We were divided on whether or not to support NIH putting this in NIH. This was simply because NIH is capable of doing it, according to one outsider familiar with the planning. He fears that NIH's rigid culture and lack of leadership will slow down the effort.POLITICO was told by a half-dozen people from the administration that they were involved in the discussions on the plan. They also said there are other options being considered, such as putting ARPAH outside Washington to avoid some of the Beltways inertia or turf battles. The theory is that more autonomy could speed up the process of scientific discoveries being turned into drugs or diagnostic tests.The consensus view is that the new agency will be part of the NIH infrastructure, which will allow it to grow and encourage communication in order to avoid unnecessary duplication. As Congress prepares to hear the first budget proposal, officials from the administration express confidence that ARPA-H will be able to create a unique identity wherever it is.Before a Senate Appropriations Subcommittee, Dr. Francis Collins, Director of the NIH, testifies about budget estimates for National Institute of Health. Sarah Silbiger/Pool via APFrancis Collins, Director of NIH, stated that [the established NIH culture] is a legitimate concern and that we must do everything possible to prevent it from becoming the default. He referred to the many components of his agency and said, "This is not going to become the 28th institute."Biden long desired to create a broad successor for the Cancer Moonshot, the $1billion initiative he started as Vice President during the Obama administration. This was in the hope of encouraging a decade of research on cancer in half the time, according to three people who know his vision. In the same 2016 Rose Garden speech, Biden announced the Moonshot, where he also stated that he would not be running for president because of the grief at the loss of his son Beau to brain tumors. In less than a year, President Donald Trump was still in office and the White House's focus on the huge research initiative had ceased.It would be a great step forward to make ARPA-H a federal government agency, so it can withstand such political winds and power shifts. The bar is high, particularly with Congress budget hawks and other skeptics that question the ability of a multibillion-dollar agency to do what others cannot.Rep. Andy Harris (R.Md.), stated that if it is a vision to only do advanced translational research... the NIH has the capability to do that already. Xavier Becerra, Health and Human Services Secretary, during a hearing about his department's fiscal 2022 spending plan.FILE – In this June 28, 2012 photo, Rep. Andy Harris (Republican from Maryland) speaks at a press conference outside of the U.S. Capitol. After a quiet primary, eight Maryland members of Congress will be able to fight off less-known opponents. Harris, a long-standing tea party supporter, seeks a third term. He is being challenged by Jonathan Goff Jr., Harford County's political novice. AP PhotoThe idea of a federal agency that would cut research barriers was first discussed in 2017 with a plan called HARPA. It was presented by the Suzanne Wright Foundation, a pancreatic cancer group. Critics argued that the original vision was too narrow and that a proposal to have the agency track mentally ill people in an effort to prevent mass shootings was too controversial. Two people who were familiar with Collins's views questioned the necessity of HARPA. POLITICO was told by the director of NIH that the Covid-19 pandemic, and Biden's support of ARPA-H had changed his perspective on what was possible.The National Center for Advancing Translational Sciences is already a department within the NIH that focuses on practical applications of scientific discoveries. Harris and other Republicans believe that this type of work should be done by the private sector. The NIH's mandate is basic science, such as mapping genes. This can serve as a foundation for further studies.Collins stated that ARPA-H can bridge the gap between industry and academic research, and encourage collaborations across federal agencies. He said that there is often a gap between practical science and basic science. This is where ARPA-H could play an important role.DARPA's model is not easy to replicate, but critics claim it is. Project managers have a lot of autonomy over their work and funding decisions. This model allows scientists to quickly succeed, but also allow them to fail quickly and move on to the next work. Ellen Sigal, chairperson of Friends of Cancer Research, sits on NIH's council of public representatives. Sigal has been involved in talks about the new agency. She said: If we want to do something bold like DARPA we need to know that we will fail.Collins acknowledged the limitations and benefits of the system that he oversees. The NIH's process for funding research is the most efficient in the world because of its rigorous peer review system. However, it is slow and conservative. It isn't going to take on the truly transformative projects that might result in someone sending you a grant request.Many of these big decisions, including which diseases to address and whether to focus on practical or basic research, will be made by ARPA's first leader. This could lead to an extremely high-stakes hunt for its founding director.This is an important decision as the first director of the organization will be made. They are setting the tone for the future. Tara Schwetz is assistant director for biomedical incentive in the White Houses Science Office. She is also creating a plan for new agency with Eric Lander, the White House's top science official. It is difficult to change culture. It is important to start from the beginning, as it can be hard to fix later.ARPA-H will be able to spend $6.5 billion over three years if Congress agrees with Biden's funding requests. This timeframe allows the agency to build its ranks and finance its first major projects. Schwetz and other experts agree that it is important to quickly win to build momentum and sustain congressional support. As advocates for Alzheimer's disease, cancer and other conditions push to shape their work, the agency will need to establish priorities.One chance at this is yours, and you only get one shot. A person who has been involved in talks between government groups or outside advocates said that it must have all the ingredients to succeed. ARPA-H must have an ambitious agenda so that it addresses the most pressing problems in a way that is accessible to all.
