Mission and Mandate: Navigating the History of Science Administration at the NIH

By Todd M. Olszewski ~

As a historian, I study the intersections among clinical medicine, health research, and health policy. What interests me especially is the history of the National Institutes of Health. Two major questions propel my work: how have NIH administrators interpreted the NIH mission, and how have these mission-driven debates shaped NIH efforts to bridge research and practice?

Despite its status as a major funder of biomedical research at American medical schools and universities, historians have left the NIH relatively understudied. Some have examined different facets of NIH history, such as its role in the development of clinical research and its contributions to biomedical technologies and research methods, but often to better understand another historical topic rather than the agency itself.

I had the good fortune to be a Stetten Fellow in the Office of NIH History from 2008-2010. During my first months in Bethesda, Dr. Elias Zerhouni was completing his term as NIH Director. One of Zerhouni’s signature initiatives had been the NIH Roadmap, which represented a set of NIH-wide priorities intended to accelerate the research and discovery process across multiple NIH institutes.

Coverage of the Roadmap sparked what has now become my longer-term study of the NIH, its mission, and its evolution as a government agency. As an NLM Micheal E. DeBakey Fellow in the History of Medicine, I had the opportunity to return to the NIH campus and examine multiple NLM collections of archival sources, government publications, and media coverage pertaining to the NIH. Given its location on the NIH’s Bethesda campus—as well as its longstanding collaboration with the Office of NIH History and Stetten Museum to ensure that the history of the NIH is documented, preserved, and accessible to current and future generations of researchers—the NLM serves as a useful repository for any historian interested in the administrative history of the NIH.

When the Ransdell Act formalized the singularly named National Institute of Health in 1930, it defined the NIH mission as encompassing the “study, investigation, and research in the fundamental problems of the diseases of man and matters pertaining thereto.” NIH Directors have since inherited their predecessors’ signature initiatives, developed their own, and responded to Congressional inquiries into the agency’s research priorities. Although incomplete, the NIH Directors’ Files collection illuminates different directors’ efforts to interpret the NIH mission and move that vision forward. The collection includes public speeches, committee meeting minutes, and other administrative reports that offer useful glimpses into how scientific administrators operated at the NIH.

For example, in 1972, NIH Director Robert Q. Marston spoke at the dedication of the O’Neill Laboratories at Johns Hopkins University in Baltimore, Maryland. During his speech, Marston focused on the federal government’s role in the medical research enterprise. As he noted, “while [the NIH’s] central task has been to build and sustain the nation’s capability for medical research, its primary purpose, as an agency of the Department of Health, Education, and Welfare, is to improve the health of the American people.” The notion of improving the public’s health proved pivotal to most NIH Director messaging.

Twenty years later, another NIH Director rolled out the first NIH-wide strategic plan. When Bernadine Healy became the first woman to be appointed NIH Director, she inherited an initiative to implement an agency-wide strategic plan. In prepared comments to the task force tasked with developing the plan, she presented the initiative as an opportunity: “should not the strategic planning effort also serve as a means to communicate NIH’s mission and activities both to the scientific community at large and to the public we serve?”  Healy’s strategic plan served as one example of uniting institutes and centers that typically operated independently under one set of guiding principles. In sum, the strategic plan outlined that the NIH would launch new grant programs to build the next generation of clinical researchers, increase the number of research grants awarded by the agency, and develop a new agency-wide communication strategy to maintain the public’s trust.

Marston’s Johns Hopkins speech, Healy’s strategic plan rollout, and Zerhouni’s roadmap each provide snapshots into how NIH Directors proposed implementing the NIH mission and coordinating agency-wide activities in the name of the public’s health.

Todd M. Olszewski, PhD, is an Associate Professor and Chair of the Department of Health Sciences at Providence College and a 2020 NLM Michael E. DeBakey Fellow in the History of Medicine.