Episode 142: How ARPA-H is Reimagining Women’s Health and Maternal Care

From maternal health to life-changing technologies, today we're exploring how ARPA-H is rethinking what's possible. You're listening to Bio from the Bayou, empowering biotech leaders with the tools, assets, and expertise to improve healthcare outcomes.

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Serving the entire Gulf South, but recorded in the heart of New Orleans. Welcome back to Bio from the Bayou. I'm your host, Dr. Elaine Hamm, the executive in residence at Tulane School of And with me is today's guest, Dr. Kate Arnold. She is a program manager at the Advanced Research Projects Agency for Health, or ARPA-H, a lot easier to say. Welcome to the show, Kate.

Thank you. Thank you for having me.

Well, we know each other beyond the government, so let's talk a little. I mean, we met back in Oklahoma City. Were you in your residency at that time? Remind me.

I was just a little intern.

Oh, you were an intern at that time?

Okay.

So—

So nice to meet you. I was just a little intern.

I, Had just landed in Oklahoma City. I was a little bit of a hot mess. I had just adopted 3 kids and I had this idea of a surgical device and you took me seriously and you were so kind.

And I really think that has like truly encouraged me to continue on this route.

So.

Oh, that's really great to hear. Well, I'm glad. I'm so glad. Yeah, it's always great. I love it when physicians come in with their ideas because they, they know the problems because they're experiencing the problems. So I love hearing that because you're the customer as well of just trying to make sure that you're doing right by your patients and. getting cool technologies out. But now you are from Oklahoma City to DC. Let's talk a little bit about how that transition works. So you spent your career as an OB-GYN and healthcare leader. How did you wind up in DC as a program manager at ARPA?

Well, I mean, I don't know if you're my fairy godmother or what, but interestingly, you played a little bit of a role in that transition as well.

Really?

Yeah. So after residency, I stayed in Oklahoma. I was the medical director at a federally qualified health center there, which I loved. It was like half leadership job, half patient care. I got to keep working with residents. It was fantastic. And then I felt like I wanted to do some innovative ideas, which prompted me to get my MBA because using my doctor lingo was not working for communicating new ideas.

I got my MBA.

And then eventually when my family and I decided to move to Washington, DC, I was really feeling the itch to kind of make this broader, bigger impact and take all that, that I had learned from every single patient into a bigger impact. I reached out to you again.

Yep. You connected me to Allison. And so then I got to join Allison as part of Yoni Fit, which was incredible. I learned from her. Yeah.

Allison Conti. Yeah. She's working on a bladder incontinence device.

So yeah, and she is just such an impactful leader. And so definitely working with her was amazing.

And then ultimately, literally somebody reached out on LinkedIn from ARPA and said like, hey, you look like you're an OB-GYN who likes doing innovative things.

Are you interested? I didn't know at that point you had to come in with like this program idea and everything. So really, that was a little bit of a surprise. But ultimately, I was working as a hospitalist at that point, which means I was just on labor and delivery all the time.

Just staring at these fetal heart rate tracings, trying to make the right decision.

Having doctors fresh out of training coming into my call room literally crying because they thought they were preventing the C-section and instead—

Yeah.

The sick baby. So as soon as we landed on that topic, things with ARPA were, were really exciting. I immediately got paired with all kinds of multidisciplinary people who could really develop it into a whole program with a vision of how we want things to look.

That's really where you start at ARPA.

It's, it's a crazy job cuz you come in with this, this program idea and then run from there.

That's a heck of a job interview of like, here's, you know, how I wanna impact medicine for the future and help save babies. No pressure whatsoever on that job interview.

Yeah.

And at the bottom they're always like, what are your additional 2 to 3 ideas? Yeah.

4.

Step 2, question marks. Step 3, profit. Yes. Love that. Well, so ARPA, let's talk a little bit about that for— can you please explain a little bit about ARPA-H for our listeners that may not know a ton? I mean, we mainly have scientists and biotech and entrepreneurs as our listeners, but ARPA and government can sometimes blur together and it's a little nebulous sometimes. So I'd love to understand a little bit about the agency and how it differs really from the traditional sort of NIH piece. That we often think of.

Yes, absolutely.

I would say people, especially in women's health, and a lot of scientists are not familiar with ARPA. So I think that's a very wonderful question. And we, we are really looking to work with everyone in the scientific community. So I'm excited to get your listeners some information. So at ARPA, we fund specific ambitious health outcomes. So not incremental. There are like Tons of analogies for this. I think our first director used to say that we want to be like Ford, where everyone else is trying to add a horse and we invent the car.

Right now, like, our mission office director, Natalie Cates, is talking about it, that we want to go from gravel roads to high-speed rails.

Wow.

OK. Our, our, our CMO describes it as a time machine that goes decades into the future, but it only takes a couple of years. So—

Again, no pressure whatsoever on that. I love that, though.

It is a lot of pressure.

It's also obviously an incredible opportunity.

Yeah. Hey, there's money sitting here.

Yeah.

It can come with your idea. You have the ability to be part of just this fundamental change.

Like, yeah, I know we'll talk about MOX, but like, if this change in how we monitor moms and babies on labor and delivery is successful, I mean, it will literally rewrite the textbooks. Like, it is such an opportunity.

Yeah. But it is an intimidating one. One thing I will say, the other thing that everyone, every like scientist we talk to is, is a little bit surprised about with ARPA, there's a couple things.

One is that we're really high risk.

So we expect that. We think that, you know, if we're not failing, then we're really not using our funding correctly. We're not looking for like the logical next best step. We're looking at like, gosh, this is a little bit of a crazy idea, but if it works, Yeah. It will totally change healthcare.

In that, I think because of that, we're incredibly involved. So this is not a grant where like, congratulations, here's your money, we'll see you in a couple years.

It's milestone-based.

So performers get paid for work.

So we meet with them every month at a minimum, and we are talking about like, hey, what happened this month? Like, how did things go? You were working on XYZ, what are your results? Is this the right direction still?

Right.

And the nice thing is that we have the flexibility to pivot. So if somebody gets on the phone with us and it's like bad news, yeah, work, then we can say, okay, well, what's next? Like, what are other opportunities? What can we go after? So it truly is completely different from the NIH. And I think the more that people can understand it as like that it is something totally different as opposed to like it's Yeah.

It's kind of one of those things, like, if you're like, okay, this may sound like a crazy idea. And you're like, no, that's exactly what we're looking for.

Yes. Yes.

I love that. Well, and you're in a field that is really starting to, I wouldn't say up and coming, but it's just gotten finally enough attention, which is women's health. This has been a huge challenge in the healthcare industry for doctors like you, for patients like me and the many patients out there that are listening. And, and it's really a huge health problem that hasn't been addressed. And I feel like finally now we're seeing a lot more of pharma and diagnostic companies and investors taking women's health seriously. And it's a huge white space and good, good, because the women's health gap is adding about $1 trillion annually to the global economy. And that's complicated. And women spend about 25% more time in poor health than men. And so this has been such a huge issue. But more importantly, you're starting to dive into, and this is a really exciting program that addresses such a really, can be scary time in a mother's life, and that is pregnancy and childbirth. We always think of it as this magical, heartwarming experience for a mother, but it's a very serious medical concern too. There's a lot of risks that come with pregnancy and childbirth, and love to talk a little bit more About your new programs around that.

Thank you. Yes, we're very, very excited.

As I said, this was what I came into ARPA Health to work on. And, you know, there's the big picture that the US has highest maternal and infant mortality of any wealthy nation despite spending so much more per capita than any other country.

Yep.

And so when you look at that, you say like, gosh, we've gotta be able to improve. And I think, Physicians and patients and the healthcare team in general are pretty tired of being told to just do better with the tools they have.

Right. And so MOX is really developed to say, what new tools can we give providers and care teams and patients to make this better?

Because I think, you know, there are so many things in women's health that get billed as societal problems.

We have lots of societal problems, but technology can help.

Yeah.

And so we're looking at, is this an area where technology can help?

And I think now that we've picked our teams that we're funding, I can say absolutely.

Like this is so exciting, and really what we're targeting is saying let's give people more insight into how that baby is doing on labor and delivery.

And with that, you kind of get two impacts, right? You get that physicians get to do only the necessary C-sections. We get to stop doing unnecessary C-sections.

C-sections dramatically increase a woman's risk of mortality, and oftentimes. Just in that pregnancy, that's in the need for repeat C-sections in the future.

And then additionally, we have babies that are born hypoxic, low on oxygen, because our monitoring tools made it unclear if they had oxygen or not, and some poor doctor had to make a judgment call.

So we're really trying to address both of those things. And then lastly, as a provider, like I mentioned, burnout is just so prevalent. Because of this, because you do your best and you still get burned. And that, yeah, that getting burned part can last for years of being in a courtroom with litigation, with being told that you're a terrible doctor. Yeah. Despite the fact that you did your best with limited information. So this program is so exciting because I really think when it's successful, it will address all of that.

So talk about this program. So it's Making Obstetrics Care Smart, or MOCS.

So, mm-hmm.

Let's talk about the technologies or approaches or ideas that you're hoping come across your desk.

They have, they already have. We have chosen who to fund. It was an incredibly ambitious process, you know, not just for our requests from people, but in the timing of it. We announced this program in November, applications, like full applications were due in January, and we just made awards. So Technical Area 1 was the first area. It really came out of stakeholder discussions. So you mentioned there's, there's so many different players in women's health, and my job is to be on the phone all the time hearing all those different perspectives. And so TA1 is pretty cool because it, it literally just came out of those stakeholder discussions when people were like, oh, TA2 is cool, but what about this? Wouldn't this be nice? And so what TA1 looks at is When a woman is in triage on labor and delivery and you make the decision to admit that woman, that right now we have no clue how risky of a delivery that's apart from her demographics and her current diagnosis. Yeah.

And really this test is looking at how could we know that?

Because any delivery site benefits from that information. Right. We talked to birthing centers that said, hey, I wanna do shared decision-making with my I want to tell my patient you have a 70% risk of fetal hypoxia. Do you want to stay at this birthing center where I can't do a C-section, or prefer to be at a hospital? Yeah, and they can involve shared decision-making for that patient. Rural hospital, same concept, right? They can that risk and decide, hey, do we have the right support care for this patient? Urban hospitals or hospitals that are accustomed to high-risk patients. C-sections and all those kinds of things, want this information more for who can still be at home call and they'd be like half an hour at the hospital. Yeah.

And nursing ratio.

There's a wide range of kind of acceptable nursing ratios. And if you knew as a charge nurse, hey, I have like 5 out of my 7 patients that might get complicated, you would know to staff at the top of your nursing ratio.

So for TA1, we're funding 3 teams. ARPA really really does have downselects throughout the process.

So these 3 teams are funded for 1 year, and then they'll likely be downselects through the program so that we'll get to the end with, with not all of our performers.

And again, that's—

Sure.

Meant to acknowledge that this is high risk. So right now what we have is we have UCSD, they're going to be working on a blood test using multi-omic analysis of fetal and maternal proteins to evaluate hypoxia risk at admission.

Wow.

We have a group at UNC Charlotte that has a wide base of collaboration, but they're looking at a wearable autonomous ultrasound device to evaluate fetal health without a technician.

So what that means is that they would essentially put like an ultrasound patch on a woman and it would assess the quality of that placenta.

Wow.

Without a technician, without any interpretation, without a physician interpretation, the nurse will just get an output and tell you, hey, this is the health of that placenta. And then lastly, Wyss Institute is working on a microfluidic device that's going to look at extracellular vesicles and actually look at the contents inside them. UCSD is actually doing some work on, on the number of extracellular vesicles, but Wyss is looking at the content of those extracellular vesicles from the placenta. To predict risk.

Oh, that's super interesting.

We are really excited about those 3 tests. I think they are designed to start in triage because that's frankly where implementation will be successful given liability risk.

Yeah.

Um, because nobody wants to send a patient home with those, with that knowledge.

And so that's why we chose that point.

I think ultimately a lot of these tests kind of eventually migrate into clinical care and migrate to being like a 36-week kind of test and inform stillbirth risk and all these kinds of things. But we're starting them here and I'm so excited about what we will learn.

That's really exciting stuff. And yeah, exactly as you described, I mean, those can be real game changers. That's pretty cutting-edge stuff of looking at the contents of extracellular vesicles, being able to help you understand what's going on inside the placenta. That's— all of those sound not only scientifically interesting, but I can imagine would be incredibly impactful for patients, especially in rural areas. When you mentioned the ultrasound patch and that type of thing, I think of, you know, our own patient groups here in Louisiana, back home in Oklahoma. It can be a real challenge of getting quality healthcare. So I can see this having a really widespread impact on women and babies everywhere.

Yeah, my goal, like a very unscientific goal, but when we were looking at these proposals, we really wanted Like scientists and doctors and patients to read what we're funding and go, oh my gosh, I didn't think that was possible.

Yeah.

Those are the proposals that we looked for because again, that's the role of ARPA.

That's really cool. That's a great goal because yeah, you think about it, all of those things that you described is like, that's awesome. I love, I mean, just years ago we didn't know there was, there was stuff in those extracellular vesicles and then we found out, oh yes, there is. And Being able to translate that. I mean, we did that in microbiology. We didn't realize that though bacteria were talking to each other with these vesicles, but of course they're doing the same thing in, in, in humans. And what are the lessons that we can learn from what's in those little cargo?

Yeah. Being able to tag just the ones that are placental and then be able to look in them as a point of care test, like the amount of risk that that piles up is exactly the kind of thing ARPA is suited for. You know, I think It would obviously be much more logical to go like, can we identify them?

What's in them?

Is the information useful? Can we make it a point-of-care test?

Yeah.

And we're like, do all of it right now.

All of those things. Yes.

All of those things. Let's see. Yeah.

So it's exciting.

Oh, that's exciting for those scientists too, to just be like, no, go and do. We don't need these little small iterative steps. We want the big leaps. And, and I think that's what's so different about And even talking to you guys about your programs, I had to get out of my head of like how to talk about the work that we're doing because we're usually like trying to present it as, oh, look, this is very low risk. And, and you kind of almost have to make it seem iterative and very sort of this little tiny logical step that has all of these risk mitigating gates that you can go through. But talking to you guys is like, no, dream bigger. Oh, okay. I haven't been allowed to do that in a while. So, that's something I think that our listeners will have to think about as they're thinking about applying for things like at our of, of how to think about their project a little bit differently. So.

Yeah, I kind of joke that it's totally ruined me for any future job.

No kidding. I mean, that sounds so scientifically fun and you get the added bonus of helping people and, and helping babies. My God, that's, that's incredible. Well, so then what's the next step after that part?

So the other part is TAQ2, which is really what I had originally envisioned.

And it is completely redoing how we monitor the baby on labor and delivery. So right now, everybody knows, like, the 2 kind of hockey pucks that we put on a woman's belly during labor and delivery. That is incredibly flawed technology.

Sure.

So for, for Formers at this point, their goal is to design a completely new product that every hospital will want to replace their technology with. What we looked, we said, okay, well, maybe some people are adding, like, as needed additional information, but we Had lots of discussions and saw no one trying to replace the technology, which is weird.

We are funding an assortment of performers in this area. Our vision honestly was to probably fund like 2 or 3 full teams.

And what we ended up doing is funding kind of 1 full proposal and then 4 partial proposals. And so it's gonna be kind of this crazy rodeo of who wants to move into phase 2.

Yeah.

But I think it's really exciting because we chose just incredible technology. So the first one we chose, Carnegie Mellon University, CMU, they are kind of like our full performer team and they are doing Mears technology, fetal EEG. So like non-invasive fetal EEG from the mom's tummy.

Wow.

And then combining it with some novel ultrasound markers. So they have literally worldwide collaborators in this to try to pull together the best technology to design a totally new And then we also chose Columbia as kind of a second skeleton. So they're building a maternal belt that can monitor the fetus from any angle. So moms will be able to move, which is important. Yeah.

And then they have a, a second thing, which is a maternal earpiece. Mm-hmm.

One of the, the most challenging parts about this whole concept of monitoring the baby from an engineering standpoint is how do you separate maternal and fetal signal?

I was just thinking that, like, how do you do that if you're having, you know, how do you measure the EKG for a fetus versus how does the signaling from the mom actually interfere with that? That's hard.

It absolutely does.

And not just the mom, but the placenta.

So it's, it's hard because you have to think about that, like, the placenta is going to look different than the fetus and the mom.

Yeah.

So any kind of technology is helpful. And so Columbia is developing a maternal earpiece that has maternal vital signs from that. So that at least then you can use that to cancel out maternal signals on the belt.

Oh, interesting.

So we're funding them as kind of a second backbone. And then we have 3 sensor groups that we're funding when they are literally just trying to see, will this wild and crazy sensor work? One of those is Wavelet that is again working on fetal EEG. Neurologic disorders is really one of the main areas we're trying to do. We fund 2 fetal EEG groups. It is such a wild and crazy concept that you would be able to look at brain changes during labor and delivery. Wow. So we thought that was worth 2 investments. The next group is University of New South Wales, so an Australian performer on labor and delivery. It's interesting, we talk about fetal reserve. We say like, hey, with a bunch of contractions, can that baby still be okay?

Yeah.

Obviously an incredibly subjective discussion we have. Yeah. The University of South Wales has technology that can actually give us objective information about that. So they look at placental oxygenation and how it changes after a contraction, and does that placental oxygenation come right back? Hmm. And so it's gonna quantify this concept we always talk about, about fetal reserve. And then the last group, which is near and dear to your heart, I imagine, is Tulane. So we're actually funding a group from Tulane. And they're working on a wearable photoacoustic imaging sensor to assess placental and fetal oxygenation. There has been a lot of work on NIRS technology.

Yeah.

And it's probably the furthest in terms of commercialization, but there's also a lot of concerns about it of can it penetrate to the depth that it's going to penetrate? And when we think about that, we think about like moms who are obese. Like, can you get past 4 centimeters? 4 centimeters seems to be the wall everybody hit. And if you picture a mom who is obese and then the uterine wall and then a placenta, it's real hard to think about, could NIRS get to that baby to understand that baby's oxygenation?

Sure.

And with photoacoustics, we think that might be possible. And so we're really excited. That was definitely a technology that, that we were really excited to fund. So. They'll be in mox as well.

That's incredible. And what a great intersection of engineering and medicine too. That's really hard physics, what you're talking about, then sensors and acoustics and bringing that together with the biologists and the physicians and kind of coalescing around mom and baby. That's really exciting sort of cross, cross-section. That's, that's probably exactly what you're looking for to really make those moonshots is you need all of the The people around the table to help make that happen.

Yeah, the job, I joke, is, you know, a little bit like back to med school. It's like the pre-trauma fire hydrant kind of concept. You know how much I've learned, and I'm very appreciative. Everyone on the phone has been just incredibly patient with teaching me these things. And I think the part that is really enabling all of this truly is how far AI and machine learning have come. That's the only thing that's enabling these groups. to combine all these sensors so early. You know, if you think about like 10 or 20 years ago when AI and machine learning weren't such big players, you would really have to validate each sensor and say like, this works separately. And really what AI and machine learning has enabled Mox to say is, I don't need to know exactly what sensor can contribute. Like, I'm gonna throw all this information from all these different sensors and see what it can predict.

Yeah.

And it's not meant to be black box where we don't know what's happening and all that, but—

Right, right.

But we can at least say like, hey, you know, this sensor is really good in this situation. There's, there's incredibly complex clinical situations. Like one of them that we talked with proposers a lot about would be, what about when the mom is infected? Yeah. What about when the mom is infected and the fetal heart rate is high, but we can't tell if that's just because the mom has a fever. Or if it's because the baby's getting septic. And those are 2 dramatically different clinical scenarios. And so we talk a lot about like what technology can help sort out a baby that's in trouble versus a baby that's fine and we just need to give the mom antibiotics. So as you can tell, I'm, I'm really excited.

That's incredible. Yeah. Well, and I love the AI piece of it because I think, you know, in recent months AI has been complicated. It has a challenging public perspective right now. But AI isn't just for making memes of, here's me as a medieval princess, and putting it on Facebook. It can do some incredible things that can really enable technologies that wouldn't have been possible even 5 years ago, much less 20 years ago. So that's, that's really exciting to hear. This is why AI exists.

Exactly. And really what we're saying is like, hey, you take all these crazy novel Sensors, like you said, all these things that are cutting edge. Yeah. And we're asking it to output information that both the care team, so the provider and the nurse, can use and interpret easily. And then we're also asking it to give the patient insight, like the patient and family, you know, because right now that is something that fetal monitoring is awful at, where the patient doesn't know what's going on.

Yeah.

And usually like 7 people run into the room and say your baby's in trouble.

Literally.

Yeah.

Yeah.

And, you know, the patient's like, I, I don't know what's happened.

The squiggly line looks the same to me. Yeah.

Right. There's 7 people now in this room and a lot of alarm bells are going off. And I'm sure the stress and the cortisol and all of that does not help the mother in that process. So, yeah.

And I think it's where, you know, I think it's fundamentally where a lot of that trust breaks down between providers and patients because I'm trying to Point at this squiggly line and tell you that it looks maybe okay, maybe not okay. Like, yeah, that's a position for everyone to be in. So, so that the end goal is really improving that output to the patient and to the care team to say, hey, all get on the same page and decide what to do next.

Well, and I can imagine, I mean, you're not only empowering doctors and healthcare professionals, you're empowering patients too. And, and that, you know, that's a big challenge we've had over many years that patients feel like they've been left out of the conversation. And like you mentioned, the trust breaking down and that happens and This gives them a— makes them feel like a little more control. They have, they have an understanding as to what's happening inside. So.

Exactly. So the end of the day is that ARPA in the first year is going to invest up to $34 million in all of this.

Wow.

And by the end of the program, it'll be a $90 million investment. So I am just so happy to see this level investment go into this problem, 'cause I, I truly believe we'll You've hinted a little bit at this.

You've done some incredible things in a short amount of time. What is next? You mentioned the $90 million, but what, what are you excited about as these programs progress? Obviously, what else is on the horizon for, for you and for ARPA-H?

You know, I think with our new director, Alicia Jackson, she is one of the most ambitious people I've ever met. And so I think everything is on the horizon. We are launching more and more programs and really just driving at that commitment to launch healthcare decades into the future. For me personally, I think the next area that I'll be working on is looking at how we can develop alternatives to IVF.

Sure.

I think women are pretty frustrated with this concept that you kind of try for a year in a vacuum with not a lot of guidance, and then at a year you're referred to REI and all of a sudden the next recommendation often is for this You know, $20,000 invasive treatment that may or may not work.

Yeah.

Or may not work. And I see a lot of investment going into improving IVF, and I don't see any investment going into that time that I just described from the time a woman first starts trying to get pregnant.

Yeah.

Until IVF. And I think there are just so many exciting options in there, but they're not being worked on right now because of economic impact. So that's the next area that I wanna look at is what can be done in that timeframe.

And that's such an unknown area, and I'm so glad that you guys are looking at that. I mean, talk about a black box. I mean, it's really hard. I mean, yeah, you're given, all right, you've been trying, here's some pills that you can take, and if that doesn't work, we are gonna ramp you up to this really expensive procedure that, hey, who knows, may or may not work, and you may have to do it a couple times. So yeah, and there's just so much biologically unknown and what a really great thing for ARPA to invest in.

I'm excited about it.

I think it's gonna involve probably bringing in scientists who maybe don't think of themselves as working in women's health right now. Mm-hmm. And calling them and saying, hey, can, can you pair up with an expert in women's health? Yeah. Could you come up with solutions? The most tangible one to me is like, why should we, why do we not have Any options to fix fallopian tubes.

Like, right.

Okay.

That's it. That's all. Uh, well, I would, you know, and that's, that's a very tangible, like, easy to grasp kind of concept. But, but that takes an OB-GYN or an REI who's incredibly familiar with, like, how does that clinical course look? Where do the fallopian tubes go? All those kinds of things paired with someone who's probably working in a totally different area of medicine and saying, or in science really, and saying like, hey, what are possibilities here?

Yeah.

So we really want to look at like, hey, what are the top indications for IVF and how can you make that not an indication for IVF? It's a practical approach.

What a great way to think about investment opportunities too. I mean, it does go back to that horse versus car sort of piece of just like, yeah, cool that you can make a faster horse. No, no, no. We want to make a car. We want to make something that isn't iterative, you know, going back to that, that word again, but there's such I mean, what you're talking about is such white space. I mean, any scientist, any venture capitalist, any large company should be really excited to get into this space because there's so much we don't know and so much that we can do. And what a really interesting and fun time, honestly. I mean, a lot of unexplored horizons that you get to have an incredible impact on. So, I'm so jealous now.

Are you hiring? I planted that question, which I don't even think we did, but yes, we are really, really, really excited to bring new people in. We are looking for people who are MDs, DOs, PhDs, like people that need technical expertise who want to come in and address some crazy big idea.

I love it.

100%, we are hiring. We would love to hear from people who want to join us.

Lord knows I cannot just take on all of women's health.

Yeah.

You know, just solve all of this down. Yeah.

Yeah.

One person.

One person. Yeah. Um, and so yes, I want coworkers, please work for ourselves. We would love to have you.

Well, that's awesome. We've covered the spectrum and I'm really thrilled that you've come on this podcast to share some of the work that you've been doing since I last saw you. And it's really exciting stuff and we really appreciate you taking the time to come on our show, share Mox with us and the incredible Incredible projects that you're funding.

So, well, it only makes sense.

I talk to you at every big transition of my life.

Why not this one?

But genuinely, thank you for, for all you've done for me. Oh, thanks. And also for having me on.

Thank you. And I'm sure millions of women will be thanking you as well down the road. Thank you so much. We'll be sure to keep an eye on ARPA-H and all your work in the future. And as always, we will have contact information, as well as informational links of things that we've talked about, including maybe some potential job opportunities posted in our show notes. Make sure that you check them out to learn more, and thank you once again for joining us.

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