Doubters and Hard Choices: Challenges for California's Stem Cell Program

California's 15-year-old, $3 billion stem cell program received a modest smattering of attention during the holidays, first in an article in the Los Angeles Times and another in Bloomberg Law.

The Times, the state's largest circulation newspaper with 2 million readers on Sunday, called it one of eight, global science stories to watch in the coming year. Specifically, the brief item by Karen Kaplan referred to the proposed bond measure to refinance the agency, known formally as the California Institute for Regenerative Medicine (CIRM). She wrote about the impact of the cash handed out by the agency and said, ,

"A CIRM-funded treatment developed at UCLA has led to a cure for dozens of children who were born without a functioning immune system.

"All of this was made possible by CIRM’s initial allocation of $3 billion. Now that money has been spent, and voters will be asked to renew their commitment to stem cell science by approving a $5.5-billion ballot initiative in November 2020."

At Bloomberg Law online, Joyce Cutler wrote that supporters of the agency are refining their pitch and this month will begin seeking more than 600,000 verified signatures of registered voters to place the proposed initiative on the  ballot.  She wrote,

"They will face doubters and lots of competition for voters’ attention and tax dollars. 

"'I think that a funding decision by popular vote that locks in a substantial income stream over a decade over a particular use is not good social policy. It’s not to say that the money isn’t being used for a good purpose,' said Ken Taymor, deputy director of the Forum for Collaborative Research at the University of California Berkeley School of Public Health. 

"The question, said Taymor, is 'can we afford to spend it on what CIRM is doing as opposed to other public health needs?'"

Cutler covers more ground than does the piece in the Times. She has comments from Jeff Sheehy, a CIRM board member since 2004; Arnold Kriegstein, a CIRM grant recipient and director of UC San Francisco’s Developmental and Stem Cell Biology Program, and Zev Yaroslavsky, a specialist in state politics and government and director of the Los Angeles Initiative at UCLA’s Luskin School of Public Affairs, and Jeanne Loring, a CIRM grant recipient and chief scientific officer of Aspen Neuroscience.

Two samples:

Sheehy said he would give the agency an A plus for advancing science. He continued,

"We supported the field, we’ve grown biomedical research and biotech in California tremendously. I think if you look at returns to the state, you might say B minus. And that speaks to one of my frustrations as we try to move forward, as we talk about moving forward, that we really haven’t grappled with the mechanics of ensuring that the state gets a real return on its investment."

Yaroslavsky said,

"They’re (voters) are going to have to make a decision whether roads are more important than stem cell research, is education more important than water infrastructure."

Center for Genetics and Society: 'Wrong' to Ask for More Billions for Stem Cell Agency

IRVINE, Ca. – The Center for Genetics and Society today said it would "wrong" to ask the people of California for more money to continue financing stem cell research at state expense.

Marcy Darnovsky, associate executive director of the Berkeley, Ca., non-profit group, addressed a blue-ribbon Institute of Medicine panel evaluating the performance of the $3 billion California stem cell agency, which is financed by money borrowed by the state. The agency is expected to run out of cash in about five years.

Darnovsky said,

"In structural terms, a key question now is what will happen after CIRM’s public funding is exhausted. According to CIRM’s transition plan, another bond measure for additional public funding 'would be premature at this time,' but is still on the table. In our view, any additional public monies for CIRM would have to be justified in an analysis that emphasized health care priorities and health care disparities. While there is always tension between the allocation of public funds to scientific research and to other public goods, given our state’s economic decline and budgetary crisis, with so many critical social programs being gutted, we believe it would be simply wrong to ask Californians to set aside more money for one avenue of research, however important."

Representatives of the stem cell agency were present at today's hearing on the UC Irvine campus, but did not speak publicly at today's session. CIRM officials, however, have testified before the panel on two other days of public hearings. The agency is paying the IOM $700,000 to conduct the study. Its results and recommendations are expected to be published in November.

Darnovsky and others testifying at the morning session were critical of the agency's lack of accountability, built-in conflicts of interest and immunity from normal government oversight (see here and here).

Darnovsky said, "

The requirement for 70% super-majorities (to change the law regarding CIRM) means that there is still no meaningful oversight of CIRM by elected officials. The ICOC is still tainted by its built-in conflicts of interest. It still includes no representation of the public beyond disease advocates. Members of CIRM’s powerful Working Groups, including the one that reviews grant applications, are still not required to publicly disclose their individual financial interests.

"Given that hundreds of millions of dollars remain to be disbursed, and the widely mooted possibility that CIRM will develop a role that continues beyond the public funding stream that was allocated in 2004, now is the time to clarify and address these issues."

Here is the full text of Darnovsky's comments.
Center for Genetics and Society statement to IOM-CIRM panel, April 10 2012