New federal funding model for 'medical moonshots' shared during a virtual talk at Johns Hopkins

In 1958, a year after the Soviet Union successfully launched Sputnik, the world's first satellite, President Eisenhower created the Defense Advanced Research Projects Agency (DARPA) to provide key investments to teams of researchers in academia, industry, and the government to speed the development of breakthrough national security technologies. The rocket engines that took us to the moon are but one of its fruitful outcomes.

Two years ago, President Biden created the healthcare equivalent within the U.S. Department of Health and Human Services called the Advanced Research Projects Agency for Health (ARPA-H). Its streamlined awards process advances high-potential, high-impact biomedical and health research that cannot be readily accomplished through traditional research or commercial activity. It's been billed as "an agency for the next moonshots."

"It's all about harnessing creative solutions and new technologies to tackle the nation's most difficult healthcare challenges," said School of Medicine Dean Theodore DeWeese Tuesday during the Johns Hopkins Policy Forum, a virtual conversation with ARPA-H director Renee Wegrzyn and Kimberley Steele, who became an ARPA-H program manager last fall. Steele, a former associate professor of surgery at the Johns Hopkins University School of Medicine, now leads the Lymphatic Imaging, Genomics, and pHenotyping Technologies (LIGHT) program at ARPA-H to pursue comprehensive diagnostic tools and revolutionize detection of lymphatic dysfunction.

Steele, an expert on bariatric surgery, the gut-brain axis, and obesity, explained that she became interested in lymphatics after her son was diagnosed with a rare lymphatic disorder in what was a lengthy and challenging ordeal. As a program manager she has an initial three-year term (which can be renewed once for a maximum six-year term) to assemble and fund teams of researchers and scientists focused on the challenges of lymphatic disease. "The problem is that millions of Americans are going misdiagnosed or undiagnosed because clinicians don't have the diagnostic tools to assess lymphatic structure and function," she said, while also calling out a lack of biomarkers to help with early detection of lymphatic disease.

Wegrzyn described program managers, of which there are now more than a dozen currently focused on a range of healthcare challenges, as the "CEOs of their program responsible for making sure they solicit their ideas and fund the best teams." And she said giving these impassioned and highly motivated leaders a limited time frame "is like a pit bull with a bone versus someone being handed a project—your clock is ticking."

She also explained that there can be many reasons why certain potential healthcare advancements are underfunded through conventional means. "It might be too technically risky, or the market size is small, or there's a lack of understanding about how to transition a capability to the marketplace," she said. "Those are all completely fine for us and we want to solve not just the technical problems, but the sort of ecosystem problems around them."

Next up for Steele and LIGHT is a hybrid proposer's day in Philadelphia on May 14. It's a call for pitches outlining breakthrough research and technological advancements to improve health outcomes across patient populations, communities, diseases, and health conditions. In-person registration is open now and closes at 5 p.m. EDT on May 14; virtual registration closes May 10 at 5 p.m. EDT. For those seeking to engage with ARPA-H, you can submit project ideas, request to become a program manager, or signup for the newsletter.

"ARPA-H is a unique opportunity, and we tend to have very well-resourced programs, typically between $50 and $150 million," Wegrzyn said. And the streamlining begins when proposals are first presented. "Our approach is if you can't get your idea across in three pages, you're not going to get it across in 50," she said. "So, let's not waste each other's time and just be really concise and clear about the health outcome that you're going to impact and how you're going to do that."