09 July 2021 Vol 373, Issue 6551
ARPA-H: Accelerating biomedical breakthroughs
By Francis S. Collins, Tara A. Schwetz, Lawrence A. Tabak, Eric S. Lander
Science09 Jul 2021 : 165-167 Restricted Access
A DARPA-like culture at NIH can drive biomedical and health advances
The biomedical research ecosystem has delivered advances that not long ago would have been inconceivable, exemplified by highly effective COVID-19 vaccines developed by global partners and approved in less than a year. The United States stands at a moment of unprecedented scientific promise and is challenged to ask: What more can we do to accelerate the pace of breakthroughs to transform medicine and health? Toward that end, President Biden recently proposed to create a new entity, the Advanced Research Projects Agency for Health (ARPA-H), within the National Institutes of Health (NIH) “to develop breakthroughs—to prevent, detect, and treat diseases like Alzheimer’s, diabetes, and cancer,” requesting $6.5 billion in the fiscal year 2022 budget (1). The idea is inspired by the Defense Advanced Research Projects Agency (DARPA), which follows a flexible and nimble strategy, undeterred by the possibility of failure, and has driven breakthrough advances for the Department of Defense (DOD) for more than 60 years. To design ARPA-H, it is critical to understand what is working well within the biomedical ecosystem, where there are crucial gaps, and the key principles of DARPA’s success.