Congress must create ‘a DARPA’ for independent health research
Unknown until three years ago, COVID-19 since has claimed more than 6 million lives worldwide, with more than 500 million cases and a predicted economic impact of $12.5 trillion through 2024. Accelerated research into vaccines and treatments to combat the virus began in 2020 — an unusually rapid response.
Yet research published in a European journal finds that 300 million people around the world suffer from other communicable, chronic, genetic and rare diseases. Ideally, the medical research community’s efficiency of moving COVID vaccines and treatments to market should be replicated for all diseases. But the U.S. system of biomedical research is not built for speed, or to foster innovation and create accountability. The average lag time between health research and implementation is a staggering 17 years.
An estimated 500 to 700 of the 10,000 known human diseases have treatments or cures. That should give U.S. lawmakers a sense of urgency to fund critical scientific research to address patient needs and save lives. This would dramatically improve public health approaches and access.
The solution could be the Advanced Research Projects Agency for Health, or ARPA-H, a proposed model for driving transformative, biomedical breakthroughs that are not being accomplished through traditional research or commercial activity, according to the Office of Science and Technology Policy. At the recent House Committee on Energy and Commerce hearing, policymakers and advocates urged the establishment of ARPA-H with $6.5 billion in funding over three years.
Operating independently from the National Institutes of Health (NIH) and under the Department of Health and Human Services, ARPA-H would be “performance-based, milestone-driven [and] timeline-driven, with the efforts determined by the government,” testified Dr. Geoffrey Shiu Fei Ling, a neurology professor at Johns Hopkins Medicine and former director of the Biological Technologies Office of the Defense Advanced Research Projects Agency (DARPA), the model for ARPA-H.
With public-private cooperation, ARPA-H would incorporate input from industry professionals, patients, academia, health care and biotech companies, philanthropists and venture capitalists, as well as government and regulatory agencies. Collectively, they would address necessary research needs for widespread medical concerns such as Alzheimer’s disease, vaccines, cancers, genetic mutations, maternal morbidity and heart disease. Their work could include health care access and equity.
Unlike the NIH, which operates 27 research institutes and centers, ARPA-H would embody a business-minded, startup culture that rewards swift innovation and solutions-based projects addressing diagnostics, treatments and preventions across disease sectors.
Independence from the NIH is appropriate, considering the recent resignation of Eric Lander, policy director for the White House Office of Science and Technology and the presidential science adviser, following complaints alleging his intimidating work style. ARPA-H would augment, not replace, the NIH, widening the possibilities for improving American health care and limiting the impacts of disease.
The NIH in 2021 launched the Common Fund with a $640 million budget, and President Biden recently hailed the commitment to the Cancer Moonshot, but the U.S. needs much more groundbreaking research on a myriad of devastating health issues.
From 2017 to 2020, more than 240 research projects were conducted under the Cancer Moonshot, but that research is not reaching the patients who need it quickly enough. The NIH began in 1887 as a one-room Laboratory of Hygiene at the Marine Hospital in Staten Island, N.Y. With a 2018 budget of $37 billion in grants gifted to institutions and researchers, the NIH remains “the largest single public funder of biomedical research in the world.” Yet it is not enough.
Overseen by Congress, ARPA-H would treat each project as an investment — rewarding specific timelines, measurable outcomes, and successful moves to market and patient outcomes. It would be imperative to establish a culture at ARPA-H that fosters transparency, accountability to stakeholders, and speed of outcomes. DARPA, launched by President Dwight Eisenhower in 1958 to invest in breakthrough technologies for national security, has proven to be an efficient, effective way to drive innovation and prosperity — both privately and within the broader U.S. population.
In American health care, the current path from basic science to applied research to commercial viability is too slow. Research is not saving the lives of enough patients. ARPA-H could leverage research at the NIH and other federal agencies to deliver health breakthroughs.
We need a health research agency that is nimble, innovative, productive and created to give all Americans a healthier future. In progress since 2017, the pressing goal is to have Congress pass H.R. 5585 into law to establish ARPA-H as an independent agency. Not many issues are truly a matter of life and death, but this one is.
Sandi Drucker Wright is founder of Bespoke Impact Advisors, director of the Tamer Center for Social Enterprise at Columbia Business School, and a board member and treasurer of the Suzanne Wright Foundation.