The SB771 Debate: White Knights vs. Greedy Big Pharma?

"Mom and Apple Pie" – that's one way to look at the latest legislation to step into the affairs of the uniquely independent California stem cell agency.

The bill is crafted in such a way that it is difficult to oppose. In other words, it is virtually a "motherhood" bill. After all, who can be against the state of California receiving a fair share of the perceived bountiful booty from the $3 billion in state-financed research? Oppose that and you can be tarred with the brush of greedy Big Pharma.

We are not talking about the details of SB771. That involves the nitty gritty of intellectual property, a daunting and dense subject for the media, not to mention your average reader. It is easier to cast this as battle between avaricious Big Business and the White Knights who protect the public. Lawmakers do not want to be seen as voting in favor of $100,000-a-year treatments that would not have existed without state-financed research.

Whether or not Sen. Sheila Kuehl, D-Santa Monica, and lead author of the bill will choose to play it that way, some of the other interests involved may do so. We cannot say what Kuehl's strategy is, but all accounts, she is a very smart woman (Harvard grad and former law professor) and politically astute. As chair of the Senate Health Committee and veteran activist and politico, she knows what it takes to succeed with legislation.

Previous legislation involving CIRM was more complex, giving more people more reasons to oppose it. That's not to minimize the complexity of Kuehl's measure, but at its heart it is quite simple – give the people of California a share and help out the ailing poor. Wasn't that the promise in the Prop. 71 campaign?

The opposition is likely to be led by the California Healthcare Institute, which represents the biomedical industry. The industry is not a minor player in the Capitol and can use its resources well. But it will have to step smartly to avoid being tagged as greedy.

The scenario begins to play out in the second week of April with the first hearing on the bill by the Health Committee on April 11, the day after the Oversight Committee of the stem cell institute meets in Sacramento. As part of the day's activities, members of the 29-member panel are expected to visit some legislators to discuss areas of mutual interest.

In a case of adroit timing, California stem cell chairman Robert Klein is scheduled to speak to the Sacramento Press Club on April 9, two days ahead of the April 11 hearing. CIRM has also scheduled its own hearing into IP issues on April 9 in Sacramento. We say adroit because Klein's talk and the hearing will help frame the issues in the media ahead of the Senate hearing, if the events are covered. That is a big if. IP is a boring news topic in the minds of most editors and reporters. CIRM issues are a third tier media matter at best in the Capitol. Witness the extremely light coverage of CIRM this past year with the rare exceptions of occasions when buckets of money were rolled out (grant approvals by the CIRM Oversight Committee). Arnold's contretempts with Rush are much higher on the California news agenda, although nearly meaningless.

With four stem cell events in one week in Sacramento, news editors are likely to cover one and not the rest. The earliest may get the media worm.

With a super, super-majority vote (70 percent) required in both houses, Kuehl's bill likely will find tough sledding. On March 16, in Los Angeles at the Oversight Committee meeting, we asked Assembly Speaker Fabian Nunez about the measure. He was there for a news conference touting CIRM's good works. But he said he knew nothing about Kuehl's bill. To win a 70 percent vote in the Assembly, he will have to know more.

For those of you interested in the real stuff of IP, CIRM has posted some advance material concerning its IP hearing April 9. Among the issues CIRM wants to address are the following:

"Is there a reference or scheme in another body of law that would provide a workable formula to price drugs purchased in California that have been developed with CIRM-funded patented inventions?

"What mechanisms exist that can be used to formulate the price of non-drug therapies provided to Californians?

"Is the term 'public funds' sufficiently precise to capture the universe of purchasers intended in the scope of regulation 100406?

"What comparables would be used by which the “access plans” referenced in regulations 100406 and 100408 be assessed?

Written comments may be submitted directly to CIRM if you are unable to attend the hearing.

Here are links to additional background on the legislation. "Tall Hurdle," "Open Kimono," "CIRM IP Legislation."

(Editor's note: An earlier version of this item said the Oversight Committee meeting was April 11. It is scheduled for April 10.)

CIRM Grant Oversight Question

Lawrence Ebert has posted the following question:

"Of the procedure on grants given by CIRM, I was wondering "who" has the authority to conduct oversight. Directly, this comes up as to "who" might have been responsible for vetting the Cha proposal. Down the road, "who" would conduct any investigation of alleged research impropriety. In a different research area, this issue is currently looming large. See
http://ipbiz.blogspot.com/2007/03/more-about-congress-reviewing-purdue.html

"Separately, how much of the CIRM grants are going directly to the conduct of research, and how much are going to overhead of the respective institutions?"

Here is what we know. Re the questions of oversight of grants given by CIRM, it is CIRM itself that has oversight and the agency vets the proposal and monitors its execution. It is unclear who might conduct an investigation of research impropriety beyond CIRM, although the state Department of Justice has wide authority to investigate and prosecute violations of state law. CIRM's research regulations have the force of law.

We can't tell you the split on overhead vs. actual research, but we learned at the March 15 meeting of the Oversight Committee that comparing size of NIH grants and CIRMs for the same project is not accurate. CIRM grants apparently include funds that are not usually included in the announced figures for equivalent NIH grants.

Fresh Comment.1

Lawrence Ebert is onboard with a comment on the correction below and is a little puzzled. We have posted an comment/explanation that should clarify the matter. John Simpson has a comment on the "CHA Example" item. An anonymous comment has been posted on the "Plagiarism, prayer" item.

Fresh Comments

Jonathan Eisen has posted a new comment on the "CHA Example" item below in which he proposes a Journal of Rejected Grant Proposals. We suspect his suggestion is a bit tongue in cheek, but he makes some interesting points. Also new is an anonymous comment on the "Plagiarism, Prayer" item that involves a patent matter and Cha.

Correction

On Friday March 23, we incorrectly reported that the California Stem Cell Report was the first to pull together the plagiarism allegations and other ethical concerns involving CHA RMI and its allied organizations and link it to the CIRM grant. In fact, the Bodyhack blog on Wired.com carried much of the same information on March 17. We simply missed their earlier report. Our apologies to the folks at Bodyhack, particularly Steve Edwards, who wrote the March 17 item.

Fresh Comments

Jonathan Eisen has posted a comment on the "CHA Example" item below. We have posted a response to his comment. Click on the word "comments" at the end of the item to see the little pearls.

The WSJ, Bile and the Wind

Christopher Thomas Scott, the executive director of the Program on Stem Cells in Society at Stanford, sent the following along. He wrote it in the form of a letter to the editor after reading an op-ed piece on embryonic stem cell research in the Wall Street Journal last week.

"Dear Editors:

"It was familiar a twist in the gut. Robert George and Thomas Berg's "Six Stem Cell Facts" (March 14 Wall Street Journal) provoked the usual response: Should I write 1) a trenchant rejoinder (Six Stem Cell Lies) 2) a carefully crafted counter argument, or 3) lie in wait and pounce in the pages of another newspaper?

"I was up Thursday before dawn. I poured myself a cold, frothy tumbler of bile, and sat down to write.

"Nothing happened.

"I was mystified--George and Berg's essay was an easy target, trotting out old moral and religious tropes.

"It took me a few days to figure it out, but now I understand this odd ennui. Supporters of embryonic stem cell research, including those of us who battle in journals and newspapers, have moved on. Embryonic stem cell research has left the barn, as the saying goes, and now we're getting on with the important stuff--the business of discovery, treatments and cures--what America does better than any other.

"This leaves commentators like George, Berg, and Krauthammer all alone, caterwauling and swinging roundhouses into thin air. The ringside seats are nearly empty. The images of dismemberment (as if an itoa of cells has arms and legs) or Krauthammer's lovely description in sanctioned government reports of "fetuses hanging on meathooks" has become a rhetorical sideshow, better suited for circus barkers. Will they join us at the edge of medicine's most promising frontier, where new, nuanced debates about stem cell therapies are taking shape? Or will they remain behind, shouting into the wind?"

RHA RMI Issues Receive Little Notice in Media

The flap over the $2.6 million California stem cell grant to a Los Angeles enterprise linked to ethical lapses involving a Korean scientist received scant attention today in California newspapers.

Only one story appeared in a newspaper, and one online. Neither contained much new information. Reporter Carl Hall of the San Francisco Chronicle did carry a comment from CHA Health Systems, the parent company for CHA Regenerative Medicine Institute, which was approved for the grant last week by the CIRM Oversight Committee. Hall wrote:

"Jason Booth, a spokesman in Los Angeles for CHA Health Systems, said the research unit is a bona fide California nonprofit whose status was not at issue, and that its 'grant was based on a thorough scientific review that speaks for itself.'"

Rob Waters of Bloomberg.com, who was the first to point out the connection between CHA Health Systems and CHA RMI, also reported on the calls for an investigation. He said a representative of CHA in Korea said the company would respond later.

The Californa stem cell agency said it was in the process of conducting a routine review of all the grants approved last week, which will include an examination of whether each recipient is eligible for the award. Waters quoted the agency as saying that the review could take six weeks.

The Bodyhack blog on Wired.com was the first (on March 17) to pull together the plagiarism allegations involving the head of CHA Health Systems along with other ethical concerns involving CHA and point out that a CHA subsidiary had been approved for the $2.6 million state grant. The California Stem Cell Report on the matter appeared Wednesday night and led to the calls for the investigation.

We have emailed CHA several times seeking a comment on the matter, including a promise to run their comments verbatim. We will do so when we receive a response.

(Editor's note: An earlier version of this story incorrectly said that the California Stem Cell Report was the first to link the CIRM grant and the ethical concerns involving CHA.)

Fresh Comment Update

Jonathan Eisen has added more commentary on the openness of the CIRM grant system. See "comments" on "Sunburn" below. Lawrence Ebert has more on the issue of "hidden economic interests" in New Jersey research. See "Fresh Comments" below.

As a point of information, we have started these comments advisories in an effort to bring more attention to the contributions of those who take the time to add to this dialogue. These manual comment updates are a bit clunky but we are looking for a sleek, hotsy-totsy way of providing them automatically in a separate space on this page. If you have any suggestions for finding a nifty HTML tool that will do that, send it along. Meanwhile, as general guidance, it would be better to post comments on the items dealing with the subject matter as opposed to posting them on these advisories on comments being posted.

Keep the stuff coming. Thanks to all.

Advisory

The press release by the Center for Genetics and Society concerning the CHA grant has now been posted on its web site. Here is the location.

The CHA Example: How CIRM Decides Who Gets the Big Bucks

The $2.6 million California stem cell grant involving the CHA Regenerative Medicine Institute received a score of 77 from a panel of grant reviewers, although they commented that it "can be easily qualified as overly ambitious."

Approval of the application last week by the Oversight Committee of the California Institute for Regenerative Medicine has resulted in calls for an investigation into CHA RMI's nonprofit status and its links to a Korean scientist involved in an international plagiarism case, among other things.

The CHA application first came up for a review last January by a CIRM working group, chaired by Stuart Orkin of the Dana Farber Cancer Institute. Fourteen other scientists held seats on the group. Seven members of the Oversight Committee sat on the panel. Only one is from Los Angeles, where CHA RMI has its office. It is not known whether she was in attendance when the CHA application was discussed. All of the scientists are from out-of-state.

Meeting privately, the reviewers recommended the CHA application and others for funding. The CHA application was placed in the first tier of grants that were sent on to the Oversight Committee. The scores of the first tier grants ranged from 95 to 66. The reviewers received detailed information on the proposal, including the names of the principal researcher as well as its methodology. Only one reviewer was recused from considering the grant. He was Jeffrey Rothstein of John Hopkins, who works in ALS research, a field that was also targeted by the grant.

Prior to action by the Oversight Committee, the names of all CIRM grant applicants and their institutions are secret except during the private meetings of reviewers, according to CIRM policies. The Oversight Committee is also not told their names during the votes on the reviewers' recommendations. The names of the winning applicants are only disclosed after the vote. The names of the losers will never be disclosed by CIRM.

CIRM says its secrecy is justified for a number of reasons. The agency says it is the traditional way grant applications are handled in the scientific community. It is professionally damaging, CIRM also says, for scientists to be publicly identified as not being able to win grants. It is also damaging to be criticized in public. Maintaining secrecy means that scientists are more likely to propose more ambitious and riskier research than would otherwise be the case. The results of science will be better in the aggregate, thus benefitting the public more than would identifying the applicants and their institutions, CIRM says.

During last week's Oversight Committee meetings when the grants were approved, the 29 members of that panel were not told the names of the applicants or the institutions. They were given a summary that is also available to the public. Individual members were given a list of the grants by number on which they could not vote or participate in the debate. Those lists were withheld from the public at the meeting. Just prior to voting on or discussing an individual grant, a list was read of the committee members who could not participate in the debate. At that point, well-informed members of the audience and probably many members of the committee could identify the actual institutions involved and often the individual researchers. The persons who could not are ones who are not as well informed on stem cell research.

The Oversight Committee voted on the first tier of grants as a block. At that point, no list of recused members was read to the public. Rather each member announced that they were voting in favor of the block with exception of grants where they had a conflict. CIRM's outside counsel recommended the procedure.

Following the vote, CIRM posted a list on the Internet of Oversight Committee members recused from voting on the CHA grant. They are Ricardo Azziz, chair of Department of Obstetrics and Gynecology at Cedars-Sinai in Los Angeles, Jeanne Fontana, a surrogate for John Reed, head of the Burnham Institute in La Jolla, and Richard Murphy, president of the Salk Institute, also in the La Jolla area. Reasons for their recusal were not posted.

(The California Stem Cell Report has argued often against much of the secrecy in the grant-making process for a variety of reasons. We will write more about the issue later.)

In response to a query, Dale Carlson, chief communications officer for CIRM, supplied the following:

"The CIRM grant review and administration process does not end with the ICOC's vote on deciding which applications to approve or not approve for funding. To that point, the review process by the Grants Working Group is focused on scientific merit. After that, there is an internal administrative review by Institute staff to ensure that each approved application is from an institution and principal investigator that meet the eligibility requirements of the specific Request for Applications (RFA); of the requested budget and proposed facilities for the proposed project; and of the institution's mechanisms for complying with our grants administration policy and medical and ethical standards.

"The administrative review process can take several weeks (we are still working on the SEED grants approved in mid-February, for example) and only after it's completed to our satisfaction do Notice of Grant Awards (NGAs) go out to recipient institutions and researchers. Checks follow NGAs.

"The NIH grants review process is similar."

The principal investigator on the CHI RMI grant is Jang-Won Lee. Little information is available about him on the CIRM web site. Carlson said the score of 77 on his grant is an average of each score by each reviewer. Here are the rankings of the grants.

Below is the text of the strengths and weaknesses of his application based on the CIRM reviewers assessment. More information on the grant can be found at this location.

"STRENGTHS: The proposal is well-written and includes preliminary data in pigs and novel methods. The research plan is nicely developed and the PI has the appropriate expertise, at least in animal cloning (less with hESCs), to be successful in this endeavor. Success of the PI in the porcine model adds strength to the plan. A large collection of letters of support provides evidence of enthusiastic collaboration with the PI that will add critically needed expertise to the project. The plan to differentiate and transplant hESC-derived neural cells in a well-established mouse model with experts in the field strengthens the lack of experience with hESC culture (but not derivation) by the rest of the group.

"WEAKNESSES: This is a proposal that can be easily qualified as overly ambitious. The author provides a shopping list of all the experiments that will happen after the ALS SCNT embryos have successfully been established and characterized. This seems premature. The proposal would be successful if the derivation is first done accurately and convincingly to generate a handful of lines that will be available for the community. Preliminary data on enucleation, SCNT and hESC derivation in an animal model should be done before proposing these studies. Specifically, SCNT on frozen oocytes in an animal model should be done before using completely viable, clinically useful human oocytes. The use of frozen oocytes for SCNT has not been established, and is likely to be a significant technical problem for enucleation and whole cell injection. There is no indication of a plan to enucleate the oocytes in the proposal and a clear rationale for using one or both of the methods used previously by the collaborator who developed the method is required. A plan for the derivation of hESCs is also needed along with a rationale for the use of ALS cells for tranplantation studies, rather than normal cells. It also appears that no one on this project has experience with this hESC derivation, or the derivation of any ESC lines.

"The section on clinical grade ESCs is not necessary for the proposal and should be removed. These ESCs are not stable lines that have been shown to be maintained in vitro. In fact, they appear by the literature and preliminary data to be a mixture of hESCs and hESC-derived differentiated populations. The plans to differentiate hESCs for transplantation do not require this intermediate step. It is unfortunate, because the application of novel SCNT techniques is a reasonable way to move the field of SCNT and hESC biology forward. If the rest of the proposal was as well-designed as the pig studies, the score would be very high."

CGS: CIRM Grant Recipient Has 'Shadowed' History

The Center for Genetics and Society today said "troubling questions" have arisen in connection with California's $2.6 million stem cell research grant to CHA RMI, adding another voice to the call for an investigation.

Marcy Darnovsky, associate director of the Oakland-based center, said in a press release:

"The leadership of CHA Health Systems (a Korean firm) has a shadowed recent history, including a lawsuit that alleges the director of its fertility center lied in order to obtain a woman’s eggs, The CIRM needs to live up to its oft-stated commitments to transparency and responsibility by freezing this multi-million dollar award while a thorough investigation is undertaken. If questions cannot be satisfactorily answered, the grant should be rescinded.”

Jesse Reynolds, a policy analyst at CGS and who has attended many CIRM meetings, said:

"Did CHA Health Systems establish this subsidiary in order to pursue California public funding, at a time when South Korea government funds were unavailable because of the Hwang Woo Suk cloning scandal? Given the recent record of unethical conduct in this field, the CIRM should have known to exercise greater scrutiny."

The press release continued:

"The medical director of the CHA Fertility Center is the subject of a lawsuit filed by a woman who says that he lied about the number of eggs that had been collected from her, causing her to continue seeking treatment from him. The CHA Fertility Center and the CHA Regenerative Medicine Institute are located in the same Los Angeles office building.

"'The lawsuit suggests that CHA’s leadership placed a woman at unnecessary risk by misleading her into undergoing repeated cycles of egg retrieval,' Darnovsky said. 'Women’s health advocates have warned about the health risks of egg retrieval, as well as about likely conflicts of interest between fertility doctors conducting egg retrieval and researchers who want the eggs for their experiments.'"

Asked for a comment, Dale Carlson, chief communications officer for CIRM, said CGS' comments were "another uninformed reaction." He used similar language concerning statements by the Foundation for Taxpayer and Consumers Rights.

We have asked CHA for comment on these matters and will carry them when we receive them.

The center's press release was not posted on the Internet at the time of this writing. We will carry an advisory when it is posted.

FTCR Calls for Investigation Into California Stem Cell Grant

A California watchdog group has asked the state's stem cell research agency to investigate a Korean-linked organization that the agency approved last week for a $2.6 million grant.

John M. Simpson, stem cell project director for the Foundation for Taxpayer and Consumers Rights, said in a press release that CIRM's "secretive awards process let a questionable $2.6 million grant slip by the Oversight Committee without adequate scrutiny."

His comment came today following a report Wednesday on the California Stem Cell Report concerning the recipient of the grant, CHA RMI, and Kwang-Yul Cha, chief executive of the parent company of CHA RMI.

In a letter to the CIRM, Simpson said:

"It is not clear what (CHA RMI's) affiliation is with its corporate parents CHA Medical, CHA Biotech and other corporate for-profit entities. Kwang-Yul Cha is the chief executive of CHA Health Systems, chairman of Hollywood Presbyterian Medical Center and director of CHA Regenerative Medicine Institute. Is CHA RMI truly a non-profit institution eligible for funding in this round of grants?"

Simpson also said "serious questions" have been raised about Cha in connection with plagiarism allegations along with a state inquiry into whether he was violating the law by using MD after his name when he is not licensed to practice medicine in California.

Simpson said in the press release:

"We’ve argued that the process should be open and the applicants identified as they do in Connecticut. The stem cell institute refused to let the sun shine in and they got burned as a result."

In response to our query, Dale Carlson, chief communications officer for CIRM, said,

"Simpson appears to be uninformed about the grant review process, here and at other agencies."

We have asked Cha for a comment and will carry it when we receive it.

Simpson also said,

"I'm grateful the California Stem Cell Report first linked the CHA Regenerative Medicine Institute to the problems in its affiliates. Without David Jensen's digging this would likely have slipped by us all."

More on Plagiarism, Prayer and Cha

Patent attorney Lawrence Ebert has posted details concerning Kwang-Yul Cha, whose subsidiary has won a $2.6 million California stem cell grant, and Cha's "anonymous prayer" paper in The Journal of Reproductive Medicine.

Writing on his Ipbiz site, Ebert said:

"One co-author is a convicted felon, one co-author has had his name removed, but JRM won't retract it."

Ebert also had more details on the plagiarism issue from The Scientist magazine.

"Fertility and Sterility has censured the authors(including Cha) of a 2005 article after learning a Korean journal had published the identical paper one year earlier. The Fertility and Sterility authors also left off the name of Jeong-Hwan Kim, who was listed as the first author on the Korean paper and performed the bulk of the research reported in both papers."

The Scientist piece continued:

"The journal will also issue a note in an upcoming issue describing the transgression, and has barred every author listed on the original Fertility and Sterility paper from contributing papers to the journal for three years, editor Alan DeCherney told The Scientist. 'This is a serious punishment.'"

Fresh Comments

Lawrence Ebert has posted a new comment on the CHA item below. "Faye" has posted a comment on "hidden economic interests" on the "Fresh Comment" post from 3/20/07.

CIRM Grant Recipient Tied to Korean Scientist Involved in Plagiarism Controversy

A Los Angeles organization that is scheduled to receive a $2.6 million research grant from the California stem cell agency is a subsidiary of a Korean enterprise headed by a scientist who is enmeshed in an international plagiarism dispute.

The scientist is Kwang-Yul Cha, who also "came under criticism a few years ago for his involvement in a study suggesting that anonymous prayers from strangers might double a woman's chances of fertility," according to the Los Angeles Times.

His firm, CHA Health Systems, is the parent company of CHA Regenerative Medicine Institute (CHA RMI) of Los Angeles, a non-profit organization that last week was awarded the research grant by the Oversight Committee of the California Institute for Regenerative Medicine. The funds were approved by the 29-member committee with no specific discussion of the CHA grant. The names of the organizations were not disclosed until hours after the vote.

The information about Cha's background was first published in the Los Angeles Times Feb. 18, nearly a month before the grant was approved. The story by Charles Ornstein said Cha, whose firm also owns Hollywood Presbyterian Medical Center,

"...is listed as the primary author on a medical paper that appeared in December 2005 in the U.S. medical journal Fertility and Sterility.

"But that paper appears to be nearly a paragraph-for-paragraph, chart-for-chart copy of a junior researcher's doctoral thesis, which appeared in a Korean medical journal nearly two years earlier, according to a Times review of both papers and the findings of a Korean medical society.

"Cha has denied any wrongdoing."

Ornstein continued:

"Cha also appears to be violating state law by using MD after his name on websites and in news releases in California. He is not licensed to practice in the state, records show. His resume says he received his medical training in South Korea.

"'We don't believe it's lawful for him to hold himself out in this manner,' said Candis Cohen, a spokeswoman for the Medical Board of California."

On Feb. 28, Ornstein also reported that Thomas Kim, the medical director of another CHA organization, the CHA Fertility Center in Los Angeles, was under investigation by the state Medical Board "over a patient's allegations that the doctor seduced her into a lengthy sexual relationship and then lied to her about her treatment." Kim's lawyer has denied he did anything wrong and said that it was a consensual personal relationship involving Kim and the woman.

We have queried both CIRM and CHA's organization in Korea for a comment and will carry them when we receive them.

Responding to a query from the California Stem Cell Report, John M. Simpson, stem cell project director for the Foundation for Taxpayer and Consumers Rights in Santa Monica, said:

"It strikes me that there are enough doubts about the credibility of the leadership of the CHA Medical Group so as to warrant a serious investigation before any money is transferred to its researchers.

"First, CIRM ought to determine the relationship between the for-profit corporate parent and the non-profit CHA Regenerative Medicine Institute. It's not at all clear that CHA Regenerative Medicine is truly a non-profit organization.

"Second, the CHA Biotech website says that the institute has received approval from the Western Institutional Review Board for stem cell research involving frozen human eggs. Under CIRM rules there needs also to be approval by a SCRO committee -- Stem Cell Review Oversight committee. It's not clear that has happened. It's also important to know the source of the frozen eggs."

"Given the track record of CHA's leadership, I'd say CIRM needs to ask some tough questions and not release funds until there is a satisfactory public explanation of what's going on."

The grant to CHA RMI was part of a package that was voted on last Thursday night as a block. They had been recommended for approval by a group of out-of-state scientists and some members of the Oversight Committee, who together privately reviewed the grants some time ago. But the names of the applicants and their institutions were withheld from other members of the Oversight Committee and the public when they came up for the final vote. The Oversight Committee includes the deans of both the UCLA andUSC medical schools as well as a member of the board of the Cedars-Sinai Medical Center in Los Angeles, where the committee's meeting took place. Other prominent California medical school deans also sit on the Oversight Committee.

The Los Angeles Times carried a brief story on the grants, mentioning CHA by name but with no further background. Both Los Angeles Mayor Antonio Villaraigosa and California State Assembly Speaker Fabian Nunez hailed the grants generally at a news conference, but did not mention CHA specifically.

The CIRM grants are subject to administrative review before the checks go out. That includes the legal standing of applicant institutions, the status of the principal research investigators, among other things.

Fresh Comment

Jonathan Eisen has just posted a comment on the "Sunburn" item below. Click on "comment" at the end of the Sunburn posting to view Eisen's remarks.

Nature Warns of Sunburn; UC Davis Scientist Warns of Hidden Agendas

Amidst the hoopla about the latest research giveaway by the California stem cell agency, a couple of news items popped up that dealt with openness and conflicts of interests.

Last week Nature magazine editorialized that CIRM was amply open. And on Sunday, the agency itself disputed a Sacramento Bee editorial that suggested CIRM is "on thin legal ice" because it does not require its grant reviewers to publicly disclose their financial interests. But first the Nature editorial, which ironically is not accessible to the general public. It says, among other things,

"Calls for yet more openness may be well intentioned, but they threaten to override the element of confidentiality that is inherent to fair peer review, and to undercut the agency’s mission of supporting cutting-edge research from the best Californian scientists. There comes a point at which yet more sunshine leads to sunburn."

Nature also said that requiring identification of those who do not receive grants

"...would be akin to the state of California publicly releasing information on all the job applications it receives, complete with adverse comments made during the hiring process. "

We could not disagree more. Seeking millions of dollars in state funds with no promise of economic return, which is what the research grants are all about, is fundamentally different than applying for a position as a state park ranger.

Stuart Leavenworth, an associate editor at The Sacramento Bee, noted in an email to the California Stem Cell Report that the magazine's position did not surprise him "given that Nature has steadfastly refused to disclose the conflicts of interest of its authors, unlike other journals." He pointed to statements by the Center in the Public Interest and more than 30 scientists that Nature does not "reliably" disclose its authors' financial ties to drug and biotechnology companies.

The Nature editorial also surfaced on the "egghead" blog at UC Davis.
Jonathan Eisen, a professor at the UC Davis Genome Center, said, in part:

"While I can see (Nature's) points, I am not sure they are the most objective place to look for for ideas on this issue. The question to me is not whether too much sunshine MIGHT cause sunburn it is whether just the risk of sunburn is worth keeping things closed. I think in this case I probably agree that the review of these proposals might be changed if it were an open review system. But as someone who has served on many grant review panels, I know that there are ALL sorts of hidden agendas that play out in the review. If review were completely open, at least these hidden agendas would be exposed to the world. Yes, some reviewers might be too timid in their reviews, but this openness would eliminate so many other problems inherent in anonymous review. This is why there are a few journals out there that now have open review of papers — something I think is certainly worth testing out."

Dale Carlson, chief communications officer for CIRM, wrote the op-ed piece that challenged The Bee's position. He said that grants are not in jeopardy and that two courts have upheld the legality of CIRM's actions. Carlson referred to lawsuits that that have unsuccessfully challenged the constitutionality of the agency.

With all due respect, we suggest that the key issue has not been fully litigated. At the time of the trial cited by Carlson, CIRM had only made a small number of grants. A track record simply did not exist on whether the grant reviewers were making de facto decisions. There is no doubt, however, that the Oversight Committee has final authority on making grants.

The fundamental question about public disclosure of the financial interests of the grant reviewers concerns good public policy and openness. Should the public should be allowed to know the financial interests of those who recommend that millions of public dollars be handed out to scientists? Along with that goes the question of whether the public should be allowed to know the names of persons and institutions seeking millions of dollars in research grants.

Our position is that the interests of the science community come after the interests of the public. Unwarranted secrecy in the grant-making process only feeds suspicion and creates the possibility of insider dealings, which are not likely to be healthy for science or stem cell cures. As Eisen notes above, hidden agendas can often come into play.

(Editor's note: If you are interested in the full text of the Nature editorial, please send us a note at djensen@californiastemcellreport.com.)

Zerhouni to Bush: Nation Better Served Without Research Restrictions

The head of the National Institutes of Health, an appointee of President Bush, today defied his boss and said the president's policy on embryonic stem cell research was ill-serving the nation.

The statement came from Elias Zerhouni and was reported by Angela Zimm and Neil Roland on Bloomberg.com. They covered a Senate hearing on funding for the NIH. They wrote that Zerhouni said:

"The current lines will not be sufficient. It's not possible for me to see how we can sustain the momentum of research."

Zerhouni continued:

"It's clear that American science and the nation will be better served if we have access to more cell lines."

According to Bloomberg, this is the context of the remarks.

"Senator Tom Harkin, an Iowa Democrat, asked Zerhouni, whether lifting the restrictions would have an effect on finding new cures.

"'The answer is yes,' Zerhouni said. The exchange came at a hearing of the Senate Appropriations subcommittee on Labor, Health and Human Services and Education."

Zerhouni could have said the same thing several years ago. But Bush is now a clearly a lame duck and on the ropes with the American public. And Zerhouni has his own future to consider. Being a handmaiden to Bush's stem cell policy is not the best position for someone who may be casting about for a new line of work.

Beyond $131 Million: Looking Ahead at CIRM

You could call it the pipeline and presidency issue. Even before the directors of California's stem cell agency approved an unprecedented $75 million in grants, some of them were worrying about what happens next.

Brian Henderson, dean of the USC medical school, told his fellow members on the CIRM Oversight Committee, "We do not want to congratulate ourselves too much."

CIRM, however, does have something to congratulate itself about, as Los Angeles Mayor Antonio Villaraigosa reminded them during a Friday morning news conference. "Put a smile on your face," he said.

CIRM has pumped out $131 million in grants so far this year, making it clearly the largest single source of embryonic stem cell research funding in the world. More millions will come later this year. And before the end of the year, with a little luck, they will see even bigger bucks flowing in through the sale of state bonds that have been delayed because of litigation.

However, the 22-member staff of the agency has been working extraordinarily long hours. "Heroic" was a word that came up often during last week's two-day meetings to describe the work of the staff. One example that was cited was the case of one staffer, who was up until 4 a.m. readying documents for the first day of the meetings. While that may be a tad exceptional, Oversight Committee members for some time have expressed concern about the workload of the agency.

As Michael Friedman, president of the City of Hope, put it last week, the agency has been sprinting, and "we are in for a marathon."

The "challenges" facing CIRM include the loss of President Zach Hall in June, the search for his successor, the void until the new president comes aboard and the need to fill the pipeline with more grants as well as administering the ones already approved.

Several board members said momentum needs to be maintained to provide opportunities for the new scientists that have been arriving in California to tap CIRM's $3 billion research effort. They urged Hall to fill staff positions as rapidly as possible to maintain the workflow. "Please don't scrimp," Friedman said.

CIRM is not likely to have a new president on board by the time Hall leaves, which will accentuate the normal uncertainty that arises with the arrival of new CEOs, especially in small, new organizations. However, something of a model exists for working through that period. Hall will take a vacation this month and has designated two persons to act in his stead, Arlene Chiu, scientific program director, on scientific matters and Lorraine Hoffman, chief financial officer, on other issues. How they fulfill their responsibilities will be a good test for June and later in the summer.

The 29 members of the Oversight Committee hold an important key to CIRM stability and momentum. They should curb their micro-management urges, some of which are possessed in abundance by some members of the board, and focus on filling the presidency as quickly as possible. Twenty-nine busy fingers in the CIRM pie are likely to leave a pretty mess.

Henderson and the others are right to worry about a letdown, which can easily happen during or following periods of intense effort, which has been the story since January 2005. Avoiding a letdown and leaving a healthy organization may be one of Hall's most important tasks in the next few months. But much of the burden will fall on senior CIRM management, the folks who will ride through the transition. After all, they are the ones who will be left to engineer the giveaway of a piddling $2.8 billion or so over the next 10 years.