A Biomedical DARPA? Yes, But Not at NIH

Creating a health-research counterpart to DARPA, the Pentagon's legendary Defense Advanced Research Project Agency, makes tremendous sense. DARPA, the freewheeling, cash-laden nest of sci-tech wizards, sired the Internet, stealth technology, the global positioning system, the Predator unmanned aircraft, and many more innovations throughout the Cold War and beyond. Call the biomedical version BARPA, and let it roll. Great. But if it's going to happen--and there's currently an influential proposal to do just that--do it right. Simply producing another stillborn bureaucracy (read: National Institutes of Health) that is obsessed with fulfilling every nit-picking piece of federal paperwork represents waste at its worst. Antibureaucratic and nimble, DARPA has long attracted envious glances from scientists and research managers, frustrated by the elephantine workings of the NIH, that colossus of biomedical research. NIH is renowned, rich, and politically coddled as the headquarters of America's war on diseases. With its bountiful billions, it has underwritten major sectors of the biomedical revolution. But, currently dispensing over $27 billion (US) annually (more than half of Washington's civilian research money), it's a place where nearly a year of deliberations precedes a yes or no on a grant application. Aversion to risky projects is woven into the NIH culture. On the other hand, DARPA is legendary for swift decision-making. Moreover, NIH's track record in picking winners is not as lustrous as its public-relations apparatus repeatedly claims. In stunning historic misreadings of scientific opportunity, NIH rejected early proposals for automating DNA sequencing, and it undertook the genome project only after the Department of Energy plunged in. Repeated Congressional directives were needed to prod the NIH into recognizing the behavioral aspects of disease as a legitimate research topic. Women's health research was a poor relation at the great biomedical institution until the Congressional Caucus for Women's Issues took up the cause. Research on the particular health problems of minority populations was similarly deficient until Capitol Hill growled at NIH management. Blandly titled the Director's Special Projects Program, what I call BARPA is the most interesting and important item among a slew of proposals made by the National Academy of Sciences, resulting from a Congressionally mandated study of NIH. Chaired by former Princeton University president Harold Shapiro, the study was mainly inspired by the continuing proliferation of new NIH institutes and centers. Responding to the pleas of disease lobbies that want their own research institution within the NIH empire, Congress over the decades has established 27 institutes and centers, each with its own budget, director, administrative staff, and Congressional guardians. The 27 are so autonomous that a former NIH director, the late Donald Fredrickson, once likened his job to the presidency of Switzerland. Proposals for more institutes are in the pipeline, with obesity leading the lineup for its own headquarters. Showing political acumen, the Academy committee played down the conundrum of how many is too many, noting that the separate entities attract public and political support for NIH. Furthermore, it argued, no sure formula exists for setting a proper number, but more important, proponents of the status quo would set off a costly political row should any attempt be made to consolidate the NIH's sprawling components. Organizational layout isn't the problem at NIH, the committee concluded. Rather, a major missing factor is power at the central core, in the director's office, particularly at a time when biomedical science is becoming big science, and health problems and research opportunities transcend the boundaries of individual institutes and centers. And another factor, it candidly noted, is the revered peer-review system, which "has a tendency to enforce conservatism by discriminating against research whose outcome is highly uncertain." To evaluate research at the "cutting edge," the report added, "fairly requires a culture, mindset, and process that views informative failures as the necessary price of strategic innovation." From this dual analysis came the major recommendations, namely, to give the NIH director control over 10% of the institutes' and centers' research budgets, and to create the Director's Special Projects Program, modeled on the Pentagon's DARPA, starting with $100 million per annum and quickly rising to $1 billion. Commendable prescriptions, except that planting the new biomedical agency within NIH is no way to emulate the repeated successes of the Pentagon model. Despite its creators' good intentions, the fledgling agency will be enveloped by the culture of timidity that remains solidly entrenched at NIH, despite numerous critical reports and repeated vows to do better. Let BARPA come into being, but it must exist far from, and independent of, the administratively complex and congested NIH headquarters. Exempt from the bureaucratic constraints that famously coagulate the great NIH, the new agency would be an affront to the usual way of doing business there. And in governmental back alleys, there are ways of dealing with such uppity threats. Daniel S. Greenberg is the author of Science, Money, and Politics, and is a guest scholar at the Brookings Institution while working on a book about the impact of commercialization on academic health research. function sendData() { document.frm.pathName.value = location.pathname; result = false if (document.frm.score[0].checked) result = true; if (document.frm.score[1].checked) result = true; if (document.frm.score[2].checked) result = true; if (document.frm.score[3].checked) result = true; if (document.frm.score[4].checked) result = true; if (!result) alert("Please select") return result; } .myradio{background-color : #94bee5} Please indicate on a 1 - 5 scale how strongly you would recommend this article to your colleagues? Not recommended 1 2 3 4 5 Highly recommended Please register your vote

A Biomedical DARPA? Yes, But Not at NIH

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