Cancer, National Institutes Of Health (NIH),

National Institutes of Health (NIH), 
agency of the United States government dedicated to biomedical and clinical research. The NIH works to improve the prevention, diagnosis, and treatment of a wide variety of medical conditions, from the common cold to rare genetic disorders. The agency conducts research in its own laboratories; funds research by scientists and health-care workers in hospitals, schools, and research institutions worldwide; and encourages the dissemination of biomedical information. The NIH also administers the National Library of Medicine, the most comprehensive collection of medical information in the world. The agency’s headquarters, which consists of more than 75 buildings and cover more than 120 hectares (300 acres), is located in Bethesda, Maryland.

II  ORGANIZATION 

The NIH is composed of 18 specialized institutes, which coordinate research and most NIH activities. Each institute conducts and funds federal research into specific diseases, health conditions, or systems of the body. The NIH also includes seven centers that provide services in support of the NIH mission.

Each NIH institute and center has its own director, administration, and budget. The institutes are highly independent and determine their own research priorities, although they often collaborate with other institutes and federal agencies. The NIH maintains more than 140 advisory committees, which formulate policy guidelines and provide peer review of scientific research.

The director of the NIH oversees the agency’s activities and represents the NIH in its relations with other branches and agencies of the federal government. The NIH director and the director of the National Cancer Institute are presidential appointees who must be confirmed by the U.S. Senate. The other directors of NIH institutes are hired according to federal employment guidelines.

The NIH is one of eight health agencies that compose the Public Health Service, a division of the U.S. Department of Health and Human Services.

III  FUNDING 

Each year, the director of the NIH develops and presents a proposed budget to the Congress of the United States. Congressional committees determine the budget of each center and institute individually. The proposed NIH budget is part of the larger federal budget that must be passed by Congress and signed by the president, and the final budget granted to the agency may be more or less than the amount requested by the NIH director. A very small percentage of the NIH budget is donated by people and agencies outside of the federal government. Usually, private gifts fund specific NIH projects or fellowships.

IV  NIH INSTITUTES AND CENTERS 

 National Cancer Institute 

Established by Congress in 1937, the National Cancer Institute has the largest budget and staff of the NIH institutes. It leads federal research efforts directed at the prevention, cause, detection, and treatment of cancer. The institute houses a data bank that collects, catalogs, and distributes the results of cancer studies conducted worldwide. The institute also sponsors and funds demonstration centers that train doctors in advanced diagnostic and treatment methods.

The National Cancer Institute sponsors several education programs for the public. The institute maintains CancerNet, an Internet database of cancer information for patients, doctors, and researchers. The National Cancer Institute also operates the Cancer Information Service, which provides information by telephone about cancer.

National Eye Institute 

Established by Congress in 1968, the National Eye Institute seeks methods to prevent, diagnose, and treat disorders of the human eye and visual system. It funds research that investigates cataracts, glaucoma, and retinal and corneal diseases, and the institute supports efforts to discover possible links between specific gene sequences and these disorders. The National Eye Institute’s laboratories investigate unconventional therapies for people with low vision and blindness, including drugs that may restore sight. Other laboratories study how genetic factors may contribute to blindness and investigate how impaired vision affects the development of motor coordination. The National Eye Institute funds more than 80 percent of vision-related research conducted in the United States.

National Heart, Lung, and Blood Institute 

Established by Congress in 1948, the National Heart, Lung, and Blood Institute funds research involving diseases of the heart, lungs, blood vessels, and blood. The institute conducts its own research initiatives in laboratories located at NIH headquarters. It also administers the National Center on Sleep Disorders, which directs research concerning sleep and sleep ailments. 

The National Heart, Lung, and Blood institute sponsors internships and training programs for students and researchers. The institute also educates health professionals, patients, and the public about high blood pressure, asthma, obesity, and sleep disorders.

National Human Genome Research Institute  

The National Human Genome Research Institute, founded in 1989, directs NIH involvement in the Human Genome Project, a worldwide effort to decode the entire human genetic “blueprint.” The institute funds genetic research at universities and other research facilities throughout the United States. In its own laboratories, the institute tests the effectiveness of gene therapies in the treatment of inherited diseases.

The National Human Genome Research Institute is the lead agency among eight NIH institutes that jointly established the Center for Inherited Disease Research in 1996. The center performs laboratory analyses for researchers attempting to link specific genes to human diseases.

The institute also administers the Ethical, Legal, and Social Implications Research Program, which investigates the social and moral significance of genetic research. The program educates health professionals, policymakers, and the public about genetic research and therapies.

National Institute of Allergy and Infectious Diseases 

Established in 1948, the National Institute of Allergy and Infectious Diseases coordinates and funds research involving allergic, immunologic, and infectious diseases, and it seeks improved prevention, diagnosis, and treatment of these illnesses. It funds and conducts research into asthma, cholera, tuberculosis, and sexually transmitted infections such as chlamydia, syphilis, and herpes. The institute is the lead agency in the Public Health System for vaccine research and funds the development of vaccines from initial research to clinical trials. It supports international scientific studies aimed at eradicating diseases, such as malaria and leprosy, that are prevalent in developing countries. The institute also directs many federal research efforts involving acquired immunodeficiency syndrome (AIDS), including an initiative to develop a safe and effective vaccine against the disease.

The National Institute of Allergy and Infectious Diseases administers a number of laboratories where it conducts its own research. Thirteen of the laboratories are on or near NIH headquarters in Bethesda, and three are located at the institute’s Rocky Mountain Laboratories in Hamilton, Montana.

National Institute of Arthritis and Musculoskeletal and Skin Diseases 

Established by Congress in 1985, the National Institute of Arthritis and Musculoskeletal and Skin Diseases investigates the causes, treatment, and prevention of musculoskeletal and skin diseases. It seeks improved methods of treating arthritis, muscular dystrophy, osteoporosis, and other debilitating diseases of the muscles and bones. The institute also supports clinical research in sports and rehabilitation medicine.

 National Institute of Child Health and Human Development 

Established in 1962, the National Institute of Child Health and Human Development leads federal research efforts that investigate fertility, pregnancy, and child growth and development. According to its mission statement, the institute “seeks to assure that every individual is born healthy, is born wanted, and has the opportunity to fulfill his or her potential for a healthy and productive life unhampered by disease or disability.” As part of this mission, the institute supports basic and clinical research aimed at helping people plan and regulate reproduction through contraception. It also develops improved methods to screen fetuses and newborns for developmental diseases and birth defects.

The National Institute of Child Health and Human Development supports research that investigates sudden infant death syndrome (SIDS) and other causes of infant mortality. It also investigates how biological factors may contribute to developmental problems in children, such as reading disabilities.

 National Institute of Dental and Craniofacial Research 

Established in 1948, the National Institute of Dental and Craniofacial Research coordinates and funds research on dental and oral health. The institute also studies methods of preventing and treating facial disfigurement caused by inherited disease, and it supports research involving the repair and regeneration of damaged facial tissues.

National Institute of Diabetes and Digestive and Kidney Diseases 

Founded in 1950, the National Institute of Diabetes and Digestive and Kidney Diseases funds and coordinates research involving metabolic disorders such as diabetes, digestive diseases, and kidney dysfunction. It also leads federal research on nutrition and supports more than 20 centers around the United States dedicated to nutrition, digestive diseases, and obesity.

 National Institute of Environmental Health Sciences 

Located in Research Triangle Park, North Carolina, the National Institute of Environmental Health Sciences conducts and funds research that investigates how human health is affected by environmental factors and individual susceptibility to toxins. The institute was established in 1969. It investigates the dangers of both natural and human-made substances, and it assesses their risk when combined with other environmental factors. The National Institute of Environmental Health Sciences leads the Environmental Genome Project, which investigates how genetic factors may increase susceptibility to environmentally induced diseases.

The institute funds more than 20 research centers at universities throughout the United States. As part of the institute’s community outreach, these centers advise the public about environmental hazards in their homes or neighborhoods. Since 1987 the institute has funded a network of nonprofit organizations that train workers to protect themselves and their communities from exposure to industrial toxins.

 National Institute of General Medical Sciences 

Established in 1962, the National Institute of General Medical Sciences conducts and funds research not related to specific diseases or systems of the body. The institute investigates fundamental life processes, such as how cells work and reproduce, and it maintains a repository of abnormal cells and other genetic samples for research purposes. The institute’s divisions support research and training in three broad biomedical fields: cell biology and biophysics; genetics and developmental biology; and pharmacology, physiology, and biological chemistry.

 National Institute of Mental Health 

Founded in 1949, the National Institute of Mental Health sponsors research that involves the brain, mental illness, and mental health. The institute seeks to improve the diagnosis and treatment of illnesses such as depression, anxiety disorders, schizophrenia, bipolar disorder, autism, and attention-deficit hyperactivity disorder. The institute studies the biological and behavioral manifestations of mental illness and investigates the role of genetics in mental health. In addition, the institute serves as a source of information for the public about the causes and treatment of specific mental illnesses.

National Institute of Neurological Disorders and Stroke 

Established in 1950, the National Institute of Neurological Disorders and Stroke directs research and research training into the brain and the human nervous system. The institute investigates more than 600 neurologic disorders, including epilepsy, multiple sclerosis, and Parkinson disease. The institute also investigates how stroke and trauma impair neurological function, and it seeks methods of repairing and regenerating neurological function.

 National Institute of Nursing Research 

Established in 1993, the National Institute of Nursing Research funds and conducts research related to patient care. It supports research to develop clinical procedures that foster good health, delay the onset of disease, ease suffering, and address the needs of patients’ families and caregivers. The institute funds mentorships and grants research service awards to advance the careers of nurse scientists. In 1997 the National Institute of Nursing Research was designated as the lead NIH institute to coordinate research into treatments that can ease suffering at the end of life.

National Institute on Aging 

Founded in 1974, the National Institute on Aging directs research related to the human aging process. The institute funds social and behavioral studies of the elderly (see Gerontology), geriatrics research aimed at improving the care and treatment of older people, and basic research on the biological effects of age. Most of the institute’s own research is conducted at the Gerontology Research Center in Baltimore, Maryland.

National Institute on Alcohol Abuse and Alcoholism 

Established in 1970, the National Institute on Alcohol Abuse and Alcoholism investigates the causes and treatment of alcoholism and alcohol-related illnesses such as ulcers, liver disease, and fetal alcohol syndrome. The institute funds many studies investigating how genetics may influence alcohol abuse and alcoholism, and it also supports research to determine whether alcohol abuse contributes to other physical and mental disorders, such as compulsive gambling.

The National Institute on Alcohol Abuse and Alcoholism frequently collaborates with other NIH institutes and federal agencies in alcohol-related research and conducts policy studies to assess the effectiveness of alcoholism prevention and treatment programs. The institute maintains a comprehensive Internet database of scientific information about alcohol and alcohol-related illnesses.

 National Institute on Deafness and Other Communication Disorders 

Established in 1988, the National Institute on Deafness and Other Communication Disorders supports research and research training on deafness and other disorders that affect speech and language communication. It also funds and conducts research into taste, smell, and other human senses.

Scientists supported by the institute are developing improved methods of detecting and diagnosing larynx cancer, which can destroy speaking ability if not detected early enough. Other researchers associated with the institute are also working to improve cochlear implants and other hearing aids that can restore hearing ability to some deaf people.

National Institute on Drug Abuse 

Established in 1974, the National Institute on Drug Abuse became part of the NIH in 1992. The institute funds and conducts research that investigates the biological, social, behavioral, and neurological effects of drug abuse, as well as the causes, prevention, and treatment of drug addiction. The institute’s Office on AIDS investigates possible connections between drug addiction and AIDS. The National Institute on Drug Abuse provides literature about drugs and drug abuse to health professionals, educators, and the public.

Fogarty International Center for Advanced Study in the Health Sciences 

Established in 1968, the John E. Fogarty International Center for Advanced Study in the Health Sciences establishes partnerships between American scientists and researchers abroad through grants, fellowships, exchange awards, and international agreements. The center collaborates with foreign governments and international aid organizations to provide research training to scientists and health-care professionals outside the United States.

National Center for Research Resources 

The National Center for Research Resources, founded in 1990, builds and strengthens research infrastructure in the United States. It funds the development of specialized medical instruments, computer models, and other tools that scientists can share. The center also pays for the maintenance of biological materials used by researchers, such as cells, tissues, and organs. The center funds the breeding and maintenance of animals used for medical research. It also finances construction, renovation, and maintenance of laboratories at other research institutions.

National Center for Complementary and Alternative Medicine 

Established by Congress in 1992, the National Center for Complementary and Alternative Medicine conducts and funds research to determine the effectiveness of alternative and nontraditional health-care practices, such as acupuncture, homeopathy, hypnosis, herbal medicine, and biofeedback. It funds ten specialized offices throughout the United States that investigate the use of alternative treatments for specific diseases, health conditions, and at-risk populations.

Although the center does not endorse alternative therapies, it encourages discussion between practitioners of alternative medicine and traditional medical professionals. It also distributes information about alternative and complementary medicine to the public, media, and health-care professionals. It was originally named the Office of Alternative Medicine, but in 1998 Congress elevated the office to the status of an NIH center, increasing its budget and authority.

 Other NIH Centers 

The Warren Grant Magnuson Clinical Center, founded in 1953, is the primary research hospital used by NIH researchers. The center provides hospital care for patients participating in NIH clinical research. The center admits about 7,000 patients per year. About 70,000 patients receive outpatient care every year at the center’s Ambulatory Care Research Center.

The National Center on Minority Health and Health Disparities, established in 2000, conducts and funds research on health problems affecting minorities and on disparities in the health status of minorities compared to that of the population as a whole. It also trains researchers.

The Center for Scientific Review provides scientific merit reviews of most research grant and fellowship applications submitted to the NIH. It assigns the applications to appropriate institutes, centers, or other scientific advisory groups for further review. The Center for Scientific Review also helps the NIH formulate policies and procedures for awarding grants. 

The Center for Information Technology, established in 1998, operates and manages the computer and telecommunications resources of the NIH. The center provides advanced computing facilities and data processing for NIH institutes.

The National Library of Medicine 

The NIH houses the National Library of Medicine, the most comprehensive collection of medical information in the world. The library’s collection includes more than 5 million books, journals, pamphlets, rare manuscripts, films, and other items related to medical research and care. The National Library of Medicine maintains several widely used databases of bibliographic information related to medical care. Originally named the Library of the Office of the Surgeon General, the library became a part of the NIH in 1968.

V  HISTORY 

The National Institutes of Health traces its roots to a one-room laboratory established in 1887 by the Marine Hospital Service, which provided medical care to officers and enlisted men in the United States Navy. The Marine Hospital Service authorized a young physician named Joseph J. Kinyoun to set up a laboratory for bacterial research at the Marine Hospital on Staten Island, New York. After studying cholera-infected immigrants arriving at Ellis Island, in 1888 Kinyoun isolated the organism that causes the disease.

The laboratory moved to Washington, D.C., in 1891. Kinyoun served as the director of the Hygienic Laboratory, as it came to be called, until 1899. In 1901 the U.S. Congress authorized the Hygienic Laboratory to undertake “the investigation of infections and contagious diseases and matters pertaining to the public health.” The laboratory expanded to include divisions of pathology and bacteriology, chemistry, pharmacology, and zoology.

Congress further expanded the Hygienic Lab in 1930, renaming it the National Institute of Health. In 1937 Congress created the National Cancer Institute as a separate agency and authorized it to award grants to research scientists outside of the institute.

In 1938 the institute moved to the site of its current headquarters in Bethesda, Maryland. In 1944, the National Cancer Institute became a part of the National Institute of Health. The agency was renamed the National Institutes of Health in 1946.

After 1945 the entire NIH adopted the National Cancer Institute’s system of funding research conducted at other institutions, and the agency’s budget swelled. Congress’s annual appropriation to the NIH grew from about $4 million in 1947 to more than $100 million a decade later. Congress also authorized the addition of a series of specialized institutes to the NIH, each dedicated to a specific disease, health condition, or system of the body. By 1960 the NIH comprised 10 distinct institutes, and by 2000 there were 18. By the late 1990s the agency supported more than 35,000 researchers at 1,700 universities, medical schools, hospitals, and research centers in the United States and other countries.