ARPA-H: Risky or Revolutionary? The Challenges and Opportunities of Biden’s New Biomedical Research Agency

The acceleration of COVID-19 testing platforms and vaccine development has demonstrated the possibility of expediting research for similar biomedical breakthroughs. However, the National Institutes of Health (NIH) lacks a framework to regularly sustain this type of research. A new federal agency, the Advanced Research Projects Agency for Health (ARPA-H), offers a unique opportunity to capitalize on the lessons learned from the COVID-19 pandemic and drive federal investment into high-risk, high-reward biomedical research. ARPA-H will mirror the flat bureaucratic structure of the successful Defense Advanced Research Projects Agency (DARPA) through the employment of independent project managers. ARPA-H is also unique in how it centers equity in the agency's core mission. These unique traits could enable the agency to fill the gaps in current biomedical research under the NIH. Nonetheless, ARPA-H’s implementation is not without challenges: its incorporation within the NIH has raised concerns regarding its ability to specialize in high-risk research and the diversion of funding away from the rest of the NIH. These worries can be mitigated through the separation of ARPA-H and the NIH. Successful implementation of the ARPA-H framework would supplement current NIH work, diversify the US federal research strategy, accelerate promising breakthroughs, promote equity in health, and transform the nature of biomedical research in the US.