budget has grown to more than $13.6 billion in 1998.
What is the Goal of NIH Research?
Simply described, the goal of NIH research is to acquire new knowledge to help prevent, detect, diagnose, and treat disease and disability, from the rarest genetic disorder to the common cold.
How Does the NIH Help Scientists Reach This Goal?
The NIH Supports Research
A principal concern of the NIH is to invest wisely the tax dollars entrusted to it for the support and conduct of biomedical research.
More than 81 percent of the investment is made through grants and contracts supporting research and training in more than 1,700 research institutions throughout the U.S. and abroad. In fact, NIH grantees are located in every State in the country. These grants and contracts comprise the NIH Extramural Research Program.
Approximately 11 percent of the budget goes to NIH's Intramural Research Programs, the more than 2,000 projects conducted mainly in its own laboratories. About 8 percent of the budget is for both intramural and extramural research support costs.
NIH Research Grants
Final decisions about funding extramural research are made at the NIH headquarters. But long before this happens, the process begins with an idea that an individual scientist describes in a written application for a research grant.
The project might be small, or it might involve millions of dollars. The project might become useful immediately as a diagnostic test or new treatment, or it might involve studies of basic biological processes whose practical value may not be apparent for many years.
Each research grant application undergoes a peer review process.
A panel of scientific experts, primarily from outside the government, who are active and productive researchers in the biomedical sciences, first evaluates the scientific merit of the application. Then, a national advisory council or board, comprised of eminent scientists as well as public members who are interested in health issues or the biomedical sciences, determines the project's overall merit and priority in advancing the research agenda of the particular NIH funding institute.
Altogether, about 36,000 research and training applications are reviewed annually through the NIH peer review system. At any given time, the NIH supports 35,000 grants in universitites, medical schools, and other research and research training institutions both nationally and internationally.
The NIH Conducts Research
The Intramural Research Programs, although representing only a small part of the total NIH budget, are central to the NIH scientific effort.
First-rate scientists are key to NIH intramural research. They collaborate with one another regardless of institute affiliation or scientific discipline, and have the intellectual freedom to pursue their research leads in NIH's own laboratories. These explorations range from basic biology, to behavioral research, to studies on treatment of major diseases.
NIH Research Laboratories
NIH scientists conduct their research in laboratories located on the NIH campus in Bethesda, and in several field units across the country and abroad.
Following are some of the NIH on-campus facilities:
A leading research hospital and laboratory complex, the Warren Grant Magnuson Clinical Center is a 14-story, 350-bed facility designed to allow NIH's intramural scientists to bring research closer to patients' bedsides.
Each year there are about 7,000 inpatient admissions to the Clinical Center. Individuals come from all over the world, upon referral by their physicians, to participate as inpatients in clinical studies at the NIH. These patients not only receive clinical care, they also contribute to a better understanding of disease.
Also, in 1996, the Clinical Center accepted about 3,400 normal or healthy individuals as participants in the Clinical Research Volunteer Program.
THE CHILDREN'S INN at NIH, constructed and operated through private donations, serves as a "home away from home" for chronically ill children and their families while the children are being treated and studied at the NIH.
The Clinical Center's Ambulatory Care Research Facility (ACRF) provides additional space for laboratories and for the Center's rapidly growing outpatient programs. Recent medical advances allow many people with serious chronic diseases to lead nearly normal lives while their illnesses are being studied on an outpatient basis. Each year there are about 68,000 outpatient visits to the ACRF.
The Clinical Center also houses the Visitor Information Center, which is NIH's information liaison and host to thousands of visitors each year.*
Other On-Campus Sites:
- The Fogarty International Center promotes international cooperation and scholarship in science, and serves as the focus for international biomedical research activities at NIH.
- The Mary Woodard Lasker Center for Health Research and Education is the location for the NIH-Howard Hughes Medical Institute research program for medical students.
- The 10-story Lister Hill Center houses the Lister Hill National Center for Biomedical Communications, and the National Center for Biotechnology Information. Both are components of the National Library of Medicine.
- THE NATIONAL LIBRARY OF MEDICINE is the world's largest medical library. Its collection of 5 million medical books, journals, pamphlets, rare manuscripts, films, and other items has been called the "Fort Knox of health information" because of the richness of its resources. The Library produces Index Medicus, a comprehensive monthly listing of articles appearing in the world's leading medical journals. The Library also operates a computerized Index Medicus, known as MEDLINE, and has pioneered the introduction of large medical bibliographic data bases.
- The NIH's National Institute of Environmental Health Sciences studies the adverse effects of environmental factors on human health, and is located in Research Triangle Park, NC. Other laboratory facilities include the NIH Animal Center in Poolesville, MD; the National Institute on Aging's Gerontology Research Center in Baltimore, MD; the Addiction Research Center of the National Institute on Drug Abuse, also in Baltimore; the National Institute of Allergy and Infectious Diseases' Rocky Mountain Laboratories in Hamilton, MT; and several smaller field stations.
Who Are the Scientists NIH Supports?
Scientific progress depends mainly on the scientist. About 35,000 principal investigators -- working in every State and in several foreign countries, from every specialty in medicine, every biomedical discipline, and at every major university and medical school -- receive NIH extramural funding to explore unknown areas of biomedical science.
Supporting and conducting both NIH's extramural and intramural programs are about 19,000 employees, more than 4,500 of whom hold professional or research doctorate degrees. The NIH staff includes intramural scientists, physicians, dentists, veterinarians, nurses, and laboratory, administrative, and support personnel, plus an ever-changing array of research scientists in training.
The NIH Nobelists
The rosters of those who have conducted research, or who have received NIH support over the years include the world's most illustrious scientists and physicians. Among them are 93 scientists who have won Nobel Prizes for achievements as diverse as deciphering the genetic code and learning what causes hepatitis.
Five Nobelists made their prize-winning discoveries in NIH laboratories: Drs. Christian B. Anfinsen, Julius Axelrod, D. Carleton Gajdusek, Marshall W. Nirenberg, and Martin Rodbell.
Who Are the NIH's Other Partners in Research?
NIH is a key element in a partnership that has thrived for decades and includes universities and academic health centers, independent research institutions, and private industry where research programs and product development activities help make federally-funded research findings more widely available.
The partnership, which has produced many of the medical advances that benefit Americans today, also includes voluntary and professional health organizations, and the Congress, which consistently has supported this vast enterprise.
What Impact Has the NIH Had on the Health of the Nation?
NIH research played a major role in making possible the following achievements of the last few decades:
- Mortality from heart disease, the number one killer in the United States, dropped by 47 percent between 1975 and 1995.
- Death rates from stroke decreased by 50 percent during the same period.
- Improved treatments and detection methods increased the relative 5-year survival rate for people with cancer to 52 percent. At present, the survival gain over the rate that existed in the 1960s represents more than 80,000 additional cancer survivors each year.
- Paralysis from spinal cord injury is significantly reduced by rapid treatment with high doses of a steroid. Treatment given within the first 8 hours after injury increases recovery in severely injured patients who have lost sensation or mobility below the point of injury.
- Long-term treatment with anticlotting medicines cuts stroke risk by 80 percent from a common heart condition known as atrial fibrillation.
- In schizophrenia, where suicide is always a potential danger, new medications reduce troublesome symptoms such as delusions and hallucinations in 80 percent of patients.
- Chances for survival increased for infants with respiratory distress syndrome, an immaturity of the lungs, due to development of a substance to prevent the lungs from collapsing. In general, life expectancy for a baby born today is almost three decades longer than one born at the beginning of the century.
- Those suffering from depression now look forward to returning to work and leisure activities, thanks to treatments which give them an 80 percent chance to resume a full life in a matter of weeks.
- Vaccines protect against infectious diseases that once killed and disabled millions of children and adults.
- Dental sealants have proved 100 percent effective in protecting the chewing surfaces of children's molars and premolars where most cavities occur.
- Molecular genetics and genomics research has revolutionized biomedical science. In the 1980s and 1990s, researchers performed the first trial of gene therapy in humans, and are able to locate, identify, and describe the function of many of the genes in the human genome. Scientists predict this new knowledge will lead to genetic tests to diagnose diseases such as colon, breast, and other cancers, and the eventual development of preventive drug treatments for individuals in families known to be at risk. The ultimate goal is to develop screening tools and gene therapies for the general population, not only for cancer but many other diseases.
NIH Research in the 21st Century
The NIH has enabled scientists to learn much since its humble beginnings as a one-room laboratory in 1887. But many discoveries remain to be made:
- Better ways to prevent and treat cancer, heart disease, stroke, blindness, arthritis, diabetes, kidney diseases, Alzheimer's disease, communication disorders, mental illness, drug abuse and alcoholism, AIDS and other unconquered diseases.
- Ways to continue improving the health of infants and children, women, and minorities.
- Better ways to understand the aging process, and behavior and lifestyle practices that affect health.
These are some of the areas where the NIH's investment in health research promises to yield the greatest good for the greatest number of people.
NIH's Institutes, Centers, and Divisions
Office of the Director
National Institute on Drug Abuse
National Cancer Institute
National Institute of Environmental Health Sciences
National Eye Institute
National Institute of General Medical Sciences
National Heart, Lung, and Blood Institute
National Institute of Mental Health
National Human Genome Research Institute
National Institute of Neurological Disorders and Stroke
National Institute on Aging
National Institute of Nursing Research
National Institute on Alcohol Abuse and Alcoholism
National Library of Medicine
National Institute of Allergy and Infectious Diseases
National Center for Research Resources
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Center for Scientific Review (formerly Division of Research Grants)
National Institute of Child Health and Human Development
John E. Fogarty International Center
National Institute on Deafness and Other Communication Disorders
Warren Grant Magnuson Clinical Center
National Institute of Dental Research
Division of Computer Research and Technology
National Institute of Diabetes and Digestive and Kidney Diseases
*Visitor Information Center
(Call for information on tours of NIH for the general public)
Prepared by the Office of Communications, Office of the Director, NIH September 1997
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