Short History of NIH

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

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

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

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.

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

Intellectual Revolution, 1870s-1890s

The Germ Theory

Louis Pasteur

Robert Koch

The Power of the Germ Theory

National Board of Health

First grants for medical research to university scientists

Bitter political disagreements

1878-1883/93

Laboratory of Hygiene Marine Hospital Service

Marine Hospital, Staten Island, NY

Joseph J. Kinyoun, M.D.

Kinyoun’s laboratory

Kinyoun’s microscope & first publication

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

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

1901 NIH’s 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

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

1912 Non-infectious disease

research

New Name: Public Health Service

Hygienic Laboratory authorized to investigate noncontagious diseases and the pollution of waterways

Pellagra: niacin deficiency

Who got pellagra? Dr. Joseph Goldberger

Hookworm: parasitic helminth

Who got hookworm?Dr. Charles Wardell Stiles

1916First professional woman

hired

Dr. Ida Bengtson, Bacteriologist

Worked in Biologics Control

Ransdell Act, 1930Hygienic Laboratory

renamedNational Institute of Health

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

Senator Joseph Ransdell (Louisiana)

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

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 BethesdaNIH Campus under construction, ca.

1939

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

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

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

Research for the home front:Workers protected

Dangers of specific munitions

Diagnostic tests for toxic materials

Working conditions of >300,000 defense workers improved

Research for the battlefield

Exotic diseases

Malaria Yellow fever Epidemic

typhus Tsutsugamus

hi (scrub typhus)

schistosomiasis

Battlefield trauma

Shock Burns Blood & blood

products High altitude

physiology

Architects of today’s NIH

Surgeon General Thomas Parran

NIH Director Rolla E. Dyer

World War II leader

s

1944 PHS Act

Authorized NIH grants program

Authorized clinical research

Mandated materials prepared for public

Rapid growth, 1945-2001

1945: NIH and NCI 1949: 6 institutes 1969: 15 institutes, centers &

divisions 1999: 25 institutes & centers 2001: 27 institutes & centers

NIH Clinical Center

NIH Clinical Center, 1953

“Pool of Bethesda”

Lorraine cross design philosophy

Goal: transfer new biomedical knowledge as rapidly as possible from the laboratory to the patient’s bedside

• 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, DHHSestablished June 2000

Protection for Human Subjects

Major lines of research, 1945-2003: Human Genetics

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

NIH and Genetics Research

1961—Nirenberg broke genetic code

1973—rDNA safety issues Guidelines written RAC established

1988—Human Genome Project launched

2003—Human Genome Project completed

Major lines of research, 1945-2003:

Basic Research

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

NIH and Basic Research

>100 Nobel prizes, 5 intramural

Biochemical instrumentation, 1945-1968

Molecular biology, 1970s-present

Neuroscience: emphasis on “brain” rather than “mind”

Major lines of research, 1945-2003:

Chronic Diseases

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

NIH and Chronic Diseases Drug addiction: search for

“nonaddicting opiate” Heart disease, stroke, sickle cell

anemia Cancer Diabetes, types I and II Arthritis

Major lines of research, 1945-2003:

infectious diseases

http://aidshistory.nih.gov/home.html

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

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