Have a Way to Beat an Illness?These Federal Experts Need to Hear From You 

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Margaret Flinter ( 00:01 ):
Recorded on location at Aspen Ideas Health in Aspen, Colorado.
Mark Masselli ( 00:12 ):
Is there a radical new way to stop cancer and Alzheimer's? And can a new innovative government
agency succeed where others have failed?
Renee Wegrzyn ( 00:21 ):
We bring in these technical experts that very clearly see these gaps, and then they just are just
passionate about addressing those. And so in the case of cancer, it wouldn't be saying, "I want to launch
a program to cure cancer." I want to launch a program to address digital histopathology, which is three -
dimensional analysis of tumors.
Margaret Flinter ( 00:41 ):
We're talking today with two highly accomplished people who are playing critical roles in this new
effort. They're scientists. They have extensive credits to their names. Renee Wegrzyn is the director of
the Advanced Research Projects Agency for Health, ARPA - H, as it's commonly called. Amy Jenkins is the
Director of Health Science Futures. They're our guests here today at Aspen Ideas Health. We are
delighted to come to you live as opposed to our often virtual shows.
Amy Jenkins ( 01:10 ):
We want ideas from across the country and there's great ideas across this country at a variety of
institutions, and we want those ideas brought to us. This is a solution for all people. We're not going to
get to that solution if we don't have all people bringing us the ideas.
Margaret Flinter ( 01:23 ):
And this is Conversations on Healthcare.
Mark Masselli ( 01:34 ):
Well, welcome to both of you to Conversations on Healthcare.
Renee Wegrzyn ( 01:34 ):
Thank you.
Amy Jenkins ( 01:34 ):
Thank you.
Mark Masselli ( 01:37 ):
And let me start with you, Renee. Tell us more about the Advanced Research Project Agency for Health.
Renee Wegrzyn ( 01:45 ):
You got it.
Mark Masselli ( 01:46 ):

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I got it right. Oh my God, I was just, there was that moment. But it's about one year old, give or take.
And it really has incredible aims in terms of what wants to achieve. But I think for many of our listeners,
it's a new name, new concept, but a bold idea.

Renee Wegrzyn ( 02:04 ):
And this is really the vision of President Biden. So a little over a year ago, he announced and call on
Congress to fund ARPA - H to be a place that we can take these really big bets on health, big audacious
ideas to work towards cures in cancer and Alzheimer's, but actually be agnostic and be an agency that
could launch a multitude of moonshots for health moving forward. And so a really special part about
ARPA - H is there's not a single one of our dollars is aligned to a single disease or technology, but instead,
we want to really address these big problems in health. And we do that in a really special way through
our program managers that come in for short - term appointments to really take that shot on goal, to
solve that problem, and then rinse and repeat. We bring a lot through address those problems going
forward.

Mark Masselli ( 02:51 ):
So that's a radical approach, right? That's new to maybe NIH. I'm not sure. Maybe it will be as part of an
independent agency within NIH. But who came up with that concept of how to manage new projects?

Renee Wegrzyn ( 03:05 ):
So it's not a brand new concept. DARPA, the Defense Advanced Research Projects Agency, has really
developed the business model of being able to pursue, in their case, breakthrough technologies for
national security in a problem - based approach, but really taking that business model where you give a
lot of autonomy to those program managers to pursue those goals. But it's really the Congress that gave
us our authorities to do special things like have direct hiring authorities. So we can hire the experts who
want to solve these problems very quickly, that we can bring in - house and a lot of autonomy in decision -
making. So while we have been stood up within NIH and we have a wonderful relationship, especially
with the technical world - class experts that work there, we bring in their insights to ARPA - H, but we're
the ultimate decision makers. We set the timelines, we set those really aggressive milestones because
that's our unique role in the ecosystem, to take these big risks that NIH, that the private sector can't
take, and then we de - risk it and then it leaves the agency. So that's really this new piece for us.

Mark Masselli ( 04:07 ):
Margaret. I just was recollecting as you said, that you can hire your own agency. We're here at the
Aspen Institute and last night we had this unique opportunity to have three secretaries of HHS, and one
of their advice was, make sure you get to hire your own people, which I thought was -

Margaret Flinter ( 04:21 ):
Yeah, I think they meant higher and fire your own people was kind of the subtitle there. But you're at
this incredibly exciting time, aspirational, the vision is laid out for you and such opportunity. Money of
course, matters in these things, and we followed the progress. I know the president originally you had
hoped a $6.5 billion budget and in the end, 2.5 billion. Still a lot of money. But tell us, as you think about
what happens over these next couple of years, is it enough to launch the kind of work, we know it's
going to go on for a long time, but is 2.5 billion for you to really lay out this and carry out this ambitious
agenda of design for yourselves? Amy.

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Amy Jenkins ( 05:06 ):
I think that the two and a half billion is going to give us a great start. We've got program managers here
now. We have five program managers that are hired, they're on our website. We have more coming
every month. Those program managers, as Renee mentioned, are going to bring in their great ideas,
their innovative ideas, and they're going to ask for budgets associated with those. And of course, we're
good stewards of taxpayer dollars. We scrutinize those budgets, but this two and a half billion certainly
is going to get us a good start on this. And we have program managers that already have some
programs. And in this round, one of our first programs was announced just over a month ago now, the
NITRO program out of the Health Science Futures office. We're very proud of it. And an audacious goal
to eliminate osteoarthritis, the reverse the effects of osteoarthritis. This is just an example of some of
the things that we'll be able to do -

Mark Masselli ( 05:50 ):
Which is important for those of us getting older.

Amy Jenkins ( 05:52 ):
You don't know anybody that isn't going to need a knee replacement or a hip replacement in the future.
We haven't met anybody out there that says, "Oh, we don't need osteoarthritis reversal." So this is a
good example of the types of things that we'll be able to do with this funding and with these program
managers as they come on board.

Margaret Flinter ( 06:07 ):
And these program managers, if I can just ask, I went a little bit exploring on this content expert
specialists in the problem or experts in the management of a research project to get to a certain end, or
both?

Amy Jenkins ( 06:22 ):
Both. Program managers tend to be a very unique type of person, a very unique personality. We ask for
both the personality and the idea. So they need to be technical experts in their realm. They need to
understand this field. They oftentimes are practicing physicians or practicing professors or have been in
industry for many years. They understand the gaps in the healthcare system, and they also have a real
passion and a drive to push and motivate people. That's one of the most important things that a
program manager does, and I think maybe is some of those little less than tangible, less than scientific.
Can you motivate a community to go out and do something that's audacious that they've never
considered doing before? Do you have that personality? The example that I'll use in our NITRO program,
our first program manager that launched that program, Dr. Ross Uhrich, he's a surgeon and he's dealt
with many people and he's replaced joints. And he said, "I could do this for the rest of my career, or I
could try to fix the problem from the source."

Mark Masselli ( 07:18 ):
Renee, you started off talking about the audacious nature, and I was thinking about how President Biden
originally said that, which was completely doable, to cut cancer rates by 50% over the next 25 years.
That is a lofty, lofty, and audacious goal. Do you think you have the resources to do that? And I know
you're probably trying to level set what are the expectations for the general public? Maybe talk about
what you think might be realistic to look at, and yet, the president has been such a great champion and

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spokesperson around the issue, around cancer that he's dealt with on a personal level. And obviously,
this is something Americans are and everyone around the world is very concerned about as well.

Renee Wegrzyn ( 08:04 ):
Right. Absolutely. And it's very personal for the president, obviously. Personal for myself as well, I lost
my mother to cancer. And so we know that there's a lot left to do. And there isn't going to be, I think
one cure for cancer. There's so many different types of cancers. And the way you should think about
ARPA - H in this context is again, as Amy said, we bring in these technical experts that very clearly see
these gaps, and then they just are just passionate about addressing those. And so in the case of cancer,
it wouldn't be saying, "I want to launch a program to cure cancer." I want to launch a program to
address digital histopathology, which is three - dimensional analysis of tumors using AI to help accelerate
diagnostics and then make that accessible from bridging from the innovation that happens in a research
lab all the way to the clinic where that gap is, it's not closed today.
( 08:52 ):
And so in a three year investment, let's say, it's up to the program manager to set these timelines, but
how can I set this goal to get to that seamless diagnosis and delivery of that data into the clinic? And
then everything that needs to happen in that three years. And so across the moonshot objectives, we're
looking for opportunities for ARPA - H too, that we know with our investment, it's so high risk that if
we're successful, it's going to just change the state - of - the - art. And so whether that is looking at
screening or surgical interventions is an area that we think there's some opportunities there, for
example, that's where we're really going to make those big shots on goal.

Mark Masselli ( 09:31 ):
And when you're hiring somebody for a three year, is there a KPI? Are there deliverables that they have?
And I was thinking like investment firms, they didn't get there in a year and a half, they're sort of gone.
What's the strategy?

Renee Wegrzyn ( 09:46 ):
So it's just like an investment firm, it's a portfolio approach. So first my approach and Amy's approach to
developing our offices and our program managers. We have a portfolio of problems that we want to
solve. This year, we have a goal that we've set for ourselves to hire 20 program managers. Those should
be in 20 totally different areas, technical experts. Maybe we have a surgical expert, maybe we have an
osteoarthritis surgeon on staff. All of those folks are relevant. And also help, I think just create the
imagination for the public to say, "Okay, I get it now, what ARPA - H is going to be about."
( 10:22 ):
Now, then inside those programs. So Ross, for example, who's launching this NITRO program, he has
announced how he wants to get to a solution in five years in the clinic. And he's asked the performer
community is what we call the people that we fund to say, bring me your idea of how you are going to
get there. So he won't prescribe a solution. And then he's going to select several teams and then it's up
to him. He's going to set those metrics and milestones and measure them. And as the manager of that
program, he will divert resources if he needs to, he'll double down in places where he needs to. And so
that's that really active program manager and being a good steward of taxpayer dollars. But at the end
of the day, maybe not all the teams make it to that final solution, but he's always driving towards that.
And I'll actually invite Amy to share failure's okay too, and what that could mean for ARPA=H.

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Amy Jenkins ( 11:14 ):
Yeah, I think related to what you were saying, Renee, one point I do want to make is that we look for
audacious goals. We're trying to really change and be very revolutionary. And so the idea of curing
cancer, we want to look at very defined problems because when you define the problem, then you can
define the end goal. So that's what you need. You may take a chunk of the goal towards curing cancer
and work on that one defined problem related to maybe surgical outcomes, as Renee mentioned.
( 11:41 ):
And so we also, in the process of defining those goals and thinking about what the future holds and how
we could be revolutionary, we want to take risk. You don't change the world if you're not risky. But we
also want to have some successes. I will point to a former program manager that I worked with at
DARPA. He said that, "If you don't invent the internet at DARPA, you get a B. And I'll give him full credit
for that quote, but it's true. We still want successes even though we're being very, very risky. And so we
look for things called successful failures. If we are looking for the 100% goal and we only reach the 75,
the program, writ large, the metrics may not have been met. But the 75% goal actually might be quite
revolutionary and still changed the world.

Margaret Flinter ( 12:25 ):
That's great. Well, I know you referenced DARPA and we know you both served there, the Defense
Advanced Research Projects Agency. Like Mark, I'm trying to make sure I get that whole name in there.
And we now know, and I think it's widely known that DARPA was about creating the internet and GPS,
which I'm very grateful for, being directionally challenged. But I don't recall ever hearing about that
while it was in play.
( 12:47 ):
And I'm wondering, as you design ARPA and have the freedom to be a little more creative, are you going
to be more like Francis Collins and All of Us Project where from the very beginning of that 10 year
project, they have made sure to be widely communicating with the American people and with the
people it was most likely to impact and wondering, what's that balance? Do you have an active strategy?
Are one of you in charge of that strategy for really letting the American people know what are the
projects that you're working on and why should they care about this? Which of course might translate
into why should they be supportive of additional funding. Tell us about your thinking and strategy on
that.

Renee Wegrzyn ( 13:24 ):
Maybe I'll kick us off and then hand it off. So what's really unusual about ARPA - H when you compare to
DARPA, our customer base is so much larger. It's all Americans and probably the whole world in fact. But
even if we just focus on all Americans as a huge audience, and from pediatrics to geriatrics and rural and
urban. And so we really thought a lot about how do we reach those patients? Because we're here to
build this bridge between innovation and getting this to the American people. Our mission is to
accelerate better health outcomes for everyone. And so really take that to heart, that everyone piece.
( 13:56 ):
And so there's two things I kind of want to mention. One is we got a little bit creative and we did
something called the ARPA - H Dash. So we have a prize authority and we put just a small $15,000 prize
just to solicit ideas from the general public. So it could be my kids submitting an idea, but also serious
researchers out there. What are the types of ideas that ARPA - H should be working on? And so we did
this as a bracket style challenge, launched in the March timeframe. And so every week we did a little bit

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of a down select to get folks voting on these ideas. But we are training the public to think in the ARPA
model. So we have this set of 10 questions called the Heilmeier questions that frame every problem. So
it's what are you trying to do? What's the problem you're solving? How is it done today? What's new in
your approach?
( 14:43 ):
And those three questions we made everybody who submitted an idea answer those questions so they
understood that we are different from... so to directly answer, are we going to be like the Francis
Collins? No, because this is how we address it. And then they asked them to provide a piece of evidence
of why they thought now is the time to make this investment because there's a patent or there's a paper
that shows this is possible, there's a new company that's working on that. So that was one fun way I
think, to really engage the public and get them thinking the way that we are and we're thinking about
future ways to continue that engagement.
( 15:15 ):
The second is Congress and their infinite wisdom has given us three geographic sites for ARPA=H, but
only 210 employees. So there isn't any one office or three offices that really represent all American
geographies that we want to serve. So we kind struggled with this a little bit. How are we going to really
reach all Americans? We have such a small footprint. So we've decided to actually use this as an
opportunity to launch a hub and spoke network where we can have three hubs, but each hub really is
tasked with recruiting 50 state level spokes where we can, if there's a new osteoarthritis program, which
there is, that is launching a clinical trial that needs to address a diverse population, which is a
requirement of the program, that it can't just be a clinical trial, it has to be one that's representative of
the diversity of patients, we can lean into this network to actually get those people enrolled in clinical
trials and accelerate those health outcomes.
( 16:11 ):
So by design, we're trying to build this in. And the way we've been describing this is, yes, the internet
came from DARPA. It was called the ARPANET, the original four nodes. So this is the ARPANET for health.
And so this is a connection of people, of institutions to really come together and serve ARPA - H. And so
that's our latest experiment. But I know there's other ways we're reaching out, so I'd love to hear what
you think about it.

Amy Jenkins ( 16:33 ):
We absolutely want people to know what we're doing. So unlike DARPA, we don't maybe have that
mystique and we don't want that mystique.

Margaret Flinter ( 16:33 ):
You don't have defense in front of your name.

Amy Jenkins ( 16:39 ):
Right. We don't have defense in front of it. Although DARPA was very open as well, we want to be very
open. Frankly, we want patients, we want advocates, we want doctors, we want healthcare providers to
be talking to us so that we know what the problems are. We don't want to do this in a bubble, in a
building in Arlington. We want to ensure that we know what the problems are and we will go out into
these communities. We have what we call PM excursions. And so the PMs will go out and immersion
experiences. They'll spend time in these communities so that they understand what the problems are

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and so that they can think about what their next program might be. If it's osteoarthritis today, maybe it's
something completely different tomorrow. And so we want those interactions.
( 17:19 ):
The other thing I will say is that while a lot of folks say, you mentioned how DARPA invented the internet
and did all these things in GPS and we didn't know about it. I don't know that DARPA knew about it
when they were doing it.

Mark Masselli ( 17:30 ):
That's right.

Amy Jenkins ( 17:31 ):
They didn't know this was going to be coming. So a lot of things that we're funding and the advances
we're making, we may not see the fruition of that for 20 or 30 years. But we're laying the seeds,
particularly in the Health Science Futures office, that's really our goal in this ecosystem, is to lay those
scientific and technological seeds so that we have these great advances in the future. And so you might
not even know that the imaging device that's going to be used on your grandchildren and my
grandchildren was a seed that we laid in the Health Science Futures office in the next five years.

Mark Masselli ( 18:01 ):
That's great. Margaret, I so much like the idea of the prize. I'm a Trekkie, and there used to be a
tricorder prize. So I have to sort of think about, am I going to do a Sheldon award or something for
young people to be thinking about that. But I want to just pull the thread on the issue around
communication because it's not only the American public, but you have Congress. And you have a
change in Congress that has happened. You've got some people who voted for this legislation, and yet,
had reservations about its location in NIH. What's the general communication strategy around
Congress? This is such an important program. We want it to be be bipartisan, and I'm sure you want it to
be bipartisan as well, and why that hub and spoke model makes sense. What's happening on the hill
around this? What do you need to do? You're both knee - deep in the let's produce something, but you
also have responsibilities to make sure that Congress and the government is supportive.

Renee Wegrzyn ( 19:01 ):
So we didn't have our authorities when I walked in the door. And so it was a little bit of a risk taking the
job because as you heard in the panel last night, there's certain things you want, must haves for being
successful. And so the first three months that I was at ARPA - H, I spent a lot of time on the Hill meeting
directly with members and their teams and just letting them know when I'm not here and you're in a
room and you're talking about ARPA - H, these are the things that you cannot compromise on and here's
why. And I always had listening ears for every member that I met, regardless of where they were from
and what party. And at the end of the day, everybody wants ARPA - H to be successful. They may have a
slightly different vision and passion for what they hope that we invest in, but health is universal.
( 19:45 ):
We all struggle with it, we all want there to be better solutions, faster solutions. And so it's really leaning
into that common thread that we all have and figuring out how can we bring everybody to the table?
And I do ask every member what specifically, what does success look like for ARPA - H? And what a
learning opportunity for me.

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Mark Masselli ( 19:45 ):
That's right.

Renee Wegrzyn ( 20:02 ):
So speaking with some folks in rural areas, really just addressing substance abuse and how do you
address that? Others, very passionate about cures for cancer, which makes absolute sense. Others,
making sure that marginalized communities are brought along and that we don't generate another
million dollar gene therapy coming down the pipeline. And so we take all of those nuggets and make
sure as we make investments in those areas to let them know," Hey, we're investing in these areas that
you care about. Here's our growing portfolio." And so it's been a great conversation moving forward.
Everybody does want ARPA - H in their district or their state. And so what we really are emphasizing is
ARPA - H is everywhere. If we're doing our jobs right, ARPA - H is everywhere. As we launched new
programs, Ross just had a proposer's day in Minnesota, Minneapolis. So really trying to get out there
and engage communities and have a presence is so important.

Mark Masselli ( 20:56 ):
Can I just pick up on the issue of marginalized population? Margaret mentioned Francis Collins work on
All of Us, and it's a program that's near and dear to our heart. We're part of the IRB development for
that.

Renee Wegrzyn ( 20:56 ):
Fantastic.

Mark Masselli ( 21:10 ):
And you've got so much data out there, but it doesn't relate to all of us. And you're looking at this, if
you're a program manager, you're looking at information that might be about a white population and
not really a diverse population. Again, just your thoughts on how you might be addressing that. And the
lens that people look through in that is so clouded by scientific data that is leaning in one direction, not
leaning forward.

Renee Wegrzyn ( 21:41 ):
A few concrete things. I'll come back to this ARPANET for health that we're establishing across the
country. What I didn't mention is that there's a data layer, there's a data commons on top of this to
address exactly the problem that you're talking about. So whether we have an osteoarthritis program or
a surgery program, we want to make sure that we are collecting all of the data that represents truly all
of us because we want to usher in these new AI technologies are going to be incredible to healthcare,
but we need to make sure that the data set is reflective of the American population. And so we have
fantastic data experts that, one of them, Dr. Jen Roberts leads our resilient systems office who is helping
really think about how do we make these data fabrics is hard work. How do we do it in an automated
way too, that non - experts can also benefit from that sharing of the data?
( 22:32 ):
We have a really unique authority that we can reimburse FDA directly. And so we're in discussions with
commissioner's office and other folks in the different centers at FDA of how can we incentivize pre -
competitive data sharing, right? So we heard yesterday about repurposing drugs to cure diseases.

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Margaret Flinter ( 22:50 ):
Very exciting.

Renee Wegrzyn ( 22:51 ):
Well, any drug that gets approved, how many mountains of data are sitting at the drug company that
nobody gets to see. Okay, how do we incentivize sharing of that data? Maybe we can cure these other
diseases, the cure is right under our noses with something that's already FDA approved. So we want to
be creative about incentivizing that, not just creating some of those technologies, but incentivizing it. I
don't know if you want to add anything.

Amy Jenkins ( 23:12 ):
I think you heard it last night and for anybody that was at the quick ideas last night, I think we also are
entering a phase where whole genome sequencing, the cost of that has been brought down to a point
where genetic therapies and things that are going to specifically target genes, we can actually have the
specificity to target genetic populations and to ensure that the therapies that we're developing actually
will work in all of the populations. They may need to be slightly tweaked, just based on different genetic
backgrounds, but that will be certainly an important push for us at ARPA - H.

Margaret Flinter ( 23:45 ):
I don't know about you, but I'm getting very excited hearing about all this. Among the many things we
do, we have a research institute, the Weitzman Institute, which is set up to focus on research with
special populations and the underserved populations. But as you're speaking, I'm thinking about all the
tools at our disposal that we didn't have even a few years ago, the statewide health information
exchanges, which Connecticut has achieved as well. The all claims databases, the database that was
developed off of the COVID vaccine, whole project, and nationally made available. And there are more
and more atypical groups engaged in research. I imagine the Harvards and the Yales will all be right
there with their ideas, but increasingly there's the people engaged in community participatory research,
the community health center network across the country is engaged.
( 24:32 ):
It seems you've really got your work cut out for you reaching out to all of these groups. And I'm
wondering, is it two plus 20 people fanning out across the country? Tell us more about how people can
connect in with this mission. People who are engaged in research today, but it may not be the bench
science that they have typically associated with NIH. And to NIH's credit, they've also been really
expanding their view.

Amy Jenkins ( 24:58 ):
I'm happy to jump in first. So I have been going out to meetings across the country and really wanting
people to focus and wanting people to understand that... I actually had a question in an audience one
time that said, "Are you interested in proposals from academic institutions that aren't on the coast?"
And I was floored. I sit in North Carolina, in Western North Carolina. I was floored that of course, and
actually I think we take it very, very seriously. The coasts are great. I grew up on the coast, educated on
the coast. But we want ideas from across the country. And there's great ideas across this country at a
variety of institutions and we want those ideas brought to us. This is a solution for all people. We're not
going to get to that solution if we don't have all people bringing us the ideas. So we have an open broad

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agency announcement where people can submit their ideas. Just three pages. So these are for the
researchers of the community that want to bring us their ideas. Please bring us those ideas.

Margaret Flinter ( 25:54 ):
What's that website they go to?

Amy Jenkins ( 25:55 ):
It's at ARPA - H.gov. ARPA - H.gov. And you can say, work with us or I think it's engage, and right under
there, it's a very clear link to our open broad agency announcement. Please bring us the ideas from
across the country. We're taking that very seriously. We want program managers from across the
country that represent diverse backgrounds. We are actively going out and seeking out these
populations and meetings and engagements across the country so that we can bring in program
managers that represent the entire population and bring their ideas to us. So if you're a program
manager and you say, "Wow, this sounds great, but this isn't typically the kind of job I would consider,"
please again, on ARPA - H.gov, there's the apply now. You can see some videos about what it means to be
a program program manager and put in a very quick application. We'd love to talk to people because we
want to bring that diversity of opinions.

Mark Masselli ( 26:48 ):
Well, you seem like you're open to all ideas across the country, and that's so great. And Renee, maybe
talk a little bit about the four focus areas. Were those Congress developed or internally developed or
sort of jointly?

Renee Wegrzyn ( 27:01 ):
Yeah. So this is one of the privileges of being a director is taking in insights and perspectives from a lot of
places. So it was a lot of listening. I do want to emphasize what Amy just said. People that are going to
be great leaders at ARPA - H and great program managers have to be good listeners. You can't just
assume you know the ideas. So it was a little bit, the White House even before I got there, had listening
sessions, listening to the members of Congress. But also having just come from the private sector, I also
understood what are areas that are kind of ripe. If we were able to have further investment at ARPA - H I
know there's going to be somebody to pick it up on the other end, right? That is there's not, like DARPA
has the Department of Defense is going to be the advanced developer of missiles and weapons systems.
There isn't that thing for med tech and health tech. So we have to make sure that we are putting them
out into the world in a way that they can be picked up and sustained by somebody else.
( 27:51 ):
And so the four focus areas that we've aligned on Health Science Futures, which is more the
fundamental research of what are the fundamental proofs of concept that don't exist yet, maybe they're
just on the back of the napkin today, that we can show that are possible. Scalable solutions. This is really
reaching all Americans where they're at no matter what. So think about during the pandemic, we
literally use the US Postal Service to deliver antigen tests. Not a lot of tech innovation in there, but it's
like the brilliance of bringing a new capability to get to more people. How do we scale that? How do we
even scale manufacturing in a cost - effective manner? That's what we're thinking of scalable solutions.
( 28:28 ):
For proactive health, this is really recognizing we want to extend the healthy lifespan of any one
American as long as possible and to prevent them from becoming patients in the first place. So whether

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it's detection and diagnostics or behavioral science, those are the investments we want to make from
that office. And then the office that Dr. Jen Roberts runs, Resilience Systems is really thinking, okay, how
are we have a systems integration approach to this? We need new health systems. And if we want to
include everybody, and so what does that look like in terms of infrastructure that we eventually want to
build but want to create a vision for improving, but also what's the data layer associated with that? And
these are very high level concepts, and any one program manager may actually pitch concepts in each of
those offices. So I require they launch at least a program a year, they hit the ground running when they
arrive. But maybe their first program is Health Science Futures and maybe they have a scalable solutions
idea, and that's completely within scope for us.

Margaret Flinter ( 29:28 ):
Wonderful. Well, this is kind of a moot point because the decision is made should ARPA - HB outside of
NIH, should ARPA - H be inside NIH, and now as I understand it, you're one of the institutes of NIH. That's
accurate to say?

Renee Wegrzyn ( 29:40 ):
No, not accurate.

Margaret Flinter ( 29:41 ):
Okay. Correct me right there.

Renee Wegrzyn ( 29:43 ):
I'll do some myth busting,

Margaret Flinter ( 29:45 ):
Do the myth busting and then I'll have my part B question.

Renee Wegrzyn ( 29:47 ):
Yeah, close though. So it's like we are not an institute, so there are 27 in institutes at NIH. We are the
first agency that was stood up within NIH. So we have incredible access to all of those institutes to folks
like the All of Us program and incredible partners and thought leaders together with us. But I report to
Secretary Becerra. And so we have a different agenda, we have a different budget, and we have
autonomy that's based on our reporting structure and it really is kind of the best of both worlds that=.

Margaret Flinter ( 30:23 ):
Thank you for clarifying that. That's great. I had read that, but I hadn't gotten clear exactly what the
nature of being an institute or not was. So the follow - up question I guess would be tell us a little bit
about maybe past the reception and welcome, which I'm sure you got from the institutes, what's the
ongoing path of working together, sharing ideas? There isn't one of those institutes that doesn't do work
that we're interested in alcohol and drug abuse, the Institute of Nursing Research, infectious Disease,
you name it, right? It's all of interest to people who are engaged in healthcare, but what's the
community of collaboration or even just sharing what people are working on that's going on there?

Amy Jenkins ( 31:02 ):

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So one things, our program managers, so like we've heard before, our program managers come in, they
come in with an idea and they work on that idea and they push that out as a program. In their initial
stages, when they first come into the agency, one of the very first things in the first week, oftentimes
the first week or two weeks, they go around to the relevant institutes and centers and they ask for
points of contact or they may know some of them to talk about. Here's are some of my ideas. I know
you guys are in this space. Clearly, the NIH is going to be, and many of the things and have efforts. What
can we leverage the foundational and the fundamental basic research that the NIH maybe is funding to
then push our revolutionary idea? And so we're bringing in those experts to ensure that we're not being
duplicative, but to ensure that what we're doing is both revolutionary but synergistic.
( 31:49 ):
We also have had a lot of interactions where this may be something that's so risky that it's maybe likely
to fail or it could fail. And so we can push on that revolutionary aspect. But if we're successful in five
years, this could then transition into an NIH program and it could be funded by an NIH clinical program,
or it could be in a run by a clinical trial within the NIH. So we have a lot of both opportunities for
business relationships, but then also a lot of opportunities for our program managers to work with the
experts within all the centers within NIH.

Margaret Flinter ( 32:22 ):
That's their job description, expert networker, not afraid competition, big on collaboration.

Amy Jenkins ( 32:28 ):
We joke that they talked to about 50 to a hundred people in their first about a month to two months
within the organization to ensure that they really do understand the landscape. Occasionally you're
going to miss somebody, but you've talked to people and then you ask that person to give you five more
people to talk to. It's really important that we understand the landscape.

Mark Masselli ( 32:44 ):
Well, that's so good. It sounds like you have the best of both worlds. But Amy, I want to follow up on the
program managers. Can people still apply.

Amy Jenkins ( 32:52 ):
Please, yes.

Mark Masselli ( 32:53 ):
How do they apply? I'm sure you're out there across the country looking at bright lights everywhere, but
maybe tell our audience here, what's the best pathway in.

Amy Jenkins ( 33:03 ):
Absolutely. So there's a couple. We are still recruiting. What I say is that, as Renee mentioned, we're
trying to hire 20 program managers by the end of this year. At steady state, we'll anticipate we'll have
anywhere between 60 and maybe 100 program managers. So we have a lot more to go. So we're hiring
today. But the very interesting part about ARPA - H is that the program managers have a three - year term,
and then they could possibly be renewed for up to another three years, maximum of six years, and then
they have to leave. By the time we fill out our whole entire agency, the first group are already going to

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be leaving and we're going to be hiring again. So we'll be hiring in perpetuity. And so we're looking for
those people. There's a couple of different ways to get engaged with ARPA - H on our website.
( 33:41 ):
If you go to how to apply or how to become a program manager, it's actually right across the top of our
website. There's a couple of different videos there of myself and Renee, and myself and Dr. Roberts
talking about what it means to be a program manager so that people have an understanding of this.
There's a very clear application process. We're looking for a cover letter, a CV, the standard things, and
then we ask that people tell us, what's your idea? And they tell us their idea and using those Heilmeier
questions that Renee mentioned. And so they fill out those questions and they submit it.
( 34:08 ):
The other thing I will note is that people get very nervous. They're like, this is a very different type of
job. We very typically are not going to look at your... nobody so far has come to ARPA - H and been hired
on day one. It is very much a learning experience. We want people to know that you don't have to have
the perfect application. We have a whole team of people that are helping. People understand what it
means to be an ARPA program manager. So we just want the idea.
Mark Masselli ( 34:33 ):
Thank you both for being here, and I can't think of a better place for you to engage in conversations with
people. It's probably the Aspen Institute Ideas and health gathering is really something similar to what
you want to build in your own organization, this cultivation of ideas. And we are very excited that you're
in the leadership positions and look forward to continuing to follow your work.
Renee Wegrzyn ( 34:33 ):
Great. Thank you so much.
Amy Jenkins ( 34:33 ):
Thank you so much.
Margaret Flinter ( 35:01 ):
Thank you to our audience for joining us today from this incredibly beautiful spot. It is not a green
screen behind us. We're here. Aspen Ideas Health. Amy, Renee, thank you so much for joining us today.
Renee Wegrzyn ( 35:01 ):
Thank you.
Amy Jenkins ( 35:01 ):
Thank you.
Renee Wegrzyn ( 35:10 ):
And for sharing your audacious goals with us.
Mark Masselli ( 35:13 ):
Great.

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Renee Wegrzyn ( 35:13 ):
Appreciate it.
Mark Masselli ( 35:13 ):
Thanks so much. That's great. Wonderful. Perfect.
Renee Wegrzyn ( 35:16 ):
Appreciate it.
Margaret Flinter ( 35:16 ):
Best of luck.
Renee Wegrzyn ( 35:17 ):
Yeah, thank you.
Amy Jenkins ( 35:17 ):
Thanks.
Margaret Flinter ( 35:22 ):
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