The National Institutes of Health (NIH): Organization, Funding, and Congressional Issues

The National Institutes of Health is the focal point for federal health research. An agency of the Department of Health and Human Services HHS, it uses its 28.5 billion budget to support more than 200,000 scientists and research personnel working at over 3,100 institutions across the U.S. and abroad, as well as to conduct biomedical and behavioral research and research training at its own facilities. The agency consists of the Office of the Director, in charge of overall policy and program coordination, and 27 institutes and centers, each of which focuses on particular diseases or research areas in human health. A range of basic and clinical research is funded through a highly competitive system of peer-reviewed grants and contracts. The NIH appropriation in the past three years has shifted from marked growth to low or no increases. Appropriators and authorizers face many issues in working with NIH to set research priorities in the face of tight budgets. Congress accepts, for the most part, the priorities established through the agencys complex process of weighing scientific opportunity and public health needs. While the Public Health Service Act PHSA provides the statutory basis for NIH programs, it is primarily through appropriations report language, not budget line items or earmarks, that Congress gives direction to NIH and allows a voice for advocacy groups. Congress also monitors ethics rules on conflicts of interest and tracks the efficacy of procedures intended to make results of NIH-sponsored research accessible to the public.