Dr. Brett Giroir is a physician scientist and chief executive officer of The Texas A&M Health Science Center, and former Director of the Defense Sciences Office at DARPA (The Defense Advanced Research Projects Agency).
In Dr. Giroir’s first editorial for BioNews Texas, he discusses his experience working at DARPA, how that organization’s ethos should be applied to health science centers, and how the Texas A&M Health Science Center is building a research team complemented by researchers from outside the life sciences to solve the world’s most critical unmet health needs.
In 1957, the Sputnik orbiting telemetry signal left an indelible and audible imprint on the world. It was clear to President Eisenhower, and all Americans, that our nation was losing the “space race.” More importantly, it was clear that U.S. technical superiority was not our birthright, but rather an earned distinction based on creativity and technical implementation. That is why in 1958, the president created a small agency to prevent technological surprise; stated another way, the agency was designed to be the world’s leader in technology, harvesting bleeding-edge science and developing novel solutions for our national defense. Fifty-seven years later, the Defense Advanced Research Projects Agency (DARPA – originally “ARPA”) still exists with the same mission. Although the technical challenges have changed since its founding, advances such as the internet, stealth, GPS, advanced semiconductors, spintronics, composite materials, autonomous vehicles, and hundreds of other revolutionary technologies — many still classified — provide immense affirmation that the DARPA method “works,” at least within these national security domains.
After five years working with DARPA as my “night job” while on the faculty at UT Southwestern in Dallas, I had the unique opportunity in 2004 to join the approximately 100-member science and technology leadership team at DARPA, initially as deputy director, then director, of the Defense Sciences Office (DSO). DSO was one of the technical offices at DARPA, and the originator of most of the agency’s core discoveries. DSO is affectionately known as “DARPA’s DARPA,” and our motto at that time was “Ideas Begin Here.” As the first physician to lead a technical office in DARPA’s history, it was an intimidating experience to say the least. Although my office was indeed responsible for creating a DARPA “BioRevolution,” most of my budget (about $500 million per year) was still dedicated to fundamental physics, materials science, engineering, and mathematics. However, after four and a half years — the typical DARPA “term limit” — my office had provided the vision and creativity, as well as the program management and funding, for diverse innovations ranging from micro-air vehicles and new stealth materials to novel biological warfare detection and a brain-controlled, fully functional, bionic prosthetic arm.
DARPA successes, as well as its glorious failures, have led the remainder of the U.S. government, and most of the world, to attempt to replicate the DARPA model in other domains, but it takes more than coining a similar name (for example Intelligence ARPA (IARPA)) to replicate the success of the original; but that is not my concern. My concern — and perhaps new obsession — is how lessons from DARPA can inform, and even transform, research and development at academic institutions and specifically at health science centers. Let there be no doubts, there clearly is a need for such transformation. Nearly every influence, both externally from the National Institutes of Health and internally from academic politics, incentivizes the antithesis of the DARPA culture: incremental thinking, silos of narrow disciplines, institutional administrative barriers discouraging cross-unit collaborations, mountains of red tape, and lack of funding to catalyze new initiatives. Moreover, accolades generally stem from processes, publications and expenditures, but rarely from tangible outcomes and solutions.
I believe Texas institutions are leading national change, and my institution (Texas A&M Health Science Center) is certainly doing what we can in that regard. An absolute key to DARPA success is recruiting “non-traditional” disciplines into any initiative, so for medical science and public health, this means recruiting colleagues from engineering, physics, mathematics, and agriculture to the research team. It is not just about what these disciplines “know,” but more about how these “brilliant uninitiated” experts think and approach problems. For example, the field of quantum optics will undoubtedly provide the ultimate resolution for biological diagnostics and visualization, but I am more interested in how quantum scientists approach biological problems. Similarly, engineers deliver. They succeed, on time and on budget, because of their unique problem-solving approach. I remain greatly influenced by our DARPA Revolutionizing Prosthetics Program, which brought to reality in just a few years a dream previously considered “science fiction.” Certainly, neurosurgeons and neurologists were essential, but the true action was with the engineers, material scientists, mathematician decipherers of neural impulses, computer scientists, control theorists — all led by a visionary and passionate DARPA program manager (Dr. Geoff Ling) and perhaps the world’s most gifted systems engineer (Dean Kamen).
I believe diverse disciplines will self-assemble if supported by leadership, especially when there is a compelling and inspirational challenge to galvanize collaboration, but we cannot implement new models of innovation and still play by the old academic rules. I don’t have the answers, but we are testing several hypotheses: special laboratory space and seed funding for ad hoc multi-disciplinary teams; extra time on the “tenure clock” for high-risk, high-reward research programs; objectively valued non-tenure positions for critical team members who are not traditional principal investigators; incentivized collaborations across colleges; alliances with commercial partners such as Google and Dell; iterated goals that include tangible deliverables defining the pathway to real solutions.
An audacious goal, a multi-disciplinary team that included engineering and industry (GSK), and a relentless execution strategy were the “DARPA-like” characteristics that led to Texas A&M being awarded a U.S. Department of Health and Human Services Center for Innovation – a 25-year contract with a value of up to $3 billion dollars and the responsibility to safeguard the nation by rapidly producing vaccines (up to 50 million doses in four months) and other biotherapeutics to protect against pandemic threats and emerging infectious diseases.
This DARPA culture of transformative innovation is designed to achieve measurable outcomes; and I suggest that it applies to nearly all areas of medical scholarship, including drugs and devices, primary care delivery, translation and commercialization, and even the design of effective health policy. With half the state’s budget now consumed by health-related spending, without commensurate health improvement, there is an urgent need for this type of new approach.
Institutions are also coming together across Texas in a way that will be profound, emulating DARPA principles whether explicitly stated in that context or not. For example in the Texas Medical Center (TMC), led by the vision of Dr. Bobby Robbins, the great Houston institutions have come together with a bold strategic plan for the TMC to be “the world’s leader in life sciences research and health care.” A 100,000-square-foot accelerator is already in place with dynamic industry partners and innovative new academic spin-off companies. Additionally, plans are underway so that in just a few years, a multi-million square-foot translational research campus, featuring several highly-funded multi-disciplinary institutes, will shatter inter-institutional barriers, as well as those between academia and industry. The result will be an innovation environment that will rival, and in my opinion surpass, that which is available on either coast at present.
There is also a critical need for state and local governments to financially support our nascent innovation environment, and also to provide incentives not only for academia, but also for non-profit and commercial partners that are essential to technology translation. Texas has led in this area, and we must consciously and carefully continue to advance policies that will empower the state in ultimately achieving its long-term goals.
Right now, my view remains bullish on Texas and Texas institutions. However, like DARPA, what makes us successful is both precious and fragile, and must be continually supported by visionary leaders, and defended against the multitude of naysayers — like those that chided the Wright brothers and claimed the “flying machine” would take millions of years to develop. Instead, may Texans always “look for the pony” (a favorite DSO saying), or in the words of Robert Kennedy, may we continue to “dream of things that never were, and ask why not.”