番茄社区

So you want to propose a project to that new federal agency, the Advanced Research Projects Agency for Health (ARPA-H)? Well, they have money available -- they just won't say how much.

"There isn't a set price for any given project, but rather we look for what is proposed, and is the proposal for the cost volume sufficient to achieve the work?" ARPA-H Director Renee Wegrzyn, PhD, said during a January 16 briefing with reporters. "That is all part of ARPA-H's budget."

Wegrzyn explained the agency's unusual funding framework during a Zoom call to announce a new project area focused on rural health. The project, known as the Platform Accelerating Rural Access to Distributed & InteGrated Medical care (PARADIGM), is designed to "enhance early detection and management" of diseases such as cancer "in rural communities across the nation," ARPA-H .

"So why did we launch PARADIGM? It's because the 60 million people living in rural areas are losing their healthcare infrastructure," Bon Ku, MD, MPP, PARADIGM's program manager, said on the reporter call. "One hundred rural hospitals have closed in the past 10 years, and 30% of the remaining 1,800 rural hospitals are at risk of closing at any moment ... PARADIGM is a platform to be able to deliver those hospital services conveniently to rural Americans to increase their access to essential healthcare services."

To accomplish this, "we aim ... to develop a mobile vehicle unit platform that essentially acts as a unit of a hospital," he continued. "This platform will allow patients to not only have virtual visits, but also to obtain advanced imaging tests like CT scans, MRIs, ultrasounds, lab testing, and also interventions ranging from maternal health appointments to sophisticated appointments like obtaining dialysis."

"We aim to provide hospital-level services in remote locations, so that rural Americans don't have to travel 10, 50, or 100 miles to get the care that they need," said Ku. He added that as an emergency physician himself, "I witnessed the wonders of American medicine, that we are able to improve the health of patients coming into the hospital -- but what if you can't access a hospital? Living in rural America shouldn't be a risk factor for dying earlier for most diseases."

Each of these mobile units will only see several patients at a time, Ku told 番茄社区. And it still could be more efficient than building a brick-and-mortar clinic in a particular rural area, he said. "There's a lot of investment in that, and the only problem is, what if those communities move, or patient needs change? Then that brick-and-mortar facility that had a lot of investment will not be able to provide the services that that community needs." A mobile unit can be flexible and can be customized to meet the needs of particular patients in a particular community.

Maternal health is a good example, according to Ku. "We've been hearing from stakeholders that maternal health services are disappearing from many rural areas of the country," he said. "A mom has to make, on average, about 15 prenatal visits. But what if those maternal services are 50 or 100 miles away? An expectant mother isn't going to be able to make those visits, so what we want to do is to be able to provide access to make it as convenient as possible for patients in many different clinical scenarios."

PARADIGM is only one of several project announcements ARPA-H officials have made in recent days. On January 11, the agency announced the launch of its Transplantation of Human Eye Allografts (THEA) program, which "intends to transplant whole human eyes to restore vision for the blind and visually impaired," .

The agency noted that although more than 70,000 people per year donate their eyes after death, "only parts of the eye, most commonly the front surface or cornea, are currently able to be used for transplantation. As a result, the millions of people blinded by conditions of their retina and optic nerve have no options for improvement. THEA aims to address this issue, as it would transplant the whole donor eye and reconnect the nerves, muscles, and blood vessels to the brain so that the eye can function for sight."

ARPA-H plans to do this by using new microsurgical techniques as well as genetic and cell-based therapies, to preserve or regrow nerves from the eye to the brain. THEA will concentrate on three areas, the press release said: retrieval of donor eyes and maintenance of the health of donor eyes until transplantation; optic nerve repair and regeneration; and surgical procedures, postoperative care, and functional assessment.

Two days before the THEA launch, on January 9, ARPA-H unveiled its Health care Rewards to Achieve Improved Outcomes (HEROES) program, a venture to encourage investment in community-level preventative care resources, especially in communities that have had difficulty accessing healthcare breakthroughs.

Under the HEROES program, ARPA-H will seek funding proposals from what it calls "Health Accelerators" -- groups like health consortiums or community health centers -- to address health challenges that lead to preventable deaths, including alcohol-related harms, cardiovascular disease and risks, opioid overdoses, and severe pregnancy and birth complications.

Last year the agency launched a series of other projects in a wide variety of areas, including strengthening the immune system, developing new cancer technologies, helping joints heal themselves, and combatting antimicrobial resistance. ARPA-H had an of $1.5 billion in fiscal year 2023, a $500 million increase over the previous year.

Correction: This story was corrected on Jan. 25, 2024 to clarify that ARPA-H funding is not a grant and that the mobile units will see more than one patient at a time.

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