The White House must move swiftly to fill key health posts to advance biomedical initiatives after the departure of its first-ever, Cabinet-level science adviser, research groups say.
Eric Lander said he will resign by Feb. 18 from his role as President
“This administration has invested organizational capital in putting science at the heart of decision making. They’ve invested political capital in things like the Cancer Moonshot,” Sudip Parikh, CEO of the American Association for the Advancement of Science, said Tuesday. “What’s impressive is all of them are at the cusp of going from an abstract concept to something that’s concrete.”
The OSTP director is the critical coordinator and face of these activities to multiple audiences, including Congress, the public, and scientists, Parikh added. “So we’re going to need another scientist in that role that has these excellent situational communication skills because this administration has put a lot of effort into this.”
The administration also needs to fill other top posts, including
Former NIH Director Francis S. Collins, who retired in December 2021, was one of the major forces—along with Lander—behind Biden’s proposed biomedical incubator known as the Advanced Research Projects Agency for Health. Tara Schwetz was OSTP’s point person on ARPA-H, but she left the White House to become the NIH’s acting principal deputy director—the second highest post at that agency.
“Moving quickly to fill these positions with trusted individuals to make sure that the focus on science remains front of mind while dealing with the current situation” is essential to keep the momentum going on these projects, Heather H. Pierce, senior director for science policy and regulatory counsel for the Association of American Medical Colleges, said Tuesday.
Lander’s appointment was historic because it was the first time a president elevated the science adviser to a Cabinet-level position. He was also the first scientist with a biomedical background—a geneticist whose work was critical to mapping the human genome—to fill that post.
Lander was overseeing two major projects at OSTP: Cancer Moonshot 2.0 and ARPA-H.
Parikh believes both projects have enough support on Capitol Hill to move legislation forward. If bills to create those initiatives make it across the finish line, permanent leadership in the executive branch to implement them will be critical.
“We need an OSTP director. We need an FDA commissioner. We need them in place because implementation of that legislation over the next year is going to require people in the executive branch who are in charge,” Parikh said. Acting directors don’t have the political capital to say a new program needs to be this way or have this kind of culture, he said.
“Then you get a mechanical implementation. And the mechanical implementation is very different from an expansive implementation, visionary implementation of this kind of legislation. So it is important to have those political appointees in place by the time this legislation is passed,” Parikh said.
A major provision of the biomedical innovation bill Cures 2.0 (H.R. 6000) would set up ARPA-H within the National Institutes of Health. A separate bill by Rep. Anna G. Eshoo (D-Calif.), head of a key House health panel, would put the new entity within the Department of Health and Human Services.
“It’s hard to get legislation through when you don’t have people in place,” Sen. Richard Burr (R-N.C.), ranking member of the Senate Health Education Labor and Pensions Committee, told Bloomberg Government. “You would think this would be a priority for the administration to fill those slots they need in the midst of the pandemic, but it doesn’t seem to impact them.”
But some policy analysts say Lander’s departure won’t have a noticeable impact on these initiatives.
“ARPA-H and the Cancer Moonshot have so much momentum behind them from so many quarters,” Ellie Dehoney, vice president of policy and advocacy for Research!America. “And it was not an Eric Lander initiative. It was a Biden initiative that has now received some bipartisan support.”
Pierce expressed similar thoughts. “This is clearly not ideal,” but “science itself will continue to be a priority of the administration,” she said.
An OSTP spokesperson told Bloomberg Law that there’s “alignment throughout the team at OSTP on the work and the approach, and that work continues today.” The spokesperson added that much of the office’s core projects are “personal and policy priorities” for Biden, including Cancer Moonshot.
Shortly before he resigned, the White House pulled Lander from a Tuesday hearing on ARPA-H before the House Energy and Commerce Committee’s health panel.
The fact that the subcommittee still held the hearing is “a sign that they have no intention of slowing down. And I think that’s terrific,” Dehoney said.
Lawmakers from both sides of the aisle seemed to agree with the White House’s decision to pull Lander as a witness. But the absence of any testimony from the Biden administration left important questions on the table, such as whether to house ARPA-H in the NIH or the HHS more generally.
“I’m glad he’s not here today” if he’s just been mean to staff,” Rep. Brett Guthrie (R-Ky.), ranking member of the health subcommittee said. “But he has answers that we need. Hopefully the White House will have somebody that can answer questions.”
Lawmakers during the hearing voiced their support for ARPA-H, but some Republicans including Reps. Dan Crenshaw (Texas) and Cathy Rodgers (Wash.) expressed concern that it would duplicate existing NIH programs. Collins told Bloomberg Law last June that while ARPA-H builds on successes of previous NIH projects, it takes a different approach that would depart from the traditional grant-making process.
Another issue to iron out is how to package and pass legislation to create ARPA-H.
Cures law architects Rep. Diana DeGette (D-Colo.) and Fred Upton (R-Mich.) are working with Eshoo to harmonize ARPA-H and Cures, DeGette told Bloomberg Government.
“ARPA H and Cures 2.0 are interlocking bills because you can’t do some of the research and some of the work you’re going to do at ARPA-H without updating and improving Cures. So the three of us are all working together on that,” DeGette said.
Eshoo also said during the hearing she wants to move the two bills together.
Sen. Roy Blunt (R-Mo.), the top Republican on the spending panel that oversees NIH funding, told Bloomberg Government he was surprised that the House Energy & Commerce Committee, which authorizes health programs, had scheduled its first hearing on ARPA-H this week. Blunt said he’s been talking to the White House, but there’s very little reason to appropriate money unless there’s some agreement on authorizing the entity.
“I’m supportive of and support the president’s effort to get there but for whatever reason this has had a hard time getting off the ground,” Blunt said.
“It’s certainly possible that part of that has been whatever problems they were having at the White House that involve Dr. Lander. But the only time I saw him ever was in his external role, which everybody was saying is different than his internal role.”