Biomedical Technology

The Rapid Battlefield Triage program is advancing capabilities to quickly triage warfighters requiring urgent life-saving medical intervention and enable medical resources to provide an appropriate response in current and future battlefields. Today, triage at point-of-injury is limited by subjective assessments, tools that are manually intensive, and physiological signatures with little diagnostic and prognostic value. This program will build on recent biomarker discoveries and innovations in sensing platforms to develop field-portable technologies that support triage in the most challenging operational domains. By optimizing allocation of scarce medical resources and scaling to multiple casualties, these devices will help far-forward units maximize their fighting strength against adversaries that inflict large numbers of casualties and constrain evacuation to advanced medical facilities. Beginning in FY 2026, this program will be funded in PE 0602024E, Project WP-02.

The Neurological Assessment and Protection from Brain Injury program is transforming our current detection and protection strategies against traumatic brain injury (TBI), such as injury from blast exposure. This program is developing prophylactic countermeasures to prevent severe brain injury. Current available tools in far forward operating domains for these injuries are lacking especially those that effectively discriminate between mild- and medium-level trauma. These novel technologies will change the paradigm for treatment of TBI by preventing injury rather than attempting to reverse or repair it. Beginning in FY 2026, this program will be funded in PE 0602024E, Project WP-02.

The Reengineering Enabling Sleep Transition in Operationally Restrictive Environments (RESTORE) program aims to enhance the efficiency of sleep to optimize warfighter performance following sleep restriction, as commonly occurs in combat operations. Sleep is a critical factor in cognitive function and decision-making, yet the tempo of military operations often results in acute and chronic sleep restriction. To optimize sleep recovery in such conditions, RESTORE seeks to develop a multi-modal system that enables precision control of sleep macro- (i.e., orchestration of transition between sleep phases) and micro-architectures (i.e., efficiency within sleep phases). By optimizing efficiency of recovery despite sleep restriction, RESTORE seeks to enable warfighter to perform at their best, even in the most challenging operational environments, and to enhance their overall readiness and effectiveness. Beginning in FY 2026, this program will be funded in PE 0602024E, Project WP-02.

The Bridging the Gap after Spinal Cord Injury program is developing and integrating technologies to heal and restore function associated with spinal cord injuries. This program will significantly advance treatment technologies by developing implantable, adaptive devices to address different stages of spinal cord injury. For early phases of injury, this program will develop technologies for real-time biomarker tracking and delivery of therapies to stabilize or rebuild nerve connections at the injury site. For final phase of injury, the Bridging the Gap after Spinal Cord Injury program will develop and integrate a network of devices deployed across the body to effectively create a synthetic nervous system and "bridge the gap" of the spinal cord injury to restore function and sensory feedback. The Bridging the Gap after Spinal Cord Injury program will dramatically improve the quality of life for wounded warfighters and veterans suffering from spinal cord injuries.

Maintaining robust protection and treatment against infectious disease threats during stabilization operations (e.g., Humanitarian and Disaster Relief [HADR]) requires rapid drug discovery and reducing manufacturing and supply chain burdens. A major limitation of our current response to emerging biological and chemical threats is the lack of immediate availability of ideal medical countermeasures (MCMs) for rapid response, which includes high quality nucleic acid templates for MCM manufacturing. These nucleic acids are also critical for research and development (R&D) applications ranging from synthetic biology to the testing and development of medical countermeasures. Current U.S.-based DNA production capabilities are limited to less than a handful of manufacturers; it takes weeks to months to produce adequate quality and quantity of DNA at these manufacturing sites and ship them to downstream partners. The Deployable Medical Countermeasures for Warfighter Readiness program is developing an on-demand deployable platform to manufacture nucleic acid drugs safely at scale, in short timeframes. The platform will be comprised of a fully contained system capable of selectively manufacturing relevant doses of current Good Manufacturing Process (cGMP) grade nucleic acid therapeutics at or near the point of care. This effort will also develop high quality gene-length DNA for R&D. This on-demand platform will enable countermeasures capable of combating novel threats, allowing a small force to prevent regional outbreaks from becoming global emergencies.

The goal of the Distributed Access to Critical Biotherapeutics for Warfighters program was to ensure DoD access to critical medical countermeasures (MCMs) by establishing the foundational technologies needed for fully distributable, on-demand manufacturing of protein-based MCMs and critical reagents. To achieve this, investments were made in technologies that enabled immediate, high-yield synthesis of bioactive protein MCMs. This effort reduced the risk associated with the development of cell-free protein synthesis systems that support access to DoD-relevant therapeutic proteins and bolstered the biomanufacturing industrial base.

The DoD responds to a variety of chemical, biological, and radiological threats around the globe that require protective medical countermeasures that ensure force health protection and warfighter readiness. The Forensic Indicators of Threat Exposure (FITE) program has developed a field-deployable resource that revealed an individual's exposure history to chemical, biological, and radiological threats by characterizing epigenetic signatures in an individual's genome and other biological responses. The program has created the framework for modular technology capable of performing forensic or diagnostic analysis using epigenetic information that provided high specificity of the type of exposure and when it occurred. This novel capability served as a field-forward forensic tool for use by the DoD and assisted in Chemical, Biological, Radiological, and Nuclear (CBRN) threat detection and response.

Survival from combat trauma is predicated on a rapid sequence of events that escalate care as soon as possible. The GOLDen hour extended EVACuation (GOLDEVAC) program is developing new technologies that will provide medical care closer to the point of injury and facilitate effective evacuation. This will extend the time available to evacuate injured service members to higher levels of care. Building upon technologies discovered under the Rapid Battlefield Triage program (budgeted in PE 0602115E, Project BT-01), this program will explore technologies that enable autonomous care of patients and/or which act as force multipliers that enable caregivers to effectively take care of larger number of patients. Beginning in FY 2026, this program will be funded in PE 0602024E, Project WP-02.

The Next-Generation Combat Casualty Care program is developing advances in critical efforts to preserve warfighter life and well-being in the battlefields of the future. This research will directly address a leading cause of potentially preventable battlefield casualties by investigating new approaches for developing whole blood substitutes for traumatic injury that can be deployed on the battlefield in far forward settings. Additional potential uses apply to disaster relief, mass casualty events, and stabilization missions. Advances within this program will ensure that the U.S. remains able to care for service members in peer and near-peer conflict by addressing gaps in combat casualty care. Beginning in FY 2026, this program will be funded in PE 0602024E, Project WP-02.

The Improved Personnel Placement (IPP) program aims to improve force lethality and overmatch by developing assays to determine physical/cognitive states in order to maximize performance and resilience, while minimizing attrition. IPP will identify and measure biomarkers for unique physical, cognitive, and behavioral traits associated with a broad spectrum of military specialties. This knowledge will help individualize training and provide novel measures of physical/cognitive states for specialized roles, while providing training cadres greater precision for predicting candidate readiness without bias. Measuring an individual's biological system will ensure that they achieve their maximum potential while facilitating readiness and resilience for the DoD. Beginning in FY 2026, this program will be funded in PE 0602024E, Project WP-02.

The DoD requires rapid development of medical countermeasures (MCM) to ensure force health protection and improve our ability to respond to emerging and novel biological threats. Despite recent advancements in development of new MCMs, challenges with delivery limits their current therapeutic potential. While emerging targeted delivery systems such as polymer/lipid nanoparticles and viral vectors have enabled the delivery of large, complex MCM molecules, they are still plagued by lack of widespread availability and effectiveness. Investing in efficient, adaptable delivery technology is crucial for strengthening biosecurity preparedness and will enable rapid response to the evolving biological threat landscape, whether the threat is natural or manmade. The Novel Delivery Technology for Medical Countermeasures program will develop minimally invasive MCM delivery systems, in which any therapeutic can be quickly formulated and administered to treat or prevent any disease. Developing novel delivery platforms will maintain warfighter health and readiness and enable rapid response to existing and novel biothreats. Beginning in FY 2026, this program will be funded in PE 0602024E, Project WP-02.

Warfighters operate in extreme, austere, and dangerous domains that stress physiology, contain pathogens, and compromise health and performance. Protective equipment often hinders performance (e.g., loss of dexterity, rapid overheating, visual obstruction, etc.) and pharmacological approaches can carry unpleasant-to-dangerous side effects. The Red Blood Cell Factory (RBC-Factory) program will explore the limits of what biologically active components, or cargoes, can be placed inside red blood cells (RBCs) to help protect the warfighter from within. Cargoes can include natural or synthetic products and may not perturb the physiological characteristics that allow RBCs to safely operate in a body. RBC-Factory aims to deliver a method capable of high-throughput modification of RBCs and a knowledge product identifying what kinds of cargo and how many can be put inside an RBC. RBC-Factory will determine if RBCs are a suitable vector for medium-term passive protection for warfighters against threats and, if so, de-risk future programs that operationalize the technology for specific applications. Beginning in FY 2026, this program will be funded in PE 0602024E, Project WP-02.

The Alert WARfighter Enablement (AWARE) program is developing a combination drug and device to non-invasively increase alertness following sleep loss in humans, without negative side effects, and with reduced addictive potential. AWARE program goals include developing candidate photoswitchable molecules that can be reversibly activated in the presence of near infrared (NIR) light, and wearable device elements that emit NIR light to activate the candidate molecules. The combination of an ingested photoswitchable molecule and a NIR-emitting device will selectively activate neural pathways responsible for executive function, working memory, and decision making, wherever and whenever both drug and light are simultaneously present. If successful, AWARE technology will enable warfighters to maintain cognitive function and alertness during long-range missions and to obtain restorative sleep when needed, without negative side effects. Beginning in FY 2026, this program will be funded in PE 0602024E, Project WP-02.

The Controlled Genome Protection program will develop advanced capabilities to control and tune the activity of gene editing technologies. Advances in synthetic biology have significantly expanded the suite of genome editors and modulators available. Many of the new genome editors have been identified from rare, slow-growing microorganisms with unique metabolic capabilities. New tools across these new classes of genome editors are required to advance our understanding of, our control of, and ultimately our leverage of gene editing technologies across all domains of life. Advances within this program will ensure that the U.S. leads innovation in this widespread, advancing field that poses potential national security threats due to the large-scale democratization of gene editing technologies. Beginning in FY 2026, this program will be funded in PE 0602024E, Project WP-02.

The BioElectronics to Sense and Treat (BEST) program seeks to improve warfighter recovery from battlefield injuries by developing technologies to diagnose, prevent, and treat wound infections in real-time. This program will generate high-resolution sensors that continually monitor a wound by assessing the community composition of contaminating microorganisms and/or the host immune response. Data from these sensors will be used to predict if a wound will become infected and to regulate the targeted administration of known and novel treatments to prevent infections or resolve existing infections. Ultimately, the sensor and treatment elements will be combined into a closed-loop smart bandage that can provide rapid diagnostics and precise treatments at all levels of deployed military medical care. Beginning in FY 2026, this program will be funded in PE 0602024E, Project WP-02.