Speed, Agility, Opportunity
122nd ACD Discusses Wide Range of Topics
A lot has happened in the few months since President Joe Biden told a joint session of Congress on Apr. 28 that he wanted NIH to have a new component with the “singular purpose—to develop breakthroughs to prevent, detect and treat diseases like Alzheimer’s, diabetes and cancer.”
The proposed organization, an “Advanced Research Projects Agency for Health” (ARPA-H), to be built using DARPA (Defense Advanced Research Projects Agency) as a model, moved swiftly into high-level conversations—from briefings with lawmakers visiting NIH to hearings with NIH leaders visiting Capitol Hill.
Recently, NIH director Dr. Francis Collins moved ARPA-H further ahead, bringing the concept to his top thought leaders outside the agency—the advisory committee to the director (ACD). The group gathered June 10-11—virtually again—for its first meeting of 2021.
Accent on Boldness
And, who better to present the paradigm-shifting ARPA-H premise than the President’s chief science advisor and director of the White House Office of Science and Technology Policy Dr. Eric Lander, the first biologist appointed to the post and the first person to hold the position at Cabinet level. He’s also a longtime NIH friend and a former ACD member.
“There are at least two reasons why we should always be thinking that even though we have the most amazing biomedical enterprise ever created, why couldn’t it be better?” Lander said, after pointing out the nation’s extraordinary biomedical ecosystem driven by two powerful forces—fundamental biomedical research and a vibrant commercial sector—that “connect in this virtuous cycle” to discover knowledge and therapies beneficial to all.
But, he asked, are there things missing in the ecosystem? And isn’t now the perfect time to tackle some big questions in science that don’t naturally fit into the current research apparatus?
Advances in the last decade or so have shown what’s possible, he said, and the current “moment of unprecedented scientific promise” challenges us to look at critical gaps in the traditional research structure.
Noting that speed, risk and agility would be critical elements of ARPA-H, Lander said, “The idea is to have this entity coupled closely to NIH so it can draw on the vast knowledge, expertise and activities of NIH…but it should be different. It should be something with a unique culture, organization and independence to take risks and do things in different ways.”
Another familiar face, NIH associate deputy director Dr. Tara Schwetz, currently on detail to OSTP, outlined aspects of DARPA that a fledgling ARPA-H could adapt.
ACD members expressed both excitement and some concern.
“Nobody’s sold yet that we have [ARPA-H design] exactly right,” Collins acknowledged, “but we have a pretty interesting shape that now needs some of those details to be filled in, and that’s what we’re going to be doing.”
Listening Sessions on ARPA-H have been planned. See sidebar below for schedule.
Progress Versus Covid
The 122nd ACD meeting deliberated for more than 10 hours spread over the course of 2 days. Collins began day 1 of the ACD meeting as usual with a director’s report covering NIH news, events, as well as budget and legislative outlooks that had developed since the December ACD gathering.
Of course, in the age of worldwide pandemic, “normal” updates have given way to progress reports on NIH’s advances against Covid-19.
Most of the first day focused on updates from senior leadership: NIAID director Dr. Anthony Fauci discussed vaccines. NIAID deputy director for clinical research and special projects Dr. Clifford Lane and NHLBI director Dr. Gary Gibbons talked about accelerating Covid therapeutic interventions (ACTIV).
NIMHD deputy director Dr. Monica Webb Hooper and NHLBI senior advisor Dr. George Mensah briefed the group on the Community Engagement Research Alliance (CEAL).
“We have begun to surface a number of important insights from the work of field research teams who are on the ground working in real time—listening humbly and in a bi-directional way,” noted Webb Hooper. “Their work is shaping the adaptation of public health messages and interventions, based on engagement within communities.”
Field insights from more than 100 engagement activities include notable misinformation about Covid-19 and vaccines, elevated vaccine hesitancy and low vaccine confidence, inequitable access to vaccine, and overall adverse effects of the pandemic on mental health. For the latest CEAL news, visit https://covid19community.nih.gov/.
NICHD director Dr. Diana Bianchi and special assistant to the NIH director for Covid diagnostics Dr. Rachael Fleurence described progress with rapid acceleration of diagnostics (RADx).
NHLBI deputy director Dr. Amy Patterson ended the Covid presentations with a report on RECOVER (researching Covid-19 to enhance recovery), NIH’s comprehensive effort aimed at understanding and addressing long-term effects of the illness (also known as PASC, or post-acute sequelae of SARS-CoV-2).
NIH deputy director for extramural research Dr. Mike Lauer and NIH deputy director for management Dr. Alfred Johnson closed the day’s session with a presentation on NIH efforts to redress harassment.
UNITE Update Offered
Day 2 began with a report on UNITE by its co-chairs, new chief officer for scientific workforce diversity Dr. Marie Bernard, Johnson and NIH principal deputy director Dr. Lawrence Tabak. A representative of each of UNITE’s five subcommittees briefly discussed objectives and long- and short-range targets to eliminate structural racism in biomedical science at NIH and in the broader scientific community that NIH funds and influences.
“Francis has done something extraordinary,” said ACD member Dr. James Hildreth of Meharry Medical College, after UNITE’s presentation of its initial goals and progress. “What [NIH is] doing is going to change the prospects for folks who look like me in research for many decades to come.”
NIH Office of Strategic Coordination program officer Dr. Gene Civillico and NIH deputy director for program coordination, planning and strategic initiatives Dr. James Anderson talked about the Common Fund’s Bridge to Artificial Intelligence initiative.
Final Report Delivered on Animal Research
The ACD working group on enhancing rigor, transparency and translatability in animal research delivered its comprehensive 53-page final report, which contained a number of recommendations organized in five themes.
“What we’re all working toward,” concluded working group co-chair Dr. Barbara Wold of California Institute of Technology, “is a much more robust body of knowledge—for the time that we scientists put into the entire enterprise, for the use of animals in the most ethical way, for the dollars coming from the public and, ultimately, for the amount of benefit that we all get from improved health care.”
After discussion, ACD members voted unanimously to accept the group’s report, which is online at https://acd.od.nih.gov/documents/presentations/06112021_ACD_WorkingGroup_FinalReport.pdf.
Adjourning the 2-day meeting, Collins congratulated the group for surviving the marathon Zoom session with resilience and enthusiasm.
“It has been quite an intense and widely divergent set of topics that we put in front of you,” he said, noting the impact of occurrences over the last 18 months of global pandemic coupled with national civic unrest. “We are energized by your presence and the opportunity to talk about these things. We do grow weary at times, but we don’t lose heart. We’re privileged to be involved in this noble enterprise of biomedical research. We do shoulder a lot of responsibilities, but we embrace that.”
With notes of optimism, a video of Collins performing his Covid-specific rendition of Here Comes the Sun closed the meeting.