Nirsevimab

Alicia Jackson, Ph.D., credits her experience as a founder of two startups, Evernow and Drawbridge Health, as formative for her Advanced Research Projects Agency for Health tenure.\n The new leader of the Advanced Research Projects Agency for Health (ARPA-H), a Biden-era health innovation program that has remained intact despite President Donald Trump’s substantial cuts to federal science funding, thinks her office can help make the current controversy around vaccines a thing of the past—by rendering vaccines themselves obsolete.“It\'s funny how we always talk about vaccines,” Alicia Jackson, Ph.D., told Fierce in early January. “There\'s actually a multitude of other technologies that you can use to protect people against infectious disease.”One day, she added, we all may wonder “why were we even having that debate in the first place.”Jackson sees advancing new approaches to quell infectious diseases, like monoclonal antibodies, as a key part of her mandate as the head of ARPA-H. The agency is offering up to $30 million to Vanderbilt University Medical Center to build an antibody-generating artificial intelligence algorithm that can be used for a range of diseases, including viral and bacterial infections, as part of a broader $204 million effort to find new viral antigens.She also pointed to the success of AstraZeneca and Sanofi’s Beyfortus (nirsevimab), an antibody that can protect infants from respiratory syncytial virus (RSV).“It gives you passive protection through antibodies for five months,” Jackson explained. “So one question is, can we make antibodies last longer?” Beyfortus and Merck’s prophylactic RSV antibody Enflonsia (clesrovimab) are both currently under scrutiny from the FDA for perceived safety issues, as part of the administration’s broader attacks on vaccination—even though both are not traditional vaccines.“Monoclonal antibodies have a role, especially for people who cannot receive vaccinations, but they do have several limitations,” Anna Durbin, M.D., director of the Center for Immunization Research at Johns Hopkins Bloomberg School of Public Health, told Fierce. Most importantly, they don’t trigger memory in the immune system the way vaccines do, so they have to be administered “again and again and again each time you want protection.”“For some diseases, such as flu where we give annual vaccination, a monoclonal antibody may be fine,” Durbin explained. “But for other illnesses such as measles, mumps, rubella, chicken pox, polio, etc., vaccination provides long-lived protection that monoclonal antibodies cannot.”Antibodies also have the disadvantage of being given through IV infusion, Durbin added, and are much costlier than vaccines.“Most countries in the world cannot afford them,” she said.Before Jackson took office at ARPA-H, the agency’s chief data officer departed after disagreeing with the administration’s decision to cancel $500 million in funding for mRNA vaccine research from the Biomedical Advanced Research and Development Authority (BARDA). BARDA is a separate division of the Department of Health and Human Services (HHS).Asked about the mRNA research cancellations, Jackson responded that mRNA as a tool and technology is still being developed for a variety of other purposes, like cancer therapies.“We develop the technology, but it\'s really up to Congress and the American people and the regulatory bodies to decide how we want to deploy that and to determine the safety of it,” she said.Outside of vaccines and therapeutics, ARPA-H also recently announced the awardees of an up to $156 million initiative to improve indoor air quality in order to prevent the spread of pathogens and allergens.The effort “will revolutionize public health by greatly advancing our ability to detect and address indoor air quality threats like never before,” Jason Roos, Ph.D., who was then the acting director of ARPA-H, said in a Sep. 29 release. “ARPA-H’s investment has the potential to bring about the next-generation of smart buildings, making sure indoor air is always clean and healthy.”Health agency homecoming       Getting the call to rejoin the government and lead ARPA-H was a dream come true for Jackson, who previously worked for six years at the Defense Advanced Research Projects Agency (DARPA), including a stint as deputy director of the biological technologies office.“I\'d always said after I left DARPA, the only job I\'d ever come back for would basically be to lead an ARPA-H,” Jackson said. Former President Joe Biden launched ARPA-H in 2022, with the initiative modeled after DARPA.Jackson was sworn in as ARPA-H director in October 2025, leaving behind her women’s health startup Evernow to take the government gig. She credits her experience as a founder of two companies, Evernow and Drawbridge Health, as formative for her ARPA-H tenure.As leader of a young agency, her experience “building something from scratch” has “come to play” for ARPA-H, she said. “Understanding how you do that step by step, build a culture, build a vision, and also how to operate super leanly like at startups.” Sabrina Johnson, founder and CEO of women’s health biotech Daré Bioscience, told Fierce at the J.P. Morgan Healthcare Conference last week that Jackson is the “real deal.”Jackson “brings exactly the kind of leadership ARPA-H was designed to have,” Johnson elaborated on Jan. 16. “A rare combination of scientific rigor, clinical insight and real-world experience translating innovation into patient impact.”ARPA-H currently employs about 30 program managers, whom Jackson called the “life and blood” of the agency. The director added that she hopes to hire as many as 20 more.“They\'re the folks coming from academia or industry or research organizations, and they\'re here for only three years,” Jackson told Fierce. “They have to go after a big area. They got a new idea that they pitch before they come in, that they get to bake when they get here and launch. They\'re the most important people here.”Each program manager is like a mini CEO, she said, inking contracts with external companies and academic institutions in order to develop groundbreaking new technology. Recent major funding initiatives from ARPA-H have supported in vivo CAR-T cell therapy, custom gene editing therapies like the one that treated baby KJ and autonomous stroke-treating robots.As other nations like China ascend in the life sciences, Jackson’s goal is “winning the biotech race” by supporting daring new technologies that the industry would find too risky to fund. Areas of focus for the new director include rare diseases, like pediatric cancers, as well as reversing the effects of aging.“If you can reverse biological age by one year across the nation, there are estimates [of] about $38 trillion in economic value [that] could be created through saved health care costs,” Jackson said.Achieving her mission means aligning with the rest of the federal health apparatus, which has faced significant leadership upheaval during Trump’s second term, including the February firing of Jackson’s predecessor. On that front, Jackson said she’s faced little friction.“Every conversation we have is constructive, and everybody gets everybody\'s mission,” she said, adding that she regularly meets in person with HHS Secretary Robert F. Kennedy, Jr., as well as FDA Commissioner Marty Makary, M.D., Centers for Medicare and Medicaid Services Administrator Mehmet Oz, M.D., and NIH Director Jay Bhattacharya, M.D., Ph.D.“It\'s awesome right now,” Jackson said. “I\'ve never had that experience before in government.”