New Report: Too Soon To Tell About CIRM?

A new report on the California stem cell agency concludes that "it is too soon to tell whether the state’s effort is the right way, or even a good way, to support research the federal government will not."

At least that is the conclusion drawn by the organization that sponsored the study, entitled "Prop. 71: A Model for State Involvement in Biomedical Research?"

“California’s bold stroke to pursue stem cell research free from federal restrictions – and federal dollars – has been slowed by the debate over how to assemble a governing structure for the new institute," said Greg Simon, president of FasterCures, which commissioned the report.

"They’ve come a long way. But the real question is whether they can quickly resolve these debates in a way that allows them to fund the kind of high risk, high reward research that the public expects in order to make progress in the fight against disease,” Simon said.

Kathi E. Hanna oversaw and wrote the study on behalf of FasterCures, an offshoot of the Milken Institute that works for faster development of medical therapies. Hanna is a science and health policy consultant and once served as research director and senior consultant to President Clinton’s National Bioethics Advisory Commission.

Hanna wrote that four lessons can be drawn from the experience so far of the California stem cell agency.

1. "The passing of Prop. 71 did not insulate embryonic stem cell research from political risk. Even after California voters gave the go-ahead to Prop. 71, opponents in Sacramento and around the state found ways to challenge its very existence as well as its policies and nascent procedures."

2. "An initiative that promises success and preaches optimism can have far-ranging impact.(CIRM President) Zach Hall says he is reminded every day that 'a message of hope' is what propels him and supporters of the initiative to keep at it, despite the daily challenges of bureaucracies and politics."

3. "There are dangers in overselling the potential benefits of such an investment. High expectations that cannot be met, either in the form of cures or intellectual property revenues, will result in heightened scrutiny and dwindling political support. This requires educating policymakers and the public about what they can reasonably expect. In addition, tying complex social
goals, such as affordable healthcare, to a research program imposes an unreachable standard."

4. "There are advantages and disadvantages to creating a new research infrastructure from the ground up rather than using existing infrastructure and institutions. One advantage is that the program is relatively free from the political and administrative constraints of entrenched bureaucracies. On the other hand, CIRM has had to re-create an administrative infrastructure that in essence replicates that which is already in place in California agencies and academic institutions or in the federal research environment, but is inaccessible because of the requirement for CIRM’s independence. On the other hand, once established, CIRM will be able to leverage existing infrastructure as it makes awards to California researchers and institutions. (California Stem Cell Report Publisher David) Jensen doubts that the measure would have passed if the recipient institutions—University of California schools, for example—had been named at the outset. 'It would have brought out the usual enemies of the University of California, complaints about its lack of transparency, its past failures, for example, oversight of the Livermore Lab, and so forth,' said Jensen. 'What helped to make Prop. 71 attractive is that the new agency carried no baggage.'”

Hanna concludes:

"The true measure of whether Prop. 71 is a success will be in the science conducted and the results translated, not in how well CIRM operates administratively. There will continue to be conflict between those who expect efficiency and streamlining as a measure of wise public investment and those who understand that science is imprecise and unpredictable, that it cannot aim for efficiency as a goal. And one can expect that other measures of success, such as patents, royalties, and revenue streams will continue to create conflicts between those who want to fill state coffers and those who want to spur commercialization."