RLINGTON, Va. — The next big thing in disease detection — a device that could stop the next Ebola outbreak in its tracks — looks like a five-pound block of gray plastic, with five buttons, a small monochrome screen, and a slot in the front for a medical sample.
It’s one of the newest projects of the DARPA Biological Technologies Office, a small, secretive Pentagon outpost that has more than a whiff of Star Trek about it. Its mission: Invest in research that sounds like science fiction.
Founded just 18 months ago, the office already has a reputation for funding risky projects the rest of the government won’t touch — and for pulling the plug quickly if those projects falter. Critics say it’s not the best way to advance biomedical research, which often takes a long, slow, meandering path to success. But the founding director of the biotech office, Dr. Geoffrey Ling, will have none of that. He practically boils over with impatience with small-ball goals. He demands big-time breakthroughs.
“I mean, at the end of the day, if you’re going to go and cure cancer, by God, cure the cancer and quit jerking around,” Ling said in an interview.
His office develops projects ranging from robotic arms that can be controlled by a person’s mind, to prosthetic hands that can “feel” things, to electrical implants that send currents jolting through the nervous system to treat arthritis or other diseases. It’s even working on brain implants that could one day help soldiers recover from traumatic brain injuries.
Then there’s the infectious disease detection device, which is about the size of a large brick and could lead to speedier diagnoses, both on the battlefield and eventually in hospitals, if it works as designed. STAT got a sneak peek in a recent visit to the DARPA biotech office, located in a low-key office building that gives little hint of the intensity of the work that goes on inside.
The tool is called a MAP device — it stands for “Mobile Analysis Platform.”
To test someone for an infectious disease, you stick a sample of bodily fluid in a small port. Next, you slide a disposable card into the device. The card is coated with various reagents, which will react if they come into contact with certain pathogens. The machine makes a loud buzz and clicking noise as the sample is analyzed.
The results pop up on the screen within 30 minutes — and the MAP device announces whether the patient has tested positive for an infectious disease like the flu, Middle East Respiratory Syndrome, malaria, dengue fever, or Ebola. At least, that’s the concept. DARPA officials wouldn’t talk much about how it has fared in early testing.
They do say that if a device like the MAP had been available at the Dallas hospital that treated a patient with Ebola last year (and the staff thought to use it), he might have been diagnosed right away — not sent home with antibiotics.
There are already some effective tests for Ebola, including a quick-turnaround test based on a few drops of blood. But there have been concerns that those tests return too many false positives. And the MAP device, if it works, could prove more versatile, testing for an array of infections at once — including, in the future, sexually transmitted diseases such as chlamydia and gonorrhea.
The ability to diagnose a patient in half-an-hour or less would be “transformative. It’s an absolute breakthrough,” said Col. Matthew Hepburn, the project manager. He said clinical trials would start this fall.
A magnet for Trekkies
The biological office – which was created in April 2014 to consolidate programs from two other offices — doesn’t have the commanding physical presence you might expect from the Pentagon. It’s in a standard, slightly-less-than-modern office building on an uncrowded street in Arlington, Va.
On the inside, though, it’s full of futuristic devices and experiments — even the camera used to take visitors’ ID pictures, which is encased in a tiny bulb that moves and clicks into place like an alien eyeball. And since it is the Defense Department, there’s a touch of secrecy, too. Visitors aren’t allowed to bring in electronics, including cameras or digital recorders, without special clearance.
The DARPA biotech office has ambitious project managers, but no one captures the swaggering, no-nonsense attitude better than Ling, a fast-talking Army physician who served in Iraq and Afghanistan. He’s leaving at the end of November, after 11 years with DARPA, because he abhors the idea of getting comfortable in a job. “Bureaucracy comes from people staying in one place too long doing things the same old way. DARPA doesn’t do that,” Ling said.
Contractors know that if they don’t aim high and show results, Ling and his team will be happy to cut off their money and work with someone else.
“People will tell you, a lot of people don’t like to work with DARPA because it’s not a guarantee of funding. Well, so freaking what?” Ling said, his voice escalating to a shout.
“I mean, I don’t want to hear about the damned mice, I don’t want to hear about your damned papers, I don’t want to hear, you know, what awards you got. I want to hear, did you cure the stinking disease? Right? And if you can’t play in our sandbox, then don’t. We will find someone who will.”
The agency is widely seen as a smaller, gutsier alternative to the National Institutes of Health.
“DARPA is designed to have a high failure rate. …. They embrace failure.”
Steven Block, Stanford University
“DARPA is designed to have a high failure rate. They see their role as avoiding the natural conservatism of, say, the NIH,” said Steven Block, a professor of applied physics and biology at Stanford University who has advised the government on biowarfare. “They embrace failure, and the NIH does the exact opposite.”
He’s not so sure the quick-burst approach to funding is the best way to get real advances in medical science. “These victories are hard-won, and they’re slowly won,” Block said.
But DARPA, which stands for the Defense Advanced Research Projects Agency, does have a track record of success; for one thing, the Internet sprang from its research. Medical products that started with DARPA research include a portable ventilator and vaccines that are produced from plants.
‘Performers,’ not contractors
To the contractors, working with DARPA can be exciting and nerve-wracking at the same time. (The agency calls them “performers,” not contractors — because, as Ling explains, they’re expected to perform.)
“They’re not interested in anything that’s run-of-the-mill or incremental. They’re interested in quantum advances. It’s exciting to work on quantum advances,” said David Ecker, divisional vice president at Ibis Biosciences, a California-based biotech company owned by Abbott Laboratories that’s working on the infectious disease diagnostic device.
On the other hand, Ecker said, “they do monitor your performance very carefully.” And even though every researcher dreams of a project that achieves the kind of scientific breakthrough that DARPA wants, Ecker said, “while you’re doing them, it’s not clear that they’re going to break through anything. There could be technical showstoppers.”
Officials won’t identify any specific biotech projects where they had to pull the plug, but they also say the office is too new for most projects to reach that point. And they say they often find other uses for research that hasn’t worked out quite as planned.
The biological team has 11 full-time staff, including Ling and the eight program managers. Most of the research and development work is done by outside contractors. The diagnostic device, for example, is being developed under a $15.5 million contract with Ibis Biosciences.
Dr. Francis Collins, the director of the NIH, said his agency is trying to learn from DARPA’s approach to “rapid-turnaround risky research.” The two agencies are working together on a project to develop biochips that can be used to assess the toxicity of drugs before they’re used on patients.
And DARPA doesn’t see itself in competition with NIH, or the National Science Foundation. It’s too small for that. DARPA’s budget is about $2.9 billion, and the biotech office itself runs on roughly $300 million a year. That’s just one-tenth of the current NIH budget, which is a little more than $30 billion.
“I think that what we are is, we’re a teeny-tiny, super small, itty-bitty complementary approach,” Ling said. “If I took the $300 million and I threw it in the same cauldron of the NIH and the NSF, it would be meaningless … That would be an inefficient way to use the taxpayers’ money.”
Correction: An earlier version of this story misstated the way the MAP device tests for infectious diseases. The story was updated on Nov. 24.