Short History of NIH

1
Short History of NIH

• Victoria A. Harden, Ph.D.
• Historian, NIH

2
Federal Government and Medical Research

• No support at all before late 19th century
• Medical system based on humoral theory
• U.S. Constitution made no mention of health or
  medicine

3
Marine Hospital Service

• Established in 1798 under the commerce clause of
  the Constitution
• Series of hospitals for merchant seamen
• Placed in Treasury Department to collect 20 cents
  per month from each sailor

Marine Hospital, New Orleans, Louisiana
4
Political Philosophy

• Americans were suspicious of government funding
  because they believed
• If government funds research, government can
  control what research gets done.
• People who accept funds from the government are
  not self-reliant.

5
Discovery of Anesthesia

• Only major U.S. contribution to medicine before
  the U.S. Civil War
• Wholly in the private sector

The First Operation with Ether by Robert
Hinckley
6
Intellectual Revolution, 1870s-1890s The Germ
Theory

• Louis Pasteur

• Robert Koch

7
The Power of the Germ Theory
8
National Board of Health

• First grants for medical research to university
  scientists
• Bitter political disagreements
• 1878-1883/93

9
Laboratory of Hygiene Marine Hospital Service

• Marine Hospital,
• Staten Island, NY

• Joseph J. Kinyoun, M.D.

10
Kinyouns laboratory
Kinyouns microscope first publication
11
Growth of laboratory

• 1891--moved to Washington, DC
• 1894--production of diphtheria antitoxin begun
• rabies vaccine, smallpox vaccine made available

Diphtheria antitoxin made by Hygienic Laboratory,
1895
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1902 Biologics Control Act

• 1901 13 children in St. Louis died from
  contaminated diphtheria antitoxin
• 1902 Congress acted
• Hygienic Laboratory given regulatory
  responsibility

Mulford rabies vaccine outfit
13
1901 NIHs organic legislation

• Buried in a supplemental appropriations act
• Authorized 35,000 to build one building
• Authority to investigate infectious and
  contagious diseases

25th E Sts, Washington, DC, 1904-1939/41 home
of NIH
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1902 Research Program Begins

• New Name Public Health and Marine Hospital
  Service
• Hygienic Laboratory organized into 4 divisions
• Pathology and Bacteriology (original work)
• Zoology
• Chemistry
• Pharmacology
• Ph.D.s hired to head new divisions

15
1912 Non-infectious disease research

• New Name Public Health Service
• Hygienic Laboratory authorized to investigate
  noncontagious diseases and the pollution of
  waterways

16
Pellagra niacin deficiency

• Dr. Joseph Goldberger

• Who got pellagra?

17
Hookworm parasitic helminth

• Who got hookworm?

• Dr. Charles Wardell Stiles

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1916First professional woman hired
Dr. Ida Bengtson, Bacteriologist Worked in
Biologics Control
19
Ransdell Act, 1930Hygienic Laboratory
renamedNational Institute of Health

• Charles H. Herty
• (Georgia and N.C.)

• Senator Joseph Ransdell (Louisiana)

20
1930sChange in Political Philosophy

• Government control can be used to rectify
  injustices
• Government control can provide oversight of
  ethics of research
• Scientists can remain self-reliant if they decide
  which projects to undertake

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NCI created, NIH moved to Bethesda

• 1937--National Cancer Act
• foreshadowed categorical structure
• authorized to give grants
• and fellowships
• 1939-41--move from DC to Bethesda

NIH Campus under construction, ca. 1939
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1938-41 70 Acres for Science

• Some opposition to construction from Bethesda
  Chamber of Commerce and Montgomery County
  Commission
• October 31, 1940 FDR dedicated campus

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Steps Toward War

• Sept. 1, 1939
• June 1940
• Sept. 1940

• Germany invaded Poland
• Battle of Britain
• U.S. National Defense Council established
• Japan signed mutual assistance pact with Germany
  and Italy global war
• Congress enacted first peacetime draft in US
  history

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Health of Recruits

• 43 percent unfit for military service
• 28 percent not fit for any military service
• 15 percent fit for limited service only

NIH Division of Public Health Methods worked with
the Selective Service
25
Research for the home frontWorkers protected

• Dangers of specific munitions
• Diagnostic tests for toxic materials

• Working conditions of gt300,000 defense workers
  improved

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Research for the battlefield

• Battlefield trauma
• Shock
• Burns
• Blood blood products
• High altitude physiology

• Exotic diseases
• Malaria
• Yellow fever
• Epidemic typhus
• Tsutsugamushi (scrub typhus)
• schistosomiasis

27
Architects of todays NIH
World War II leaders

• Surgeon General
• Thomas Parran

• NIH Director
• Rolla E. Dyer

28
1944 PHS Act

• Authorized NIH grants program
• Authorized clinical research
• Mandated materials prepared for public

29
Rapid growth, 1945-2001

• 1945 NIH and NCI
• 1949 6 institutes
• 1969 15 institutes, centers divisions
• 1999 25 institutes centers
• 2001 27 institutes centers

30
NIH Clinical Center
NIH Clinical Center, 1953
Pool of Bethesda
31
Lorraine cross design philosophy

• Goal transfer new biomedical knowledge as
  rapidly as possible from the laboratory to the
  patients bedside

32
Protection for Human Subjects

• Hippocratic Oath First, do no harm
• Nazi medical experiments
• Nuremberg Code (1946) Informed consent must be
  obtained
• Clinical Center review of protocols, 1953
• Tuskegee syphilis study (begun 1932, recognized
  as public scandal 1972)
• Protection for Human Subjects Act (1974)
• Institutional Review Boards established
• NIH Office of Protection from Research Risks
  established
• Office of Human Research Protections, DHHS
• established June 2000

33
Major lines of research, 1945-2003 Human Genetics

• http//history.nih.gov/exhibits/genetics/

34
NIH and Genetics Research

• 1961Nirenberg broke genetic code
• 1973rDNA safety issues
• Guidelines written
• RAC established
• 1988Human Genome Project launched
• 2003Human Genome Project completed

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Major lines of research, 1945-2003Basic Research

• http//history.nih.gov/exhibits/bowman/

36
NIH and Basic Research

• gt100 Nobel prizes, 5 intramural
• Biochemical instrumentation, 1945-1968
• Molecular biology, 1970s-present
• Neuroscience emphasis on brain rather than
  mind

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Major lines of research, 1945-2003Chronic
Diseases

• http//history.nih.gov/exhibits/opiates/

38
NIH and Chronic Diseases

• Drug addiction search for nonaddicting opiate
• Heart disease, stroke, sickle cell anemia
• Cancer
• Diabetes, types I and II
• Arthritis

39
Major lines of research, 1945-2003infectious
diseases

• http//aidshistory.nih.gov/home.html

40
NIH and infectious diseases

• Surprising reappearance in 1981 AIDS
• Emerging diseases SARS, Ebola, hanta virus, etc.
• Bioterror agents anthrax, plague, smallpox,
  botulism, tularemia
• Major world killers malaria, rotavirus, polio

41
NIH worldview absorbing but dangerous.How do we
deal with the brave new world?