BACKGROUND

NIH is located in the U.S. Department of Health and Human Services (DHHS) with other health-related agencies of the federal government, including the Agency for Health Care Policy and Research, Centers for Disease Control and Prevention, Food and Drug Administration, Health Care Financing Administration, and Health Resources and Services Administration. NIH is the primary agency for research on health, accounting for 94 percent of DHHS's budget for health research and development (calculated from data from the National Science Foundation [NSF; 1997a:Table 8]).

NIH, which traces its roots to 1887, has grown steadily in size and scope, especially since the end of World War II, when the National Cancer Institute (NCI) was the only separately organized entity and the budget was $3 million. Currently, in FY 1998, there are 21 institutes and centers addressing different aspects of health research and several other major organizational units, and the budget for all NIH institutes and centers (see Box 1-1) is $13.6 billion.

BOX 1-1 Institutes and Centers of the National Institutes of Health

John E. Fogarty International Center

National Cancer Institute

National Center for Research Resources

National Eye Institute

National Heart, Lung, and Blood Institute

National Human Genome Research Institute

National Institute of Allergy and Infectious Diseases

National Institute of Arthritis and Musculoskeletal and Skin Diseases

National Institute of Child Health and Human Development

National Institute of Dental Research

National Institute of Diabetes and Digestive and Kidney Diseases

National Institute of Environmental Health Sciences

National Institute of General Medical Sciences

National Institute of Mental Health

National Institute of Neurological Disorders and Stroke

National Institute of Nursing Research

National Institute on Aging

National Institute on Alcohol Abuse and Alcoholism

National Institute on Deafness and Other Communication Disorders

National Institute on Drug Abuse

National Library of Medicine

According to the NIH Manual (National Institutes of Health, 1994b), "The National Institutes of Health is the steward of biomedical and behavioral re-



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