Sunday, February 11, 2007

The CIRM Money Machine and Potential Scandal

Giving away millions is not always easy.

Eighteen months ago, the talk included references to rubber stamps, "re-reviewing" not to mention honesty and legality.

The scene was Sacramento, Sept. 9, 2005, when the Oversight Committee of the California stem cell agency awarded its first-ever grants, which went for training programs for stem cell scholars at California schools.

The 29-member panel was whipping through the list of soon-to-be recipients when they ran out of applicants with really high scores. It was then that discussion surfaced about whether the board was merely rubber-stamping decisions of its grant reviewers or doing something more.

And it was then that Philip Pizzo, dean of the Stanford School of Medicine, said,
"In a sense our job was to really choose or approve the people who are going to be reviewers, and by way of delegated authority, we're asking them to make recommendations which are really decisions because we don't have all the data."
Pizzo's comment and similar ones by other CIRM overseeers 18 months ago are critical to understanding questions of conflicts-of-interest, openness and transparency at the grant review level. CIRM has imposed a lid of secrecy on virtually all of the doings of the grant review group. Not even the Oversight Committee members, for example, are supposed to know the names of the institutions seeking grants, although it was relatively straight forward to identify a goodly number of the applicants in 2005 based on the bowdlerized information available then. You just needed to be conversant with California institutions involved in stem cell research.

CIRM conceals the names of the applicants lest it embarrass the losers. CIRM says that encourages good science by encouraging potentially rewarding but risky ventures – ones that the authors might not want to vet in public. Moreover, CIRM says the Oversight Committee actually makes the grant decisions – not the grant review committee. Thus such matters as the economic interests of the grant reviewers and their closed-door meetings to give away tens of millions of public dollars are not really important in terms of openness and transparency.

Eighteen months ago, the Oversight Committee only turned down a couple of grant applications that were recommended by the grant review group(the number is not entirely clear from the transcript of the session). The Oversight group is not likely to reject any significant number of recommendations this Friday for SEED grants. If it does, it soon will not have anybody willing to serve on the grant review committee. Moreover, the CIRM directors simply do not have enough information to perform any sort of significant second-guessing of its hard-working reviewers, all of whom are from out-of-state.

CIRM Chairman Robert Klein, in 2005, bridled at Pizzo's remark that reviewers were actually making decisions, which Pizzo conceded was an impolitic choice of words although they clearly reflected the sentiment of a number of committee members. Klein commented again later when Gerald Levey, dean of the UCLA medical school, said, "What is the purpose of discussing everything on an individual basis? Why don't we just vote en bloc? We're just going through this on an individual basis, but it has no meaning."

Klein, who is an attorney, replied,
"We have to go through this on an individual basis because of the laws of the state of California. And to observe the very high standard of conflicts adopted by this board, we have to make sure we have roll call votes on every application. That is the challenge and it is a new process for California as well as a nation."
It IS a challenging and new process, one that does not have to follow the well-trod but not necessarily applicable procedures of older institutions that are fundamentally different than CIRM. The NIH is often cited as a precedent for CIRM's secrecy on grants. But the NIH can easily be controlled by Congress and the President. CIRM is virtually immune from control by the California Legislature and governor.

The California stem cell agency should rethink its policies on financial disclosure and transparency. Opening the doors will help to protect the agency from the suspicions that will certainly surface as the CIRM money machine begins to hand out hundreds of millions of dollars. Not to mention helping to prevent an outright scandal that would be relished by opponents of embryonic stem cell research.

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