national institutes of health national institutes of health the national institutes of health, commonly referred to as nih (initialism), is the primary agency of the united states government responsible for biomedical and public health research. it was founded in the late 1880s and is now part of the united states department of health and human services. many nih facilities are located in bethesda, maryland, and other nearby suburbs of the washington metropolitan area, with other primary facilities in the research triangle park in north carolina and smaller satellite facilities located around the united states. the nih conducts its own scientific research through the nih intramural research program (irp) and provides major biomedical research funding to non-nih research facilities through its extramural research program. national institutes of health (nih)national institutes of health logoaerial photo of the nih mark o. hatfield clinical research center, bethesda, marylandagency overviewformedaugust 1887 (1887-08)preceding agencyhygienic laboratoryheadquartersbethesda, maryland, u.s.39°00′09″n 77°06′16″wemployees18,478 (2021), annual budget$45 billion (2022)agency executivelawrence a. tabak, acting directorparent agencydepartment of health & human serviceschild agenciesnational cancer institutenational institute of allergy and infectious diseasesnational institute of diabetes and digestive and kidney diseasesnational heart, lung, and blood institutenational library of medicinewebsitenih.gov 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). in 2019, the nih was ranked number two in the world, behind harvard university, for biomedical sciences in the nature index, which measured the largest contributors to papers published in a subset of leading journals from 2015 to 2018. history origins ida a. bengtson, a bacteriologist who in 1916 was the first woman hired to work in the hygienic laboratory nih campus in bethesda, maryland, in 1945 in 1887, a laboratory for the study of bacteria, the hygienic laboratory, was established within the marine hospital service, which at the time was expanding its functions beyond the system of marine hospitals into quarantine and research programs. it was initially located at the new york marine hospital on staten island. in 1891, it moved to the top floor of the butler building in washington, d.c. in 1904, it moved again to a new campus at the old naval observatory, which grew to include five major buildings. in 1901, the division of scientific research was formed, which included the hygienic laboratory as well as other research offices of the marine hospital service. in 1912, the marine hospital service became the public health service (phs). in 1922, phs 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 institute of health by the ransdell act, and was given $750,000 to construct two nih buildings at the old naval observatory campus. in 1937, nih absorbed the rest of the division of scientific research, of which it was formerly part. in 1938, nih moved to its current campus in bethesda, maryland. over the next few decades, congress would markedly increase funding of the nih, and various institutes and centers within the nih were created for specific research programs. in 1944, the public health service act was approved, and the national cancer institute became a division of nih. in 1948, the name changed from national institute of health to national institutes of health. later history 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 the 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. leadership the nih office of the director is the central office responsible for setting policy for nih, and for planning, managing, and coordinating the programs and activities of all nih components. the nih director plays an active role in shaping the agency's activities and outlook. the director is responsible for providing leadership to the institutes and centers by identifying needs and opportunities, especially in efforts involving multiple institutes. within the director's office is the division of program coordination, planning and strategic initiatives with 12 divisions including: office of aids research office of research on women's health office of disease prevention sexual and gender minority research office tribal health research office office of program evaluation and performance the agency intramural research integrity officer "is directly responsible for overseeing the resolution of all research misconduct allegations involving intramural research, and for promoting research integrity within the nih office of intramural research (oir)." there is a division of extramural activities, which has its own director. the office of ethics has its own director, as does the office of global research. locations and campuses intramural research is primarily conducted at the main campus in bethesda, maryland, and rockville, maryland, and the surrounding communities. clinical research center at nih main lobby wall at the clinical research center at nih looking at the main lobby at the clinical research center at nih looking at the main lobby at the clinical research center at nih the bayview campus in baltimore, maryland houses the research programs of the national institute on aging, national institute on drug abuse, and national human genome research institute with nearly 1,000 scientists and support staff. the frederick national laboratory in frederick, md and the nearby riverside research park, houses many components of the national cancer institute, including the center for cancer research, office of scientific operations, management operations support branch, the division of cancer epidemiology and genetics and the division of cancer treatment and diagnosis. the national institute of environmental health sciences is located in the research triangle region of north carolina. 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. niddk operates the phoenix epidemiology and clinical research branch in phoenix, arizona. research clinical center – building 10 as of 2017, 153 scientists receiving financial support from the nih have been awarded a nobel prize and 195 have been awarded a lasker award. intramural and extramural research nih devotes 10% of its funding to research within its own facilities (intramural research), and 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. as of 2011, the extramural funding consisted of about 50,000 grants to more than 325,000 researchers at more than 3000 institutions. by 2018, this rate of granting remained reasonably steady, at 47,000 grants to 2,700 organizations. 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 in 2008 a congressional mandate called for investigators funded by the nih to submit an electronic version of their final manuscripts to the national library of medicine's research repository, pubmed central (pmc), no later than 12 months after the official date of publication. the nih public access policy was the first public access mandate for a u.s. public funding agency. economic return 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. one study found nih funding aided either directly or indirectly in developing the drugs or drug targets for all of the 210 fda-approved drugs from 2010 to 2016. in 2015, pierre azoulay et al. 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. 1940s–1950s: bernard horecker and colleagues described the pentose phosphate pathway. 1950s: 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. nih toolbox in september 2006, the nih blueprint for neuroscience research