Stem Cell Miracles and Campaign Promises : Thomas-Trounson vs. Hiltzik of the Times

The Proposition 71 campaign of 2004, which has filled the coffers of more than 500 researchers and institutions with $1.4 billion, was the subject today of a discussion about miracles.

Specifically did the campaign promise miracles?

The story begins with a column May 27 by Michael Hiltzik of the Los Angeles Times about the "Son of CIRM" initiative, Proposition 29, on the June ballot. It seeks to fund more medical research with $800 million handed out by an organization patterned after the stem cell agency.

In the column, Hiltzik did not speak well of the agency and said the 2004 campaign promised miracles.

In a letter today in the Times, J.T, Thomas, chairman of CIRM, and Alan Trounson, president of CIRM, said the campaign did not promise "miraculous cures."

Hiltzik filed a riposte this afternoon on his blog, quoting from TV campaign ads featuring Christopher Reeve and Michael J. Fox. Hiltzik also wrote,

"Joan Samuelson, a leading Parkinson's patient advocate, is shown in another ad asserting, 'There are more Americans than I think we can count who are sick now, or are going to be sick in the future, whose lives will be saved by Prop. 71.' Shortly after the measure passed, Samuelson was appointed to the stem cell program's board. 

"Do these ads amount to promising 'miracles'? Given that the essence of scientific research is that no one can predict the outcome, to assert as fact that 'lives will be saved by Prop. 71' is plainly to promise something downright extraordinary, if not outright miraculous. 

"Yes, this is the language of advertising, not research, but for Trounson and Thomas to pretend that the ad campaign somehow promised merely 'good science' and not specific outcomes, as their letter suggested, is (at least) miraculously disingenuous."

Michael J. Fox Backs Away From Stem Cell Cure for Parkinson's

It was not exactly a case of "Back to the Future," the hit movie starring Michael J. Fox, but it did offer a reflection on the past.

It involves the actor's changing views on stem cell research in connection with Parkinson's disease, which he has had since the 1990s.

Fox's 2004 Ad

Early on, Fox was well-known for his support of human embryonic stem cell research. ABC News recently described him as having become "one of the country’s most visible advocates for stem cell research." In California, Fox was a prominent promoter of the ballot initiative, Proposition 71, that created the $3 billion California stem cell agency in 2004. "

He filmed a TV commercial that was aired widely during the 2004 campaign to create the stem cell agency, declaring,

 "It could save the life of someone you love."

Today he is considerably less confident. In an interview last week with ABC, he cited "problems along the way." Fox said,

“It’s not so much that [stem cell research has] diminished in its prospects for breakthroughs as much as it’s the other avenues of research have grown and multiplied and become as much or more promising. So, an answer may come from stem cell research but it’s more than likely to come from another area.”

Engineering Stem Cells on the Ballot: Chuck Winner and the California Stem Cell Agency

Chuck Winner is a name that doesn't surface often in connection with California's $3 billion stem cell research effort.

Chuck Winner (left) at USC in 2006
USC Photo

In fact, he rarely appears in the news. Winner's name, however, did surface yesterday when Gov. Jerry Brown appointed him to the state's horse racing board. Most of the stories about the appointment were in horse racing publications. But none, including The Sacramento Bee's, mentioned the Prop. 71 campaign managed by his firm, Winner & Mandabach Campaigns of Santa Monica, Ca.

Nonetheless, he and his firm were the key to winning approval of the 2004 ballot measure that created the California Institute of Regenerative Medicine, an enterprise that is unprecedented in state or national history.

The firm's $35 million campaign for Prop. 71 attracted 59 percent of the vote. That same year, the firm also successfully managed four other ballot measures in the Golden State. Its lifetime average is remarkable. The firm's web site says it has won 90 percent of the 150 ballot measure campaigns it has run throughout the country.

Winner-Mandabach has this to say about how it pulled off the Prop. 71 campaign:

"Surveys (in 2003-04) showed that most voters supported the basic concept of expanding stem cell research. However, because of the state’s serious budget and debt problems, it was also clear that passing such a huge bond measure for any purpose would be a major challenge.

"The campaign overseen by Winner & Mandabach to overcome those odds involved a year-long coalition building effort that ultimately recruited over 40 Nobel Prize winning scientists and more than 100 patient groups, disease foundations and business groups – the largest, most diverse coalition of its kind ever formed to support a state ballot measure. The supporting groups helped mount an intense grassroots outreach and activation effort to their members, who numbered in the millions."

Winner-Mandabach continued,

"The TV advertising developed by the firm featured award-winning scientists, patients and their families, and highly-respected patient advocates like Michael J. Fox and the late Christopher Reeve. The ads focused on the potential for cures that could save millions of lives. Details of the initiative and economic issues were addressed through in-depth mail pieces and earned media efforts that included the release of an economic study showing that stem cell cures would help reduce the state’s skyrocketing health care costs. Prior to the implementation of the paid media campaign in late-September, polling showed Proposition 71 below the 50% threshold. But after an intense 6-week advertising, earned media and grassroots campaign, Prop. 71 steadily gained support, even in the face of final attacks by conservative groups and activists like Mel Gibson, and attacks from the left by some anti-biotech groups. Because of its precedent-setting nature, the Prop. 71 campaign became the most watched ballot measure campaign in the nation and generated worldwide press attention. On election day, it was approved overwhelmingly by a vote of 59% to 41%."

The key to success on any ballot measure is a firm like Winner-Mandabach, although high profile individuals – in the case of Prop. 71, Robert Klein, who became the first chairman of the stem cell agency – are often given complete credit. Top notch campaign firms have a keen understanding of voters, appropriate political timing and effective PR and TV advertising campaigns. Without Winner-Mandabach – or a firm with the same skillset – the California stem cell agency would not exist.

Chuck Winner, however, does not have an uncritical view of the ballot initiative process, which has resulted in much expensive mischief in California. He told a USC audience in 2006,

"It’s abused time and again. My opinion is that when you circumvent the legislative process or representative democracy to solve a problem, you can take it to an extreme and that extreme becomes, in some ways, worse than the problem you were trying to solve in the first place. Single-issue up or down initiative votes are very often not the best way to govern."

As for the horse racing business, Winner, a Beverly Hills resident, has been involved in horse racing since 1986. His partner, Paul Mandabach, is also involved in the sport of kings. Their firm has not disclosed their record at the track.

(Click here to see two powerful ads developed for the 2004 campaign, including the famous Christopher Reeve spot.)

Stem Cell Agency on Bee Article and Voter Expectations

The California stem cell agency today said the seven-year-old "audacious vision" of voters when they created the $3 billion research effort "is still possible."

The comment was made in an item on the agency's blog by Amy Adams, the agency's communications manager.

Her entry point was an opinion piece in The Sacramento Bee on Sunday exploring some of the ins and outs of the agency. Among other things, CIRM President Alan Trounson was quoted by writer David Lesher as "optimistically" predicting successful California stem cell treatments in five years.

Adams wrote,

"Lesher makes clear that there are many challenges ahead in bringing new therapies to patients: he said of the voters who created CIRM, 'It was pretty audacious of them in 2004 to try to create another economic driver like Silicon Valley and save lives at the same time.'

"And while the vote was audacious, we agree with his conclusion that despite risks and challenges that vision is still possible." 

California Stem Cell PR and Spongy Voter Mandates

Some connected to the California stem cell agency, notably its founding father Robert Klein, are fond of declaring that the $3 billion enterprise has an immutable mandate from voters to pursue its endeavors.

Well, mandates come and go.

That lesson was learned once again this morning with the results of a Field Poll that showed that another big ticket effort, the California high speed rail project which was approved by 53 percent of voters, has lost not only its luster but its support. According to the poll, 64 percent of voters would now like another chance to vote on it. And 59 percent would reject it.

The reasons for the change of heart? Severe economic conditions in California, increased mainstream media coverage of high speed rail's deficiencies and bungling by its management.

While a San Francisco Chronicle columnist last summer called CIRM "the high speed rail of medicine," the stem cell agency has not suffered from the same sort of heavy and critical media attention. CIRM is all but invisible to the public. But agency is now is embarking on an ambitious PR effort to raise its profile and to move forward to win voter approval of another multibillion bond measure. Otherwise it will run out of funds in 2017.

CIRM must tread carefully with its new communications campaign. It has a legitimate responsibility to better inform Californians, and its PR could be more robust(which is a sort of the word of the day at CIRM).

But downsides do exist. With a possible ballot measure coming up, some ungenerous folks might construe aggressive CIRM PR as electioneering at taxpayer expense, including its subsidies of patient advocate activities, such as attendance at conventions. Even without a looming election campaign, the high speed rail project's $12.5 million PR effort attracted negative attention in at least two major newspapers just this week(see here and here).

Klein, who led the campaign that created CIRM and served as its chairman for seven years, is now gone, but his footprints remain. The agency, however, cannot assume that voter support seven years ago, in a much, much different world, translates to support today.

The CIRM 'Debt' to George Bush and Disgraced Korean Researcher

It was brief but pointed comment on the differences in the stem cell world of 2004 compared to the stem cell world of 2011.

Larry Ebert, a patent attorney, made the remark on his blog, IPBiz. He was writing about an observation on this website that without George Bush and his restrictions on federal hESC research, there would have been no California stem cell agency.

Ebert said,

"IPBiz notes that when the California voters voted Prop. 71 in, scientists thought Huang Woo Suk's work on hESC was real. In 2011, the current state of the art is still not up to what Huang Woo Suk falsely reported in the journal Science. Californiastemcellreport should give Huang Woo Suk some credit for the passage of Prop. 71."

Consider Woo Suk duly credited.

Has CIRM Funded Stem Cell Research that Bush Would Have Banned?

When California voters approved creation of an unprecedented, $3 billion stem cell research program more than six years ago, they were told the money would go to finance research that then-President George Bush had banned.

Has that actually happened? Yes, but mainly no, according to a research paper published in Nature Biotechnology in December 2010.

In the first-ever such analysis of CIRM grants, Aaron Levine, assistant professor in the School of Public Policy at Georgia Tech, reported that through 2009 only 18 percent of California's dollars went for grants that were "clearly" not eligible for federal funding.

Levine's finding has implications for another, multibillion-dollar bond ballot measure that CIRM Chairman Robert Klein has proposed. The campaign for such a measure would have to address the question of whether the promises of the 2004 ballot initiative that created CIRM have been fulfilled.

CIRM does not offer on its web site figures that can be compared to Levine's calculations. The agency does present some statistics about the amount of funding for embryonic stem cell research, but makes no effort to break out the percentage of grants that would not have received funding during the Bush years.

Levine's numbers on California were part of a broader look at state funding of stem cell research in recent years. He reported that by the end of 2009, six states had awarded nearly 750 grants totalling $1.25 billion. California accounted for $1 billion of the total. Per capita funding amounted to about $1 in Illinois and nearly $28 in California.

In all of the states, percentages were low for research that was clearly ineligible for federal cash under the Bush standards. Levine wrote,

"Most state hESC funding appears to have supported research also eligible for federal funding during the Bush Administration. This finding is surprising, given the explicit intent of several state programs to preferentially support science not eligible for federal funding, but likely reflects the nature of the grant proposals state agencies received, particularly given the number of grants states awarded to scientists relatively new to the field of hESC research.

Levine continued,

"Several factors could explain the relatively small share of grants that went toward clearly ineligible research. Some scientists who wished to pursue this research may have been unable to access the raw materials or acquire the intellectual property rights required to do so. Alternatively, these findings could simply reflect scientific interest. The discovery of induced pluripotent stem cells may, for instance, have reduced scientific interest in the derivation of new hESC lines. Finally, these findings may reflect a preference on the part of scientists to use well-established and well-studied hESC lines. This last explanation may be particularly relevant for new scientists entering the field of hESC research, as using recognized cell lines may give their initial research efforts greater credibility."

In California, another factor enters into funding for Bush-banned research, particularly given the 2004 campaign promises. CIRM makes overt decisions about what to fund. Its RFAs spell out what is acceptable and non-acceptable. The agency could have specified that it would not fund any research that would be eligible for federal funding. But whether that would have been "good science" is another question. CIRM also spent nearly $271 million on new labs at many of its directors' research institutions, diluting the percentage that would be construed as financing Bush-banned research.

We are querying CIRM concerning Levine's statistics.

Levine also reported that the state stem cell research efforts appear to have drawn new scientists into the field, with the largest impact occuring in California. He wrote that 42 percent of those funded in this state appeared to be fresh to the field.

In addition to the Nature Biotechnology piece, Levine has created an online database of state grants that he plans to update regularly. In an email to the California Stem Cell Report, he said,

"While CIRM already makes this information readily accessible, some of the other state programs do not and I hope this database will facilitate comparisons among the various programs and prove to be a useful tool for people interested in state stem cell programs. "