February 23, 2022
On Tuesday, February 8th, the Health Subcommittee of the House Committee on Energy and Commerce (E&C) held a public hearing, “ARPA-H: The Next Frontier of Biomedical Research,” to discuss President Biden’s proposal for the Advanced Research Projects Agency for Health (ARPA-H). ARPA-H would establish a new research agency to “develop breakthroughs—to prevent, detect, and treat diseases like Alzheimer’s, diabetes, and cancer.”
The Committee sought testimony from experts in health research and development in the public and private sectors. This included two witnesses with experience working at the Defense Advanced Research Projects Agency (DARPA) – on which ARPA-H is modeled. Members of Congress pursued questions to identify the key challenges that a new approach would be necessary to overcome and create a clearer picture of the structure and mechanisms to ensure the new agency’s success.
Much of the conversation focused on whether ARPA-H should be housed within the National Institutes of Health (NIH) or created as a separate, independent agency. (There are two bills currently under consideration in the House which would establish ARPA-H; Cures 2.0 would place the agency within NIH and the ARPA-H Act would make it independent.) Most witnesses recommended an independent agency. They argued that the new agency must use different approaches, have a unique culture, and be flexible and nimble enough to adapt quickly. Essentially, if the goal is to create an agency that accomplishes what NIH is unable to, it cannot be constrained by the culture and structure of that institution. One witness, however, Esther Krofah, Executive Director of FasterCures and the Center for Public Health at the Miken Institute, advocated that NIH has the capacity to accomplish the goals of ARPA-H, citing other successful initiatives, such as Rapid Acceleration of Diagnostics (RADx), that have incorporated innovative approaches within NIH.
Transparency and accountability also emerged as important considerations. Witnesses emphasized that the success of DARPA is based on clear accountability requirements that empower program officers to adjust projects based on participants’ ability to meet measurable benchmarks of progress. This also emerged as an area of some contention. Several members of the Committee, especially Rep. McMorris Rodgers (R-WA), raised concerns about inefficiencies and a lack of transparency at NIH. They questioned whether we should be spending more money to create a new agency rather than reforming and streamlining what we already have.
ARPA-H represents a potentially significant new investment in health research. FABBS has had the opportunity to be engaged in the development of the ARPA-H proposal. We will continue to monitor progress on Capitol Hill and in the Executive Branch as policymakers narrow in on the shape that this agency will take.