Public Still Barred from Sweeping CIRM Review

The California stem cell agency confirmed this morning that the public remains barred from the key sessions of this week's sweeping review of the operations of the $3 billion public enterprise.

In response to a query, Don Gibbons, chief communications officer for CIRM, said,

“The public is only invited to the sessions that are marked as public.”

We raised the question because CIRM removed information this week from its Web site that explicitly said the public was banned. Also removed was information about the location, time and subjects of the closed-door proceedings. The  new announcement, posted just two days ago, additionally said that more time was being allotted for public comment.

The external review of CIRM,  the most comprehensive ever, begins this morning at San Francisco's Marriott Hotel.

We will be providing coverage today of the proceedings that we have access to.

More Time for Public Comment at CIRM Review But Doors Still Closed Otherwise to Public

Making a last minute change, the California stem cell agency has decided to allow more time for public comment during the sweeping review this week of its operations, but still will apparently bar the public from hearing testimony by witnesses.

The first public comment session will come tomorrow morning at 8 a.m. Other public comment sessions will be on Thursday and Friday mornings.

In the announcement posted just yesterday on the CIRM Web site, the agency also changed the location of the public comment sessions from CIRM headquarters to the Marriott Hotel in San Francisco.

The new information on the CIRM Web site removed an earlier agenda that said that the public would be barred from the panel's other sessions. However, this afternoon when we encountered Don Gibbons, CIRM's chief communications officer, at CIRM headquarters, he did not mention any change in policy. But that encounter was before we saw CIRM's new announcement, and we are querying Gibbons again concerning the likelihood of a change.

Also posted on Monday was a 29-page report (dated Oct. 8) by CIRM Chairman Robert Klein that will be presented to the blue-ribbon panel that is conducting the most comprehensive review ever of the $3 billion agency.

Our view on these last minute changes? The notice comes too late for all nearly all interested parties to find the time and make the effort necessary to prepare thoughtful comments. Plus the public still is apparently banned from hearing information that will be critical in determing the future direction of an agency that is spending $6 billion (including interest) of taxpayer funds.

We first wrote about the external review on Sept. 23. At that time, CIRM had not notified the public that the external review would occur nor had it solicited publicly any comments from interested parties, although the review had been planned for many months. Nor was any provision being made for public testimony at the review. CIRM has changed its position somewhat, but the public is still barred from what essentially is its own business.

Stem Cell Agency Apologizes for Its Choice of Poetry

The California stem cell agency stepped into a bit of an unnecessary mess last week that, of all things, involved poetry.

Perhaps it was a sign from above that government agencies should not try to commit literature, if you could call it that.

The case in point was a poem that won a prize from CIRM as part of its “stem cell awareness day,” a drum-beating effort to build support for human embryonic stem cell research. Winners of CIRM's poetry contest were announced last Wednesday in a widely distributed news release that was also posted on the CIRM Web site.

However, not only did the contest draw exceedingly few entries (only 18), the poem by one of the two winners was offensive to some who take their religion quite seriously. That in connection with research that already has more than its share of controversy.

In an item headlined “How to Offend 101,” one critic, J. Wesley Smith, wrote,

“One of the two top winners wrote a poem using the words of Jesus at the Last Supper to apply to embryonic stem cell research....

“Was it an intentional slam on Christians, many of which oppose ESCR, which the CIRM realized in retrospect would blow up in their faces?  Or did they think the poem, by using the words of Jesus at the Last Supper, would somehow appeal to Christians?  Or did they just think it was clever?   Whatever it was the judges were thinking–they weren’t thinking.”

Smith also used words like “hubris,” “arrogance” and “clueless.”

By Friday, CIRM had excised from its Web site the poem in question, which you can find at the end of this item. And the agency published an apology on its Web site that said,

“CIRM recently announced two winners of the second annual poetry contest, one of which contained some religious language that is identical to liturgical language used in the context of Christian and Catholic sacraments. The language introduces a religious element that we now realize was offensive to some people.

“We are deeply sorry for any offense caused by the poem. Neither the author nor CIRM intended for the language to insult or offend any religious group.

“When CIRM recognized that the language was of concern we removed all four poems from the CIRM web site and from the Stem Cell Awareness Day web site.”

CIRM's statement carried no comment from the three judges of the contest: Don Gibbons, CIRM's chief of communications, who said in the poetry press release that he studied poetry and creative writing at Indiana University; Margaret Hermes, also an Indiana alum and a “practicing poet and teacher,” and Don Reed of Fremont, Ca., a patient advocate.

The issue here is not the poem itself, which would have attracted little attention in a literary venue. But it was not published and touted privately. It was ballyhooed by a $3 billion California state agency, which has responsibilities to all of California – not just the scientific community.

CIRM had little to gain from running a poetry competition. Even under the best of circumstances, it would not generate sufficient PR payback to justify the time and expense involved, which was not much. And the prize for winners was equally neglible – “a framed stem cell image of their choice from CIRM’s Flickr web site.” Here is the poem from Tyson Anderson, a U.S. Army linguist from Tampa Fla.

Stem C.

This is my body
which is given for you.
But I am not great.
I have neither wealth,
nor fame, nor grace.
I cannot comfort with words,
nor inspire to march.
I am small and simple,
so leave me this.
Let me heal you.
This is my body
which is given for you.
Take this
in remembrance of me.

Parsing Statistics vs. the Reality of Biotech Concerns About CIRM

The California stem cell agency is missing the essential point of complaints from the biotech industry concerning CIRM's record on funding commercial research.

In its response to the biotech concerns, CIRM parsed statistics compiled by BayBio, the biotech industry group in Northern California, but ignored the reason for the private dinner meeting in August between top executives of the $3 billion agency and the area's stem cell firms.

Industry is less than happy with the California Institute of Regenerative Medicine. BayBio and the Orrick law firm did not bring together all those CEOs in August to pat CIRM on the back.

The industry concerns are not new. They have been around for several years. They have been acknowledged more than once by CIRM directors, some of whom have spoken pointedly about the need to funnel more cash to stem cell businesses. It is not just a matter of spreading money around equally. It is a matter of actually creating usable medical products, something that Stanford, the University of California and nonprofits are not going to do.

Director Jeff Sheehy, a patient advocate member of the CIRM board who works at UC San Francisco, said at the August CIRM board meeting,

“From the minute I've been on this agency I've heard...(at)all the industry meetings -- I've heard (that) we've got products waiting for money.”

According to the transcript of the meeting, CIRM Chairman Robert Klein, a real estate investment banker, acknowledged that CIRM does not have a “big supply” of grant reviewers with industry expenence – one of the problems cited by BayBio for the lack of grants to business. Finding them is “difficult,” Klein said.

Director Philip Pizzo, dean of the Stanford School of Medicine, additionally raised a question about CIRM's outreach to business.

“If industry has got things in the pipeline...are there ways that we could seed this to happen in more novel manners?

“Have we had, for example, as part of our strategic planning effort, an off-the-record kind of think tank between industry leaders, academic, venture capitalists in the same room at the same time, not separate -- would you buy into this ...approach -- but really coming together and say if we could create the world differently, how might we think about novel ways of approaching these kinds of both research and translation efforts?”

The question went unanswered at the board meeting. The strategic plan, however, comes up next week at CIRM headquarters in San Francisco when a blue-ribbon panel of external reviewers will conduct a closed-door examination of CIRM and its performance. The meeting's agenda, however, does not mention the stem cell industry's concerns.

Industry executives have been reluctant to go public with their issues, understandably wary of offending a financially powerful organization. Privately, they are more frank. We have heard bitterness and frustration from a number of them.

The industry found an unusual ally, at least on this issue, in Consumer Watchdog's John M. Simpson, who worked closely with some firms during CIRM hearings on its IP policy. He came up with a constructive proposal in June to deal with business issues that was brushed off by Klein.

But, as on any matter, there is not complete unanimity within the industry about CIRM. Funded firms are not likely to complain much.

CIRM has an additional $5 billion reason to move concretely to deal with biotech's concerns. Klein is touting for the ballot a CIRM bond measure of that magnitude, possibly in two years. The electoral campaign that created CIRM six years ago cost $30 million. Another ballot measure will run upwards of that amount, which means raising buckets of cash. And the only likely major donors will come from the biotech industry and its investors.

(A footnote: CIRM disputes statistics produced by BayBio on the percentage of awards given to business. We suspect the industry's figures were based on earlier grant numbers published by CIRM. The agency's totals change each time it approves another grant round every month or so. The presumably old percentages probably indicate that BayBio has been stewing over this issue for quite some time. BayBio has also filed a comment on an earlier item on this subject. Its carefully worded remarks said the August meeting created “a renewed sense of collaboration and areas to address.” BayBio did not speak to CIRM's criticism of its statistics.)

Stem Cell Agency Says It Is "Not Biased Against Industry"

The California stem cell agency responded today to an item reporting dissatisfaction on the part of the biotech industry concerning its meager share of the $1 billion that CIRM has awarded so far.

Don Gibbons, chief communications officer for the agency, filed his remarks earlier today as a comment on the second piece we wrote on the subject. (Here is a link to the first.) Because of the important nature of the controversy, we are reprinting his statement verbatim below to give it greater visibility. We are sure it is not the last to be heard on the subject from either the agency or industry.

Here is what Gibbons wrote as a comment on the item on the California Stem Cell Report.

“Your post distorts the facts. The document you quote from BayBio is not a 'report' it was a letter written to highlight issues and get the group’s membership excited about attending the session. It was not intended to be a document of record regarding the organization’s stance on CIRM.

“You did not check the facts in the letter. You could quickly tally the for-profit grants on our web site and see that the $45 million awarded to industry is 4.5 percent of the amount awarded not the 3 percent cited. But you know that even this number is not a good comparative number. Anyone who follows CIRM knows we are working from a 'pipeline' strategy moving from basic research and infrastructure to clinical application. Industry was not, and should not have been, eligible for the early rounds of grants. I do not believe the taxpayers wanted us building facilities for for-profit entities. Also companies would not have been appropriate recipients for our training grants. So, if you look at only research dollars, the pie shrinks to $628 million and industry’s share is 7 percent.

“However, that is still not an appropriate number to use. The first two research awards, the SEED and Comprehensive grants, were called the Jumpstart program designed to get this new field launched. They were issued before we had an intellectual property (IP) policy in place and therefore could not be offered to industry. (And don’t suggest we should have had an IP policy in place by then given the vast number of new systems the agency was developing simultaneously.) If you subtract those dollars the pie shrinks to $511 million and industry’s share rises to almost 9 percent.

“Given our pipeline strategy and our stated intent to start out more focused on basic science and move into the translational and clinical arenas when the science matured, this is a respectable percentage. As you well know we have a $50 million Targeted Clinical Development Request For Applications active now and that could double industry’s share in one grant round.

“If you look at the industry partnerships our academic grantees have formed, the dollar amount committed to industry is already probably double actual grant total. While only one disease team Principal Investigator was from industry, a second team had a co-PI from industry and another eight have major contracted relationships with industry.

“CIRM’s management team is certainly not biased against industry. Seven of 12 science officers came to us from industry, and there is frequent discussion in the office about ways to bring industry more firmly on board with our mission and to clear misconceptions on our policy.  This is the reason we developed a webinar on grant writing that is now on our website http://www.cirm.ca.gov/GrantWritingWebinar030310

“Also, a little fact checking would have revealed that the number of industry reviewers on our grants working group was wrong in the BayBio letter. Thirteen members are currently employed by industry and another 13 have strong ties to industry as former industry employees or having been involved in founding a company. So, that is 26 out of 136 reviewers, not the six suggested.

“Your posting did not represent the over all tone of the BayBio meeting. It was generally a very constructive session. One executive present noted that when our regulations were explained, his company was comfortable enough to apply.

“Distortions relying heavily on a single disgruntled source do not do a service for the stem cell field or help the reputation of the blogosphere.”

Full BayBio Report on Lack of CIRM Grants to Business

The California Stem Cell Report has offered the state's stem cell agency and its directors an opportunity to respond at length in connection with the biotech industry's concerns about the paucity of awards to business.

BayBio, which represents the industry in Northern California, documented the complaints in a six-page paper in August, just two months after CIRM Chairman Robert Klein dismissed a call by a non-industry source for action on the matter. The entire BayBio document can be found here. It was used to prepare industry executives for a closed-door meeting with Klein and other CIRM officials in August.

We have emailed directors and CIRM, asking them if they would like to respond. We promised that any comments would be carried verbatim, which is almost never done in the mainstream media.

We have also sent links to the items to the blue-ribbon panel of reviewers who will be conducting a sweeping review of CIRM next week. However, the public and industry have been barred from attending the closed-door sessions, with the exception of one-hour to make comments or ask questions. The public and industry will not be permitted to hear testimony from CIRM staff or other witnesses.

CIRM Directors to Consider $600,000 Online Journal Plan

Coming up in only three business days is a meeting of the Finance Subcommittee of the California stem cell agency, which is expected to act on a $600,000 proposal to create an online scientific journal and alter CIRM's fledgling loan program for biotech businesses.

No specifics are available, however, from CIRM's Web site, which makes it difficult for interested parties to comment thoughtfully. In fact, the agency's de facto policy of regularly withholding until the last minute details on proposals coming before its directors discourages the public from commenting.

Also on tap is “consideration” of projected cash flows for the agency in connection with its strategic plan, which is scheduled for a sweeping, two-day, closed-door review next week. It is unclear why the cash flow matter is coming before the directors' Finance Subcommittee since it would not appear to require action. It may be a discussion proposal to set the stage for creating a policy for future expenditures – such as spending the agency's cash more rapidly -- sooner rather than later.

Regarding the loan policy, the agenda for the Finance meeting said only that the program, which originally was touted as a $500 million effort, would be amended. No other clue was offered concerning the changes. CIRM has made only one, $20 million loan in the program.

The journal proposal is part of the CIRM budget that was approved last June. At the time, CIRM President Alan Trounson told directors,

“What we would like to do is create an interest in one of the journals to bring out a translational journal which was focused on stem cell translation and for them to do all of the independent editing and all the reviewing and so forth.”

He said it was needed to provide a forum for discussion of regulatory issues and publication of research with negative results. He said that currently “translational papers” are scattered and hard to find.

We later asked for more details from CIRM. Don Gibbons, CIRM's chief communications officers, sent along a draft of an RFP. The proposed RFP dates back to July 26 and may well change. But it says that raising unique translational issues to a higher priority in journals would accelerate the entire field.

The draft RFP called for a three-year subsidy of the online, open access publication and required a business plan that would demonstrate self-sustainibility at the end of that period.

During next Tuesday's meeting, the public can participate at teleconference locations in San Francisco, San Diego, Stanford, Irvine and La Jolla. Specific addresses can be found on the meeting agenda.

The Biotech Industry and the California Stem Cell Agency: An Unhappy Relationship

Late last June, the chairman of the California stem cell agency, Robert Klein, dismissed concerns that biotech firms are not getting a fair shake at the agency's $3 billion in research awards. That's not what he has heard, he told CIRM directors. In fact, Klein said, he had just received an award from a national industry group.

Two months later, leaders of the Northern California biotech industry sat down with Klein at private dinner at a tony San Francisco peninsula restaurant and told him that he was simply wrong.

They showed him the numbers. In the five years that CIRM has been operational, businesses have received only 3 percent of the more than $1 billion awarded so far. If CIRM really wants to produce therapies that can be used, Klein was told, it can only do so by helping to finance enterprises that actually create medical products.

One executive in attendance at the Aug. 25 dinner at the Marche restaurant in Menlo Park had harsh words for the agency. He later told the California Stem Cell Report that CIRM is “completely misaligned and mismanaged.” He said the agency is dominated by the academics on its board, whose institutions have received nearly all of the funding. The executive said the academic institutions are not going to deliver on CIRM's mission of “turning stem cells into cures.”

However, June's message of concern came from an unlikely, non-industry source. John M. Simpson, stem cell project director for Consumer Watchdog of Santa Monica, Ca., called for a major effort by CIRM to deal with the matter. The issues he addressed have been simmering for some time, largely in private because of CIRM's enormous funding clout. No one wants to be on the agency's bad side.

In a statement to CIRM directors, Simpson said,

“When Consumer Watchdog began its stem cell project almost five years ago, I naïvely expressed concerns that the program would be hijacked by the biotech industry. That has -- at least so far -- not happened; rather, it has been dominated by academic research institutions, whose representatives hold the largest number of seats on the board.”

He recommended that CIRM take a number of steps, including a public task force, to remedy the situation.

According to the meeting transcript, Klein replied in part,

“I don't think the biotech industry at large has feelings that are reflected in that statement. As some of you may know, I received a reward from biointernational conference (BIO) this year, their humanitarian award.”

The August meeting, however, that Klein attended included top executives from Geron, iPierian, Vistagen, StemCells, Inc., Cellerant and others. “All the major players,” we were told. The dinner was organized with the support of BayBio, the biotech industry organization in Northern California, and the Orrick law firm of San Francisco, which serves as bond counsel to the state of Californa. From CIRM came – in addition to Klein – Director Ted Love and Patricia Olson, the agency's executive director of scientific activities . Missing was CIRM President Alan Trounson. No reason was given for his absence.

A BayBio briefing paper for the meeting, said,

“CIRM has a perception of not being friendly to industry. Private companies with strong track records of receiving NIH funding are frequently unsuccessful in getting grant funding from CIRM. Conversely, in comparison to CIRM for-profit companies have sporadic success rate at best with CIRM grants. CIRM’s contention on this is that the non-profit applicants that are received they tend to come from well-established and research –intensive institutions, as opposed to the less known and established for-profit companies.”

The paper said,

“CIRM’s current grant review policies and practices do not track with the stated goals of RFAs and favor funding academic applications thus reducing funding opportunities for industry and discouraging future company participation.”

CIRM's leadership, including Klein, also came under criticism for a lack of understanding about what is needed bring a stem cell therapy to the clinic. “Everybody is enamored of Klein,” said the source at the meeting. The deans on the board have no knowledge of product development, he continued.

CIRM directors are not unaware of business concerns, but the situation has remained nearly unchanged over the years. Only on rare occasions has a biotech executive publicly voiced concern. One of the issues that has been raised involves the lack of grant reviewers with business backgrounds, a situation that has existed since CIRM's inception. Directors have discussed the need for improvement. Some  have said there is tilt towards basic science among reviewers that manifests itself in a lack of interest in the relatively more pedestrian research needed to produce a product.

The BayBio paper said,

“Currently there are no scientific experts from industry on the grants review group and only six (out of 89) are alternates.”

The briefing paper made three recommendations:

“BayBio and industry need clarification on CIRM IP and public access requirements to increase private sector comfort with CIRM programs and encourage more companies to participate in the program.
“Changes are needed to the grants application and approval process to increase the success rate of companies applying for CIRM funding.
“There needs to be more transparency all around with respect to the process and final decision making.”

The CIRM officials took notes on the August discussion and said they would get back to the participants.

Next week, the stem cell agency will hold a two-day, closed-door review – with the exception of one hour -- of its strategic plan. The “external review” is the most comprehensive examination ever of CIRM's direction. However, the fair treatment of business grant applications is not one of the specific subjects listed on the agenda for the blue-ribbon, international panel.

California Stem Cell Report Honored as One of The Best Stem Cell Blogs

The California Stem Cell Report has been named one of the top 13 stem cell blogs internationally by Webicina.com, a physician-directed Web site aimed at helping physicians and patients obtain reliable information.

Webicina prepared the list because of the plethora of misleading and inaccurate information on the Web. In addition to this blog, the list of best blogs included the Cancer Stem Cell News, authored by Jim Till from the Cancer Stem Cell Consortium in Canada, CellNEWS, authored by Lars Carlsson, a Swedish researcher, and Stem Cell Awareness of the Stem Cell Cell Awareness Association.

Webicina is directed by Dr. Bertalan Mesko from Hungary, who is also responsible for the ScienceRoll blog, which he reports has had more than 1.6 million views. Mesko has also been quoted by Nature, the New York Times and the British Medical Journal, among others, concerning the impact of the Web on science and medicine.

Candidates Sought for Board of California Stem Cell Agency

Want to join a small brigade of public servants working on the cutting edge of science and public policy? Looking to take part in giving away $2 billion? Here's your chance.

California's top fiscal officer, Controller John Chiang, is seeking nominations for five openings on the 29-member board of directors for the $3 billion California stem cell, which has already awarded $1 billion to a total of more than 300 recipients.

You can nominate yourself or others. But there are some legal requirements. For example, nominees for chairman of the CIRM board should have “a demonstrated history in successful stem cell research advocacy” and “experience with state and federal legislative processes that must include some experience with medical legislative approvals or standards and/or funding.”

In addition to nominating candidates for chairman and vice chairman of CIRM, Chiang is looking for candidates for three other slots on the board. The positions, which have six-year terms, also have special requirements. One, for example, must come from a California life science business. Prop. 71 did not provide for a general representative from the public.

Chiang's Web site also said,

“The controller has been a leader in promoting public and private sector board diversity and is interested in finding qualified nominees and appointments who reflect the diversity of California.”

The jobs are important, require a fair amount of work and do not pay well, except for the chairman and vice chairman positions, which also involve a great deal more work than regular board positions. The chairman and vice chairman positions carry salaries. The others do not, only a modest per diem.

Other statewide officials, including the governor, lieutenant governor and state treasurer, make nominations for positions on the CIRM board. So interested parties have more than one shot. However, none of the other officials has posted a public appeal on their Web sites. We are sure, however, they are open to suggestions from the public.

The deadline for submitting nominations to Chiang is Oct. 15. Successful applicants could begin work in December.

Public and Scientists Left in Lurch on Proposals Affecting $2 Billion in Taxpayer Funds

A key panel of directors of the California stem cell agency met late last month to consider changes in its grant procedures that will affect hundreds if not thousands of scientists in California to the tune of $2 billion.

The Science Subcommittee discussed the proposals at a session on Sept. 29. However, the public and the affected parties had little clue in advance about the specifics of what was to be considered.

The agency withheld the details of the proposals until a mere two days before the meeting, effectively preventing the public from making any thoughtful comment, even if they knew the documents had been posted on the CIRM Web site. CIRM does not make an effort through its Web site to let the public know when important information has been added to meeting agendas. Its general practice is to wait until a day or two before a meeting to post any significant information concerning matters to be considered by its directors.

The proposals before the subcommittee or variations may come up again at another meeting of the panel or possibly the CIRM board of directors.

Here are links to the documents that were posted no earlier than Sept. 27 and Sept. 28. They deal with appeals processes on grant applications, scoring of grants and a triage process on grant proposals prior to their formal legal review.
"Extraordinary Petition Process Option A / Posting Applications"

"Extraordinary Petition Process Option B / Additional Analysis"

"Extraordinary Petition Process Option C / Limited Investigation"

"Discussion of proposal for programmatic scoring of grant applications by Patient Advocate members of Grants Working Group for inclusion in discussions and decisions regarding applications."

 "Discussion of Pre-Application Process, including but not limited to the process generally and scientific feedback to applicants who are not successful in the process."

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

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

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

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

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

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

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

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

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

We will have more later on all this.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Text of CIRM Board Members Responses on Public Ban at External Review

Last week we sent an email to directors of the California stem cell agency and posed the following question.

“Do you think that the October review of CIRM's progress should be open to the public?”

We also told them that we would carry the text of any comments verbatim.

Four directors responded. Here are their comments.

Jeff Sheehy, a communications manager at UC San Francisco and a patient advocate member on the board, gave a one word response.

“Yes.”

Ed Penhoet, co-founder of Chiron and serving on the board as an executive officer of a commercial life science entity , said,

“Sorry, David, but I don't think that CIRM should conduct its board
business through an intermediary.”

David Serrano Sewell, a San Francisco deputy city attorney and a patient advocate member on the board, said,

“Here's my question to you, does this meeting qualify as a public meeting under the applicable state law requiring public meetings? No, it does not. At a minimum you've got to say that, this meeting is not required by state law to be a public meeting. Obviously, you think it should be, but it's not required.”

Floyd Bloom, former editor-in-chief of Science magazine and serving on the board as an executive officer from a California university, said,

“This aspect of the forthcoming review has not been discussed at any meeting at which I have been present, so this view is entirely my own, but I do not see the need for the Panel of Internationally distinguished scientist's review of CIRM's progress and achievements to be a Public Meeting.

“The 2006 Strategic Plan that authorized this outside review specifically calls for the report of the review committee to be made the ICOC:

"'The review will be reported to the ICOC who will consider the recommendations made in the review and, on that basis, approve modifications to the strategic plan.'

“As such the Public will hear what the outside experts have determined about the matters they have been asked to review and at the presentation to the ICOC there will be the standard opportunity for public questions and statements.” 

National Stem Cell Doings: Rat Brains and Legal Wrangling

How is it going to go in the federal case involving hESC stem cell research?

A UC Davis scientist opines – that's one of those media words you see in print but rarely hear anyone utter – that the matter could go 2-1 for funding of research but possibly 2-1 against, given that two of the judges are appointees of young Bush.

You can read more from Paul Knoepfler here on his analysis of today's proceedings along with comments from his readers.

Also on the national stem cell front – sort of – is a column by the Maureen Dowd of the New York Times. On Sunday, she quoted Stanford's Irv Weissman on some monkey business in the US Senate race in Delaware.

He made his comments to Dowd in response to a 2007 statement by the Republican candidate in Delaware, who shall remain nameless. The candidate declared,

“American scientific companies are crossbreeding humans and animals and coming up with mice with fully functioning human brains.”

Weissman, who knows something about rodents, performed the first experiments injecting human brain-forming stem cells into the brains of immune-deficient mice 10 years ago.

Dowd wrote,

“(Weissman) assured me that the mice did not suddenly start acting human. 'There were no requests for coffee from Minnie,' he said. 'The total number of human brain cells in the mouse brain was less than one in a thousand. I don’t think we would get a mouse with a full human brain. And even if the mouse made it to a human mouse it would still have a mouse-brain offspring.'”

Implications of a New Multibillion Dollar Bond Campaign for CIRM

The chairman of the California stem cell agency, Robert Klein, this week raised the possible size of a new bond issue to finance stem cell research to as high as $5 billion.

Klein made the comment in a piece by Ron Leuty in the San Francisco Business Times. Leuty reported that Klein, who directed the 2004 electoral campaign that created CIRM, said the new ballot measure could could come by 2016 and raise $3 billion to $5 billion.

Previously, the publicly reported figure topped out at $4 billion. Katie Worth of the San Francisco Examiner reported that number in August, which appears to the first disclosure in the media of the size of the bond issue. (She is also one of the few reporters that has attended a recent CIRM board meeting and written a story about it.)

Media reports of a new bond issue have significant implications -- political and financial -- for CIRM and how it is perceived by the public. To win voter approval of a bond issue will require a political campaign. The Prop. 71 in 2004 cost about $30 million. Another campaign is not likely to require as much, but the cost will run into millions. Funds will needed to be raised from many sources, some of whom will be making flinty-eyed judgments on the financial value of CIRM's activities on their particular enterprises. Some are likely to expect something in return for their campaign contributions.

The proposed bond issue also places CIRM squarely in a political context. Nearly all of its actions will be judged in the not-so-pleasant light of an electoral campaign. Klein acknowledges the need for politically acceptable results from CIRM. Not coincidentally they can also mean advancing the science and therapies.

Here is part of what Leuty wrote concerning Klein's discussion of another electoral campaign for a multibillion dollar bond issue.

"That may seem like a tough sell in a state smacked upside the head by a recession, but Klein is the ultimate salesman/evangelizer/patient advocate. He pulled together a powerful group of people cutting across political party lines and backgrounds to get Prop. 71 passed when most people had no scientific concept of stem cells."

Leuty continued,

"'Strategically, what we’re focused on is trying to make sure there is enough therapies advanced to Phase I or Phase II efficacy trials (where) voters of California can judge the performance and decide if they should approve another $3 billion to $5 billion,' Klein, the outgoing chairman of the San Francisco-based agency, told me in a phone conversation Tuesday. 'The voters are going to have to see real evidence.'"

Klein said CIRM will not run out of funding until late 2016 or early 2017, although different scenarios exist, depending on quickly CIRM hands out money. Leuty wrote,

"By then, many clinical trials will be well under way. Even if the National Institutes of Health starts funding basic embryonic stem cell research, Klein said, CIRM would be a natural partner for funding the translation of that work into bedside therapies.

"'In five or six years, we will have a very strong showing and evidence that when given stable funding we will have novel ways to reduce suffering,' Klein said."

Stem Cell Agency Bans Public from Critical Review of its Operations

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

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

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

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

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

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

Gibbons said in an email,

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

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

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

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

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

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

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

Consumer Watchdog's Simpson said,

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

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

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

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

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

Later, Gibbons added,

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

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

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

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

Text of CIRM Comments on October Review of its Operations

Here is the text of what CIRM has told the California Stem Cell Report (CSCR) concerning the California stem cell agency's October review of its operations. All responses were given via email by Don Gibbons, CIRM's chief communications officer, in response to questions, also via email.

CSCR query Sept. 13, 2010

“Please send me the schedule and location for the external review sessions in October.”

CIRM response Sept. 13, 2010

“It will be at CIRM headquarters October 13, 8:00-6:15; October 14, 8:30-7:15; and October 15, 9:00-5:00”

CSCR query Sept. 13, 2010

“Is there a particular agenda or order of business? Will the strategic plan or elements of the plan be examined page by page or section by section or ?”

CIRM response Sept. 20, 2010

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

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

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

CSCR query Sept. 20, 2010

“I assume that all of these sessions are open to the public, right?”

CIRM response Sept. 22, 2010

“The reviewers will not meet in public. A review of this nature will only be valuable if the reviewers can ask tough questions and receive candid, unfiltered responses.

“The reviewers are not public officials and have no governmental authority; they were asked to serve by staff not the CIRM board. They have been asked to give their opinion, not make decisions. Their opinions will be placed in a public document not edited by CIRM.

“If CIRM board members, as public officials, seek to take any action on the basis of the report, they would do that through public meetings.”

CSCR query Sept. 22, 2010

“Do any board members plan to attend the meeting? Will they be barred from the sessions?”

CIRM response Sept. 22, 2010

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

Text of Consumer Watchdog Remarks on Closing of CIRM External Review

Here is the text of the comments from John M. Simpson, stem cell project director for Consumer Watchdog of Santa Monica, Ca., on the closed-door, “external review” that the California stem cell agency has scheduled for October. Simpson made his response as the result of an inquiry from the California Stem Cell Report.

"One might justify a brief executive session during a three-day review of
CIRM, but to hold the entire process behind closed doors shows an agency
with leaders who are completely unaware of their responsibility to the
public, or worse, don't care.

"This evaluation looks to be conducted by insiders, some with clear
conflicting ties to CIRM. That is highly improper and inappropriate. I had
thought CIRM's leaders finally understood that they are public officials.
Clearly they do not."

"Despite what Alan Trounson and Bob Klein may think, CIRM is not a private
club where they may do whatever they wish."

More Details on Jockey Martinez' Bid to Enroll in Geron Clinical Trial

The New York Daily News is reporting more specifics on the case of California jockey Michael Martinez, who was rejected as a candidate for Geron's hESC clinical trial.

Among other things, the article by Christian Red, who has provided the most complete coverage of Martinez' situation, said,

“According to an email that Northwestern's Dr. Richard Fessler sent to Martinez's treating physician at Highland (Hospital in Oakland, Ca.), Martinez failed to qualify for embryonic stem cell treatment. Fessler cited several reasons, including that patients with severed or lacerated spinal cords are automatically eliminated from eligibility. (David) Seftel (Martinz's primary physician) has said that MRI exams on Martinez's thoracic region - where he sustained the spinal cord injury - have proven inconclusive. Fessler also stated that the transfer of Martinez to Northwestern "has to be based on 'medical necessity' unrelated to the study," and that Fessler does not consider Martinez's situation as meeting that criteria.”

Red also wrote,

“Making matters more complicated has been the Martinez family's and Seftel's dealings with Highland. Seftel has said that the family had difficulty securing Michael's medical records in a timely fashion, and that Highland hampered Michael's transfer to another spine center in the San Francisco area when the treating physician, Dr. Federico Castro-Moure, refused to provide a letter to the state Division of Worker's Compensation.

"It is an absolute outrage," said Seftel.”