Monday, October 31, 2011

IOM and California Stem Cell Agency: Study Lacks Key Perspective

The prestigious Institute of Medicine earlier this month kicked off its $700,000 study of the California stem cell agency minus an important perspective – the view directly from California.

None of the persons on the 13-member panel evaluating the performance of the $3 billion enterprise comes from California. The reasons for that are not clear. The IOM is all but mum on the matter.

One could argue that it is not necessary to be geographically located in California to determine whether CIRM is working at peak performance. However, some conditions do exist in California that are difficult for many others to grasp. They include its state budget crisis that has now placed the once Golden State at the bottom of the heap in terms of its credit. Some even liken it to Greece. Obviously that situation can be understood in the abstract by reading The Sacramento Bee and the Los Angeles Times. But the intensity and emotion surrounding that issue and others are difficult to comprehend for many folks living in more blessed states.

Count among the other volatile issues the cutbacks in the state's once vaunted higher education system, including the University of California, which showed its back to students by increasing tuition by nearly 18 percent this fall. Couple that with a visceral antipathy -- and that is putting it mildly -- among some Californians to what they regard as execessive state salaries, including those at the stem cell agency.

What does all this have to with financing stem cell research through an agency that was supposed to have a guaranteed stream of income isolated from mischief that could be wreaked by the governor or legislature. It turns out that CIRM's cash flow is not as guaranteed as its backers believed. Instead of issuing bonds, the state is going to finance the agency over the next 18 months with commercial paper, if necessary. That's because Gov. Jerry Brown wants to reduce the interest costs on state borrowing, which have risen sharply and now consume 8 percent of the state budget along with funds that could otherwise go to educate California's children, among other things.

Brown's parsimony is famous. During his first term in office, he denied pay raises to state college professors, saying they are amply rewarded through "psychic income." More recently, he objected to out-of-state travel by CIRM staff. Too much "lollygagging in London on the taxpayer's dime," a Brown spokesman said. CIRM Chairman Jonathan Thomas promptly cut travel in the chairman's office by 50 percent and asked CIRM President Alan Trounson to do the same for the rest of the staff.

It is an environment that can be difficult to navigate under the best of circumstances. It places limitations on the stem cell agency and tends to focus its operations and funding in different directions than might be the case if California's economic climate were rosier.

The IOM has no real response to the question of why no Californian is on the panel. The California Stem Cell Report last week asked the institute whether an overt decision had been made to exclude persons from California. The IOM did not answer directly. Instead it referred to a generic description of how panel members are selected. The institute's unwillingness to address the specific question does not speak well for the openness and transparency of the IOM examination of CIRM.

Currently the IOM does have a comment period available on the selection of the panel members, who will not become official for another three days. Interested parties can make their views known to the IOM by using this link.

A Californian or two on the IOM panel would help to bring a valuable, broader perspective to this important study, which is sure to affect the future of the state's stem cell research and voter approval of another possible multibillion dollar bond issue in the next few years.

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