The National Institutes of Health NIH

The NIH traces itself to a one-room laboratory opened in 1887 at the Marine Hospital on Staten Island to study cholera and other diseases arriving with immigrants. The Hygienic Laboratory, as it was called, moved to Washington and in 1930 became the National Institute of Health under the Ransdell Act, the first federal commitment to basic medical research. The National Cancer Institute followed in 1937, the Bethesda campus in 1938, and after World War II Congress added institute after institute, each named for a disease or organ, until the singular became plural in 1948.

Twenty-seven institutes and centers now make up the NIH, from the National Cancer Institute and the National Heart, Lung, and Blood Institute to institutes for aging, mental health, allergy and infectious diseases, and child health. More than eighty percent of the agency's budget leaves Bethesda as grants to roughly 300,000 researchers at 2,500 universities, medical schools, and hospitals in every state, awarded through a peer-review system in which panels of outside scientists score each proposal. The remaining fifth funds the intramural program, including the Clinical Center, the largest hospital in the world devoted entirely to research.

NIH-funded work underlies most of modern medicine. Nearly every drug approved in recent decades drew on research the agency paid for, and its scientists or grantees have won more than a hundred Nobel Prizes. The budget, about 47 billion dollars, doubled between 1998 and 2003 with bipartisan support and has been the rare federal program both parties compete to expand. About 18,000 people work at the agency, most on the Bethesda campus. The Director is appointed by the President and, since 2017, confirmed by the Senate.

In 2025 the agency became a target of the administration's effort to cut research spending and reshape science policy. It terminated thousands of grants on subjects the administration opposed, proposed capping the overhead payments universities rely on, delayed or canceled review panels, and lost staff in the HHS reorganization, while the President's budget proposed cutting its funding by roughly forty percent and consolidating the institutes. Universities, scientific societies, and state attorneys general sued over several of the changes. Congress, which has defended the agency for decades, largely declined to enact the deepest cuts.