The headlines march like legions across the
Internet and throughout the world.
But then there is this extraordinarily
rare headline that sounds a harshly different note:
All these headlines go to address, in
one form or another, a request/question posed last month by an
anonymous reader of the
California Stem Cell Report. The comment came
on an item about the California stem cell agency's
$70 million plan
to establish a network of “Alpha” stem cell clinics in
California.
The reader said,
“It would be nice to have an overall
update on how much as been spent on California's stem cell research
project and what progress has been made.”
On the surface, the answer is easy. The
agency has given away $1.8 billion. The agency says it has made
tremendous progress and expects to make even more with the about $600
million it has left. The prestigious
Institute of Medicine has said the
agency has
“achieved many notable results.”
However, no thorough, rigorous
evaluation has been made of the details of the agency's scientific
contributions, specific grant awards or its impact on the field of
regenerative medicine. No one has attempted to genuinely assess
whether the work of the agency is or will be worth the roughly $6
billion(including interest) that California taxpayers will have paid
for the agency's ambitious efforts.
Then there is the question of “progress
towards what?” Is the progress to be measured against the promises
of the 2004 ballot campaign that resulted in creation of the stem
cell agency or more modest goals that eschew the hype of the
campaign?
The stem cell agency is burdened in a way that most science is not. The 2004 campaign
created a sort of contract with voters. They were led to
believe nine years ago that the cures for diseases that the campaign said afflict nearly
one-half of all California families were, in fact, right around the corner. Few,
if any California stem cell researchers were publicly warning that a
hard and long, long slog remained before therapies reached patients.
Last week, however, Simon Roach of the
British newspapers, The Guardian and Observer, shed some light on the
early, rosy promises of stem cell science compared to the world as it exists
today.
He wrote that in 1998,
“(B)iomedical engineer Professor
Michael Sefton declared that within 10 years, scientists would have
grown an entire heart, fit for transplant. 'We're shooting big,' he
said. 'Our vision is that we'll be able to pop out a damaged heart
and replace it as easily as you would replace a carburetor in a car.'
“Fifteen years on, however, we've had
some liver cells, eye cells, even a lab-grown
burger, but no whole human organs. We could be forgiven for
asking: where's our heart? It does seem strange that a field stoking
so much excitement could be so far off the mark. Speaking last week
about the vision that he and his colleagues outlined in 1998, Sefton
said they had been 'hopelessly naïve.' As time plodded on and an
understanding of the biological complexity increased, the task seemed
bigger and bigger. Even now, a cacophony of headlines later, we are
not much further ahead.
“Chris Mason is a professor of
regenerative medicine at University College London and believes that
concentrating on organ regeneration is missing a trick. 'These organs
are immensely complex,' he said. 'They've got nerves, blood vessels,
in the case of the liver, a bile system – there are huge degrees of
complexity. These things take a long time to grow in humans, let
alone in the lab without all the natural cues that occur in the
growing embryo.'"
The final paragraph in Roach's article
said,
“There's a tension in medical
research between the glory of the big discovery and the
assiduous commitment to real application. 'We're hoping the scope and
possibilities of this project will catch the public's imagination,'
Sefton concluded in 1998. It did, but perhaps the public's
imagination isn't always what science should be vying for.”
Little doubt exists that the California
stem cell agency has made a significant contribution to stem cell
science, although the size of that contribution – beyond dollars –
remains to be measured. For now, the key for the agency and the
public is to focus on activities that will generate the greatest value over the
next few years and advance the science that has already been financed
by the agency.
As the $700,000 Institute of Medicine
report said,
“The challenge of moving its research
programs closer to the clinic and California’s large biotechnology
sector is certainly on CIRM’s agenda, but substantial achievements
in this arena remain to be made.”
