CIRM Director Prieto on Disclosure of Reviewer Financial Interests

A member of the governing board of the $3 billion California stem cell agency is weighing in on an item on the California Stem Cell Report that called for public disclosure of the financial interests of the scientific reviewers, who make 98 percent of the decisions on awards by the agency.

Francisco Prieto, a Sacramento physician and a patient advocate member of the board, said in an email:

“ It seems to me there's a bit of 'damned if we do and damned if we don't' here. If the ICOC (the agency governing board) decides to listen to some of the members of the public who come to our meetings and overrule a recommendation of the Grants Working Group(GWG), we're slammed for letting emotion trump science, or bowing to special interests. If we just accept the rankings of the GWG and approve all their recommendations, we're criticized for not being truly independent.  I think we don't do it often (for good reason) but should and do retain the right to look at other factors besides those our scientific reviewers do, and make our own decisions about funding. We are ultimately responsible, not the scientific reviewers. 

“As for the issue of their disclosure of personal conflicts of interest, from what I've read of the NIH processes, ours are no less strict. The NIH requires that reviewers disclose any conflicts to their institutions which I believe must disclose them to the NIH, but I have not seen anything requiring them to disclose all their personal financial & other interests publicly, as we (ICOC members) have to.  When we were assembling our group of reviewers initially, the fear was that many of the best scientists would turn us down if we required them to make the kind of personal disclosures we have to. I don't know how many we might actually lose if that were the case, but as you know we do require them to disclose to CIRM, and they have to leave the room when any application for which they have a conflict is discussed.”

Our take: Prieto is right about the board being perched on the horns of a dilemma, which has a lot to do with Proposition 71, which created the agency, and American scientific traditions, which place an extraordinary value on the “integrity” of the review process. In this case, integrity refers to adherence to reviewers' scientific judgments.

Proposition 71 placed the legal authority for grant approvals in the hands of the CIRM board, which has overridden decisions by reviewers in only 2 percent of the cases since 2005. However, that was enough, with at least one high profile case coupled with public appeals, to cause the Institute of Medicine to raise concerns about the integrity of the CIRM grant review process. Traditionally, peer reviewers are deemed to be the most capable of making the scientific decisions about grant applications, rather than a board appointed by University of California chancellors and elected state officials.

Yet, if the board concedes the decisions to the grant reviewers, state law is likely to require public disclosure of their financial interests, a move that the board has opposed for years. Former CIRM Chairman Robert Klein repeatedly advised the board during its public grant approval processes that reviewers' actions were only ”recommendations” and that the board was actually making the decisions. However, it has long been apparent that the reviewers were making the de facto decisions. A CIRM memo in January confirmed that, producing the 98 percent figure.

The issues involving disclosure by reviewers, integrity of peer reviews, the language of Proposition 71 and state law are difficult and may, in some cases, be at odds.

However, it makes little difference what the NIH is doing. It is a much different organization and has had a history of conflict of interest problems that it has been trying to work through.

The trend in the academic and scientific research community has been towards more public disclosure rather than less because of many well-documented instances of problems. What is at stake is the public's faith in scientific research and the integrity of public institutions.

Our thanks to Prieto for his comments on this important subject.  

Kudos to CIRM: Stem Cell Agency Sticks with Full Financial Disclosure

A key panel of directors of the $3 billion California stem cell agency yesterday voted unanimously to retain full public disclosure of the financial interests of its directors and top executives.

The director's Governance Subcommittee bypassed a proposal that would have substantially weakened disclosure at a time when the agency is moving closer to industry in an effort to develop cures.

"Because of CIRM's unique mission and the agency's longstanding commitment to transparency," said Kevin McCormack, the agency's spokesman, "they believed that CIRM should continue to set an example by requiring the broadest disclosure of members of the board and high level staff."

Currently CIRM board members and top executives must disclose all their investments and income – in a general way – along with California real property that they hold. Under the rejected changes, disclosures would have instead been required only "if the business entity or source of income is of the type to receive grants or other monies from or through the California Institute for Regenerative Medicine." 

The proposed changes would also have relieved CIRM officials of reporting investment in or income from venture capital or other firms that may be engaged in financing biotech or stem cell enterprises, since the firms do not receive cash from CIRM or engage in biomedical research.

The subcommittee's action will go before the full CIRM board later this month, where it is expected to be ratified. 

Our take? The Governance Subcommittee took the right action and is to be commended for going beyond the letter of the law. The integrity and credibility of CIRM are paramount. As the California Stem Cell Report wrote last week, narrowing disclosure would only have engendered suspicion and unnecessarily raised questions about the conduct of the agency as it embarks on an aggressive push for stem cell cures.

CIRM Comments on New NIH Disclosure Rules

Don Gibbons, chief communications officer for the California stem cell agency, filed this comment today on our post, “Disclosure Proposal Likely to Affect CIRM.”

“Casual readers of your posts will take away the notion that NIH is now requiring scientist peer reviewers to post their financial conflicts on the web. That is not true. Existing NIH policy, which is mirrored by CIRM policy, as well as the revised NIH policy, pertains to recipients of NIH grants, not reviewers. Therefore, why does your headline assert the NIH policy change is "likely to affect CIRM." Yes, most of our grant reviewers have NIH grants and will need to post their financial forms on their home institution web sites, but that does not impact CIRM.”

Our point is that CIRM, whose chairman has repeatedly vowed to adhere to the highest standards of openness and transparency, cannot ignore a new standard for disclosure of industry ties by researchers. Currently CIRM scientific reviewers do not have to disclose publicly their financial interests. Under the new NIH rules, those reviewers will be disclosing their industry ties on their home institution Web sites. If CIRM does not disclose the same industry ties of its reviewers on its Web site, the agency will effectively be flouting what will be THE national standard for disclosure by researchers(albeit a weak one, based on what the Institute of Medicine has to say).

The financial interests of CIRM reviewers do have a potential impact on their grant application decisions, which CIRM acknowledges. As Francis Collins, director of the NIH, said, the rules are needed to preserve the “integrity of the scientific enterprise.”

Sacramento Bee: Curb Klein's 'Political Adventures'

"Nagging problems" persist at the California stem cell agency, including "political adventures" by its chairman, Robert Klein, The Sacramento Bee said today.

In an editorial, The Bee said that in addition to Klein's dabbling in politics, the problems include efforts by the biotech industry to weaken CIRM rules to generate revenue and affordable care and failure to disclose the economic interests of scientists who review applications for hundreds of millions of dollars in grants.

The Bee had some good things to say as well. CIRM is now "the nation's largest financier of embryonic stem cell research," which is what voters approved in 2004, newspaper said.

In its "memo" to CIRM, The Bee said:

"You've also hired a fine scientific staff to help administer grants and design a strategic plan. These employees will help your institute transition to new leadership, since President Zach Hall will be retiring in June and you are currently interviewing for his replacement."

But the newspaper said,

"Your board chairman, Robert Klein, continues to dabble in political adventures that don't comport with his responsibilities as a public official. Last year, he used a nonprofit organization to campaign against state Sen. Deborah Ortiz in her bid for secretary of state, after Ortiz had sought reforms in the stem cell institute. Klein's nonprofit also took sides in the lieutenant governor race. Rarely have we seen the head of a state agency create his own separate political apparatus to punish enemies and reward friends. These tactics have hurt the institute's standing and you need to put an end to them."

The editorial also said:

"So far, you've resisted public disclosure, claiming it could scare away qualified reviewers. Yet researchers make such disclosures all the time. As one of your reviewers, Rainer Storb, told The Scientist last year, such disclosures "are a bit of a nuisance. But I'm perfectly fine with things being made public."

CIRM's Conflicts: Beware the WARF Syndrome

The California State Auditor has freshened the debate over public disclosure of the economic interests of the men and women who review the applications of scientists and others seeking hundreds of millions of dollars in grants from the state of California.

The auditor's report Tuesday recommended that the California stem cell agency seek an attorney general's opinion on whether its policy is appropriate. CIRM does not require the grant reviewers to disclose publicly their economic and other interests. But it does require them to disclose confidentially to CIRM.

The position of the California Stem Cell Report is that the reviewers make de facto decisions on the grants and that they should disclose their economic interests. Others advocate disclosure as well, including The Sacramento Bee and the San Jose Mercury News.

We are presenting here the text of what the auditor had to say and CIRM's response along with a related paragraph from the Court of Appeal Monday. CIRM has not yet decided whether to seek an AG's opinion. We should note that Jerry Brown, the attorney general, decades ago sponsored the Political Reform Act mentioned in the discussion below, an initiative he touted as a much-needed good government measure.

We have written much on this subject, but would like to add a few additional comments at this point. CIRM is in danger of falling prey to the WARF Syndrome. We refer to the Wisconsin Alumni Research Foundation, which last year told California that it had to cough up royalties for its state-financed stem cell research. The position triggered a flap that only ended with WARF declaring that it would not require the royalties after all. WARF, a nonprofit organization with a longstanding record of supporting science, finally did what was right, rather than focusing narrowly on self-interest and protecting its patents. In this case of reviewer disclosure, CIRM is narrowly focused as well. Various interests obviously have to be balanced. But CIRM has tilted too far in protecting its reviewers from public scrutiny, justifying its position on the untested, hoary premise that the secrecy is the only way to generate "good science." This is a case where CIRM should let the sun shine in. Billions are literally at stake along with public trust in the agency. Public disclosure is the right position. It not only reflects the public's best interests and the best interests of good government, but it helps to protect CIRM itself from the possibility of a truly nasty scandal.
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Here is what the auditor had to say:

Although the institute developed a Conflict of-Interest code and policies, improvements are needed to ensure that they are followed

With certain exceptions, committee members and institute employees are subject to the requirements of the Political Reform Act of 1974 (Political Reform Act). The purpose of the Political Reform Act, in part, is to ensure that public officials perform their duties impartially, free from bias resulting from their own financial interests or the financial interests of those supporting them. In response, the committee adopted a conflictof-interest code—a set of rules intended to identify and prevent conflicts of interest that institute employees and committee members might have with entities with financial interests in the stem cell research program, as required by the Political Reform Act and state regulations pertaining to the Fair Political Practices Commission (FPPC).

To supplement the code, the committee also adopted policies designed to ensure that committee members and institute employees avoid conflicts of interest, and that the public views its conduct as open, fair, and free from bias. In addition, the committee adopted conflict-of-interest policies for the working groups that advise and assist it in establishing policies and standards, as well as evaluating grant applications. However, the FPPC has raised questions about the applicability of the Political Reform Act to the institute’s working group members, and improvements were needed in the committee’s conflictof-interest policies, as well as its procedures, to ensure that the policies are followed.

The FPPC Has Questioned the Exclusion of the Working Groups From the Institute’s Conflict-of-Interest Code

The institute formulated and the committee adopted a conflict-of-interest code. With certain exceptions, the institute’s act requires that the committee and the institute comply with the Political Reform Act, which includes the requirement to prepare a conflict-of-interest code. The Political Reform Act also specifies the required contents of such a code. The key requirements are presented in the text box.(See item at the end of this statement.) To provide information on employees designated as decision makers that may affect financial interests and the types of financial interests those designated employees must disclose, government agencies that do not wish to draft their own conflict-of-interest codes may adopt a model code provided by state regulations. This model code may be modified to designate the employees who must disclose financial interests and the extent to which they make disclosures. The committee adopted a modified model code.

The Political Reform Act requires that the institute submit its conflict-of-interest code to the FPPC for review and approval. The FPPC must review the code to determine if it provides reasonable assurance that all foreseeable conflicts of interest will be disclosed or prevented, all affected persons have clear and specific statements of their duties under the code, and the code differentiates between designated employees with different powers and responsibilities. The institute submitted its code to the FPPC in July 2005, and after an exchange of correspondence between the FPPC and the institute, the FPPC approved the institute’s code in May 2006. Subsequent to FPPC approval, the institute submitted the conflict-of-interest code to the Office of Administrative Law for its review and inclusion in state regulations. The Office of Administrative Law approved the institute’s code in September 2006.

However, the FPPC has raised questions about the exclusion of the working groups from the institute’s conflict-of-interest code. The FPPC believes that members of working groups, who perform duties such as advising the committee on standards and policy or evaluating grant applications and making award recommendations to the committee, may need to be included in the conflict-of-interest code. Specifically, the FPPC believes that, under state regulations, working group members may act as decision makers if they make substantive recommendations that are, over an extended period, regularly approved without significant amendment or modification by the committee. Thus, as decision makers, working group members would need to be subject to the conflict-of-interest code. This would mean that working groups would be subject not only to the financial disclosure requirements of the Political Reform Act but also to the prohibition against a member participating in a government decision in which that member has a disqualifying financial interest and may be subject to the penalties that may be imposed on individuals who violate that act.

In response to the FPPC, the institute stated that members of the working groups are not subject to the pertinent requirements because the language in the institute’s act expressly exempts those members from the Political Reform Act, even when the recommendations of a working group are approved over an extended period. Therefore, according to the institute, it is not necessary to engage in ongoing analysis to determine whether, over time, the committee routinely approves the working groups’ recommendations. The FPPC responded that the language of the act “is no basis for exempting working group members from the [Political Reform Act’s] most fundamental disclosure rules if it becomes apparent that the working group’s role in governmental decisions is more than purely advisory.” It concluded that this issue may need to be revisited in the future.

The institute requires working group members to make financial disclosures (as discussed later). However, there are some differences between the Political Reform Act and the institute’s requirements for working group members that would apply if the FFPC’s view were correct. One key difference is that, under the Political Reform Act, the financial disclosures must be made public; the institute’s requirements keep the disclosures private. Also, an individual who is subject to the Political Reform Act may be subject to certain penalties if the individual violates the requirements of that act. As of December 2006, it was too early to assess whether the working groups will make recommendations on grant funding or other substantive recommendations that the committee will accept without significant amendment or modification that might result in a challenge to the institute’s interpretation.

The committee chair commented that the Superior Court of the County of Alameda, when it ruled in May 2006 on the legal challenge to the constitutionality of the institute’s act, considered the question of whether the grants review working group was a decision-making body. The court, based on the evidence presented at trial, including testimony of committee members and the experiences at the one grant award meeting that had been held, concluded that the committee is the “ultimate decision-making body” and not the working group. However, this ruling is not binding as the case is pending appeal.

Our legal counsel advised that, although a court will give deference to the institute’s interpretation of the act, ultimately only a court of law can make the determination of which interpretation is correct. Our legal counsel also noted that other provisions governing conflicts of interest that the act specifically references, and that the institute believes the act also exempts working groups from, may be implicated if the FFPC’s interpretation is correct. For example, California Government Code, Section 1090, prohibits a public official from being financially interested in any contract made in his or her official capacity. Various judicial decisions have held that Section 1090 also applies to those who advise the members of the governing body. The attorney general has opined that an adviser who has a financial interest in a contract or grant must abstain from giving any advice on that matter to avoid a conflict of interest. A violation of Section 1090 may result in a felony conviction and void a contract.

In view of the seriousness of a violation of conflict-of-interest laws and the concerns raised by the FPPC, we believe that it would benefit the institute to seek a formal opinion from the attorney general regarding whether the exemptions created for working groups from conflict-of-interest laws are intended to exempt them from the conflict-of-interest provisions that apply if the recommendations of an advisory body are adopted routinely and regularly by the decision-making body to whom they are made.

Conflict-of-Interest Code as Specified by the Political Reform Act

• Agency positions, known as designated employees, that participate in making decisions that might materially affect their financial interests.

• The types of investments, business positions,real property interests, or sources of income that might be materially affected by decisions made by designated employees. These are considered reportable financial interests.

• Requirements that designated employees periodically file Statements of Economic Interest disclosing their reportable financial interests.

• Specific circumstances that would require designated employees to disqualify themselves from making decisions or influencing the making of decisions. Disqualification is required when a designated employee has a financial interest that could be affected materially by the decision.

The Institute Has Established Processes to Disclose Financial Interests

Committee members and institute employees are requiredto disclose their financial interests, such as investments and incomes, that meet thresholds identified by the Political Reform Act. These financial interests are reported on Statements of Economic Interest, which are public documents. The Political Reform Act sets timelines for public officials to file these forms. Committee members are required to file within 30 days of assuming office, annually thereafter, and within 30 days of leaving office. All committee members and their alternates filed their Statements of Economic Interest from 2004 to 2006. We found 10 occurrences of late filings by members and alternates during 2004 and 2005. The number of late filings decreased to four in 2006.

Institute employees were not required to file their initial Statements of Economic Interest until 30 days after the conflict-of-interest code became effective. However, to promote transparency, the institute asked its employees to file their statements before the required date. After the conflict-of-interest code became effective, institute employees filed their statements again, within the required time frame.

Although the institute maintains that working group members are not subject to the Political Reform Act, the institute’s act requires the committee to adopt conflict-of-interest rules for noncommittee members of the working groups, such as scientists and other experts. These rules must be based on standards applicable to members of scientific review committees of the NIH. NIH standards require reviewers to alert officials to any possible conflict of interest and, before and after every meeting, identify any application on which they have a conflict of interest and certify that they will not be, and have not been, involved in the review of any application in which their participation constituted a conflict of interest.

In response to the act’s requirements, the committee has adopted conflict-of-interest policies modeled after the NIH for its two working groups that review grants. The standards used for the rules of the third working group are described in the next section. In addition, although not required by NIH standards, the noncommittee members of the three working groups are required to file confidential financial disclosure statements signed under penalty of perjury. The institute considers these conflict-of interest policies to be so significant to the public interest that it has submitted them to the Office of Administrative Law to have them included in the institute’s regulations.

During the public comment portion of this rulemaking process, members of the public expressed concern that the act does not preclude the institute from publicly disclosing the working group members’ confidential financial disclosure statements and urged the committee to require public disclosure. The committee disagreed with the suggestion. According to the institute’s president, making the financial disclosure statements public would deter scientists from joining the working groups because grant reviewers feel that a public disclosure is an invasion of their privacy. Further, the institute’s president stated that grant reviewers consider the confidential disclosure statements to be sufficient because they sign them under penalty of perjury, and they believe their work is an act of “good will” because it helps their competitors get funded and because their per diem rate is low.

The financial disclosure statements for working group members require information similar to what is required from the committee members and institute employees, such as sources of income of $5,000 or more from biotechnology and pharmaceutical companies, as well as California-based academic or nonprofit institutions. All noncommittee members of the Scientific and Medical Accountability Standards Working Group (standards working group) and the Scientific and Medical Facilities Working Group (facilities working group) who participated in committee meetings, as well as all the members of the grants review working group who reviewed training grant applications, filed confidential financial disclosure statements, as required.

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Here is what CIRM had to say concerning the recommendation that it seek an attorney general's opinion on its disclosure policies for grant reviewers:


CIRM is committed to ensuring that the evaluation of grant applications is free from both real and apparent conflicts of interests. For this reason, the ICOC has adopted conflict of interest policies for members of the working groups that go beyond the requirements of the Political Reform Act (“PRA”). As the audit notes, however, CIRM disagrees with the FPPC’s opinion that members of CIRM’s working groups might be subject to the PRA at some point in the future.

Although we believe that Proposition 71 clearly exempts the working groups from the Political Reform Act, we understand the merits of seeking an opinion from the office of the Attorney General and we will seriously consider the recommendation to do so. But for the record, it is important to consider what is not in dispute.

First, even under the FPPC’s interpretation of the law, the members of CIRM’s working groups are not currently subject to the PRA’s economic disclosure and disqualification requirements. As the Alameda County Superior Court found, the ICOC made significant changes to the Grants Working Group’s recommendations regarding the training grants. The ICOC, the Court concluded, is the ultimate decision-making body, not the Grants Working Group. Second, as required by Proposition 71, the members of CIRM’s working groups are currently bound by conflict of interest rules adopted by the ICOC. These rules, which are modeled on the National Institutes of Health and National Academies of Science’s conflict provisions, require disclosure and disqualification, but unlike the Political Reform Act, they also extend to “personal” and “professional” conflicts of interest. Because the FPPC’s opinion may lead to the erroneous belief that working group members are not currently subject to conflict of interest rules, or that the PRA’s provisions are stronger than those adopted by the ICOC, we believe a brief discussion of the law and the ICOC’s policies and regulations is warranted.

Health and Safety Code section 125290.50, enacted by Proposition 71, requires the ICOC to adopt conflict of interest rules for the working groups based on standards applicable to members of scientific review committees of the National Institutes of Health (“NIH”) and to appoint an ethics officer from among the staff of the institute. Importantly, it also exempts members of the working groups from the PRA and other Government Code provisions:
“(3) Because the working groups are purely advisory and have no final decisionmaking authority, members of the working groups shall not be considered public officials, employees, or consultants for purposes of the Political Reform Act (Title 9 (commencing with Section 81000) of the Government Code), Sections 1090 and 19990 of the Government Code, and Sections 10516 and 10517 of the Public Contract Code.”

These provisions establish a regime by which the members of the working groups are covered by conflict of interest rules based on the NIH standards as opposed to the PRA. This makes sense for two reasons: First, the working groups are closest to the peer review committees of the National Institute for Health; no similar body exists under state law. Thus, it is logical to look to federal conflict of interest policies as the model for CIRM’s working groups. Second, the PRA would impose narrower conflict of interest rules on the working groups and it would impose such rules only after certain requirements are satisfied, i.e., if a working group makes substantive recommendations that are, and over an extended period of time have been, regularly approved without significant amendment or modification by the ICOC (FPPC Regulation 18701). If these conditions were never met, the working groups would not be subject to PRA conflict of interest rules. Furthermore, because FPPC Regulation 18701 requires an analysis of past conduct, it necessarily draws a line that is visible only after it is crossed.

Section 125290.50 avoids this uncertainty by declaring that the working groups are advisory, exempting them from the PRA, and by imposing separate and more extensive conflict of interest rules on working group members. In so doing, this section ensures that conflict of interest disclosure and disqualification rules are in place from the outset of working groups’ work.

As stated in the audit report, the success of the CIRM research program and its ability to maintain the confidence of the people of California depends critically upon the agency’s ability to fund the highest quality research proposals, chosen without bias. Strong CIRM conflict of interest policies are therefore essential. Thus, the ICOC adopted conflict of interest policies in 2005 to apply to each working group. These rules were inspired by policies of the National Institutes of Health, as required by Health and Safety Code section 125290.50, subdivision (e)(1). The ICOC did not stop there - the ICOC has taken the unprecedented step of codifying these policies in regulations. Unlike the Political Reform Act, these regulations encompass not only financial sources of conflicts but also address professional and personal sources. Thus, the working groups, under Proposition 71 and the policies and regulations adopted by the ICOC, are subject to more stringent rules than nonadvisory public officials under the Political Reform Act.

Moreover, the members of the two grants working groups, research and facilities, undergo a pre and post-award review of their required disclosures and the potential sources of conflict, and attest under penalty of perjury that they have not participated in review of any application for which they might have a conflict of interest. This is not required of any public official under the PRA. CIRM will maintain appropriate records of the disclosures and participation of working group members to make them available for audit AND will report to the Legislature any violations of the rules AND describe corrective actions taken to prevent future occurrences. Neither the report nor corrective action is required under the Political Reform Act.

These regulations strike the proper balance between the privacy of volunteer advisory body members and the public’s desire for information about the individuals. The review by staff and independent auditors, and the records that substantiate those reviews, ensure that the utmost vigilance will be maintained to ensure the integrity of the working groups’ efforts. As a result, the Institute has in place conflict of interest regulations and policies that are stronger than either the PRA or NIH standards.
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Here is what the Court of Appeals had to say regarding decision-making by grant reviewers:

The Council (editor's note: meaning CIRM opponents) contends that if the more general statutory and common law conflict of interest provisions are not applicable to the ICOC members, they should nonetheless apply to members of the grants working group. This argument is based on the incorrect assertion that the grants working group is a decisionmaking rather than an advisory body. However, section 125290.50, subdivision (e)(3) provides that '[b]ecause the working groups are purely advisory and have no final decisionmaking authority, members of the working groups shall not be considered public officials, employees or consultants for purposes of the Political Reform Act' and other conflict of interest statutes.

Economic Disclosure from the California Stem Cell Report

Here is the annual economic disclosure statement from the California Stem Cell Report. We are filing it because of normal questions that might arise concerning our economic interest in stem cell research.

We, meaning my wife and I, have no investments in biotech firms or any other organizations that could benefit from stem cell research, except through mutual funds, which, of course, we have no control over. We do not hold any mutual funds that are industry specific to biotech.

Beyond that, we are not employed nor do we receive funds from any organization involved in biotech or stem cell activities. Nor is any member of our immediate family (meaning wife and adult children) involved in such a fashion. As far as we know, no distant relatives are involved in biotech or have investments in that area.

We also have no financial connections with organizations that support or oppose CIRM.

All of the above is unchanged from last year.

One would hope that reporters, observers or others trying to influence CIRM (which is not the same as reporters) would be willing to make the same sort of economic disclosure as above. By that we mean specific dollar amounts, from $1 (one dollar) and up – not those wimpy disclosures required under state law or by CIRM.

Beyond the economics, the California Stem Cell Report supports embryonic stem cell research. We believe that CIRM is pursuing a worthwhile endeavor. We also believe that openness, transparency and disclosure are fundamental to good government. That means providing background agenda material well ahead of meeting dates, among other things. Otherwise, meetings can amount to nothing more than sneak-through business, plenty of which can be seen in Congress and the California Legislature.

We also believe in maximum disclosure -- when it doubt lay it out. Specifically all persons with signficant responsibility within CIRM, including members of CIRM working groups, should publicly disclose their economic interests in more detail than required by state law. Outside contractors should disclose their interests as well.

If you have questions or comments on this, you can post them by clicking the word "comment" below or by sending them directly to djensen@californiastemcellreport.blogspot.com. It is possible to comment anonymously by using the "comments" function.

More Disclosure in Billion Dollar Giveaway Is In CIRM's Best Interest

California's $3 billion stem cell giveaway program began another important step today – one that is cloaked in nearly total secrecy despite the fact that it involves public funds.

Scientists in San Francisco are reviewing applications for $80 million in major grants. CIRM says their actions are only recommendations. However, the reality is that they are defacto decisions that are unlikely to be overturned by the agency's Oversight Committee.

A certain amount of confidentiality is to be expected, but the agency has gone overboard to protect the tender sensitivities of those seek the funds. It is a practice that will serve the agency poorly should questions arise – as they are certain to do over the next decade – about the propriety of its grant-making process.

We have written repeatedly about failings in transparency and disclosure at the agency. It is also a topic of concern to a number of newspapers and watchdog groups. John M. Simpson, stem cell project director of the Foundation for Taxpayer and Consumer Rights in Santa Monica, Ca., authored an op-ed piece that appeared today in the Oakland Tribune and other California newspapers.

He wrote:

"Everyone concerned claims they want a transparent process to ensure that awards are based on scientific merit, not favoritism and cronyism. Despite mouthing high-minded slogans, the institute's leaders too frequently miss the mark whenever there is a clear opportunity to build faith in its processes by being completely open.

"In California we don't know who applied for the grants or their affiliations. Our stem cell institute need only look to Connecticut where applicants' names and pertinent details are public record for a model of how to conduct the public's business.

"Fortunately at least one California scientist understands the importance of a completely transparent process when dealing with public funds. Connecticut's stem cell peer review committee — the equivalent of California's grants working group — is chaired by Dr. Leslie P. Weiner, professor of neurology at the University of Southern California's Keck School of Medicine.

"The California stem cell institute won't identify the 70 researchers from 23 unidentified institutions vying for 25 grants under the Comprehensive Research Grants program.

"In my personal life, I don't give money to people unless I know who they are, why they want it and what they plan to do with it. It shouldn't be any different with the taxpayers' $3 billion. Another opportunity for transparency and to build public faith in the institute's procedures is being squandered."

So wrote Mr. Simpson, who has followed CIRM's activities for more than a year and is a supporter of ESC research.

As for us at the California Stem Cell Report, if we were one of the scientists making decisions on the grants, we would want to have the maximum amount of openness, including disclosure of the financial interests of our fellow reviewers. Without transparency, it is all too easy for enemies of embryonic stem cell research to impugn the integrity of reviewers and to insuinate – as they most certainly will do -- that something other than good science is playing a role in handing out hundreds of millions of dollars in California taxpayer funds.

Embryonic stem cell research generates more than enough controversy. It is past time for the California stem cell agency to take steps to protect itself and its grant reviewers -- all of whom come the tiny circle of stem cell scientists around the world -- from the inevitable charges of self-dealing, cronyism and favoritism.

Newspapers Take a Whack or Two at CIRM

During a week when the California stem cell agency might think it should be receiving some kudos, it has taken a couple of stiff shots in the media.

On Thursday CIRM's Oversight Committee is expected to approve its strategic plan for spending $3 billion on embryonic stem cell research. It is a remarkable document, the result of many months of work and involving ideas and suggestions from hundreds of persons, including the top scientists in the field and patient groups. The plan is a key bench mark in the life of an extraordinary agency that is unlike any other state department in the United States. In addition, CIRM represents the single largest source of embryonic stem cell funding in the world.

But some of that is what irritates its critics. Perhaps the harshest view came from Investors Business Daily, a financial newspaper with about 211,000 national circulation. In an editorial headlined "Fool's Gold Rush," the newspaper said,

"Californians were promised wonder cures if they passed Proposition 71 to fund stem-cell research in 2004. Turns out they have bought a $3 billion jug of snake oil."

The editorial continued:

"Activist complaints about the private sector's focus on adult and umbilical-cord stem cells have driven the state to spend $3 billion on embryonic stem-cell research — something the market won't touch, even though you can find plenty of liberal venture capitalists out there willing to pay for political campaigns with celebrity endorsers.

"The only thing this amounts to is a boondoggle for voters — fool's gold the private sector had already panned for and rejected, having found the truth out first."

The emphasis on the results of adult stem cell research echoes the party line from the foes of ESC research. The newspaper also quotes the LA Times piece earlier this week. That article has been widely cited online around the country by ESC opponents. The business newspaper piece is also surfacing rapidly on anti-ESC web sites.

The Sacramento Bee, which has not said much recently about CIRM, published an editorial today that pressed for more public disclosure from the agency, a theme the paper was early to emphasize. The Bee, which has about 331,000 circulation in California's capital, said,

"...(I)t remains baffling why the institute can't be completely transparent and publicly reveal the financial interests of its grant reviewers. Scientists regularly disclose such conflicts when presenting papers at conferences. They should do so when making recommendations on grants that involve millions -- and potentially, billions -- of taxpayer dollars.

"The institute has made some good progress this year, including adoption of a strategic plan that sets realistic goals and lowers the inflated expectations of the Proposition 71 "countdown for cures" campaign. If institute leaders could take another step and come clean about internal conflicts, they could go a long way toward securing the trust they have risked squandering the last two years."

Moral Seduction and CIRM's $24 Million Grant Giveaway

Some of the top stem cell scientists in the nation today began the arduous task of sifting through more than 200 pleas for about $24 million in research grants from the California stem cell agency, a process that is being conducted in secret with no public disclosure of the financial interests of the reviewers.

Is the process fair? Who is seeking the money? Do the reviewers have conflicts of interest? Will grant applicants with ties to CIRM's benefactors receive special treatment? Are applicants with representatives on the CIRM Oversight Committee moving to the head of the line? All of this is impossible to tell. And it all places CIRM in an unnecessarily vulnerable position because the agency has assumed responsibility for policing the secret statements of economic and other professional and personal interests of the scientists who review the grant applications.

Alternatives exist. Applicant names and their institutions could be publicly identified. The statements of economic interests by grant reviewers could be made public.

John M. Simpson, stem cell project director for the Foundation for Taxpayer and Consumer Rights, today told the grant reviewers in San Francisco that Connecticut is leading the way in terms of openness and transparency on the grant reviews. Simpson said in a statment:

"California's stem cell institute will tell you that they epitomize a transparent and publicly accountable operation, but it's simply not true. In fact they won't even tell you who applied for public money or with whom they are affiliated."

The foundation's press release "contrasted California's policy, where only grant recipients are identified, to Connecticut's process that discloses all applicants identities and affiliations and other key information."

The press release continued:

"Last week (Connecticut's) Stem Cell Advisory Committee awarded $20 million in research grants. There were 21 grants awarded from a pool of 70 applications. The grants were discussed and awarded at a public meeting where pplicants were identified by name. A proposed project's scientific score was listed along with comments from peer reviewers.

"Applications for grants are public records when they are made, except that proprietary information can be redacted.

"'California's stem cell overseers talk about transparency and public accountability,' said Simpson. 'Connecticut's leaders don't just talk the talk; they walk the walk. We should be ashamed of ourselves.'"

Recently we discussed, via email, some of the issues of openness and transparency at CIRM with Robert M. Stern, president of the Center for Governmental Studies in Los Angeles and one of the key authors of California's public disclosure law.

Stern told the California Stem Cell Report:

"I totally agree with you that the statements of economic interests (of grant reviewers) should be public. It is the only way that Californians can have confidence that there are no conflicts of interest."(For more from Stern see the item below.)

No one is talking about outright corruption on the part of the reviewers or CIRM. At this point, the issue is more subtle.

Some top thinkers on conflicts of interest call it "moral seduction," a process "that encourages complacency among professionals" and is "illustrated by the common assertion that 'we aren’t doing anything wrong.'"

In a working paper on conflicts, Don A. Moore of Carnegie Mellon University, Philip E. Tetlock of the Haas School of Business and Lloyd Tanlu and Max H. Bazerman, both of the Harvard Business School, also write:

"Although it is tempting to be cynical about motivation, and to assume that professionals always realize when they are succumbing to conflicts of interest, we suggest this judgment is too harsh. Putting the most Machiavellian fringes of professional communities to the side, we suggest that the majority of professionals are unaware of the gradual accumulation of pressures on them to slant their conclusions, a process we characterize as moral seduction. Most professionals feel that their conclusions are justified and that they are being unfairly maligned by ignorant or demagogic outsiders who raise concerns about conflicts of interest."

Last week the identities of foundations and individuals (see item below) that are loaning CIRM tens of millions of dollars were released. Is it ridiculous to wonder whether grant applicants linked to those CIRM benefactors might receive some special consideration? Only CIRM will know, based on its current rules. Will the agency act to intervene to prevent an abuse of the review process but at the same time offend a multimillion dollar donor? No one can tell.

Embryonic stem cell research is already fraught with controversy. California's $3 billion stem cell agency is riddled with built-in conflicts of interest – all legal. It operates like no other state department, uncontrolled by the governor or the legislature. And this week involves only the first look at applications for research grants, which are expected to pour out at a rate of $300 million annually. It behooves CIRM to go beyond its existing disclosure rules and open its important grant decision-making process to more public scrutiny.

Looking Closely at CIRM's Disclosure Rules

Are CIRM's disclosure rules for its grant reviewers good enough? Robert M. Stern, president of the Center for Governmental Studies in Los Angeles, found some weaknesses. Keep in mind that the only disclosure the reviewers make is basically to CIRM itself – not the public, which Stern believes is necessary once the agency clarifies some of its rules. You can find the text of the rules here.

Here is what Stern told the California Stem Cell Report:

"The CIRM requirements are too broad and too vague, and I would not make their disclosures public until they are made more specific. Some examples: what is a 'common financial interest' and what is a 'financial benefit of any amount?' They are not defined.

"Are former students for all-time considered professional associates? There needs to be a time period.

"What is the distinction between 'long-standing personal differences' and 'long-standing scientific differences or disagreements?'

"These are examples of terms that are very subjective and thus difficult to understand and comply with.

"Perhaps other agencies in other states or at the federal level have used these terms and have interpreted them. If so, it would be helpful to have their guidance.

"One further point, if these terms are interpreted in advice letters or
regulations, are the interpretations and advice letters public?"