Following a lengthy deliberation process, US health secretary Xavier Becerra determined on Wednesday (March 30) that a new high-risk, high-reward biomedical research agency known as ARPA-H will be part of the National Institutes of Health, STAT reports.
In early March, Congress passed the 2022 US spending bill, which included $1 billion of funds for the Advanced Research Projects Agency for Health (ARPA-H), an agency intended to accelerate the pace of biomedical research. The bill gave the Department of Health and Human Services (HHS), of which the NIH is a part, the power to decide whether the new agency would be independent or part of the existing institution. This led to a lobbying campaign by several policymakers and researchers to separate the agency from the NIH, which they say is bureaucratic and slow-moving, STAT reported earlier this week.
Others advocated for ARPA-H to remain within the NIH, to help accelerate the agency’s launch by drawing on existing resources. Last year, President Joe Biden called for the creation of the ARPA-H as a biomedical research version of the military’s Defense Advanced Research Projects Agency (DARPA), which is known for risky projects and “blue-sky” thinking and is partially credited for innovations such as the internet. Biden, along with former NIH director and interim White House science advisor Francis Collins and Sudip Parikh, the CEO of the American Association for the Advancement of Science (AAAS), supported the inclusion of the ARPA-H under the NIH umbrella. Collins tells Science that placing ARPA-H within the NIH would allow it to draw on the NIH’s “brain trust.”
An HHS spokesperson confirms to STAT in a statement that ARPA-H will be “under the auspices” of the NIH but that its director will report directly to Becerra. The new agency will exist “as a new member of the HHS family with a distinct mission that will focus on rapid application of knowledge and catalyzing breakthrough medicines and technologies,” he writes in the statement.
At a hearing held yesterday by the House of Representatives appropriations subcommittee, which oversees the HHS budget, Becerra said that by placing the director “under my supervision . . . what we’re hoping to do is show that there will be autonomy.” The NIH’s role, he says, will be to provide “the administrative work,” to launch the agency, reports Science. He added that ARPA-H will be physically separate. “We need to make sure it’s not anchored or tethered to doing things an older way,” Becerra said.
Science reports that Becerra’s decision faces opposition in the House and the Senate. A Senate bill proposes making ARPA-H part of NIH but specifies that its physical location be far from the agency’s campus in Bethesda, Maryland. The House proposal would make ARPA-H completely independent. That bill’s sponsor, Anna Eshoo (D-CA), comments in a statement to Science that the “decision to place ARPA-H in the organizational chart of NIH is an opportunity squandered.”
Some who’ve weighed in on the debate around where ARPA-H should be housed, including former DARPA director Arati Prabhakar, tell STAT that the NIH is too conservative to support the initiative. Geoffrey Ling and Michael Stebbins, two former federal researchers who years ago authored the original white paper outlining the ARPA-H concept, also oppose ARPA-H being housed within the NIH, STAT reports.
The NIH has a long history of funding basic research projects aimed at achieving attainable goals that don’t have strict benchmarks for success. NIH contracts are typically multiple years long, allowing projects latitude for scientific exploration. In contrast, like DARPA, ARPA-H will likely hire program managers on short-term contracts who will solicit research ideas and fund them almost immediately, according to Science. It will fund fast-paced, high-risk projects meant to accelerate the development of medical treatments. According to a Bloomberg editorial, this will allow contracts to be ended if experiments fail and resources to be redirected.
In the fiscal year 2022 budget, Congress allocated $1 billion for the new agency. On March 28, Biden released a budget proposal for fiscal year 2023 that asks for $5 billion for ARPA-H, Nature reports, though the actual budget has yet to be decided, and Congress considerably scaled back most of Biden’s more ambitious 2022 proposals, including his request for an initial $6.5 billion to launch ARPA-H.
Some lawmakers have expressed concerns that NIH’s 27 other institutes will receive fewer resources due to the focus on ARPA-H. “I think it’s a mistake to shift funding away from basic biomedical research into a brand-new program in 1 year” for an agency “that will take time to get up and running,” Tom Cole (R-OK), a leader of the House appropriations subcommittee, tells Science. Biden has proposed an increase in funding for the rest of the NIH, mostly via a request for $62.5 billion in funds to prepare the US for future pandemics and biological threats, reports Nature. Excluding the ARPA-H and pandemic preparedness funds, however, the proposal only requests a smaller-than-usual $275 million (0.6 percent) increase for NIH over 2022.