National Institutes of Health: Funding and Findings

Introduction

Raj is interested in pursuing a career in medical research to help find cures for diseases and understand mental health disorders. Recently, he’s been reading works from a medical library, which gives him background knowledge on recent research and discoveries in the field. 

Explanation

If Raj does go into the medical research field, he could end up working with the National Institutes of Health, which conducts its own research and funds others to develop resources that increase the U.S.’s capability to prevent disease. It also works with programs that promote and support medical libraries to share information among medical professionals.

National Institutes of Health

The National Institutes of Health, or the NIH, is one of eleven agencies within the Department of Health and Human Services, or the HHS, a federal executive department responsible for disease prevention and wellness, social services, and biodefense. Within the HHS, the primary operating division is the United States Public Health Service, which contains eight of the HHS’s eleven operating divisions, including the NIH. Founded in 1887, the NIH is the main U.S. agency in charge of biomedical and public health research. It is the largest public funder of biomedical research in the world.

The History

In 1887, Joseph Kinyoun set up a one-room laboratory within the Marine Hospital Service, or the MHS. His training in bacteriological methods was of interest to MHS officials, and they allowed him to research issues affecting public health. In 1922, the MHS changed its name to the Public Health Service. In 1930, the Ransdell Act expanded and renamed the Hygienic Laboratory that Kinyoun had started, turning it into the National Institute of Health. In 1948, the National Institute of Health became the National Institutes of Health. The Public Health Service joined the Federal Security Agency in 1939, which went on to become the Department of Health and Human Services in 1979. 

The Hygienic Laboratory did not hire a woman scientist until Ida Bengston in 1916. Bengston was a bacteriologist who made several important discoveries during her career, such as assisting in the development of the typhus vaccine. In 1957, Margaret Pitman became the head of the Laboratory of Bacterial Products, making her the first woman laboratory chief in the NIH. She isolated the influenza strain responsible for most childhood meningitis and made observations that were key in developing a Salmonella vaccine.

Some notable projects and discoveries of the NIH include the Human Genome Project in the 1990s and the 1960s discovery that tooth decay is caused by bacteria and can be treated by fluoride. 

How It Works

With 28 different research institutes and centers, the NIH works in several different biomedical disciplines. For example, the National Cancer Institute, or the NCI, is the federal government’s primary agency in charge of cancer research and training. The NCI supports clinical trials nationwide, construction of new facilities for cancer research, and the Frederick National Laboratory for Cancer Research. It also leads the National Cancer Program. 

Another institute that reports to the NIH is the National Environmental Health Sciences Institute, or the NEHSI. This institute is responsible for researching environmental effects on human biology and genetics to promote healthier lives and provide global leadership for research that prevents disease and disability.

The NIH is run by the Office of the Director. It is in charge of setting policy for the agency, as well as managing and coordinating programs and activities for the various centers and institutes of the NIH. This office has several program offices that encourage and support specific research areas through the NIH, as well as offices that focus on policy, administration, and funding. For instance, the Office of Research on Women’s Health, or the ORWH, is the first Public Health Service office to specifically promote women’s health research. Despite strides toward equality, there are still disparities between men and women’s health care, and some illnesses, such as cardiovascular disease, can present differently. As of 2020, only 44% of medical schools report having a women’s health curriculum, and the ORWH works to increase awareness of this issue and take steps to address it.

Applying It

The NIH has its flaws. Scientists have criticized the agency for its tendency to fund large, wealthy institutions, often at the expense of smaller and poorer ones. There are also significant disparities in grant funding across race, gender, and age. Eleven percent of NIH research project grant money goes to just one percent of the scientists who receive funding. On an institutional level, half of all research project grant money goes to two percent of funded organizations and ten percent of states, with wealthier institutions receiving far more grant funding than poorer ones. Evidently, there is still a problem of systemic inequality in who gets funding for their research and the amounts of that funding.

The NIH does essential work in funding and researching a wide range of topics to contribute to the field of biomedical study. However, it is also important to remember that American biomedical research has historically focused on white men and the issues that affect them, excluding women, people of color, and LGBTQ+ people. The NIH is no exception. Knowing more about the benefits and drawbacks to the NIH allows you to think more critically about its role in scientific research and understand the history that affects today's actions.

Think Further

  1. Which public health issue, such as obesity, lack of access to safe drinking water and food, and mental health, do you think is most pressing? Why?
  2. What actions could you take to raise awareness about inequality within the medical field?
  3. What steps could the NIH take to reduce inequality within the agency?

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Learn More

  1. A Short History of the National Institutes of Health – A Short History of the National Institutes of Health – Office of NIH History and Stetten Museum. https://history.nih.gov/display/history/A+Short+History+of+the+National+Institutes+of+Health.
  2. Early Women Scientists at the NIH – Early Women Scientists at the NIH – Office of NIH History and Stetten Museum. https://history.nih.gov/display/history/Early+Women+Scientists+at+the+NIH.
  3. How Sex and Gender Affect Health (And Why Knowing Matters) | Office of Research on Women’s Health. https://orwh.od.nih.gov/about/director/messages/how-sex-and-gender-affect-health-and-why-knowing-matters.
  4. NIEHS Sustainability Report 2019. National Institute of Environmental Health Sciences, 2019, https://www.niehs.nih.gov/about/assets/files/niehs_sustainability_report_2019_508.pdf.
  5. Wahls, Wayne P. “The NIH Must Reduce Disparities in Funding to Maximize Its Return on Investments from Taxpayers.” ELife, vol. 7. PubMed Central, 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882298/pdf/elife-34965.pdf.