November 15th was World Pancreatic Cancer Day. And while this may seem like just another annual awareness day, it should be so much more. It should serve as an urgent call to our national policy leaders that we need a bold new approach to the disease with the highest mortality rate of all major cancers. Statistics have a way of masking the true human tragedy behind our failure to detect, treat and cure disease. In this era of “disruption” and technological revolution, millions of patients across the country are left behind because of institutional barriers to progress. It is unconscionable that for 50 years we have failed to develop detection tools and curative treatments, while continuing to approach this disease the same way. My mother-in-law lost her life nine months after she was diagnosed with Stage IV pancreatic cancer despite the resources and access to the best medicine has to offer. Pancreatic cancer is just one example of a disease that has seen no progress. I watched my father’s decline as he suffered from Alzheimer’s Disease without hope of recovery. Senator Ted Kennedy, former Delaware Attorney General Beau Biden and Senator John McCain all died from glioblastoma in the last ten years. Life expectancy for patients with ALS averages two to five years after diagnosis. We need drastic change.
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Federal investment is the fastest, most effective way to de-risk the private marketplace for medical innovation. We know this works, because it’s not a new idea. In 1958, Eisenhower created the Defense Advanced Research Projects Agency (DARPA) to reestablish America as a dominant techno-commercial power after the Soviet Union’s launch of Sputnik. What if we applied DARPA’s collaborative structure and results-driven approach to a new government agency focused on these modern health challenges? Our great and powerful nation could create HARPA - the Health Advanced Research Projects Agency – within Health and Human Services (HHS). HARPA would work with existing federal research efforts and pursue projects too targeted for the National Institutes of Health (NIH).
The government does not have a vehicle to translate the scientific research coming out of labs into commercial products for patients. The NIH supports research that produces broad, foundational knowledge for the medical community - but their noble mission contributes to less than 20% of all new drug and vaccine discoveries. Private sector pharmaceutical companies pick up the other 80%, but their research and development is focused on common diseases whose treatments are profitable. The current approach to research fails to produce meaningful interventions in a timely manner for those who need them the most. During the two years my father suffered from Alzheimer's, I heard a lot about promising new research. But nothing made it to the market before his death, and nothing has made it since.
Federal agencies and over 90% of universities do not see a positive return on investment (ROI) on their intellectual property (IP) ventures because of a failure to license their invention. HARPA will model DARPA’s approach to IP. The modest calculation of DARPA’s ROI is ten to one. The actual ROI is incalculable. The economic contributions of the Internet alone, as of 2014, stood at approximately 6% of U.S. GDP . As of 2013, the economic benefits of GPS navigation were about 0.4% of GDP. This does not include indirect economic benefits, or benefits to health, safety and the environment. With HARPA, the government will have access to IP, but that IP will belong to the innovators. Commercializing IP will help translate our scientific investments into products and interventions, create jobs, and drive economic growth. Early detection of disease will save millions of lives and billions of dollars. The Centers for Medicare and Medicaid would be the greatest beneficiary of early detection, as it would reduce treatment costs dramatically.
We all have something to gain from the success of an innovative health establishment that is required to push the boundaries of modern research and treatment. Even though DARPA’s mission for the last 60 years has been to develop capabilities for national security, its collaborative research led to household products as profound as the Internet and as superficial as the Roomba. What might exist in 60 years because of HARPA: a pill that prevents cancer? Eye drops that make UV light visible? An immunotherapy treatment to thwart pancreatic cancer for those identified to be at risk?
I have hope for a healthcare revolution. The country craves it. But if we want revolutionary change, we need to build a revolutionary apparatus for it. So, while we wear purple and raise awareness for World Pancreatic Cancer Day, I encourage you to consider the facts: No detection, no cure, only one in ten patients will survive more than five years. For fifty years, these unwavering statistics have been reported, and yet the traditional approach remains unchanged. Now consider the potential of HARPA and the millions of lives that could be saved with leadership, innovation and a goal-oriented approach to healthcare. HARPA will do that on a national scale. The patients are waiting.
Sandi Drucker Wright is Director at the Tamer Center for Social Enterprise at Columbia Business School and a member of the board of directors of the Suzanne Wright Foundation.
The original version of this article was published on November 15, 2018.