Combat & Casualty Care

Summer 2017

Military Magazines in the United States and Canada, Covering Combat and Casualty Care, first responders, rescue and medical products programs and news\Tactical Defense Media

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Battlefield logistics are a challenge regardless of the mission. Adversaries, terrain, and the environment can all serve to complicate the process of delivering supplies to warfighters. The current Department of Defense (DoD) approach to medical supply logistics is limited in its reach to far-forward emergency settings, response to emergent in-theater threats, and utility for bio-preparedness stockpiling. It can often take weeks to months to manufacture and airlift organic pharmaceuticals and protein therapeutics to battlefield frontlines, meaning that critical medical supplies often do not arrive in time where they are needed most. Furthermore, the need to prepare medical supplies in advance based on an anticipated, specific threat can result in wasted materials, labor, and money when that threat is not realized. The DoD needs a new approach to manufacturing and delivering pharmaceuticals to enhance disaster responsiveness and enable timely response to emergent threats. The U.S. Defense Advanced Research Projects Agency (DARPA) Battlefield Medicine program seeks to address this capability gap through two integrated research thrusts: the Pharmacy on Demand (PoD) and Biologically-derived Medicines on Demand (Bio-MOD) initiatives. The combined efforts seek to develop miniaturized device platforms and techniques that can produce multiple small-molecule active pharmaceutical ingredients (APIs) and therapeutic proteins in response to specific battlefield threats and medical needs as they arise. The PoD research is aimed at developing and demonstrating the capability to manufacture multiple APIs of varying chemical complexity using shelf-stable precursors, while the Bio-MOD research is focused on developing novel, flexible methodologies for genetic engineering and modification of microbial strains, mammalian cell lines, and cell- free systems to synthesize multiple protein-based therapeutics. As a proof of concept, both PoD and Bio-MOD efforts will seek to develop platforms for manufacturing single-dose levels of FDA-approved APIs and biologics and demonstrate high purity, efficacy, and potency in short timeframes. In developing a flexible, miniaturized synthesis and manufacturing platform, Battlefield Medicine will leverage continuous flow approaches that will, if successful, pave the path forward for enabling distributed, on-demand medicine manufacturing capabilities in battlefield and other austere environments. Additionally, the platform would have built-in flexibility to produce multiple types of therapeutics through its modular reaction design. The ultimate vision for Battlefield Medicine is to enable effective small-batch pharmaceutical production that obviates the need for individual drug stockpiling, cold storage, and complex logistics. BATTLEFIELD MEDICINE 1st Lt. Michael Kehoe and Sgt. 1st Class Ismael Rodriguez, representing the 30th Medical Brigade, provide first aid to a simulated patient during the U.S. Army's Best Medic Competition at Camp Bullis, Texas. (U.S. Army Photo by Sgt. Jose A. Torres Jr.) By Dr. Tyler McQuade, DARPA Defense Sciences Office www.tacticaldefensemedia.com 14 | Combat & Casualty Care | Summer 2017 MedTech

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