Science Magazine Assesses CIRM: 'The Good, Bad and Ugly'

Science magazine examined California's $3 billion stem cell research effort in a piece published during the holidays, and the third paragraph of the story began with this quote,

“It's the usual CIRM circus.”

Whether one thinks the comment was well-deserved or not, it falls far short of the type of publicity that the agency needs, especially as it considers mounting a bid to secure an additional $5 billion from California voters.

Overall, the two-page article was pretty much a straight-forward overview of where CIRM stands at the beginning of 2011. The story began, however, with a look at the shenanigans of CIRM Chairman Robert Klein as he tried unsuccessfully last year to hand pick his successor. And that was what triggered the “CIRM circus” comment from Marie Csete, former chief scientific officer for CIRM.

The piece by Greg Miller was entitled, “CIRM: The Good, the Bad And the Ugly” – another less-than-felicitous phrase concerning the public agency. The article covered the basics: dollars handed out, labs built, concerns about high salaries and conflicts of interest and the recent external review report. It noted that many scientists view CIRM as a “tremendous success.” But it also reported that patient advocates “are tired of waiting for stem cell cures.” Miller's article continued,

“...(E)ven CIRM supporters say the institute has to improve its relationships with industry if it hopes to fulfill its mandate: generating stem cell therapies that help people suffering from conditions like diabetes and Parkinson’s disease. A recent report by a panel of external scientists convened by the CIRM board said translating basic science into therapies should be a major priority going forward.”

Miller wrote,

“Not surprisingly, CIRM grantees are not complaining. 'I just moved into a spectacular new building,' says Arnold Kriegstein, the director of the new Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research at the University of California, San Francisco (UCSF). CIRM kicked in $35 million for the new facility, about a third of its cost.”

(Editor's note: UCSF has received $111 million in grants. The dean of its medical school sits on the CIRM board of directors, as do several other medical school deans whose institutions have received hundreds of million dollars.)

The article continued,

“Several California biotech leaders say they have been frustrated by their interactions with CIRM. 'In the past, there’s been a lack of recognition that it takes a company to actually take a treatment forward from the bench top into the clinic,' says Chris Airriess, chief operating officer of California Stem Cell Inc. in Irvine. Airriess says his company has twice applied, unsuccessfully, for CIRM money. He and others place much of the blame on the review process, which he says is structured too much like the NIH review process for academic research grants. CIRM reviewers criticized his company’s applications for the lack of new science, but Airriess says that misses the point. 'Companies are trying to stabilize a technology and commercialize it rather than push the bleeding edge,' he says.

“Even companies that have succeeded say it hasn’t been easy. Earlier this year, San Francisco–based iPierian won a $6 million early translation award and a $1.5 million basic biology award. 'We put a ton of effort into understanding what was being asked for,' says CEO Michael Venuti.”

Science magazine concluded,

“CIRM President Alan Trounson says he is sensitive to these (industry) concerns but doesn’t think the review process is problematic: 'Companies that have put in well-formed proposals have done very well.' But he acknowledges that CIRM has had difficulty attracting proposals, particularly from larger companies. He’d like to set up an industry advisory board to help improve industry relations.

“In the coming months, he and others will be waiting anxiously to see who succeeds Klein as chair. Patient advocates want an advocate at the helm. Scientists would prefer a scientist. Trounson, who may have to work most closely with the new boss, says he’s hoping for someone with expertise in the delivery stage of therapeutic development. 'The basic science, as long as we look after it, will take care of itself,' he says. The real challenge for CIRM, he says, is getting the science into the clinic. 'We need more help on how to make it all happen.'”

In terms of the negative information in the piece, one thing helpful to CIRM is that the article is tucked away behind a subscription barrier, so it is not likely to be available to mainstream journalists (whose employers are notoriously cheap) as they do research on the agency. Nonetheless, the article is likely to be checked by most scientists interested in CIRM affairs and quite possibly by any potential, major contributors to an election campaign for more billions for the agency.

But the real problem is not with the publicity or the slant of the article – it is with the actions of Klein and the agency. There would have been little dubious to write about concerning the choice of a new chair if Klein had not tried to engineer the selection of his successor in a closed-door process that raised charges of conflict of interest. And as far as issues with the biotech industry go, those have been apparent for several years, but little has been done to deal with them.

(If you are interested in receiving the entire article, please email a request to djensen@californiastemcellreport.com, and I will send it to you.)

Nature Magazine Says Bernstein Is Still A Possibility for CIRM Chair

Canadian scientist Alan Bernstein is not necessarily off the table as a candidate to become the next chairman of the $3 billion California stem cell agency, Nature magazine's Web site is reporting today.

His name popped up in a piece by Elie Dolgin about the re-election of Bob Klein for a term of six months as chair  at the agency as he and the CIRM board search for his replacement.

Dolgin had interviewed Klein prior to yesterday's vote and reported that Klein would “like someone with industry experience who has worked with U.S. drug regulators in the past.” Previously Klein, a real estate investment banker, said he thought a nationally known scientist was necessary to replace him as chair. The CIRM board, which chooses the chair, has not specified the criteria it desires, but is scheduled to do so over the next 60 days.

Dolgin continued,

“Notably, Bernstein’s name is not necessarily off the table. According to Klein, California’s attorney general-elect Kamala Harris will look into the legality of a 1978 attorney general decision ruling that the requirement of citizenship for holding public office is unconstitutional.”

Dolgin's story was one of only two that we have seen thus far concerning Klein's re-election. The board specified yesterday that he should serve no more than six months. Klein said he hoped to leave sooner because of family reasons. He was receiving a half-time $150,000 salary but will receive no pay during his new service.

We reported earlier on the other story on the election by Ron Leuty in the San Francisco Business Times. It noted that the next nominees for chair will come from four state officials, all Democrats, including the newly elected governor and lieutenant governor, Jerry Brown and Gavin Newsom respectively. That is a good situation for Art Torres, co-vice chair of CIRM, and who is likely to be a candidate again for chair. Torres was head of the state Democratic Party and a longtime state legislator. He knows all the nominating officials. Torres was nominated by the state controller this month but withdrew his name in favor of Klein.

During its public session, the board expressed no displeasure with Klein's attempts to engineer the selection of his successor.  Sherry Lansing, chair of the directors' Governance Subcommittee, said nothing illegal or incorrect occurred.  But Dolgin wrote,

"Not everyone was happy with this scenario. In a strongly-worded letter sent two days ago, state Controller John Chiang urged the CIRM board members to delay their decision and start anew with fresh nominees. 'It is clear that the current selection process is fundamentally flawed,' Chiang wrote. 'The taxpayers who provide the funds for CIRM must be assured that the chair and vice chair are selected in an open, transparent process — not through a backroom deal or by default because a deal has fallen apart.'

"'This path that they’ve gone down is a face-saving path for Klein who screwed up this election by trying to manipulate it and tap his own successor,' says John M. Simpson, stem cell project director of the Santa Monica-based advocacy group Consumer Watchdog. “He needs to let go and let the board step up and exercise its oversight responsibilities without constantly trying to pull the strings.'"

As for Klein's mention of the possibility that Bernstein's name would come up again, that would appear to be extremely unlikely. Bernstein told the Toronto Globe and Mail that the ruckus surrounding Klein's maneuvers damaged his (Bernstein's) reputation and that of the California stem cell agency.

As for the citizenship issue, it is difficult to understand why Klein is raising the matter again, except to note that he earlier misrepresented the attorney general's opinion as the reason for Bernstein being compelled to drop out of consideration.

(Editor's note: An earlier version of this item said that Dolgin interviewed Klein yesterday.)

Klein Given New, Six-Month Term as Chairman; Board to Examine Criteria for Replacement

Directors of the California stem cell agency today re-elected Robert Klein as chairman of the $3 billion enterprise, culminating a weeks-long flap that included closed-door dealings, allegations of “sleazy” conduct and dubious, last minute financial warnings about CIRM's financial condition.

Klein said he would serve for no more than six months and would prefer a shorter term. He is expected to serve without a salary. The directors also instructed its Governance Subcommittee to examine the criteria for a replacement and report back to the full board in 60 days.

The vote on Klein was not entirely audible on the Internet audiocast but it appeared nearly unanimous with the exception of Jeff Sheehy, who abstained.

Sherry Lansing, chair of the Governance Subcommittee and a former Hollywood studio chief, supported Klein's re-election and defended the election process. She said,

"Nothing was done that was not correct."

She said all actions taken were in the best interests of CIRM's mission.

Klein had been publicly telling the board and others for months that he would not seek re-election to a six-year term. Behind the scenes, he began to attempt to engineer the selection of his successor, a Canadian scientist, Alan Bernstein, who chaired the recent “external review” of CIRM's programs.

Klein's effort began to fall apart after Bernstein's name surfaced publicly in an item Nov. 29 on the California Stem Cell Report.

A spate of articles dealing with the issue appeared in a number of publications, including the Los Angeles Times, the San Francisco Business Times, Nature magazine's Web site, the Biopolitical Times, the Toronto Globe and Mail and The Sacramento Bee as well as here. The various articles detailed the reports of backroom dealings and issues with Klein's conduct.

On Monday, the state's top fiscal officer, John Chiang, who has a special role in connection with the agency, urged cancellation of this week's election, declaring that the process was fundamentally flawed. Sheehy read Chiang's letter to the board and said he agreed with it.  No other CIRM directors publicly raised questions about the election flap.

Klein has been chairman of the California Institute for Regenerative Medicine, as the agency is formally known, since voters approved its creation in 2004 through Prop. 71. Klein and a handful of associates wrote the measure, which included a detailed legal list of qualifications that fit only one person in the state – Klein. The move so angered one early major backer of Prop. 71 that he now refuses to speak to Klein, according to Nature magazine.

Klein has been the dominate force at the stem cell agency since he was elected by the 29-member board to his first six-year term. He also has angered at least some members of the CIRM board and clashed with its first president, Zach Hall. Prop. 71 gave overlapping executive responsibilities to the chairman and president of the agency.

As of this week, CIRM has approved $1.1 billion in grants, 90 percent of which has gone to institutions that have representation on the CIRM board of directors. The board is making larger awards currently, and Klein is looking for more cash. His plans include another bond measure, perhaps as high as $5 billion, before voters possibly in 2012 or 2014.

The Pros and Cons of Retaining Klein as Chair of the California Stem Cell Agency

Directors of the California stem cell agency have a choice today whether to continue with the man who has led the agency since its inception in 2004, Robert Klein, or to choose another course that would not see him as chairman. Here is a look at the pros and cons of sticking with Klein.

First the pros

• Continuing with Klein could create a perception of stability and continuity at a time when directors are confronting recommendations for significant changes in direction. It could be regarded as a determination to continue to focus on the agency's primary tasks.
• Given Klein's endorsement by 11 top stem cell scientists, his retention could be seen as a demonstration of strong, continued support for funding basic research.
• Klein's reputation, somewhat battered in recent weeks, probably remains high in the global stem cell community.
• Continuing with Klein would likely mean retention of CIRM President Alan Trounson, who reportedly might leave if another candidate that he does not favor is elected chair. His departure would generate some instability at the agency. Trounson has headed the agency for the last two years.
• Another few months with Klein at the helm could make it easier to fill the much-needed new position of vice president of research and development. CIRM has been without a chief scientific officer for nearly 18 months. Trounson created the new slot but has not been able to bring a candidate on board. With Klein and Trounson gone, it is unlikely a top-notch hire could be made until a new president is in place.
• With Klein still in place, CIRM directors could use the time to sort through their options to determine what future changes are necessary, if any, in top agency leadership and board structure.

The cons

• Delaying Klein's departure could mean that the board is hamstrung in considering all its options in dealing with governance issues. His personality, history and continuing efforts at leadership would dominate the discourse or at least be a significant diversion.
• The continuing presence of Klein could be an impediment to the board setting its own criteria for a new chairman.
• Continuing support of Klein would deliver a message to the various stakeholders, the public and the CIRM staff that the board goes along with his misrepresentation of significant matters having to do with agency (See here, here and here.)
• Klein's retention only pushes off to another day the problems that the agency faces, ranging from Trounson's status, hiring of a VP for research and development, changes in strategic direction and more. Better to be decisive and wipe the slate clean. An interim chair or president could be selected. CIRM could function successfully without Klein or Trounson.
• Klein could better serve in a role outside the agency, particularly given his interest in another multibillion dollar bond election for CIRM. Engaging in such election campaign activities as a state employee or while on the state payroll is inappropriate. By law, Klein is a state employee regardless of whether he accepts pay.
• CIRM, like any business start-up, is maturing. Just as in business, different leadership is called for at different stages. It is not uncommon for businesses to move away from the original start-up entrepreneur as they grow and change.
• The absence of Klein would make it easier to hire a new president, if necessary. His reputation for micro-management and the dual executive arrangement legally built into CIRM pose obstacles for many qualified candidates.
• Given the endorsement of Klein by 11 top academic researchers who want continued strong funding of basic research, the biotech business community could read Klein's retention as an unwillingness by CIRM to engage fully with industry to actually deliver cures to the clinic.

There are undoubtedly other reasons on both sides of this issue. Readers can send in their own by clicking on the word "comment" at the end of this item. Or they can send their comments directly to djensen@californiastemcellreport.com for posting.

Klein's Fiscal Warning Does Not Match Up with State Treasurer's Account

In his bid to be re-elected, the chairman of the $3 billion California stem cell agency, Robert Klein has issued a financial warning to CIRM directors that is distinctly at odds with what the state treasurer's has told him.

In response to questions from the California Stem Cell Report, Tom Dresslar, spokesman for state Treasurer Bill Lockyer, provided an account that differs in major ways with information that Klein released in an election-eve pitch to CIRM directors. (The state treasurer manages the bond sales that are CIRM's only real source of cash.)

In a statement posted today on the CIRM Web site, Klein said that he was "just informed" by the state treasurer about a looming financial problem that needed "immediate" attention. Klein said it was “essential” for CIRM to quickly provide assurances of “reliability of our funding.”

However, the treasurer's statement did not carry that urgency or compelling weight. It primarily involved hypothetical bond sale timing matters. Dresslar said that CIRM was alerted to the treasurer's view of the state of CIRM bond financing on Dec. 2, the day before Klein gave a rosy financial assessment to the directors' Finance Subcommittee. Klein was also aware of the bond timing questions before last Wednesday's board of directors meeting and did not bring them to the board's attention.

Klein's statement today on CIRM's "financial stability,"  however, said,

“The (state) Treasurer's office has just informed us that the next California Stem Cell Research and Cures Finance Committee (the panel that authorizes CIRM bond sales) meeting must be held in January 2011. Recent applications for clinical trial rounds and the acceleration of our funding commitments on our other programs require an immediate focus on this issue, given there may not be another opportunity until late 2011 to authorize additional bond funding.”

Klein also said that early next year “our collaborative funding partner nations” will require “assurances of our future performance.”

Here is the full text of what the treasurer's office e-mailed to the California Stem Cell Report.

“On the record:

“We don't necessarily agree Klein issued an 'urgent financial alarm' in his statement of candidacy. Regardless, here's what the State Treasurer's Office told CIRM, and didn't tell CIRM:

“We did not say the Finance Committee had to meet in January to authorize additional bond sales. Additionally, we did not tell CIRM there was a possibility the Finance Committee, if it didn't authorize additional bonds in January, would have to wait until late 2011 to do so.

“We told CIRM that, under existing Finance Committee resolutions, the Institute effectively has zero bond authorization remaining. That means, in order for us to sell more stem cell bonds, the Finance Committee has to meet and approve additional authorization. We told
CIRM we could have a bond sale as early as next February. We said if CIRM wanted to get some of the proceeds of any February sale, the Finance Committee would have to meet in December or January.

“This communication with CIRM occurred Dec. 2.

“It's important to stress we have set no firm bond-sale schedule for 2011. Hypothetically, if the State conducted a bond sale in February 2011, and stem cell bonds were not included in the deal, the CIRM Finance Committee could meet in any subsequent month of the year and authorize additional bonds that could be sold in any subsequent 2011 sales.”

Klein's rendition of the bond sales situation is not the first such instance in recent weeks. He earlier announced that his hand-picked candidate to succeed him had to drop out because he was not a U.S. citizen. Klein, who is an attorney, based that assertion on an antiquated state law that the state attorney general has officially declared is unconstitutional.

CIRM directors meet tomorrow afternoon at 4 p.m. PST at Stanford University to deal with the chairmanship question. The public can participate in the meeting there or at teleconference locations in Los Angeles (2), La Jolla(2), Burbank and Duarte. The specific addresses can be found on the agenda. The meeting is also scheduled to be audiocast on the Internet(directions also on the agenda).

The Canadian Citizenship Question – Day Four, an Answer!

The requirement that the chairman of the California stem cell agency be a citizen of California is unconstitutional according to a 1978 opinion by the state attorney general.

That's what James Harrison, outside counsel for CIRM, told the California Stem Cell Report early today. He was responding to an email query yesterday concerning the reason that Alan Bernstein, a Canadian, was scrubbed as CIRM Chairman Robert Klein's favorite candidate to succeed him in the position. Official opinions of the attorney general are widely regarded to have the force of law. The way the attorney general's Web site puts it is,

“The formal legal opinions of the Attorney General have been accorded 'great respect' and 'great weight' by the courts."

Here is what Harrison had to say,

“We discovered the citizenship issue when Bernstein's name was mentioned as a candidate. Given the litigation CIRM has faced over the years, there was a need to be cautious and there was not sufficient time to obtain closure on this issue before the deadline for nominations. You should know that there is an AG opinion from 1978 declaring that the citizenship requirement is unconstitutional.”

As far as we can tell the first public mention of Bernstein's name as a candidate came on Nov. 29 on the California Stem Cell Report. However, his name was being bandied about privately well before that. Late on Dec. 2, Klein released a statement that Bernstein was no longer being considered because of “a technical legal requirement regarding citizenship.”

Klein's statement followed stories in the media (see here, here and here) involving closed-door meetings and concerns about conflicts of interest in connection with his attempts to engineer selection of his successor. The ostensible citizenship condition also led to a well-read story in the Toronto Globe and Mail in which scientists in Canada deplored the requirement.

Harrison's response today about the matter came four days after we asked CIRM's official spokesman to provide the exact legal language concerning what Klein said was a citizenship problem.

We still have questions about whether the citizenship question applies to CIRM President Alan Trounson, an Australian, as well as the actual date when CIRM officials became aware there might be an issue with Bernstein.

Our assessment of the situation? Klein's statement was specious, at best. At worst, it might be called something else. It appears to be a dubious effort to paper over what is serious leadership issue involving Klein and raises significant questions about his credibility.

Is Klein a Shoo-In for Chair of California Stem Cell? Maybe, Maybe Not

Is the re-election of Robert Klein as chairman of the California stem cell agency a foregone conclusion? A significant number of our readers think so.

The only other candidate to be nominated for that post is Art Torres, now co-vice chair of the $3 billion enterprise. Nature magazine has reported that he probably is not going to push his candidacy.

However, if the CIRM governing board re-elects Klein, it will be indicating to the public and the international stem cell community that it tolerates, if not approves of Klein's maladroit attempts to engineer the selection of his successor. As was pointed out in a Toronto newspaper on Saturday, Klein's machinations compromised the reputation of California's stem cell effort.

The belief that Klein is bound to be re-elected seems to be based on several assumptions. One is that if Torres is elected, CIRM President Alan Trounson will resign. Nature magazine reported last week that Torres and Trounson “cannot stand each other.”

That would leave the agency with a new chair and with no president and no vice president of research and development, a new position that replaces the post of chief scientific officer. Trounson has not filled the VP slot despite a hiring effort that began nearly 18 months ago. That leadership situation may seem daunting to some board members.

However, the CIRM board may choose other avenues. One possibility would see the board deferring all action until the dust settles. That would mean Klein would continue in his post, unless he walks directly out the door, which he may do if he is not re-elected on his own terms. If Klein does that, as co-vice chairs, Torres and Duane Roth, could split the job's responsibilities until the board decides to vote.

In another scenario, the board could name an acting chair and schedule a later election for chair. If the directors are concerned that naming an acting chair might violate the technical terms of Prop. 71, they could officially designate the position as “interim presiding officer” or something similar. The board already created a “non-statutory” vice chair in giving the posts to Torres and Roth. To avoid giving the appearance of favoritism to Torres, the board could look to somebody like Gerald Levey, a former member of the board and former dean of the UCLA medical school, for the interim job. Other possibilities include board members Ed Penhoet, co-founder of Chiron, and Sherry Lansing, former Hollywood studio chief, both currently members of the board and well-regarded.

Given a little more time, the board could put together a group of board members to deal with selection of a new chair, which could make fresh recommendations for nominations to the four statewide officials entitled to make them. The CIRM board could even ask the public, researchers and industry via its Internet site to make suggestions for candidates, as did state Controller John Chiang, one of the nominating officials.

One matter for the board to consider is Klein's lame duck status -- even if he were re-elected for a 12-month term as he has suggested. He will increasingly lose effectiveness. Outside of CIRM, researchers and the biotech industry will be looking ahead to his replacement – something that is likely occur as well within the agency.

Klein, a real estate investment banker, says it is necessary to find a nationally respected scientist to replace him and has promised to do so. However, the board has made no public statement that it wants a scientist as chairman. Plus Klein's past searches for a president for CIRM have been rocky and prolonged. It took a year to bring Trounson on board, including a delay of three months after his hiring was approved. No reason exists to expect anything different should Klein embark on his own search for his successor.

John M. Simpson, stem cell project director of Consumer Watchdog of Santa Monica, Ca., and longtime observer of CIRM, said the board should simply vote in Torres.

He made the suggestion when queried by the California Stem Cell Report. Simpson declared,

"Nobody disputes Bob Klein's substantial contributions to CIRM. The agency would not even exist if it were not for him. Nonetheless, there is a time for every leader to move on.

"That time is past due for Klein, a point that was hammered home by his sleazy and inappropriate backroom tactics to manipulate the selection of his successor."

"Suggestions to elect an interim chairman are intriguing, but unnecessary. Art Torres has been nominated for the post and has all the qualifications necessary to lead CIRM to the next level."

In whatever case, Prop. 71 makes it clear that the choice of chairman is a matter for the entire 29-member board. Klein is only one member of that board.

Klein's Re-nomination Almost Unnoted in Major Media

The hooha about CIRM Chairman Robert Klein and his maladroit attempts to manipulate the election of his successor generated little attention today in the mainstream media, but left an Internet legacy that may haunt the agency for some time.

Only three newspapers carried a story as far as we can tell: the San Francisco Business Times, the Los Angeles Times and The Sacramento Bee. The most complete story, however, appeared on Nature magazine's web site, which has a much narrower but important reach

In the Nature piece, Elie Dolgin wrote that Klein said he would not insist on the full $529,000 salary the chair is entitled to, but continue with the $150,000 he is currently receiving for the 12 months that he said he will serve.

Klein, who is a real estate investment banker, also indicated that he will insist on a top level scientist or clinician-scientist as a replacement to succeed him. Klein did not note that such a scientist would also by law be required to have “direct knowledge and experience in bond financing,” probably an extremely rare quality among scientists with national reputations.

Klein has had repeated difficulties in the past in hiring a president for the agency. CIRM also has not been able to hire a vice president for research and development despite a search that began nearly 18 months ago.

Any candidates for chair may find the agency's track record on hiring and management less than attractive, especially given Klein's latest unsuccessful attempt to engineer selection of a successor. Some cynics might wonder, however, whether Klein knew all along that Bernstein's Canadian citizenship would ultimately disqualify him and force the board into a position that would make Klein's re-nomination an apparent necessity. Few people know the law concerning the stem cell agency as well as Klein, who has more than once said he wrote Prop. 71, the measure that created CIRM.

Dolgin also reported that Art Torres, who has also been nominated for CIRM Chair, “probably” will not challenge Klein but is interested in staying on in his current co-vice chair slot.

Today's four stories are only part of what will pop up in the future as potential hires and journalists examine CIRM's performance. The coverage earlier in the week of the closed-door meetings and allegations of conflicts of interests will surface as well. CIRM would do well to keep in mind the admonition -- "If it can't stand the light of day, don't do it."

Stem Cell Chairmanship Flap Draws Major Media Coverage

The ruckus over selection of a new chairman for the California stem cell agency this morning drew the rare attention of the Los Angeles Times, the state's largest circulation newspaper.

And it wasn't the kind of attention that CIRM is looking for.

Reporter Jack Dolan mentioned a “possible conflict of interest” involving Alan Bernstein, a candidate backed by outgoing chairman Robert Klein, and said Bernstein could become “one of the highest paid employees in state government.” The position of CIRM chairman carries a salary with a top range of $529,000.

Dolan reported that state Treasurer Bill Lockyer, a longtime colleague and friend of another candidate for chair, Art Torres, has decided not to nominate anyone because of misgivings about Bernstein.

Dolan quoted Tom Dresslar, Lockyer's spokesman, as saying,

"He just doesn't have enough information to alleviate his concern about Mr. Bernstein's role in crafting the (recent external review) report.”

Dolan's article raised the conflict question in connection with completion of the report, which Dolan described as “glowing.” Bernstein chaired the panel, which included seven other persons. Presumably the conflict would arise if some sort of quid pro quo existed for generating a favorable report.

Dolan quoted Klein, a strong supporter of Bernstein, as saying,

"It would be quite a compliment to the agency if someone who has done such a thorough review of the agency, and has talked to everyone involved, would accept the nomination to be chair."

Dolan did not include in his story Klein's Portola Valley plan to install Bernstein as an executive chair.

The board is expected to take up the chairmanship election later this month, although it doesn't have to vote on any of the candidates. It has a variety of options: One would be to pass on all the candidates, choose an interim chairman, let the dust settle and make a final choice in a month or two.

The Los Angeles Times has rarely reported about activities of the California stem cell agency over the last six years. Dolan recently wrote an overview assessment of the agency that has attracted national attention. His article has ricocheted around the Internet as fodder for critics of hESC research and persons concerned about what they perceive to be unnecessary government spending.

Trounson and Torres and the Battle for Chair of the California Stem Cell Agency

The president of the California stem cell agency, Alan Trounson, may resign if the new chairman of the $3 billion research effort is not a person who has worked with the biomedical industry, Nature magazine reported today.

Trounson's position was disclosed publicly for the first time by writer Elie Dolgin in a profile of outgoing CIRM Chairman Robert Klein in the Dec. 2 edition of the internationally respected journal.

Trounson's preference could have an impact on the election of the chairman, which the CIRM board is expected to take up later this month. Art Torres, a former state legislator with little connection to industry, is one of the leading candidates, along with Alan Bernstein, head of HIV Global Vaccine Enterprise of New York, who is being backed heavily by Klein. The Trounson disclosure could also shape how the CIRM board receives the report Dec. 8 of the blue-ribbon panel that was chaired by Bernstein.

Dolgin wrote,

“Klein’s departure might also trigger the president to leave, thereby causing a complete overhaul of CIRM’s leadership. Trounson says he told Schwarzenegger that he would like that next chairperson to be 'somebody who’s in the delivery end of the spectrum — that is, somebody who has worked with the biotech or pharmaceutical industry.'
.
“But as this issue was going to press, the leading internal candidate to replace Klein, many say, is vice-chair Art Torres, a former state senator and chairman of the California Democratic Party. Torres and Trounson reportedly cannot stand each other. Trounson notes that Torres is 'a politician, so he’s in that end of the spectrum.' Torres, for his part, declined to comment on his relationship with the president.”

Trounson's foray into board politics came in a multi-dimensional look at Klein and his role in Prop. 71 and as chairman of the agency. The piece included both praise for Klein along with some of his warts.

Here are some excerpts:

“He (Klein) leaves behind an agency with a long list of accomplishments, including more than US$1.15 billion in grants, six new facilities dotted across the state and close to 700 scientific papers.

“Yet many critics say that Klein and CIRM have failed to fully deliver. Despite promises that money borrowed from the state — at least $6 billion over ten years, when interest is factored in — would be returned through commercial spin-offs and savings to health care, the first marketable therapies have yet to materialize. Only two CIRM-funded projects have made it to early-stage clinical trials, and neither of these involves embryonic stem cells — the main impetus for launching the agency in the first place. The embryonic stem-cell clinical trials that have recently been approved in the United States are the product of privately funded research.

“Klein’s critics say his promotion of stem cells’ therapeutic promise was zealous and oversimplified. He 'left voters with the impression that people will be jumping out of their wheelchairs and not being diabetic within a year,' says John Simpson, a long-time observer and critic of the agency’s governance, who is at the consumer-advocacy group Consumer Watchdog based in Santa Monica, California. 'There’s been this constant compulsion for [Klein] to say, ‘See, we’re delivering, we’re delivering’, and that’s something that’s haunted him throughout the whole thing.'

“Throughout CIRM’s existence, Klein has pulled the strings, maintaining control over nearly every aspect of its structure and science, often to the chagrin of its other leaders. Still, many observers say that no one else could have weathered CIRM’s early storms. 'With Bob, there’s always this indefatigableness,' says Douglas Wick, a movie producer and diabetes advocate who worked with Klein to get CIRM funded. 'His personal energy and charisma are so strong, and he has this ability to get punched, stand up and go at it again.'”

Dolgin continued,

“But not all the early organizers of Proposition 71 remain enthusiastic about the way Klein led the charge. 'It became Bob’s show almost entirely, and there was some friction about that,' recalls Peter Van Etten, former JDRF president and chief executive. (Home developer Tom) Coleman (an early key organizer for Prop. 71) has not spoken to Klein since the initiative passed, following disagreements over what Coleman viewed as Klein’s self-promotional approach. (Movie director Jerry) Zucker (another influential early organizer of the Prop. 71 campaign) remains on better terms with Klein, but still feels some lingering resentment.

“'If I had to do it over again I’d make the same call to Bob Klein because I don’t think the rest of us would have got it done without him,' Zucker says. But, he adds, 'What I was most unhappy about was the realization after a while that [Klein] wrote the initiative for him to be the chairman. That was something I was too naive to realize. It’s shameless almost.'”

Dolgin also spoke with Joel Adelson, a health policy researcher at UC San Francisco, who co-authored a study of the agency earlier this year. Dolgin wrote,

“'Klein has in effect acted like the chief operating officer beside Trounson and beside (former CIRM President Zach) Hall, and I can only say that this looks like it must have been very uncomfortable for these guys,' Adelson says. 'It’s an unusual situation,' says Trounson. 'And if you ask me what I prefer,I prefer the simple situation where the president is in charge of all management and reporting to a board on policies. But it’s bifurcated, and it was set up that way, so you don’t have a choice.” (Hall declined to comment for this story.)”

Dolgin also quoted a CIRM board member on Klein.

“'He’s an historic figure with real genius in terms of moving biomedicine forward,' says Jeff Sheehy, a CIRM board member and director for communications at the University of California, San Francisco’s AIDS Research Institute. 'He’s as good as they get if not better.'”

Dolgin also noted that some criticism of Klein focused on CIRM's emphasis on clinical applications. However, a significant number of folks in the biotech industry believe the agency is overbalanced towards basic research.

Text of Bee Article on the State of Affairs at CIRM

Here is the overview piece on the California stem cell agency that appeared Nov. 28, 2010, on the front page of The Sacramento Bee's Sunday's opinion section. The version in The Bee can be found here.  The author is also the publisher/editor of the California Stem Cell Report.

With a review pending, the state's stem cell agency looks for new leadership, new therapies and more money

By David Jensen
Special to The Bee

Lured by visions of nearly magical medical solutions for everything from cancer to Alzheimer's, California voters six years ago approved a plan to borrow billions of dollars to pay scientists to look into human embryonic stem cell research.

Today the unprecedented $3 billion research effort by the California Institute for Regenerative Medicine faces a watershed moment, including the most sweeping review yet of its progress along with the departure of the man whose name has become synonymous with California stem cell research. Additionally, leaders of the program are pressing hard for concrete results that will persuade voters to cough up billions more to continue the effort.

This confluence of self-examination and changing of the guard comes amid criticism over the agency's promise of transparency and openness as it operates independently from oversight of the governor and Legislature; conflicts of interest by a board of directors who have directed $1 billion in grants to universities and research enterprises to which they have links; and the fact that no embryonic stem cell therapy is ready for patients, although the 2004 campaign for Proposition 71 seemed to offer hope for speedy development of cures.

Proposition 71 was described as a 10-year effort that would sidestep the Bush administration's ban on funding of human embryonic stem cell research. Actors Michael J. Fox, who has Parkinson's disease, and the late Christopher Reeve, who played Superman, were featured in ads promising cures in the campaign.

The ballot initiative gave the new state agency $3 billion in state bond financing and has fueled a lab building spree at California research organizations and universities, fed by $271 million in seed money from the California Institute for Regenerative Medicine, known as CIRM. As of this month, CIRM has handed out $1.1 billion to about 400 California scientists and research institutions. That is a pace that runs close to $56,000 an hour since the state treasurer first sold California stem cell bonds on Oct. 4, 2007.

The campaign was headed by Robert Klein, a Palo Alto real estate investment banker who was subsequently chosen chairman of CIRM. Klein says he is stepping down in December at the end of his six-year term. The agency's 29 directors are expected to meet next month to pick a new leader.

Longtime CIRM observer John M. Simpson, stem cell project director for Consumer Watchdog of Santa Monica, said Klein's influence has been so pervasive that it is hard to predict what his departure will mean. "Perhaps, now the agency will move out of its ongoing startup mode and finally develop more routine procedures," Simpson said.

Also next month, the agency's directors will deal with a key, strategic report from a blue-ribbon panel that recently conducted the most sweeping review ever of CIRM's programs. CIRM barred the public from nearly all of the review sessions that were orchestrated over a three-day period at its headquarters in San Francisco.

The report, released Wednesday, had high praise for the agency's work, but it made no attempt to measure CIRM against the campaign promises of 2004. The panel recommended closer ties with the biotech industry, some segments of which have been unhappy with CIRM. It also recommended performing a triage on existing research to weed out nonproductive efforts, a process it warned will irk some patient advocate groups that supported Proposition 71. Also recommended was an improved public relations and public education effort, which will be necessary if voters are to approve more funding. It said the board should consider some management and structural changes in a suggestion that echoed some proposals last year from the state's Little Hoover Commission, the state's good government agency.

In an 88-page report, the Hoover commission proposed a wide range of changes at CIRM. It suggested reducing the size of the unwieldy, 29-member board and the elimination of conflicts in the roles of the chairman and president of CIRM. It also called for more oversight, disclosure of the votes of individual board members on grants and more openness and transparency.

Noting that most of CIRM's grants have gone to institutions connected to its directors, the Hoover commission said that suspicions that CIRM is an "insiders' club" undermine the legitimacy of the agency. Even the prestigious British scientific journal Nature warned in 2008 of "cronyism" at the stem cell agency.

In January, a sister panel to the CIRM board of directors unanimously called for more openness at the agency and endorsed the findings of the Hoover commission. The panel, the Citizens Financial Accountability Oversight Committee, was created by Proposition 71 to provide financial oversight of CIRM. State Controller John Chiang, the state's top fiscal officer and chairman of the committee, said, "To ensure that taxpayer dollars are spent lawfully, wisely and successfully, the stem cell program must pursue the highest standards of transparency to be fully accountable to the public."

In February, state Sen. Elaine Kontominas Alquist, D-San Jose, chair of the Senate Health Committee, introduced something of a reform bill for CIRM. She said in a news release that the agency is "essentially accountable to no one."

But a CIRM lobbying effort, led by former state Sen. Art Torres, now co-vice chair of CIRM, was successful in watering down much of Alquist's proposal, which was ultimately signed into law and will eliminate a 50-person cap on CIRM staff when the legislation goes into effect Jan. 1. Removed from the bill was a provision that would have directed Chiang's committee to conduct a performance audit, the first ever, of the agency. Instead, CIRM itself will commission the performance audit and control its terms.

CIRM laid out its own assessment of its performance last month in a document prepared for the three-day review. The stem cell agency said its spending "contributed" to research published in nearly 600 articles in scientific journals. It said that its awards played a partial role in research that has led to the initial stages of two clinical trials. It cited the funding of labs at institutions throughout the state and points to the spending as a benefit to the California economy. CIRM as well has had a significant impact on the embryonic stem cell scene nationally, keeping it alive and talked about despite the Bush ban.

However, CIRM has not delivered on the overheated campaign rhetoric of 2004. A TV ad featured twin brothers, one with cerebral palsy. The healthy brother said, "His life is different. With stem cells it doesn't have to be that way." In the ballot pamphlet sent to every voter in California, supporters said, "Vote yes on Prop. 71. It could save the life of someone you love."

Consumer Watchdog's Simpson said the "unrealistic expectations created in most voters' minds will continue to haunt the agency."

The campaign rhetoric ignored the slow and tedious nature of scientific inquiry, not to mention the required approval of therapies by federal authorities. Only one clinical trial using human embryonic stem cells is currently under way in the nation. A second was given the go-ahead by the federal government last week. Both are privately funded and do not involve California's stem cell agency. CIRM's strategic plan in 2006 acknowledged that use of the actual therapies will come only years from now.

As Klein gets ready to step down, he is publicly touting another huge bond measure for the ballot – up to $5 billion – that could come as early as 2012. He has pushed for tangible research results that can be used to sell the bond measure to voters, who don't seem to be in a mood for additional government spending.

Regardless of the outcome of a future bond measure, CIRM is likely to be in business for another decade. It still has about $2 billion to hand out. And despite the 10-year time frame bandied about in the 2004 campaign, no sunset date exists for the stem cell agency. Whether the historic $6 billion investment, which includes $3 billion in interest, ultimately pays off for California – with therapies – is still very much an open question.

(David Jensen has been writing about the California stem cell agency since 2005 on his website, the California Stem Cell Report, californiastemcellreport.blogspot.com.)

New Directions for CIRM? Closer Links with Industry, Aggressive Search for Innovation, Better Communication

The $3 billion California stem cell agency has done an “extraordinary” job so far, a blue-ribbon review panel said today, and should expand its efforts internationally, create closer ties with the biotech industry and perform triage on its existing portfolio of research grants.

The panel's 19-page report said that the agency now stands at a critical point as its first and only chairman, Robert Klein, is departing, and as it moves more aggressively into development of clinical applications.

The panel encouraged CIRM to seek out innovative projects, even from out-of-state and bring them to California, instead of merely posting requests for grant applications. Industry needs to play a much larger role in funding, the panel said, and it urged changing grant review processes to meet industry needs. “Considerable obstacles to industry engagement remain,” echoing a view stated by biotech firms for past several years. (See here and here.)

The eight-member panel was recruited by CIRM and conducted three days of mostly closed door hearings orchestrated by the agency in San Francisco in October. It was convened as part of the agency's strategic planning process. The panel was not asked to measure CIRM's current results against the campaign promises made in 2004 when voters created the program.

The 29-member CIRM board will discuss the report at its meeting Dec. 8 in Irvine. The subject could come up as early as next Wednesday at a meeting of the directors' Governance Committee.

One recommendation dealt directly with the board itself and the overlapping responsibilities of the chairman and president of the agency, which have been troublesome in the past. Noting that the board has had a “very hands-on approach” during the past six years, the panel's report said.

“We believe this is an appropriate time for the Governing Board to examine its role and composition, mindful of the legal reporting, fiduciary and accountability requirements of the state of California. With the imminent stepping down of the founding Governing Board Chair and CIRM visionary Mr. Robert Klein, it is imperative that the roles and responsibilities of the Governing Board Chair and CEO positions remain distinct but complementary to ensure the continued positive, collaborative partnership between these two key individuals. There should be clarity of the roles and responsibilities of the Governing Board Chair and CEO as it pertains to CIRM’s strategic directions, its policies, international partnerships, funding decisions, public communications and oversight.”

The panel also recommended improvements in CIRM's public relations and education efforts. The panel said,

"(It) strongly encourages CIRM to significantly increase both the quality and breadth of its community outreach and education programs. The objective should be to ensure state-wide visibility and awareness of the contributions that California is making to the global research effort and to create opportunities for Californians to be informed about advances in the research, and to engage in dialogue with the scientific and clinical community about the benefits, limits and resulting guidelines for this exciting area of biomedicine."

Such an effort is all the more important if CIRM is to win approval of the  new, multibillion dollar bond measure that Klein is touting.

The panel had strong praise for CIRM's program so far, particularly since the agency was operating with a staff of less than 50. “Remarkable” and “extraordinary” were a couple of the adjectives. The report said,

“CIRM has built significant additional research capacity in the state, has attracted scores of talented young people to stem cell research, and has catalyzed large and important stem cell projects across the state. The (panel) was most impressed with this rapid start up, the overall quality of the scientists and projects that have been funded, the development of major buildings and other facilities for stem cell research, the forging of several important international partnerships and the innovative training programs that are in place.”

The panel warned that some patient advocate groups might have to lower their expectations as the result of the grant triage, which it called “portfolio prioritization.” The report said,

“While the (the panel) appreciates the natural wishes of disease groups to move forward on particular diseases or conditions, CIRM’s Governing Board, guided by management and external advisors, must begin the difficult process of focusing the number of disease areas to those that it believes have the greatest chance of development progress and clinical success, given reasonable timelines and budget. Attempting to move forward across too broad a front might compromise moving forward on any disease. Undoubtedly, these will be difficult decisions....”

Backers of basic science might also find some reason to be concerned about the emphasis on funding development of clinical applications. However, the report said,

"We strongly encourage CIRM to continue to invest in the research programs, intellectual infrastructure, training and development necessary to advance the understanding of stem cells."

On the international front, the panel said CIRM's efforts should be expanded into non-stem cell areas that could support CIRM's mandate. The agency should "sharpen the focus on meaningful, targeted excellence required for global leadership in the development of innovative treatments based on regenerative medicine."

You can find a list of all the reports recommendations here.

The California Stem Cell Report is interested in hearing from readers about their views on the panel's recommendations and conclusions. You can post them directly by clicking on the word “comments” or you can email them to djensen@californiastemcellreport.com. We will post them verbatim. We encourage writers to identify themselves but anonymous comments are permitted.

California Stem Cell News: A Not-So-Good Story Line

If one is to believe Google, the top of the news today about the California stem cell agency is a story that relates how its $3 billion effort has failed to deliver on the emotion-ladened campaign promises of 2004.

The piece in the Los Angeles Times, the state's largest circulation newspaper, was ranked No. 2 in a Google news search this morning on the term “California Institute for Regenerative Medicine.” Ranked at No. 1 was a summary of the article. Yahoo news placed the Times article a tad higher than Google, declaring it was No. 1.

The story yesterday by Jack Dolan of the Times' Capitol bureau follows one earlier this month in the New York Times that warned that California voters are not likely to see a good return on their unprecedented investment in stem cell research.

Both stories highlight one of the major challenges facing the state stem cell agency, especially if CIRM seeks another $3 billion to $5 billion from voters in a couple of years.

To win approval of such a bond measure in a statewide election, it will take more than a few hundred research papers, one of the measures of success that CIRM uses. The papers may contribute to the development of the science, but voters expect more tangible results. They want to see paralyzed people walk, blindness cured and memories recovered – all of which are not likely between now and time for an election for more funding for CIRM.,

That is not to say that another bond measure is doomed, but it will take some great science and top-notch marketing – not to mention luck – to win approval of more cash for research.

The story that CIRM wants to see should be much different than Dolan's piece, which does not give the agency much to celebrate, at least in terms of PR.

Dolan wrote,

"Under (CIRM Chairman Robert Klein's) stewardship, the agency has funded research leading to hundreds of scientific papers, but scientists say marketable therapies for maladies such as cancer, Alzheimer's and spinal cord damage promised during the campaign remain years, if not decades, away."

Dolan cited the built-in conflicts of interest at CIRM. He wrote,

"'When you're talking about spending $1.1 billion dollars, there's absolutely no excuse for people making the decision to give themselves the money,' said Robert Fellmeth, executive director of the Center for Public Interest Law at the University of San Diego.

"While board members recuse themselves from voting on grants where they have a direct conflict, the mere presence of so many conflicted members is a concern, Fellmeth said. 'There is a quid pro quo atmosphere that develops, because you defer to each other.'"

Dolan additionally hammered at the high salaries at the upper levels of CIRM, a matter that resonates roundly and negatively with voters.

Little of what he wrote is new to the readers of this blog, but a piece in the Los Angeles Times reaches a new and far wider audience than that of the California Stem Cell Report. A story in the Times also stimulates additional links to the article, sometimes in a manner that does not cast CIRM in the best light.

The Scientist magazine linked to the story in a three-paragraph item that began like this:
“The California Institute for Regenerative Medicine has been plagued with criticisms and doubts during its first six years in operation, yet the chairman of the institute plans to ask state voters for another $3 billion in bonds in 2014 to keep the institute up and running.”

Then there was this headline from blogger Wesley Smith: “CIRM to Try and Sucker Californians Into Letting It Borrow Even More Money." Smith wrote,

"Who cares that California is falling into the ocean fiscally?  Who cares that our taxpayers are groaning under high taxes and an astonishing level of bond debt?  Not the California Institute of Regenerative Medicine.  Like the man-eating plant in (the play) 'Little Shop of Horrors,' its appetite is insatiable.  It wants more!"

Rankings of news stories on Internet search engines, of course, change over time, sometimes in a matter of hours. But pieces such as those in the New York and Los Angeles Times will still be part of the news background for CIRM come election time. Reporters from around the state and nation will find them as part of their coverage of the bond measure. More questions will be asked. And CIRM will need to find some good answers.

Kerfuffle over NY Times Take on California's Stem Cell Program

Last week, the New York Times published an article that was critical of California's approach to funding scientific research, quickly prompting denunciations that called it a “hit piece” and an “unbelievable attack.”

We differ with those characterizations, some of which seem to stem from a misunderstanding of a comment in the Times about how the NIH is like a manager of a stock index fund, as opposed to California's narrower focus.

The Nov. 8 piece was written by Nicholas Wade, who has had a long and respectable career in science reporting. The article was carried in a special section on “prognostications” about what could be coming up in 2011 in science. The article was not intended as a “balanced” news story. Rather it was an analysis based on Wade's years of covering science. That distinction might have been clear in the print version of the section, but it was easily overlooked on the Web version of the Times. That led to some misunderstandings by readers based on comments that we have read.

Basically Wade said that California – as opposed to the NIH – has made a $6 billion bet (including interest) on a narrow field of science. He wrote,

“By allocating so much money to a single field, California is placing an enormous bet on a single horse, and the chances are substantial that its taxpayers will lose their collective shirt.”

Wade contrasted that approach to the NIH, which funds all sorts of scientific research, instead of just stem cells. He wrote,

“...(T)he National Institutes of Health and the National Science Foundation are like the managers of a stock index fund: they buy everything in the market, and the few spectacular winners make up for all the disasters.

“But just as index fund managers often go astray when they try to improve on the index’s performance by overweighting the stocks they favor, the government can go wrong when it tries to pick winners.”

Writing on his blog Nov. 9, UC Davis stem cell researcher Paul Knoepfler described Wade's article as a “hit piece.” Knoepfler said,

“The NY Times has allowed Mr. Wade to publish in essence an opinion piece smearing stem cell researchers in their Science section.

“NIH is incredibly strict and deliberate in what it funds. NIH funds approximately only the top 10-15% of all grant applications after thorough peer review, which is an extremely low percentage. This hardly reflects 'buying everything', but rather is just the opposite.”

It is clear that Wade's piece reflects his opinion and would not be carried on the front page of the NY Times as a news article. However, his broad-brush analogy about the NIH being akin to a manager of a stock index fund is on the mark. The NIH does not limit its funding to only one brand of research. It is certainly deliberate and approves a small fraction of applications, but those represent a broad range of approaches, just as an index fund for the entire stock market has oil, auto, tech, health, insurance, soap and other companies represented in its portfolio. If Wade were to carry his comments further, he might say that California has only bet on or invested in the biotech sector. That creates an investment risk, looking at it from a financial viewpoint.

Knoepfler also differs with Wade's assertion related to dubious claims involving stem cell research. Wade wrote,

“Stem cell researchers have created an illusion of progress by claiming regular advances in the 12 years since human embryonic stem cells were first developed. But a notable fraction of these claims have turned out to be wrong or fraudulent, and many others have amounted to yet another new way of getting to square one by finding better methods of deriving human embryonic stem cells.”

Knoepfler described that as an attack on embryonic stem cell research and researchers.

“He(Wade) says that us scientists have 'created an illusion of progress' with our claims and that a 'notable fraction of these claims have turned out to be wrong or fraudulent'. Wow. Can you please give me some facts to support such aggressive claims?”

Wade did not carry any evidence supporting his assertion but also carried this sentence,

“Stem cell scientists, while generally avoiding rash promises themselves, have allowed politicians to portray stem cells as a likely cure for all the major diseases.”

Stem cell research has indeed been susceptible to considerable hyperbole, much of it coming during the 2004 election campaign that created the California stem cell program. We are likely to see more as the stem cell agency becomes increasingly serious about asking voters for another $5 billion(actually perhaps $10 billion including interest), as early as 2012.

California patient advocate Don Reed weighed in with a comment on Knoepfler's blog. Reed described the Times article as an “unbelievable attack.” He said that the California stem cell agency has awarded $1 billion and “received” $1 billion in matching funds. In fact, the agency has not received anything remotely like that sum. It has required matching funds on some grants, notably lab construction projects, but that cash is ginned up by applicants. It is reasonable to assume that a goodly portion of those funds would have found their way to the respective institutions even without CIRM's matching requirements.

Wade also had this to say,

“Strangely, for a project that is aimed at regenerative medicine, the arbiters of stem cell research have largely neglected the free lesson that nature is offering as to how regenerative medicine could actually work. Many little animals, like newts and zebra fish, do regenerate parts of their bodies. But their recipe is the reverse of that presented by the advocates of stem cell therapy. Instead of taking a stem cell and trying to convert it into a well-behaved adult tissue, animals like the zebra fish start with the adult cell at the wound site, and walk it backward into a stemlike state from which a new limb grows.

“For the California Institute for Regenerative Medicine to invest its $3 billion in studying newts, rather than building new science buildings on every state campus, might seem the best way of understanding regeneration, but that would be hard to explain to California’s voters, who have been assured stem cell cures are just around the corner. Even if governments do better to avoid picking winners among basic research fields, they can play a necessary role in supporting specific scientific infrastructure that lies beyond the means of individual researchers or universities, like atom-smashers or the human genome project. But even these projects are not guaranteed success.”

Wade's bottom line?

“Basic research, the attempt to understand the fundamental principles of science, is so risky, in fact, that only the federal government is willing to keep pouring money into it. It is a venture that produces far fewer hits than misses.”

One Hour Public Access at Critical Two-Day Review of $3 Billion State Stem Cell Operation

The California stem cell agency today officially notified the public for the first time about next month's sweeping review of its operations and said the public may attend for one hour at the beginning of two days of meetings.

CIRM's announcement was the first such notice that it has given the public via its Web site about the sessions that begin Oct. 13 at its San Francisco headquarters. The announcement also said for the first time that the public can submit written comments and questions in advance of the meeting.

CIRM's announcement did not make it clear that the public would be barred from the remainder of the sessions. However, a separate agenda for the meeting, also the first to be published by CIRM, specified that public would, in fact, be banned from virtually all of the most comprehensive review ever of the $3 billion operation.

The California Stem Cell Report last week wrote that the agency planned to ban the public entirely from the sessions. It was the first public news of the external review outside the sparsely attended meetings of the CIRM board of directors. Yesterday, we pointed out that the ban is not in the best interests of either the public or the agency and that the secrect testimony would not accomplish the agency's goal of candor from witnesses.

Today's announcement from CIRM implicitly recognizes that the public has a right to attend the hearings. However, barring the public from the remaining 19.5 hours falls far short of being either open or transparent, something CIRM has had problems with for years. One hour could not even be considered paying lip service to the state Constitution's guarantee of a broadly construed right of public access to the doings of state government.

CIRM gave no reason for its marginal change of position. We are querying the agency concerning its reasoning.

Material posted by CIRM also shows a change in one of the panelists. Dropped is Myrtle Potter, former head of Genentech who now runs her own San Jose, Ca., consulting firm. No explanation was given for the removal of Potter. We are querying CIRM about that as well. She is being replaced by
Igor Gonda, CEO of Aradigm Corp. of Hayward, Ca., an inhalation drug product firm.

The agency also posted a 384-page briefing document that has been given to the eight panelists who will be reviewing CIRM's strategic plan.

We will have more later on all this.

Credibility Damaged and Foes Aided: No Upside on CIRM's Ban on the Public

The California stem cell agency's ban on the public during the most sweeping review ever of its operations promises little upside for the $3 billion enterprise and plenty of downside.

That's not to mention the fact that the ban is poor policy and is not likely to achieve its stated purpose – candor from those testifying before the blue-ribbon, international panel that has scheduled three days of hearings in San Francisco beginning Oct. 13.

The “external” review, as CIRM has labelled it, is called for by the agency's strategic plan of 2006. That document recognized the need to revise the plan as conditions changed. It was prepared with substantial comments from the public and a number of open hearings,

CIRM has devoted about 2,000 hours of staff time preparing for the the latest review, which will be critical in determing how the agency will spend its remaining $2 billion. The eight-member panel, which includes a Nobel laureate, is expected to prepare a report that will be considered by the CIRM board in December.

The strategic review comes as CIRM Chairman Robert Klein is publicly discussing presenting to voters a $5 billion bond measure to continue CIRM's activities. A bond measure is necessary because the agency's only real source of funding is cash that the state borrows (bonds). Klein's new bond proposal places the agency's efforts squarely in the context of a political campaign, which could come as early as two years from now.

Last week CIRM told the California Stem Cell Report that members of the public would be barred from attending the agency's external review. CIRM also has made no public effort to solicit comment from California citizenry, which is paying $6 billion, including interest, for the research program. Nor has CIRM notified the public via its Web site that an important evaluation of CIRM will take place.

Don Gibbons, spokesman for CIRM, said the closed-door sessions were necessary so that “reviewers can ask tough questions and receive candid, unfiltered responses” from CIRM staff, biotech executives and some CIRM board members who are scheduled to appear before the review panel.

The reality, however, is much different. CIRM staffers who want to keep their jobs are not going to say anything to reviewers that they haven't already told their superiors. Biotech executives who want to receive grants or loans from CIRM are unlikely to be sharply critical of the agency. And CIRM board members are more than likely to be circumspect, given that they have to make the final judgment on whatever the panel comes up with.

Only a “small number” of the 29 board members have been invited to make comments to the panel. Their identities and topics are yet to be disclosed.

The closed-door proceedings pose a problem for any CIRM board members who might want to sit in on a session or two. Essentially, they must ask permission of the CIRM staff to attend. That's because if too many of them attend, they could run afoul of the state's open meeting law by either constituting a quorum or creating what is known as a “serial meeting.”

Board members have sometimes complained about having to act with too little information. The primary example is appeals on grant applications. The board has repeatedly been asked to overturn negative decisions by grant reviewers, but cannot actually examine the actual applications. In January 2009, the board was caught by surprise when its bond funding was endangered. That particular problem was in evidence to knowledgeable persons well prior to that meeting and could have been disclosed to the board earlier. Limiting directors' attendance at the external review distances the board even more from key aspects of CIRM operations.

Last week we polled CIRM directors about whether they thought that the external review should be open. While we can't say our email reached all directors, we believe most saw it. Four responded. Only one director, Jeff Sheehy, said yes. Others may feel likewise while some are opposed, but at the same time feel constrained about responding via our query.

Director Floyd Bloom, former editor of Science magazine, said he did not see a need for the public to able to attend the review, He said the panel's report will be considered later by CIRM directors, and the public could comment then. (You can read all of the results here of the query including comments from some directors.)

CIRM has yet to provide a legal justification for closing the review. However, little doubt exists that the agency believes the ban on the public is lawful. Presumably CIRM would make a similar argument to one presented last July in connection with another CIRM meeting that barred the public.

However, those arguments fail to take into account a major change in the state Constitution in 2004 that guaranteed the public a broadly construed right to access to governmental affairs. The state's open meeting laws were written before that change and have not yet been amended to reflect its broader constitutional access provisions.

From a political and good government perspective, the ban on the public, coupled with continuing complaints about a lack of transparency at CIRM, unnecessarily provide major ammunition to its foes along with the foes of hESC research across the nation. Closed-door proceedings breed suspicion, even on the part of a public inclined to support stem cell research. They provide a fertile ground for the worst sort of rumors and add evidence that CIRM is an “insiders club,” as others, including Nature magazine, have complained. No doubt exists that Klein's $5 billion bond measure campaign will have to confront severe criticism about the lack of openness at CIRM.

One reader of this report, who is knowledgeable about CIRM affairs but who must remain anonymous, told us,

“The failure to provide any opportunity for public input in the process diminishes its credibility and utility. This is a hand-picked body following a pre-determined agenda that was defined  by CIRM. CIRM (i.e. Klein) decides what's presented and what's considered. The outcome is predictable.”

CIRM carries a special burden in connection with openness and transparency because of its unprecedented nature. As opposed to other state departments, it is not subject to normal oversight by the governor and the legislature. Funds flow to it unaffected by the financial crisis that is damaging public education and medical assistance to the poor in California.

Gov. Arnold Schwarzenegger has been advocate of more openness throughout state government and also a strong supporter of CIRM's operations. He has opened up other state departments' activities, including executives expense accounts, to public scrutiny. He said some time ago,

“Transparency is fundamental to promoting efficiency and effectiveness in government and strengthening the democratic process by giving citizens enough information to reach their own conclusions about how their tax dollars are being spent.”

CIRM should reconsider its position and open the external review to the persons who are actually financing its operations.

Stem Cell Agency Bans Public from Critical Review of its Operations

The California stem cell agency said yesterday it will bar the public from three days of the most sweeping hearings ever into how well it is spending $3 billion in taxpayer funds.

The blue-ribbon assessment of the California Institute for Regenerative Medicine will be the first such in the agency's five-year history and will be critical in determining how CIRM will spend its remaining $2 billion. The sessions also represent the most exhaustive review of the agency's past performance. CIRM has already committed more than $1 billion to 364 scientists and institutions.

Although CIRM directors have been told that the review will occur, the public has not been notified via CIRM's Web site or other means that the Oct.13-15 assessment will take place. Nor has the agency publicly solicited from citizens or other interested parties comments or suggestions of issues to be addressed.

CIRM has repeatedly come under fire from state officials for its lack of transparency. An influential state lawmaker said last February that the agency is “essentially accountable to no one.” The ban on the public at the October review also appears to fly in the face of a state constitutional amendment adopted in 2004. By an overwhelming 83 percent, voters altered the constitution to guarantee the public a broadly construed right of access to what state government is doing.

John M. Simpson of Consumer Watchdog of Santa Monica, Ca., a longtime observer of CIRM, said that conducting the "entire process behind closed doors shows an agency with leaders who are completely unaware of their responsibility to the public, or worse, don't care." (The full text of his remarks can be found here.)

Responding to a query, Don Gibbons, chief communications officer for the agency, told the California Stem Cell Report that the closed-door sessions are justified so that “reviewers can ask tough questions and receive candid, unfiltered responses” from CIRM staff and board members, among others.

Gibbons said in an email,

“The reviewers are not public officials and have no governmental authority; they were asked to serve by staff not the CIRM board. They have been asked to give their opinion, not make decisions.”

He said that the reviewers will produce a written report during their closed-door sessions that will be reviewed by the CIRM board of directors in a public meeting. (All of Gibbons' remarks can be read here.)

The “external review,” as it is known, is called for by the agency's strategic plan. CIRM President Alan Trounson told directors in August that preparation for the meetings at CIRM headquarters in San Francisco is taking 2,000 hours of staff time.

The sessions will be conducted beginning Oct. 13 by an eight-member panel. The members are Alan Bernstein, executive director of the Global HIV Vaccine Enterprise of New York, NY; George Daley of Harvard and director of stem cell transplantation at the Children's Hospital and Dana Farber Cancer Institute; Sir Martin Evans, Nobel Laureate and director of the School of Biosciences of Cardiff University of Great Britain; Judy Illes, director of the National Core for Neuroethics at the University of British Columbia; Richard Insel, executive vice president of Research for the Juvenile Diabetes Research Foundation of New York, NY; Richard Klausner, formerly the global health executive director of the Bill and Melinda Gates Foundation's Global Health program and now an independent consultant, Myrtle Potter, now head of her own consulting firm and former president of Genentech, Inc., and Nancy Wexler, Higgins Professor of Neuropsychology in the Departments of Neurology and Psychiatry at Columbia University and president of the Hereditary Disease Foundation. (Full biographies can be found here.)

Two of the panelists have links to CIRM. Daley is a scientific co-founder and co-chair of the scientific advisory board of iPierian, Inc., of South San Francisco, which holds a $1.5 million grant from the agency. Ipierian is expected to apply for an award in CIRM's upcoming, $50 million clinical trials round. Daley is also an ad hoc member of the CIRM grant review committee and serves on a national consortium created by CIRM.

Potter served for six years on a panel that is charged with overseeing CIRM's financial operations, the Citizen's Financial Accountability Oversight Committee.

Insel's organization has longstanding ties with CIRM Chairman Robert Klein, who currently serves on the foundation's board of chancellors.

Consumer Watchdog's Simpson said,

"This evaluation looks to be conducted by insiders, some with clear conflicting ties to CIRM. That is highly improper and inappropriate."

In response to a query, Gibbons outlined the order of business for the review. He said,

“The first day will be presentations by staff about various aspects of our operations and goals, with ample time for discussion during each session.

“The second morning will be presentations by the Chair (Klein) and his staff about governance and bonds, with the afternoon being given over to a series of discussions with small groups: members of the Grants Working Group, biotech execs, CIRM grantees, and patient advocates.

“The third day will begin with a Q&A session with Alan (Trounson) and then the reviewers will begin to outline the draft of their report with only a facilitator present.”

Later, Gibbons added,

“A small group of board members will be interviewed by the group the second afternoon.”

The California stem cell agency has drawn strong criticism for its lack of openness. Last February, state Sen. Elaine Kontaminas Alquist, D-San Jose, chair of the Senate Health Committee, said CIRM is “essentially accountable to no one.” In January, the Citizens Financial Accountability Oversight Committee, chaired by the state's top fiscal office, Controller John Chiang, unanimously recommended more transparency at CIRM. Commenting on the committee's action to CIRM directors last February, Trounson said it was an "irrational attack on the governance of the institute without any real information backing it up."

The Little Hoover Commission, the state's good government oversight group, last year prepared an 88-page report on CIRM. The commission's recommendations included improved transparency, noting that it would help to ease criticism that CIRM amounts to an “insider's club.”

CIRM is not subject to normal state oversight, including that of the governor and the legislature. Under the terms of Prop. 71, which created the agency in 2004, CIRM is immune from the usual budgetary controls imposed on other state departments. Its funds, which come from state bonds, flow to CIRM directly and cannot be touched by the governor or the legislation.

Economic Interest Statements of CIRM Directors Posted Online by California Stem Cell Report

Eight months ago, the only public body charged with overseeing the financial practices of the California stem cell agency unanimously recommended more openness and transparency on the part of the $3 billion enterprise.

Chaired by California's top fiscal officer, Democrat John Chiang, the Citizens Financial Accountability Oversight Committee said that CIRM should post online the statements of economic interests of its directors and top executives, following the practice of both Republican Gov. Arnold Schwarzenegger and Chiang himself.

Chiang said,

“To ensure that taxpayer dollars are spent lawfully, wisely and successfully, the stem cell program must pursue the highest standards of transparency to be fully accountable to the public.”

CIRM has all but ignored the recommendation. Instead, it has moved to prevent the committee from exercising more financial oversight of the state's unprecedented research operation.

In response to the controller's recommendation, the California Stem Cell Report is publishing online the statements of economic interest of the 29 directors of the stem cell agency along with those of some of the agency's top executives.

When Schwarzenegger announced his efforts at improving openness, he said,

“Transparency is fundamental to promoting efficiency and effectiveness in government and strengthening the democratic process by giving citizens enough information to reach their own conclusions about how their tax dollars are being spent.”

Understanding and assessing the performance of the California stem cell agency is even more critical than with most other state enterprises. CIRM holds a unique and unprecedented place in state government. Created by a $30 million ballot initiative campaign, it is isolated from the normal financial oversight functions of the governor and legislature. Its stream of income – all borrowed money(state bonds) – cannot be touched, despite California's grave financial crisis.

At the same time, CIRM is riddled with built-in conflicts of interest. Its 29-member board is
heavily influenced by directors tied to institutions that are the beneficiaries of its largess. More than $900 million of the $1 billion-plus that directors have handed out has gone to enterprises with members on the board.

None of this is going to change any time in the near future. Which makes it all the more important for the public to understand who has what at stake when it comes to giving away billions of dollars.

You can find the statements of economic interest here. Here is a link to a state document that helps to explain the nature of the information. You can find the statements of economic interest for Chiang's stem cell oversight committee on his Web site. Here is a link to the transcript of the committee's meeting last January during which questions were raised about accountability and openness at CIRM. Here is a link to the transcript of a subsequent CIRM board meeting during which CIRM President Alan Trounson described  (on p. 132) the discussion at Chiang committee meeting as a “strange critique” and “irrational attack.”  Here is a link to a piece by Los Angeles Times columnist Michael Hiltzik, who attended the meeting and wrote that the agency "has self-righteously fought every attempt to improve public oversight over its disbursement of what is, after all, the people's money."

(The statements of economic interest involving CIRM directors were provided via email by the agency at the request of the California Stem Cell Report, which the agency is required to do by law. They are also available via conventional mail from the Fair Political Practices Commission in Sacramento and in person at both agencies.)

It's Official: Wechsler-Reya Signs with Sanford-Burnham

The $6 million-plus recruitment of a Duke stem cell researcher to California seems certain to be the topic of considerable discussion this week in research labs around the nation, if not overseas.

The move – first reported by the California Stem Cell Report on Sunday – was officially confirmed today by the Sanford-Burnham Medical Research Institute in La Jolla and the California stem cell agency.

The agency put up $5.9 million in taxpayer funds in the form of a research grant. Sanford-Burnham added an “extremely generous commitment” to bring Robert Wechsler-Reya to the Golden State. He is the first recipient in CIRM's $44 million research leadership award program.

The stem cell agency's program is also likely the first of its kind in the nation. The Wechsler-Reya recruitment starts it off well, given its goal of bringing "franchise players" to California. The agency sent a message to stem cell researchers across the nation that they should be looking ever more closely at California if they want to move forward aggressively with their careers.

The effort also highlights the built-in conflicts of interest at CIRM. Potential beneficiaries of the program include 12 members of the 29-member CIRM governing board whose institutions could use the funds to lure talent.

Others outside of the state may not look kindly on the effort. It could increase the cost of retaining talent, which, of course, could lead to sweeter deals for researchers, even if they stay in place.

In California, some researchers may regard the recruitment as boosting the field generally. Others are likely to think the money may have been better used to fund scientists already in the state. Adding Wechsler-Reya to the pool of potential applicants for CIRM's remaining $2 billion also increases the competition.

Robert Klein, chairman of the California stem cell agency, said in a statement that scientists recruited through the effort will help develop innovative therapies and push CIRM's mission forward. He touted the effort as something of a job creation program for California, which is mired in a serious economic slump and a state budget crisis. Klein said,

“Bringing this caliber of scientist to California also creates high paying positions to staff the labs, providing new jobs and tax revenue to the state.”

The official statement from Sanford-Burnham today said that Wechsler-Reya was appointed professor and director of the Tumor Development Program in the institute’s NCI-designated cancer center.

The announcement quoted Wechsler-Reya as saying,

“The strength of the scientific community there, particularly in cancer biology, stem cell biology and neurobiology, is unparalleled. This move promises to transform the way we do science, and I am grateful to Sanford-Burnham and CIRM for making it possible.”

The news release did not mention Wechsler-Reya's wife, Tannistha, who is also a Duke stem cell researcher. We are querying the couple and Sanford-Burnham about whether she is also joining the institute, as was originally expected.

Oddly, CIRM's news release on the consummation of the deal seemed to downplay the monetary size of its role. It said that the grant to Wechsler-Reya was only $5 million, as opposed to $5.9 million.