Addressing the Organ Donor Crisis

Summary

The organ-donation crisis is one of the most persistent, expensive, and yet solvable public-health challenges of our time. As of January 2020, nearly 115,000 Americans were waitlisted for an organ transplant.  The vast majority have kidney failure, which, as one of the rare conditions qualifying patients for Medicare, imposes billions of dollars of costs on taxpayers. In 2016 alone, taxpayers spent an alarming $113 billion on kidney disease — more than the entire budgets of the National Institutes of Health ($39 billion), the Department of Homeland Security ($44 billion), and the National Aeronautics and Space Administration (NASA, $21.5 billion) combined. The clear solution is to shorten the organ waiting list. For every Medicare patient who receives a kidney transplant, taxpayers save $250,000 in avoided dialysis costs.  This proposal presents a discrete set of actions for the federal government to take to quickly and decisively to address the organ-donation crisis.

Ambitious, Achievable, and Sustainable: A Blueprint for Reclaiming American Research Leadership

Summary

The next Administration should accelerate federal basic and applied research investments over a period of five years to return funding to its historical average as a share of GDP.  While this ambitious yet achievable strategy should encompass the entire research portfolio, it should particularly seek to reverse the long-term erosion of collective investments in physical and computer science, mathematics, and engineering to lay the foundation for economic competitiveness deep into the 21st century. This proposal outlines a strategy and series of steps for the federal government to take to reinvigorate U.S. competitiveness by restoring research and development investments. 

A Civic Research Initiative to Transform State and Local Government

Summary

State and local governments are not taking full advantage of data and technology innovation that could help address key priorities such as delivery of local public services, management and design of the built environment, and fulfillment of climate goals. Supporting innovation across these domains is difficult for state and local governments due to limited technical staff, procurement challenges, and poor incentives and mechanisms to develop and scale creative solutions. Civic research is a collaborative process for addressing public priorities and improving communities by connecting technical experts to policymakers and civic partners, creating a platform for evidence-based, research-informed action. This process relies on partnerships among universities, state and local agencies, and community organizations, and has proven successful in communities nationwide. This paper recommends seven actions the next administration can take to advance civic research nationwide.

Establishing a National Manufacturing Foundation

Summary

Emerging technologies developed in the United States are routinely scaled up overseas due to a lack of domestic engineering skills, manufacturing know-how, investment capital, and supply chains.  A new national initiative is needed to ensure that discoveries and inventions made in the United States are manufactured at scale in the United States. Such an initiative will create good-paying jobs, strengthen defense preparedness, and protect intellectual property (IP) created through federally funded research. Building a strong manufacturing base at home will also strengthen the domestic innovation cycle, as the knowledge gained through manufacturing supports process improvements and new product iterations. We propose the creation of a new agency—a National Manufacturing Foundation (NMF)—to address this gap.

National Energy Storage Initiative

The next administration should establish a national initiative built around ambitious goals to accelerate development and deployment of dramatically improved energy-storage technologies. Developing such technologies would help establish a strategic new domestic manufacturing sector. Deploying such technologies would expand the range of low-carbon pathways available to fight climate change—especially those relying on variable renewable energy resources, like wind and solar power. Deploying such technologies would also improve the performance of smartphones, drones, and other vital electronic tools of the 21st century.

Challenge and Opportunity

Electricity systems, no matter how big or small, must instantaneously balance supply and demand, generation and load—or suffer blackouts. This imperative has long motivated scientists and technologists to seek the holy grail of affordable, reliable, durable, and safe energy storage. Yet, despite many decades of efforts, batteries remain expensive, fickle, short-lived, and dangerous for many applications. Other forms of energy storage, like thermal and compressed-air storage, suffer from major drawbacks as well. 

Radically improved energy-storage technologies would help the nation and the world solve some of their most pressing problems. Most urgently, improved energy storage would expand the range of low-carbon pathways to fight climate change and reduce dependence on fossil fuels by allowing the electricity grid to accommodate higher levels of renewable energy. Improved energy storage would allow electric vehicles (EVs) to better meet drivers’ expectations for value and performance, thereby speeding up EV adoption and further helping to address the climate challenge. Better batteries would also let people stop worrying about whether their electronic devices are charged, improving security and strengthening the economy in a world where these and other connected devices are ubiquitous.

Given the importance and magnitude of these opportunities, energy storage has become a critical industry of the future—one that nations around the world seek to capture. China and the European Union, for instance, are making significant strategic investments to build domestic capabilities for development and manufacturing of energy storage technologies. These and other international competitors are challenging the U.S. energy innovation ecosystem—our research universities, national laboratories, start-up companies, and established technology firms to invent, commercialize, and scale-up next-generation energy-storage technologies.

Opportunities by sector

Electric power

The rapidly dropping cost of wind and solar power has opened major pathways to decarbonize electricity systems. But these power generation technologies are variable: that is, their output fluctuates by the hour, day, and season. As the renewable share of generation rises on a grid, such fluctuations make balancing supply and demand increasingly difficult, threatening brownouts and blackouts. Grid-scale energy storage has the potential to address this challenge. Although one energy-storage technology (lithium-ion batteries) has been improved to the point that it has begun to make a significant impact on the grid, major gaps remain. Fully solving the grid-storage problem requires technologies that are much cheaper and last much longer than current systems. Grid-storage technologies must be able to hold enough electricity to power a grid for a week or more at a cost of just a few cents per kilowatt-hour (kWh), while operating only a few times each year.

Transportation

Lithium-ion batteries are also kick-starting the electrification of transportation. Their declining cost is one of the key factors helping to bring EVs into the mainstream. EVs are cleaner than gasoline-powered cars if they are charged on low-carbon electricity grids. EVs are also easier to maintain and cheaper to operate. However, the ultimate triumph of EVs in the auto market is far from assured. Batteries that are safer, rely on more abundant materials, allow vehicles to go 500 miles or more on a charge, last for at least a decade, and are easily recharged and recycled would make the success of EVs more likely, with huge payoffs for the global climate.

Electronics

The suite of technologies sometimes lumped together as the “fourth industrial revolution” is another broad domain that would benefit from advances in energy storage. Robots, drones, sensors, and smartphones—and the systems by which they process and exchange information—have become essential tools in modern society.

Most of these electronics are more useful when they can operate without having to maintain a constant connection to the grid. Although batteries are becoming lighter and more efficient, the demands being placed on them are also rising, straining the limits of lithium-ion technology. An order-of-magnitude leap in the energy density of batteries— the amount of electricity stored in a given mass or volume—would unlock a diverse array of valuable new applications for a wide range of electronic devices. For instance, drones, whether they are being used by combat forces, farmers, or utility crews, would be able to stay aloft for days and carry more sophisticated payloads, such as weapons or sensors.

Domestic manufacturing

Paradigm-shifting improvements in energy storage technologies would also create opportunities to build domestic manufacturing capacity in a growing industry of the future. The supply chain for making lithium-ion batteries migrated to East Asia years ago. The largest battery factory for EVs in the United States, Tesla’s “giga-factory” in Reno, NV, is run by a joint venture with the Japanese-headquartered firm Panasonic. Tesla has been unable to fully master the finicky methods used to make battery cells. Other U.S.- based EV assembly plants rely on Asian-headquartered battery contractors as well. 

Nonetheless, the United States continues to generate new energy storage technologies, including some that could supplant the current generation of lithium-ion batteries. For example, Sila Nanotechnologies, founded in 2011 and based in the San Francisco Bay Area, raised $215 million in 2019 to scale up its manufacturing activity. A half-dozen other U.S.-based battery start-ups have also raised large funding rounds in the past year. Investors include not only venture-capital firms, but also big companies based in Europe and Asia as well as North America. It remains to be seen where the battery supply chain of the future will be located.

Plan of Action

The next administration, building on the Department of Energy’s (DOE) recently announced “Energy Storage Grand Challenge,” should establish a National Energy Storage Initiative (NESI) built around ambitious goals to accelerate development and deployment of dramatically improved energy-storage technologies. These goals should include widespread adoption of:

The NESI should also seek to achieve economic and international goals such as:

The NESI will require deep collaboration among key federal agencies and with the private sector, academia, and states and localities. This initiative would galvanize the still-thriving energy-storage science and technology community in the United States, spurring the development of better energy-storage technologies and ensuring that the next generation of storage devices are built here. The case for the NESI is two-fold. First, expanded research, development, and demonstration (RD&D) funding is needed to address market failures in the energy-storage domain. Expanded funding would enable scientific and mission agencies to pursue a diverse array of promising opportunities that have gone un- or under-explored. The result would be new energy-storage materials and concepts, breaking through barriers that have limited current technologies. Second, federal resources and leadership—as well as deep engagement with the private industrial and financial sectors and with key states and localities—are crucial for domestic scale-up and manufacturing made possible by this expanded RD&D portfolio. International competition surrounding energy storage is already fierce. China, in particular, has made no secret of its plan to dominate the global battery and EV industries. The United States must assert leadership on energy storage or risk being left behind.

Implementation

The NESI should include four key components: (1) White House leadership and coordination, (2) a federal RD&D budget commitment, (3) increased agency participation and use of an array of policy tools, and (4) mobilization of non-federal actors to undertake aligned actions.

White House leadership and coordination

An Executive Order (EO) from the White House, implemented by the Office of Science and Technology Policy (OSTP) and the National Science and Technology Council (NSTC), would be the foundational action to launch the NESI. White House leadership and attention would catalyze implementing agencies to identify lead units and staff members for the interagency initiative and to undertake internal coordination among their component units (e.g., the science and applied energy offices within DOE). OSTP, NSTC, and agency staff would spearhead the initiative, driving its progress throughout the executive branch and mobilizing support in Congress, industry, science, and the public.

Budget

Delivering on the aforementioned goals would require, at a minimum, tripling current spending on energy storage RD&D programs over five years. The most comprehensive estimate of federal RD&D spending on energy storage comes from a 2015 OMB interagency “crosscut”: $300 million. Increasing spending to $900 million or more per year would allow participating agencies to take the following actions:

Increased agency participation and use of other policy tools

In addition to DOE, the Departments of Agriculture (USDA), Commerce (DOC), Defense (DOD), Health and Human Services (HHS), Housing and Urban Development (HUD), and Transportation (DOT) as well as the National Science Foundation (NSF) and National Aeronautics and Space Administration (NASA) should be mobilized to accelerate innovation in energy storage. DOC, DOD, HHS, and NSF should collaborate with DOE in expanding the energy storage RD&D enterprise. The other agencies, along with DOE and DOD, should use policy tools such as procurement, regulation, and investment support (e.g., loan guarantees) to help “pull” nascent energy-storage technologies into markets and to assist in establishing domestic production capacity. Tax incentives, legislated by Congress and administered by executive agencies, may also be helpful to accelerate market growth and drive down costs for particular technologies.

Mobilization of non-federal actors

Academia and industry are critical to the success of energy-storage RD&D, manufacturing, and adoption. The vast scope of energy-storage applications amplifies the importance of engaging with a wide variety of end-user industries—especially power-system vendors, utilities, electronics manufacturers, and automakers—as well as producers of storage technology. States and localities, many of which have announced ambitious goals for grid-scale storage, should also be incorporated into the NESI. A few states could house federally supported manufacturing and innovation “clusters” for energy-storage solutions. All states could accelerate adoption of improved energystorage technologies by fostering receptive markets: for instance, by reforming electricity regulation.

Precedents

The proposed NESI is similar to successful efforts such as the Clinton administration’s nanotechnology initiative and the Obama administration’s advanced manufacturing initiative. Such initiatives mobilize and coordinate multiple agencies in pursuit of technological capabilities that will contribute significantly to a set of broadly agreed national goals. Success depends on strong presidential commitment at the start and cultivation of stakeholders across partisan, regional, and sectoral lines over time. Effective technology initiatives have major on-the-ground impacts and ultimately become self-sustaining. Two keys to success are (1) White House leadership and attention to foster interagency cooperation, and (2) increased agency budgets to limit resistance from incumbent programs.

Federal funding for energy-storage science and technology has a long track record, particularly with regard to basic research. The American Recovery and Reinvestment Act (ARRA) expanded federal energy-storage funding considerably in the 2010s. ARRA funding supported establishment of the Advanced Research Projects Agency—Energy (ARPA-E), which has become a major source of funding for applied research and prototype development in energy storage. ARRA funding also supported the Joint Center for Energy Storage Research (JCESR) at Argonne National Laboratory; a collaborative demonstration program within DOE’s Office of Electricity that worked with utilities, states, and local governments; and loan guarantees for battery manufacturing and grid-scale storage projects. 

Many of these investments have paid off handsomely. For instance, an evaluation by the National Academies found that ARPA-E’s funding of energy-storage technology has been “highly productive with respect to accelerating commercialization” and led to the formation of at least six new companies in the field. JCESR was renewed for an additional five years in 2018. However, the demonstration and manufacturing elements of the ARRA-funded push were not sustained, primarily due to ideological objections by the Congressional majority that came in after the 2010 midterm elections. 

The Department of Energy announced an Energy Storage Grand Challenge on January 8, 2020. This initiative is a welcome step toward the broader initiative outlined in this paper. It seeks ambitious advances in technology, rapid commercialization, and the creation of a domestic manufacturing supply chain. But it does not extend beyond DOE, and whether it will be implemented with the appropriate resources and presidential support is uncertain.

International context

Many countries have made energy storage a priority. The European Union has embarked on a multi-billion-dollar battery initiative that led to the establishment of Northvolt, a European-owned battery cell manufacturing start-up. Volkswagen bought 20% of Northvolt and is working with it to build a second cell factory. Energy storage and EVs are among the sectors targeted by China in its Made in China 2025 program. Massive subsidies from all levels of the Chinese government have flowed through a variety of channels to energy storage projects and companies to fulfill this program, helping China become the world’s largest EV market (with more than 50% market share). Korea, Japan, and India are among the other countries undertaking national energy storage initiatives.

Although the global race to advance energy-storage technology is intense, the United States possesses many strengths that would allow a domestic energy-storage effort to succeed. These strengths include outstanding research capabilities at universities and national laboratories, a vibrant start-up ecosystem, and a strong industrial sector. The NESI would provide the leadership, funding, and coordination needed to realize the full potential of these assets. It is also important for the United States to foster international cooperation around science underlying energy-storage technology. Scientific knowledge is a global public good that will be under-provided without the leadership of the world’s top scientific nation.

Stakeholder support

The NESI has a wide range of potential champions and advocates on both sides of the aisle. Congressional Republicans have expressed their support for energy storage through expanded RD&D funding and more ambitious authorizations. The administration’s new grand challenge taps into this legislative support. Environmental advocates on the left of the political spectrum are also supportive, perceiving limited energy storage as the biggest technological barrier to expanded deployment of renewables. Similar enthusiasm may be expected from the research community and investors, as well as from states seeking to build a domestic energy-storage industry. These interests have been frustrated by the “invent here, produce there” outcomes of past breakthroughs, such as lithium-ion batteries.

Technology end users may be less enthusiastic or indifferent. Low prices in the short term may be more important to them than innovation in the long run. They may also see the location and ownership of production facilities as irrelevant or argue that the current global division of labor, in which Asian factories built with cheap public-investment capital supply U.S. needs, is favorable for the United States. Other skeptics may argue that when it comes to supporting expanded deployment of renewables, investing in demand response, larger grids, or other forms of low-carbon electricity generation, such as nuclear power or natural gas plants with carbon capture systems, are better options than energy storage.

Goals and metrics

The overarching (e.g., within 10 years) goal of NESI is to make the United States a major center for energy storage innovation and production. 

One essential short-term step towards achieving this goal is establishing key organizational components of the NESI, such as an interagency working group and a mechanism to engage with non-federal stakeholders, including industry, academia, and states. A second critical step is expanding budgets for relevant federal agencies to put them on a pathway to triple federal funding for energy-storage RD&D. 

In the medium term, metrics such as growth in scientific publications and patents, formation of new energy-storage companies, equity and project investment, product introduction, and manufacturing-cost reduction will provide insights on progress. 

In the long term, success of the NESI should be assessed by the level of market penetration of new energy-storage storage products across application domains including electric power, transportation, and electronics in the context of a growing overall storage market. Success of the NESI should also be assessed through consideration of the international trade balance related to energy storage and adoption of U.S.-developed energy-storage technologies.

Proposed initial steps

The next president should sign an EO establishing the NESI and directing the White House Office of Science and Technology Policy to convene a federal interagency task force. The task force should prepare a strategic plan and develop a budget for the initiative in consultation with key stakeholders. The plan should identify technological needs and opportunities and set specific objectives, taking into account global competition and cooperation with respect to energy storage. Congress should support the NESI by appropriating funding needed to implement the strategic plan, and by providing additional authorization as required.

Implementing agencies should pursue energy-storage RD&D as it relates to their respective missions, while collaborating to manage overlaps and avoid gaps. RD&D activities should strengthen the intramural and extramural research and industrial communities. As innovative storage technologies reach maturity, DOC, DOD, and DOE should work with states and regional economic-development agencies to foster markets and develop manufacturing capabilities. Congress should provide tax incentives that help to pull these technologies into the market, thereby driving down cost and expanding deployment.

Conclusion

Energy-storage technologies in widespread use today are not good enough to meet fundamental 21st-century challenges, including climate change, economic growth, and international security. A national initiative to accelerate domestic development and deployment of dramatically improved energy-storage technologies would position the United States to lead the world in addressing these challenges while building its economy. Although global competition in energy storage is fierce, our nation has strong capabilities that—if used strategically—position the United States to catch up with and ultimately surpass its rivals in this vital emerging industry. The NESI provides a pathway for the next president to translate this vision into reality.

Making Computer Science Education Universal for All Students

Summary

This proposal outlines steps for the Federal Government to establish a national initiative to accelerate the implementation of rigorous computer science (CS) education for preschool through 12th grade (P-12) students in the United States. The initiative should include investments in evidence-based education pathways that incorporate computational thinking, computer programming (coding), cybersecurity, data science, social impacts of computing, and ethics, and prepare students for future careers working with technologies such as artificial intelligence (AI), machine learning, virtual/augmented reality, autonomous vehicles, automation, cybersecurity and other emerging and future technologies. This initiative is critical to enhancing the United States’ global competitiveness, economic growth, and technological innovation, while addressing pressing social challenges such as healthcare, social mobility, climate change and national security in an increasingly technology-driven and innovation-based global economy.

Closing Critical Gaps from Lab to Market

Summary

Closing critical gaps across the interconnected ecosystem that supports discoveries in science and technology (S&T), developing discoveries into promising inventions, and commercializing inventions into thriving businesses should be of top priority for federal policymakers. In brief,  intentional focus and dedicating resources to discovery and commercialization of inventions ensures that the United States maintains and expands its economic vitality, its global leadership in S&T innovation, and its strategic entrepreneurial advantages. This proposal presents a rationale and vision for the launch and deployment of a national plan—called Innovate the Future: The American Inventors Initiative—to provide comprehensive support and acceleration paths for postdoctoral researchers, early-stage entrepreneurs, and S&T investors, in order to advance domestic economic growth.

Creating the Health Advanced Research Projects Agency (HARPA)

Summary

The federal government can directly address the massive market failures at the center of our healthcare enterprise by establishing a new Health Advanced Research Projects Agency (HARPA)1 modeled after the Defense Advanced Research Projects Agency (DARPA)—the agency the Department of Defense uses to build new capabilities for national defense.

The need for HARPA is twofold. First, developing treatments for disease is difficult and time consuming. HARPA will provide the sustained drive needed to push through challenges and achieve medical breakthroughs by building new platform technologies. Second, the U.S. healthcare system largely relies on the private sector to leverage national investments in basic research and develop commercially available treatments and cures. This model means that diseases for which investments are risky or downstream profit potential is low are often ignored. HARPA will step in where private companies do not, addressing market failures with direct investments that ensure that all patients have hope for a brighter future.

HARPA will leverage existing basic science research programs supported by taxpayer dollars, as well as the efforts of the private sector, to develop new capabilities for disease prevention, detection, and treatment and overcome the bottlenecks that have historically limited progress. To do this, we have to think and act differently about how we address human health challenges. HARPA would support research that directly affirms, refutes, or otherwise changes current clinical practice. It would do this using milestone-driven, time-limited contracts as the central mechanism for driving innovation. This will ensure efficiency, transparency, and optimize success.

Challenge and Opportunity

Every year, the United States spends more than $3.4 trillion on healthcare and tens of billions of dollars on biomedical research. Yet we only have treatments for around 500 of the approximately 10,000 known human diseases.2 30 million people in the United States—half of whom are children—suffer from a rare disease for which no treatment has yet been developed.3 There are no ongoing efforts to develop treatments or cures for the overwhelming majority of these diseases. That massive market failure is the big secret of the biomedical research enterprise and is simply unacceptable. We need bold action to correct this massive market failure and revolutionize how we attack disease.

In 1958, the United States created the Defense Advanced Research Projects Agency (DARPA) at the Department of Defense. This new government agency was designed to make pivotal investments in breakthrough technologies for national security and directly address market failures that were impeding innovation. The establishment of DARPA launched a new era in defense innovation that led to countless innovations, including the Internet, stealth aircraft, GPS-based precision navigation, night vision, autonomous vehicles, speech recognition, and robotic prostheses.

We need to take the same aggressive entrepreneurial approach to health innovation as we have in protecting our nation from foreign threats. Creating a new Health Advanced Research Projects Agency (HARPA) would fundamentally transform the way the United States approaches treating the majority of human diseases, and would directly address many of the shortcomings of our healthcare and biomedical research systems.

Imagine being able to predict and intervene before someone has a mental health crisis; diagnose cancers at their earliest stages when treatments are most effective; end deaths from antibiotic-resistant bacterial infections; and provide treatments for rare genetic diseases. That is the promise of HARPA.

By applying the same tools that DARPA uses to develop new capabilities for defense (Section 3), HARPA would be engineered to close the gap between basic research and real-world needs. HARPA initiatives would target the diseases that affect millions of Americans but are going unaddressed because of risk aversion and short-term, perverse incentives in academia and the private sector. These initiatives would be funded through large milestone-driven timeline limited contracts needed to take on transformational projects, and would be led by top experts recruited for focused stints at the agency. The result will be an institution designed from the ground up to finally solve the most pressing healthcare issues of our time: skyrocketing drug prices, the tragic shortcomings of our mental-health support systems, the opioid crisis, unconscionable waiting lists for organ donations, medical errors, and many more. DARPA enabled the United States to lead the world when it comes to defense innovation. HARPA will do the same for healthcare.

Function

Federal funding for medical research is primarily allocated though the National Institutes of Health (NIH). Through its $41 billion annual budget, NIH funds basic science and clinical research through grants. Grants are typically awarded to individual projects at academic institutions. Collectively, these projects form the bedrock of our knowledge about biology, health, medicine, and disease.

Importantly, NIH is not designed to develop marketable disease treatments or cures or to develop new platform technologies that are intended to revolutionize medicine. NIH funding is used to support therapeutic and technology development, but not in a way that prioritizes quick, efficient commercialization of new discoveries. Moreover, NIH does not include a mechanism for ensuring commercialization. SBIR grants flail at the challenge of commercializing innovations with woefully inadequate funding. Simply put, the current path from NIH-funded basic science to applied research to viable commercial product is too slow, and it does not address massive market failures that define health research and development today, leaving many human diseases without dedicated efforts to uncover solutions. Funds for basic science and clinical research through grants—awarded to academic institutions that pursue particular, individual interests in discovery—are great for uncovering truths about biology, but are an extremely inefficient way to drive toward therapies that make their way into the clinic.

Private companies, on the other hand, only scale up and market economically viable therapies. Therapies that are potentially effective but have a limited market remain inaccessible to the public at large or come with astronomical price tags that patients simply cannot afford.

Effectively bringing new innovations to the market requires alternative approaches to the bottom-up grant funding common to NIH programs. Again, this is not to say that the NIH dollars are poorly spent. The dollars spent on research are essential to understanding health and disease. But an alternative model is needed to advance research toward the development of necessary technologies and treatments to cure disease.

HARPA would close these gaps. Just as NIH brings federal resources to bear on basic science and early-stage research, HARPA would bring federal resources to bear on applied science and later-stage development and deployment. HARPA would have three guiding functions:

  1. Launch and manage large-scale health-research initiatives. Although multiple federal entities4 work on health research, there is little coordination among these entities regarding research priorities, activities, or progress. HARPA would work with these entities—as well as with the private sector, academia, and states and localities—to launch and carry out targeted, multi-stakeholder research initiatives aimed at our most pressing underserved health challenges. Using milestone driven and timeline limited funding contracts, HARPA will be able to ensure rapid continuous progress. These initiatives would integrate the diverse capabilities of participating institutions to make real progress on persistent and pressing health problems.
  2. Invest in transformational platform technologies. HARPA’s focus will be on projects that have direct impact on clinical care. Basic science tends to advance methodologically and incrementally. This partly reflects the nature of the field (one set of experiments informs the next) and partly reflects the nature of incentives in academia (moving too far and too fast away from an established knowledge base decreases the likelihood of publishable findings). By contrast, HARPA will only support transformative research that will substantially improve clinical practice and this is how potential impacts will be evaluated. Pushing for such platform technology breakthroughs is a high-risk, high-reward enterprise. HARPA will focus on the uncertain but potentially transformational medical technologies and therapies that tend to go underfunded today.
  3. Support development of treatments and cures for all diseases. All taxpayers contribute to federally funded medical research. But not all taxpayers reap the benefits. Relying on the private sector to bridge the gap between basic research and commercially available products means that those with rare or difficult-to- treat diseases are often ignored. HARPA will correct this market failure by supporting development of treatments and cures for all diseases—especially those that are being neglected by the existing healthcare ecosystem.

Structure

HARPA would be modeled on DARPA. DARPA is considered the “gold standard” for innovation and accountability within the federal government. DARPA is also distinct from other federal agencies that fund research and development in that it is focused on building capabilities rather than simply advancing knowledge. This unique mission requires DARPA to have a unique set of attributes and operating principles, including the following:

Many, if not all, of these characteristics could be carried over to HARPA. HARPA could also adopt DARPA’s funding-management model. Under this model, all funding allocations would be left to the discretion of the HARPA Director while all funding oversight would be entrusted to HARPA PMs. Funds would be awarded as milestone- driven contracts that give PMs the capacity for early termination if a particular project is not yielding desired results. This almost never happens with traditional federal grants for research and development.

Because HARPA will differ in structure and function from traditional research-funding agencies, it is sensible for HARPA to have a reporting chain of command separate from NIH. We believe that HARPA would be best situated directly under the Secretary of Health and Human Services (HHS) or under the HHS Assistant Secretary for Health. The Biomedical Advanced Research and Development Authority (BARDA) provides precedent for placement directly under the Assistant Secretary for Preparedness and Response.6

Path to Establishment

HARPA could be established under existing authorities, but, ideally, would be established through authorizing legislation and new appropriations. There are several steps the federal policymakers could take to kick-start the establishment process. First, the president could issue a Memorandum or Executive Order directing the HHS Secretary to develop a blueprint for HARPA’s establishment as well as a strategic plan for HARPA’s activities. These documents would include identification of priorities and goals; analysis of global markets, policies and production capabilities; structure and accountability; and initial funding recommendations. Ideally, they would be developed by a short-term Federal Advisory Committee (FAC)—comprised of top physicians, health researchers, and innovative thought leaders. It is important that the FAC include avenues for external input, including providing and promoting a public comments period and convening stakeholder for a across the country. After these documents are developed, the president could urge Congress to deliver a bill establishing HARPA.

Alternatively, the President could include funds for HARPA in an annual budget proposal under the Assistant Secretary for Health or Assistant Secretary for Preparedness and Response. (If Congress appropriates those dollars, HARPA could be established without authorizing legislation.7) We believe that a minimum budget of $100 million for HARPA in its first year and $300 million in its second year would be sufficient to get the agency started and to establish high-impact programs, but to be truly transformational, the agency should ramp up to several billion in research expenditures annually. Throughout this process, the president should use high-profile speeches and events to publicly explain the need for HARPA, and to advocate for its creation.

Vision

With a DARPA-inspired structure, HARPA would achieve rapid translation of biomedical discoveries into patient-care capabilities. HARPA’s mission and activities would be synergistic—not duplicative or competitive—with existing federal research efforts. In particular, HARPA would use fundamental scientific understanding developed with NIH support as a foundation for developing breakthrough medical advances.

HARPA would operate in a health ecosystem that includes biotechnology, pharmaceutical, and healthcare companies, venture capital and philanthropy, academic institutions, and government and regulatory agencies. HARPA would address two of the most prominent shortcomings of this ecosystem: (1) the aversion to failure that limits the willingness of academics and the private sector to pursue high-risk, high-reward projects, and (2) profit incentives that limit the willingness of the private sector to develop therapies for rare or difficult-to-treat diseases. HARPA would provide the capital and supportive, focused research environment needed for experts from all sectors to demonstrate “proof of principle” for various medical innovations. In doing so, HARPA will drive explosive growth in the number of technologies, treatments, and cures that cross the so-called “valley of death” separating lab-scale insights from commercially available products.

HARPA would focus on developing transformational technologies that fundamentally change the way we do health research and deliver care. By focusing on the development of tools and technologies to transform the way we approach diseases, HARPA can establish mechanisms that ensure wellness and curing disease are prioritized, while correcting the perverse incentives in the market that limit the country’s ability to receive treatment.

There is a rich history of under-funding the development of such technologies even though they are often quickly engrained into the healthcare enterprise, making it difficult to imagine life without them. They enable breakthroughs that even inventors did not anticipate, create entire new fields of research, and often result in Nobel Prizes. They establish jumping-off points and serve as accelerants for progress. Such work is typically high-risk, high-reward and aims to build transformative capabilities rather than incremental discovery-based research that is commonly funded by the NIH. While NIH does a tremendous job of funding basic science and clinical research, HARPA will build new capabilities on the foundation that agencies like NIH and the Department of Veterans Affairs establish through their funding.

For instance, HARPA could drive the following:

Beyond Health

It has not escaped our notice that the same market and institutional failures that created the valley of death and need for DARPA and HARPA exist in other areas of research and development. Our nation is facing unprecedented challenges associated with climate change and the need to provide a better world for all. We feel strongly that the federal government should establish additional Advanced Research Projects Agencies (ARPAs) to complement the efforts of other federal agencies and the private sector. Doing so would enable the government to take a leadership position in tackling monumental challenges.

We believe that, in addition to HARPA, the nation needs to establish capabilities in agriculture (AgARPA), the environment (EnARPA), and transportation/infrastructure (TARPA). Fleshing out the details for establishing each of these entities should fall upon the White House Office of Science and Technology Policy in coordination with the Office of Management and Budget, the President’s Council of Advisors on Science and Technology (PCAST), and the leadership of the appropriate federal agencies. Creating these new capabilities will kickstart new industries, create the jobs of the future, and improve our ability to be better stewards of the Earth. Without them, the nation risks continuing its piecemeal approach to addressing our most pressing challenges, while slipping further behind other nations investing heavily in innovations aimed at solving these global challenges. Establishing ARPA capabilities across the federal government would create a network of forward-thinking agencies prepared to address intractable challenges, while building an extraordinary, lasting legacy.

Combating Digital Disinformation: Resisting Foreign Influence Operations through Federal Policy

Summary

Internet-based disinformation operations have infiltrated the universe of political communications in the United States. American politics and elections carry major implications for the national and global economy, as well as for diplomatic relations conducted by and with the United States. As a result, the United States is a major target for politically charged propaganda promulgated by both foreign and domestic actors. This paper presents a two-part approach to countering internet-based disinformation.

Mass-Digitizing Biodiversity Collections of the United States

Summary

Mass digitization of U.S. biodiversity collections would position the nation to achieve massive advances in the life sciences—a leap forward on par with the way that DNA technology transformed genomics at the start of the 21st century. This heritage consists of hundreds of millions of dry, wet, and otherwise preserved specimens in U.S. museums and other collections, including plant germplasm, microbial cultures, non-human biomedical samples (e.g., parasites), fossils, and other plant and animal samples. This proposal presents actions for the Biden-Harris Administration to take to catalyze this advance to pave the way for a sustained, coordinated effort to mass digitize the physical specimens in U.S. biodiversity collections (and their associated metadata).

Modernizing Radio Spectrum Management

Summary

The Biden-Harris Administration should pursue a set of policies aimed at maximizing productive use of the radio spectrum, a key public good that can be used to create economic and social value. These policies should include adjustments to the institutions that manage the nation’s spectrum; a redefinition of spectrum rights and responsibilities enjoyed by companies that use the spectrum; and options for using the economic value created by spectrum auctions to address persistent public problems.

Smart Cities Technologies: Driving Economic Growth and Community Resilience

Summary

Today, cities across the United States face significant challenges. The future of economic growth is uncertain. Community leaders struggle to make overburdened transportation and energy systems more resilient to climate change, while workers grapple with the impacts of automation on jobs. First responders are stretched too thin as they react quickly to public-safety needs such as natural disasters.

An emerging set of smart-city technologies from industry and university labs offer communities tools to help address these challenges. Smart-city programs deploy sensors, networks, and data analysis to expand economic opportunities for citizens and make communities more resilient. While smart-city technologies are not panaceas for urban challenges, they can enable communities to move more quickly and cost- effectively in addressing some of their most difficult obstacles.

But smart-city technologies are not yet being used to their full advantage. In particular, small-and medium-sized cities lack the resources, networks, and investor appeal that has enabled larger cities to race ahead in implementing and scaling such technologies. Federal support is needed now to help advance smart-city technologies in underserved communities, helping all Americans to succeed and thrive.

To achieve this goal, federal policymakers should convene representatives of cities, industries, universities, and federal agencies to identify obstacles to adopting smart-city technologies and to identify gaps where the federal government can provide additional support. This group should be tasked with developing a National Smart Community Strategy to be carried out through a coordinated interagency effort. The Strategy should include a mix of short-, medium-, and long-term goals and actions, such as:

Challenge and Opportunity

1.1 Potential of smart-city initiatives

Over the past five years, the Internet of Things (IoT)2 has enabled communities to evolve into “smart cities”—cities that leverage sensors, networks, and data analysis to address challenges in healthcare, energy, the workforce, and other sectors. IoT networks include a range of technologies that connect everyday objects like cars, pacemakers, and thermostats to the internet to drive cost savings and improve safety. Examples of smart- city applications include:

San Diego, California and Chattanooga, Tennessee provide examples of smart-city initiatives in action in the United States. San Diego spent more than $30 million to install 4,200 LED smart lights, traffic sensors, and pedestrian and public-safety monitors. Converting to LED lights saved the city approximately $3 million a year in power costs, which covered the additional cost of the smart sensors. The success of the upgrades motivated city leadership to recently add an additional 1,000 smart lights and sensors.5 Chattanooga was an early adopter of high-speed fiber-optic internet networks and smart-grid applications. One study found that from 2011 to 2016, Chattanooga’s investment in these and related technologies helped to create 3,950 jobs.6

Yet San Diego and Chattanooga are the exception rather than the rule. In general, the potential of smart-city technologies is going under-realized in the United States. We as a nation are failing to deploy, test, and scale what works. Successful technology development must be supported by experimentation, yet U.S. investment in testing the next generation of wireless networks, sensors, and data analytics has slipped behind the likes of China, East Asia, and Europe. This has left many American cities reliant on global industry partners to implement smart-city strategies.

1.2 Obstacles facing smart-city initiatives

Deploying and scaling smart-city initiatives has proven to be technically and financially prohibitive, especially for small- to medium-sized rural and urban communities. San Diego, Chattanooga, and other larger U.S. cities possess the right mix of investment, political will, and cross-sector collaboration to realize the full benefits of smart technologies. But smaller cities lack these vital capacities, making it difficult to invest in smart-city technologies and/or to move beyond the pilot stage of smart-city strategies. Specific obstacles include the following:

The upshot is that the United States has much ground to make up when it comes to building the next generation of smart cities. Federal agencies can play an important role in laying the foundation for a new set of smart-city services and ensuring global competitiveness in urban and economic development. Federal agencies will also be key in ensuring that smart-city technologies benefit all Americans, not just those in high- income and urban settings.

Proposed Action

The federal government should launch a concerted national effort to expand the reach, readiness, and capacity of smart-city technologies, especially in smaller and underserved communities. This effort should be guided by the following fundamental principles:

To begin, federal policymakers should convene representatives of cities, industries, universities, and federal agencies to identify obstacles to adopting smart-city technologies and to identify gaps where the federal government can provide additional support. This group should be tasked with developing a National Smart Community Strategy to be carried out through a coordinated interagency effort. An interagency working group should then be established to (1) oversee Strategy implementation, (2) identify additional options for expansion of federally funded smart-city R&D, and (3) identify barriers to use of federal community funds for smart-city initiatives. The Strategy should include a mix of short-, medium-, and long-term goals and actions. Short-term goals (i.e., over the next 2–3 years) should include creating new funding and support options for researchers and communities, especially in cities underserved by existing industry and federal investments. Medium-term goals should include developing a new set of expanded city services that enable more responsive governments and new economic opportunities for U.S. cities large and small. Long-term goals include making the United States a global leader in developing and deploying smart-city technology. Below, we propose specific policy actions designed to achieve these goals. These actions are intended to span a range of national priorities—including transportation, energy, and public safety—and to build on existing federal, state, and local smart-city programs.

2.1 Launch a smart city prize competition

The federal government has, to date, completed over 1,000 prize competitions across 100 agencies through its Challenge.gov platform. One of these, DOT’s Smart City Challenge8, specifically involved deployment of smart-city technologies to improve urban transportation. This approach could be easily extended to other smart-city domains, accelerating adoption of smart-city technologies nationwide and offering startups, students, researchers, application developers, and others a valuable opportunity to work with local communities on new solutions. We recommend that a national smart city prize competition (1) reward smart-city proposals that deliver clear benefits for underserved communities and (2) require communities to scale their smart city pilots to citywide services and secure industry and local matching funds. If federal agencies offered $250 million annually in total support across a range of sectors, competing communities could raise several times that from state, local, industry, and foundation partners. Support bundled together could easily top $1 billion in federal, local, and partner funding for smart cities.

2.2 Expand existing community development programs

The Department of Housing and Urban Development’s (HUD) ConnectHome pilot program9 allows HUD funding to be used to provide digital-literacy training for and distribute internet-connected devices to public-housing residents, and to install broadband networks in public housing units. Creating similar smart-city programs at HUD or other agencies would allow local public-housing authorities to leverage HUD funding for smart-city deployments and workforce training for residents. Since some HUD programs have a match requirement, these programs could also create even larger impacts by driving community reinvestment into smart-city efforts at the local level.

2.3 Award planning grants targeted at underserved communities

Before communities can take advantage of the opportunities afforded by smart-city technologies, they have to understand just what those opportunities are—and how their cities or regions could benefit. Small planning grants, such as those awarded by the Economic Development Administration’s (EDA) Economic Development Planning Assistance Program10, could support dozens of cities with $50,000 to $100,000 each to take this first step.

2.4 Expand support for regional innovation ecosystems

EDA provides communities with funding for smart-city startup accelerators, workforce training, IoT networks, and planning.11 This funding could be increased to provide additional resources for smart-city startups or workforce training in underserved communities.

2.5 Expand R&D programs

Funding for R&D and pilot-project grants from agencies including DOT, the National Science Foundation (NSF), the Department of Energy (DOE), the Department of Homeland Security (DHS), and the Department of Defense (DOD) would accelerate domestic progress on technologies such as smart grids, autonomous vehicles, and remote healthcare. Funding should be used to enhance existing and effective programs (e.g., NSF’s Smart and Connected Communities Program, DOE’s Advanced Grid Research and Development Program12), as well as to expand funding for smart-city technologies to new agencies.

2.6 Use Presidential and Congressional authority

The next president should issue an Executive Order (EO) directing federal agencies to use existing programs to support smart-city R&D and to help expand access to smart- city technologies in underserved areas. In addition, if smart-city legislation (Section 4) does not pass in this Congressional session, the next president should support introduction of an updated and expanded smart-city bill in the next session. Such a bill should incorporate feedback from communities and other stakeholders as an important precursor to securing bipartisan support.

Historical Precedents

There are almost 50 existing federal programs related to smart cities and broadband infrastructure that could support the goals outlined in this paper.13 These programs support every stage of the smart-city pipeline, from support for R&D to community support for implementation. Some are narrowly focused on “smart cities” specifically, while others have a broader scope that includes funding for smart-city technologies as a component. Detail on several of these programs is provided below.

3.1 Smart City Challenge (Department of Transportation)

The Smart City Challenge asked “mid-sized cities across America to develop ideas for…[a] smart transportation system that would use data, applications, and technology to help people and goods move more quickly, cheaply, and efficiently.” DOT committed up to $40 million to help the winning city implement its vision. The challenge drew applications from 78 cities, and elicited proposals developed by city leaders, universities,

industry, and nonprofits working in collaboration. The challenge also led to over $90 million in matched funding from local industry partners in the winning city of Columbus, Ohio, as well as $10 million from Paul Allen’s Vulcan Inc.14 The Columbus proposal focused on providing better access to underserved neighborhoods and motivated establishment of an autonomous vehicle pilot with May Mobility in Columbus’s downtown.

Several cities, like Denver, that were selected as challenge finalists (but not winners) have followed through on ideas generated as part of the challenge process. Several of these cities have since received sizable grants from DOT (from $5 to more than $10 million) to implement projects and establish partnerships outlined in challenge proposals.

3.2 i6 Challenge (Economic Development Administration)

As part of the Department of Commerce, EDA is focused on job creation and economic development within low-income or high-unemployment areas across the country. The agency has traditionally provided communities with funding for projects ranging from training facilities to roads to networks of fiber-optic cables. The launch of EDA’s i6 Challenge in 2010 was novel for the agency in two ways: first, by being a prize competition, and second, by focusing on supporting startup accelerators. The challenge offered $12 million in funding for startup accelerators, with one prize for each of EDA’s 6 national regions (giving the program its i6 name). The i6 Challenge expanded quickly. A second round of awards was made to help communities launch new seed funds, and the program budget has been doubled to almost $24 million awarded to 44 organizations in 2019.15

3.3 Smart and Connected Communities Program (National Science Foundation)

Numerous federal programs support R&D projects narrowly targeted on one sector, such as healthcare, energy, or public safety. NSF’s Smart and Connected Communities (S&CC) program is one of the few programs that targets smart-city R&D across each of these technology areas. This annual grant opportunity offers universities and their community partners funding to develop the next generation of smart-city technologies. The S&CC program’s goal is to create “living labs” by supporting university research efforts within a partner community. Last year, NSF announced over $22 million in awards across 13 communities and 35 universities nationwide.16

3.4 ConnectHome (Department of Housing and Urban Development)

Launched in 2015, HUD’s ConnectHome pilot program allowed HUD funding to be used to provide free broadband services, digital training, and devices. The program targeted students (and their families) in public housing by leveraging newly adopted flexibility within existing HUD funding opportunities. ConnectHome started with 28 communities and quickly grew. The program reaches 56 communities and 52,000 students today, and has a goal of reaching more than 100 communities by 2021.17 While ConnectHome is not focused on smart-city technologies, this digital-inclusion initiative offers an approach for leveraging existing funding authorities and funding programs at HUD and other agencies to support smart-city technology deployment in underserved areas.

Stakeholder Support

There is bipartisan support for smart-city funding and programs at all levels of government. In Congress, the Smart City Caucus is co-chaired by Reps. Yvette Clarke (D-NY) and Susan Brooks (R-IN). A smart-city bill has been introduced in multiple Congressional sessions, although none has yet passed. On May 9, 2019, three members of the Smart Cities Caucus reintroduced their Smart Cities and Communities Act, which would provide $1.1 billion in agency funding over five years for smart-city initiatives.18

A large contingent of industry leaders and startups have entered the smart-city space to provide equipment, software, data analytics, and other smart-city services to cities. Stakeholders include large telecommunications providers, technology vendors, chip manufacturers, and cloud-service providers plus dozens of unique startups with their own market niche. No single company can supply a full range of smart-city services to a community, so many companies have begun forming partnerships to provide a “one- stop shop” for city leaders. These new partnerships can foster new applications of smart- city technologies and smart-city services.

Universities strongly support more R&D funding for foundational smart-city technologies, such as linking communications networks, IoT sensors, and data analytics. There is a particular need to fund real-world tests and evaluations of novel technologies emerging from university labs. Federal funding designated to support commercialization and deployment of new technologies would help researchers cross the “valley of death” that separates the lab from the marketplace.

Conclusion

Building resilient, equitable, and sustainable communities is difficult. Challenges in public safety, transportation, energy, healthcare, and other domains will only continue to grow in coming years. Smart-city technologies can help cities, small businesses, and local leaders address these challenges. The potential benefits are especially large for smaller, more rural, and lower-income communities. To help realize these benefits, the federal government should launch a national smart cities initiative with $1 billion in support from federal and external sources targeting underserved communities to catch up with leading U.S. cities, and the United States as a whole to catch up with the world.