The National Institutes of Health (NIH) is a primary agency within the United States federal government, dedicated to advancing biomedical and public health research. Established in 1887, it operates as a part of the U.S. Department of Health and Human Services (HHS). The mission of the NIH involves seeking fundamental knowledge about living systems and applying that understanding to improve health, extend life, and lessen the burden of illness and disability. It is the largest single funder of biomedical research globally.
NIH’s Mobilization Against COVID-19
As the COVID-19 pandemic emerged, the NIH swiftly redirected its focus and resources to address the global health crisis. Immediate actions included establishing task forces and redirecting substantial funding towards broad research programs across its various institutes. This rapid mobilization was driven by the urgent need to understand and combat the novel coronavirus.
The agency launched the Rapid Acceleration of Diagnostics (RADx) program in April 2020. RADx aimed to speed innovation in the development, commercialization, and implementation of COVID-19 testing technologies, supporting projects with community partnerships to increase access and uptake of testing.
The NIH’s response also involved a shift in its funding mechanisms to accelerate research. The agency adapted to disburse hundreds of millions in additional funds from Congress, allowing for quicker support of pandemic-related science.
Advancing COVID-19 Research and Development
The NIH played a significant role in fostering scientific advancements against COVID-19, particularly in the development of vaccines, therapeutic interventions, and diagnostic tools. The National Institute of Allergy and Infectious Diseases (NIAID) had a longstanding collaboration with Moderna on mRNA vaccines for emerging infectious diseases, which proved foundational.
This partnership allowed the NIH and Moderna to jointly develop the mRNA-1273 vaccine, beginning in January 2020. NIAID initiated a Phase 1 clinical trial for this investigational vaccine, leading to a Phase 3 trial that enrolled 30,000 volunteers across the United States. NIAID also led additional trials for vaccine variants and second-generation COVID-19 vaccines.
Beyond vaccines, the NIH supported extensive research into therapeutic interventions. This included studies on antivirals like remdesivir and monoclonal antibodies. Monoclonal antibodies, which are lab-engineered copies of immune system molecules, were investigated for their potential to treat and prevent COVID-19.
The agency also accelerated the development and implementation of diagnostic tools. Through the RADx program, the NIH worked with private companies to support the production and deployment of rapid, accurate tests. This initiative aimed to significantly increase testing capacity for millions of people daily, utilizing various techniques.
Public Health Communication and Resources
The NIH served as a reliable source of information and resources throughout the pandemic. Its Office of Communications and Public Liaison played a role in connecting research findings with public understanding, providing evidence-based public health guidelines.
The agency established large-scale clinical trial networks, such as Accelerating COVID-19 Treatment Interventions and Vaccines (ACTIV) and Researching COVID to Enhance Recovery (RECOVER). ACTIV, a public-private partnership led by the NIH, was initiated in April 2020 to accelerate the development and testing of vaccines and therapeutics. These networks were designed to rapidly evaluate candidate treatments.
The NIH also prioritized data sharing to foster collaboration and accelerate discovery. The National COVID Cohort Collaborative (N3C) was launched as a secure platform for collecting and analyzing clinical, laboratory, and diagnostic data. This initiative aimed to support researchers by providing access to harmonized data.
Addressing Long-Term Impacts and Future Threats
The NIH continues to address the long-term consequences of COVID-19 and strengthen preparedness for future health crises. A significant focus is on “Long COVID,” a condition with persistent symptoms after acute infection. The Researching COVID to Enhance Recovery (RECOVER) Initiative, launched in 2021, aims to understand, diagnose, prevent, and treat Long COVID.
RECOVER employs a comprehensive approach, including observational studies following thousands of participants, analysis of millions of electronic health records, and pathobiology studies examining tissue samples. The initiative has also launched Phase 2 clinical trials to evaluate potential treatments for Long COVID symptoms, including drugs, biologics, and medical devices.
The NIH is also actively strengthening pandemic preparedness for future health threats. The National Institute of Allergy and Infectious Diseases (NIAID) has developed a Pandemic Preparedness Plan that focuses on viruses with epidemic or pandemic potential. This plan prioritizes research on “prototype pathogens” to build a knowledge base applicable to similar viruses.
Investments are being made in fundamental research, surveillance systems, and rapid response platforms. The Research and Development of Vaccines and Monoclonal Antibodies for Pandemic Preparedness network (ReVAMPP) aims to develop vaccines and monoclonal antibodies for high-priority pathogens. These efforts include leveraging advanced technologies like AI for early warning systems in disease surveillance.