When we get the news about a new drug or innovative therapy, we typically hear about the university or scientist who discovered them. What most people don’t know is where a good portion of the money comes from to achieve those medical and scientific advancements. While people are often skeptical of government, this is one instance where its involvement has changed the course of history for the better.
In large part because of the support of the National Institutes of Health (NIH), scientists across the United States and around the world conduct wide-ranging research to discover ways to enhance health, lengthen life and reduce illness and disability. As part of the U.S. Department of Health and Human Services (HHS), the NIH is the nation’s medical research agency. As such it is the largest public funder of biomedical research in the world, investing some $37.3 billion annually in medical research.
According to the NIH, more than 80% of the agency’s funding is awarded through almost 50,000 competitive grants to more than 300,000 researchers at more than 2,500 universities, medical schools and other research institutions in every state and around the world. And about 10% of the NIH’s budget pays for research conducted by nearly 6,000 scientists in the agency’s own laboratories, most of which are on the NIH campus in Bethesda, Maryland.
The NIH posts a list of awards by location and organization and NIH funding by institution, state, congressional district. The agency also lists its funding levels for diseases, conditions and research areas.
Of the 285 research and disease areas funded by the NIH, the agency spent the most on clinical research in 2018, with nearly $12.5 million. Genetics was next with $8.4 million, followed by prevention, neurosciences and biotechnology. Cancer was 6th on the list at $6.6 million. Infectious diseases, brain disorders, women’s health, rare diseases, behavioral and social science, pediatric, bioengineering, and clinical trials and supportive activities were next. Aging came in at 15th with a $3.7 million investment (this figure is over and above what the agency contributes to Alzheimer’s disease and dementia).
Alzheimer’s disease including Alzheimer’s disease-related dementias; dementia; and Alzheimer’s disease were listed as 31st, 32nd and 34th respectively, but combined cost the NIH some $4.8 million.
The NIH states its mission this way: “To seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.”
To that end, they are living up to it. Americans today are living longer and healthier lives—with less disability and increased cancer survival—thanks in large part to NIH-funded medical research. “Life expectancy in the United States has jumped from 47 years in 1900 to 78 years as reported in 2009, and disability in people over age 65 has dropped dramatically in the past 3 decades,” the NIH reports. “In recent years, nationwide rates of new diagnoses and deaths from all cancers combined have fallen significantly.”
According to the NIH, its goals include:
- to foster fundamental creative discoveries, innovative research strategies, and their applications as a basis for ultimately protecting and improving health;
- to develop, maintain, and renew scientific human and physical resources that will ensure the Nation’s capability to prevent disease;
- to expand the knowledge base in medical and associated sciences in order to enhance the Nation’s economic well-being and ensure a continued high return on the public investment in research; and
- to exemplify and promote the highest level of scientific integrity, public accountability, and social responsibility in the conduct of science.
The NIH provides leadership and direction to programs designed to improve the health of the nation by conducting and supporting research:
- in the causes, diagnosis, prevention, and cure of human diseases;
- in the processes of human growth and development;
- in the biological effects of environmental contaminants;
- in the understanding of mental, addictive and physical disorders; and
- in directing programs for the collection, dissemination, and exchange of information in medicine and health, including the development and support of medical libraries and the training of medical librarians and other health information specialists.
Francis S. Collins, M.D., Ph.D. was appointed in 2009 as the 16th director of the National Institutes of Health (NIH) by President Barack Obama. President Donald Trump selected Collins to continue on in the post in 2017, where he still serves today.
Collins is a physician-geneticist known for his discoveries of disease genes and for leading the international Human Genome Project which culminated in April 2003 with the completion of a finished sequence of the human DNA instruction book. He served the NIH as the director of its National Human Genome Research Institute from 1993-2008.
To date, 156 NIH-supported scientists from around the world have been sole or shared recipients of 92 Nobel Prizes for their groundbreaking achievements in physiology or medicine; chemistry; physics; and economic sciences. Over the last century, NIH scientists’ studies have led to the understanding of how viruses can cause cancer, development of Magnetic Resonance Imaging (MRI), knowledge of how our brain processes visual information and many other scientific advances.
The NIH started in 1887 as a one-room laboratory created within the Marine Hospital Service (MHS) which had been established in 1798 to care for merchant seamen. It was the predecessor agency to the U.S. Public Health Service (PHS).
Almost since the inception of the United States, the NIH or some form of it, has overseen the health of the nation and worked to improve it. From the time of the establishment by Dr. Joseph J. Kinyoun of a bacteriological laboratory, known as the Laboratory of Hygiene at the Marine Hospital in Staten Island, New York in 1887 until now, scientists, supported by the government, have studied and developed treatments for infectious as well as non-communicable diseases (NCD) and ailments that have been the leading causes of death, disorders and disease burden worldwide.
From the influenza pandemic, Rocky Mountain Spotted Fever, venereal disease, drug and alcohol abuse, microbiology, metabolic diseases and mental health to cancer, arthritis, musculoskeletal and skin diseases, the NIH has invested in treating and curing them all and every other threat to the health of the nation in between. From the MHS’ beginnings in the 1880s examining passengers on arriving ships for clinical signs of infectious diseases like cholera and yellow fever to prevent epidemics to 2013 and the introduction of the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative budgeted at $100 million in its first year, it is not surprising that the NIH is the largest biomedical research agency in the world.
The Center for Aging Research was established in 1957 as the focal center for NIH extramural activities in gerontology. Nearly 20 years later, the Research on Aging Act of 1974 created the National Institute on Aging (NIA) which is still in operation today.
As one of the 27 institutes and centers of NIH, the NIA today leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. The agency is also the primary Federal agency supporting and conducting Alzheimer’s disease research. Fighting the disease has gained a significant amount of steam since the passage of the National Alzheimer’s Project Act (NAPA) in 2011—which calls for an aggressive and coordinated national plan to accelerate research on Alzheimer’s disease and related dementias, and to provide better clinical care and services for people living with dementia and their families. Among the goals of the plan is to prevent and effectively treat Alzheimer’s disease by 2025.
On January 15, 2007 President George W. Bush signed the National Institutes of Health Reform Act of 2006, affirming the importance of NIH and its vital role in advancing biomedical research. As a result of this reauthorization process, the NIH is able to respond strategically to Congressional legislation to adjust its programs in an era when medical research requires constant innovation and increased interdisciplinary efforts.