Biden administration begins setting up new health research agency

The new Advanced Research Project Agency for Health will be an independent entity within the National Institutes of Health. Advocates welcome the agency but don’t want its funding to come at the expense of the NIH.

President Joe Biden’s administration is moving forward with his goal of establishing a new agency aimed at developing breakthroughs in medical research.

This week, U.S. Health and Human Services Secretary Xavier Becerra established the new agency, the Advanced Research Project Agency for Health (ARPA-H), as an independent entity within the National Institutes of Health.

Becerra also announced the appointment of Adam H. Russell as acting deputy director for the new agency. Russell is the chief scientist at the University of Maryland's Applied Research Laboratory for Intelligence and Security and has held key roles in federal science agencies. He’ll begin serving in the post in June.

The Biden administration has touted ARPA-H as taking a different focus from other federal research efforts. The White House has said the agency would focus on high-risk, high-reward research to find cures for diseases such as cancer.

Health and science advocacy groups have cheered the development of the new research agency, but they warn the NIH can't be deprived of critical funds for its core mission.

Congress authorized the creation of ARPA-H in the federal spending plan approved in March. The 2022 budget package included $1 billion for the new research agency, which is less than the $6.5 billion Biden initially requested.

Biden will appoint a director to oversee ARPA-H, the health and human services department said. The ARPA-H director will report directly to the secretary of health and human services, and not to the director of the NIH.

In his new role, Russell is charged with helping to establish the agency’s structure and to begin hiring staff to get ARPA-H running as quickly as possible.

"We are ecstatic that Dr. Adam Russell has accepted the challenge to help launch ARPA-H, President Biden's bold, new endeavor to support ambitious and potentially transformational health research in this country," Becerra said in a statement. "ARPA-H will have a singular purpose: to drive breakthroughs in health, including the prevention, detection and treatment of diseases such as cancer, Alzheimer's and diabetes.”

The new agency is modeled after the Defense Advanced Research Projects Agency, which led to breakthroughs in computing, the Internet, GPS and stealth technology. Russell spent several years as a project manager at DARPA.

Concerns over funding

While most health and science advocates have welcomed the creation of the new research agency, some health advocates have said they don’t want to see it financed at the expense of the National Institutes of Health, the chief federal source of funds for medical research.

Health and science advocacy organizations criticized Biden’s proposed 2023 budget because nearly all of the planned spending increase for the NIH would be directed to the new agency. Biden has proposed an additional $5 billion for ARPA-H. Excluding the money for the new agency, the NIH would receive an increase of less than 1%.

The Ad Hoc Group for Medical Research, which represents 371 organizations, universities and advocacy groups, signed a joint letter May 17 calling for robust funding for the NIH.

“The Ad Hoc Group strongly urges lawmakers to ensure that any funding for the new Advanced Research Projects Agency for Health (ARPA-H) supplement our $49 billion recommendation for NIH’s base budget, rather than supplant the essential foundational investment in the NIH,” the letter stated.

In the 2023 budget, Biden proposes $49 billion for the NIH, a $4 billion increase over current spending. However, after the funding is directed for ARPA-H, the NIH increase amounts to less than $300 million.

Groups such as Research!America and the Association of American Medical Colleges said they support the new agency, but urged Biden to offer a substantial increase for the NIH.

The American Society for Biochemistry and Molecular Biology has also voiced concerns about the prospect of the NIH failing to get the support it needs. The group said in April it “is concerned the current proposed budget for core NIH functions will leave basic scientific research behind, which is critical for discovery and innovation.”

‘A huge moment’

Many are excited by the development of ARPA-H and the Biden’s administration’s moves in establishing the research agency.

In a post on Twitter, U.S. Rep. Diana DeGette, D-Colo., called the Biden’s administration’s first steps to establish ARPA-H “a huge moment in our effort to create this new advanced research agency that will be tasked with curing some of the most difficult diseases – such as cancer, diabetes, Alzheimer’s & more!”

“Modeled after DARPA, this new agency will be asked to make the impossible, possible,” she said.

DeGette and U.S. Rep. Fred Upton, R-Mich., have sponsored the “Cures 2.0” bill to help finance medical research, and to support ARPA-H in finding novel breakthroughs.

Upton praised the steps in setting up the new agency. “ARPA-H will focus on game changing health research and can move faster than the current bureaucracy allows,” Upton said on Twitter. “Now we need Congress to pass authorizing language to ensure the agency is stood up right.”

If ARPA-H is going to fulfill its promise, some groups, such as the American Society for Biochemistry and Molecular Biology, said the new research agency needs to operate outside of the NIH.

In a letter to lawmakers last year, the society wrote, “ARPA-H must have a significant amount of autonomy and independence from the NIH. This does not mean that ARPA-H cannot not work closely with the NIH; the two organizations will collaborate closely and pull from each other’s expertise and research efforts. But there must be a clear distinction between ARPA-H's research priorities and the NIH’s efforts funding basic biomedical research.”

Since the new agency’s director will report directly to the health and human services secretary, ARPA-H could get the independence that some advocates are seeking.

The president has been a vocal supporter of investing in medical research. Biden led the “cancer moonshot” effort when he served as vice president under President Barack Obama. Biden’s son, Beau, died of cancer at the age of 46.

In his State of the Union address, Biden touted the promise of the new research agency and urged lawmakers to support it, saying, “Let’s end cancer as we know it.”