Biden Proposes New $6.5 Billion Advanced Research Agency to End Cancer

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Cancer doesn’t care if you’re Democratic, Republican, Libertarian or Green. It strikes without prejudice or consideration. As President Joe Biden said Wednesday night in his first major speech to Congress, “I know of nothing that is more bipartisan.” 

The President was advocating in his address for a new health agency with a DARPA-like model to speed treatments by funding risky, highly-innovative health care projects. ARPA-Health (ARPA-H) would focus on the “big names” in disease such as cancer, diabetes and Alzheimer’s. Cancer is a cause near to President Biden’s heart after losing his son in 2015 to brain cancer. 

Although Biden has been talking of launching a massive health agency since the campaign trail, not much has been released about ARPA-H. The agency would be housed inside the National Institutes of Health with a $6.5 billion budget for 2022, according to a White House spending release earlier this month.  

Advocates for ARPA-H were disappointed about being under the NIH umbrella, as much of the group’s research doesn’t make it out of the lab due to lack of funding when a project is high-risk. 

“If it’s just another fund within the NIH, we’re not optimistic that it’s going to succeed,” said Liz Feld, president of the Suzanne Wright Foundation and part of a group of disease advocates who have pushed for ARPA-H since 2017. 

Using the DARPA model, decisions for project funding would be made by program managers. Instead of the traditional government approach of awarding multiyear grants, award payments would be driven by milestones. Any program not living up to its hype can be canceled by the program manager. 

Housing the new ARPA-H agency in the NIH umbrella may be the quickest route to launch, but advocates worry it will lack the structure and independence it needs to really make an impact. 

“It has tremendous potential at NIH,” says geneticist Michael Stebbins, a consultant and former White House science office official. “But it has to be based on contracts, the program directors have to have tremendous flexibility, and the ARPA-H director has to have the authority to make decisions. Otherwise, you’re just increasing the NIH budget.” Feld is less optimistic: “This is about a whole culture and operating structure that doesn't exist within the NIH,” she says. 

Congress gets the final say on numbers. Overall, the request is for a $9 billion increase to the NIH budget, bringing its total to $51 billion. The $6.5 billion allotted for ARPA-H is a good chunk more than what some expected for the first year. The intent being, presumably, that funds not cut into the 27 current institutes and centers of the NIH.  

Former chair of DARPA’s advisory council, David Walt, cautions that any new medical treatments that come from ARPA-H will still have to go through the lengthy testing and approval process that all new therapies go through. “It’s not like at [the Department of Defense], where you can invent a land mine detector and use it in the field 2 weeks later.” 

President Biden told Congress and the nation, “Let’s end cancer as we know it. It’s within our power.”