This paper focuses on the role played by Domenico Marotta, director of the ISS (Higher Institute of Health) for over twenty-five years, in the development of twentieth-century Italian biomedicine. We will show that Marotta aimed to create an integrated centre for research and production able to interact with private industry. To accomplish this, Marotta shifted the original mission of the ISS, from public health to scientific research. Yet Mussolini's policy turned most of the ISS resources towards controls and military tasks, opposing Marotta's aspiration. By contrast, in the post-war years Marotta was able to turn the ISS into the most important Italian biomedical research institution, where research and production fruitfully cohabited. Nobel laureates, such as Ernst Chain, and future Nobel laureates, such as Daniel Bovet, were hired. The ISS built up an integrated research and production centre for penicillin and antibiotics. In the 1960s, Marotta's vision was in accord with the new centre-left government. However, he pursued his goals by ruling the ISS autocratically and beyond any legal control. This eventually led to his downfall and prosecution. This also marked the decline of the ISS, intertwined with the weakness of the centre-left government, who failed to achieve structural reforms and couple the modernization of the country with the democratization of its scientific institutions.