Clashing Interests on the Stem Cell Oversight Committee

It happened so quickly that only a keen-eyed parliamentarian might have noticed.

One minute the Oversight Committee of the California stem cell agency had a quorum. The next minute it didn't. It was late in the day last Friday. Some members had already left. Then two more members left the room, after expressing displeasure about procedures to create a long overdue strategic plan on how to spend $3 billion. That stymied a vote on the proposal.

"I am extraordinarily disappointed," said Oversight Committee member Claire Pomeroy, dean of the UC Davis Medical School, "that we are not going to have a quorum. We have not carried through on our responsibilities." Her comments came well after the departure of the two other committee members.

On the surface, the matter seems minor – planning a plan, what could be more picayune? But the real stakes – broadly speaking – pit the priorities of the patient advocates against the academic contingent on the board The patient advocates – 10 out of 29 persons on the committee -- represent groups of persons who have diseases that could benefit from stem cell therapies. Generally, the advocates emphasize great speed in bringing cures to the marketplace. The academicians on the board stress thorough science and warn that it is a slow process.

Serving as backdrop to their issues is the Korean stem cell scandal. Some say the focus on speed was one of the causes leading to the fraud.

On Friday, the plan for the strategic plan was carefully laid out by CIRM President Zach Hall. He said it would be a $500,000 effort, conducted by CIRM staff and brought to the board for approval and changes in the summer of 2006. Hall said Price Waterhouse Coopers would be chosen to assist in devising the plan. Overseeing the effort would be a relatively small subcommittee of Oversight members, selected by Hall.

It was the nature of subcommittee that triggered the objections of the two board members, David Serrano-Sewell and Jeff Sheehy, who walked out of the meeting. Serrano-Sewell said he said he was uncomfortable with the subcommittee and not knowing who would be on it. Sheehy echoed his concern. Their objections were relatively brief compared to the hours-long discussion of the planning process at December's Oversight meeting.

One of the issues complicating the process of coming up with a plan is a state law that requires the public to be notified well in advance of meetings by public bodies.

Hall's plan would avoid much of the time-consuming process by minimizing the number of required public meetings. It would also make it easier to call meetings of the public subcommittee. A smaller group means fewer schedule conflicts when setting up sessions. Hall did indicate that he did not want to short-change the public in terms of its opportunity to make its voices heard.

Representatives from academic institutions praised Hall's plan at Friday's meeting, noting that it was similar to the way their organizations operated. In other words, charging the staff to develop the proposal and bring to it the full board for changes and approval.

But Joan Samuelson, a patient advocate, said the strategic plan was very important and that the board was going to have to "own" it. She later told us that the patient advocates wanted to be very involved in planning and said that others seemed more worried about complying with open meeting laws than the stem cell research.

The discussion of the issue at Friday's meeting was relatively brief. To catch a better flavor of the positions here are a few excerpts from December's Oversight Committee meeting, which unveiled many concerns.

Jonathan Shestack, founder and president of Cure Autism Now:

"The motion that you have before you is a recipe for no board involvement in the strategic planning. Yes, it is. It makes that possibility very real. it makes all input be at will of staff except for presentation at the ICOC meetings. These are large, fairly unwieldy meetings....I don't mean to be negative about the staff because they are expert and fantastic, and we depend on them, but there is right now no real mechanism on the strategic decisions for the various communities to participate, particularly advocacy and particularly industry. And I think that just giving the full duty to staff and saying present it to us once in a while, and we'll tell you what we think is not to get into the detail that some people would want."

David Serrano-Sewell, representing the
Amyotrophic Lateral Sclerosis Association and National Multiple Sclerosis Society

"Commitments from the office of the (CIRM)president...just putting it in one individual -- for me, right now --is not enough. (During) my conversations with my appointing officer (the person who appointed Sewell to the CIRM board), there was a real commitment that we do a good job to represent our constituencies. and for me that's MS and ALS".

Shestack

"I also think there is a danger when all the positions -- academic, advocacy, industry -- are not talking to each other, talking only to a central person who then filters their needs."

Gerald Levey, dean of the UCLA Medical School

"I would hope that the board is not so balkanized that we think about who we represent and how we got here. i think now that we're a board, we're supposed to be thinking like we all have the same goal, the same purpose. and I would hope that the goal is to further stem cell research in the state of California -- not whether academia is being served better in the process or industry or what have you. So i hope that we don't get into a situation where we have us against them on the board."

"The matter of the plan concluded at Friday's meeting with discussion of another plan to hold a conference-call meeting in the next few weeks of the Oversight Committee to vote on Hall's plan for the plan

."

One final note: Nineteen members of the 29-member Oversight Committee are required for a quorum. Otherwise, the board cannot take legal action.

Human Tidbits Amid Stem Cell Policy

The California Stem Cell Report spends most of its time blathering about policy issues involving the California stem cell agency. Good grits for wonks. But there is another view. I just took a quick look at Don Reed's blog, stemcellbattles.com, and his report on last Friday's meeting of the Oversight Committee meeting. He focused on the "spotlight" on diabetes prior to the actual meeting. Nice, human touches and tidbits about the people and players you won't read elsewhere.

Valentine's Day Editorials on CIRM

Two California newspapers came out with editorials today praising actions last week by the California stem cell agency. It is only coincidental that the pieces appeared on Valentine's Day. The critics still want more.

The Sacramento Bee, one of the stronger critics of CIRM, said.

"On Friday, Klein and the oversight committee took a big step toward reversing past mistakes and demonstrating they can operate as an open, responsive public body. After listening to public interest groups, ethicists and legislators, the 29-member committee approved policies on medical standards and commercial licensing of stem cell therapies that, while not perfect, are a vast improvement over where the institute was heading just a few months ago."

But it also wrote,

"For the last several months, the institute has refused to make public the economic disclosure forms filed by out-of-state scientists who will recommend millions of dollars in research grants. The public deserves to know if these advisers have ties to companies and researchers applying for public monies. Since scientists regularly disclose their potential conflicts when publishing or presenting their work, there is no reason they cannot do so while making key decisions on taxpayer-funded grants."

The San Jose Mercury News also praised the egg and royalty sharing policies adopted last week by CIRM.

The Foundation for Taxpayer and Consumer Rights hitched a bit of a ride too on the Valentine Day bandwagon, lauding the actions as moving in the right direction.

But it urged more royalty money for the state, tougher enforcement mechanisms to assure low prices on therapies and creation of a stem cell patent pool to share information on CIRM-funded inventions.

"Certainly companies should make a fair profit on drugs they develop based on Proposition 71-funded research. But they must not be allowed to benefit unreasonably at the public's expense. The Attorney General should have the right to intervene -- 'march-in rights' -- in the event of unreasonable pricing," said John M. Simpson, stem cell project director for the foundation in a letter to CIRM Chairman Robert Klein.

We should also note the piece by Marisa Lagos of the San Francisco Examiner on last Friday's meeting. It pointed out that the CIRM regulations could become a model for the nation.

Reader's Write

The following email came in from John M. Simpson, stem cell project director of the Foundation for Taxpayer and Consumer Rights, regarding our "What's in a Name?" item.

"I liked your astute analysis of the naming rights issue.

"I agree that in a perfect world it wouldn’t happen, but given CIRM’s circumstances the institute probably needs the money.

"The ICOC will have to screen potential donors to make sure there are no outrageous or inappropriate contributions. That’s why the board is there.

"All the transactions must be completely transparent and organizations like the Foundation for Taxpayer and Consumer Rights will continue to monitor ICOC activities to ensure no abuses occur."

We encourage comments, favorable or unfavorable, or even insightful and enlightening. You can post them directly or anonymously by clicking on the word "comment" below each item. Or you can send them to djensen@californiastemcellreport.com.

Egg Irony

LifeNews.com is a Web site adamantly opposed to embryonic stem cell research. It is describes itself as an enterprise that reaches 150,000 pro-life advocates each week through various means.

So it comes as a bit of a shock to see ads on at least one of its Web pages soliciting egg donors. One of the ad sites, Loving Donation, says it pays its egg donors a minimum of $3,000 with high demand donors commanding higher fees. The ads are placed on LifeNews.com pages automatically by Google so LifeNews.com has no direct control over them. It is also unclear whether any of the fertility clinics that advertise also supply excess eggs for research purposes.

The Google ads change regularly on Web pages so there is no guarantee that you will find them there in just the same way. But here is the link to the page where we saw them.

What's in a Name? Ten Million Dollars or More

California is not likely to see something called the Pfizer/CIRM Research Scholars Program, but the stem cell agency is on its way to peddling naming rights in the world's largest stem cell research effort.

Peddling probably is not the most generous way to describe the effort, which seems to be an essential ingredient in assuring funding of programs this year. A more euphemistic way to say it would be: Providing an incentive to make a $10 million gift to CIRM.

The Oversight Committee moved forward with the program last week after stem cell chairman Robert Klein said it would apply only to grants of $10 million or more. Naming rights would not be available to purchasers of bond anticipation notes.

Initial screening of the naming candidates would be done by the executive committee of CIRM in private. The names of candidates would then come before the Oversight Committee in a public session for approval or rejection.

Generally board members last week favored the program, declaring it was a good example of public/private partnerships. Klein said that universities have naming programs for lectureships, fellowships and buildings. Oversight Committee member Jeff Sheehy noted the NIH has a naming program for one of its grant efforts.

During his discussion of the plan, Klein implied that he has a potential donor who is very interested in a naming opportunity.

The naming proposal was discussed publicly as early as August during a Governance Subcommittee meeting (see page 66 of the transcript). It came up again late in the day at an Oversight Committee meeting September. It was then that it encountered its only serious opposition(see page 315 of the transcript).

Gayle Wilson, who is no longer a member of the Oversight Committee, said she did not know of other state agencies with similar programs outside of academic institutions. The wife of former Gov. Pete Wilson said, "I don't think it's a good idea. I think we'll be blasted for it."

Tina Nova, another Oversight Committee member and president of Genoptix, a San Diego biotech and lab firm, said,

"I can see a lot of downside because, as we all know, people are constantly trying to figure out what are the motivations, what are the hidden agendas. At the end of the day, people who are trying to support this initiative in a pure sense ought to be doing it for the benefit of seeing the research advance and not for the benefit of seeing their name associated with fellows who are trained. So I think I'm probably more cautious because I do wonder if at the end of the day we could create more challenges and if it really does help us that much."

Nova did not express opposition to the plan on Friday, but she may have left the meeting by the time it came up late in the session. (It is difficult to keep track of the comings and goings of the 29 committee members, particularly late in the meetings.)

Jesse Reynolds of the Center for Genetics and Society voiced the only public opposition to the plan. He said it could "open the door to real or perceived conflicts of interest." For example, he said it would be inappropriate to grant naming rights to Geron, a California stem cell firm. Klein said he was in "heated agreement" on that position.

Our judgment: In a perfect world, CIRM should not do this. But it needs the money and this is relatively benign, although experience tells us that bigtime donors generally expect a quid pro quo. Sometimes they are innocuous (say front row seats at the exciting Oversight Committee meetings). Other times, CIRM officials may have to vigorously resist inappropriate overtures from the $10 million donors. But that is part of the public responsibilities of CIRM executives and board members. Failure to do so will ultimately surface (there are no secrets in government) and embarrass the agency and the officials personally.

Still Coming Up

We have not forgotten our promise for more exciting items from Friday's meeting, particularly the item about naming rights and the strategic plan flap. We still are planning on those and much, much more. So stay in your seats, folks. However, this time we are not going to promise a specific time frame. But certainly sooner than Bob Klein comes up with his $50 million(see item down one from here.)

CIRM-UK Stem Cell Conference Later This Year

The California stem cell agency plans to co-host a joint conference with the United Kingdom's Medical Research Council and CIRM later this year in Great Britain.

Zach Hall, president of CIRM, announced the plans at Friday's Oversight Committee meeting. He said 16 US scientists and 16 UK scientists would convene to discuss stem cell self-renewal and differentiation.

Hall noted that Council is the equivalent to the National Institutes of Health in the United States and that it is unusual for a state organization and a foreign national council to co-host such a conference. The arrangement carries particular weight because the UK is an international leader in stem cell research.

"California has become sort of a surrogate for the U.S. effort on stem cell research," Hall said. The CIRM president credited Stephen Lynn of the British consulate in California with helping to put together the conference.

Lynn is one of the regular attendees at CIRM meetings and keeps close track of its affairs. We also should add that we know of at least several readers of the California Stem Cell Report with UK connections.

Hall said that his agency still must raise funds to uphold its end of the conference.

Klein Confirms $40 Million Commitment

Stem cell chairman Robert Klein says he is not expecting to be ready to have $50 million to hand over to the stem cell agency at its next scheduled meeting in April, but he says he is close.

During a brief interview following Friday's Oversight Committee meeting, we asked him for more details on his efforts to sell bond anticipation notes to fund the activities of the agency. He said he has more than $40 million in commitments but wants $50 million. Then, Klein said, the state treasurer's office will have to take five to six weeks to complete the paperwork, but he declined to go into more detail.

The notes are expected to be sold to philanthropic organizations. If CIRM loses the lawsuits against it, the notes will not be repaid.

The agency will run out of money in June under its present budget plan.

Ortiz Not Satisfied with Egg Expense Rules

California State Sen. Deborah Ortiz has proposed legislation that could overturn plans by the state's stem cell agency to permit egg donors to be reimbursed for lost wages.

Ortiz, chair of the Senate Health Committee, introduced her bill last Thursday, the day before agency was scheduled to consider proposed rules on egg donations. She sent a letter to stem cell Chairman Robert Klein late Thursday that said,

"The amount and difficulty of administering reimbursement for lost wages, and the possibility that such reimbursement may induce women to undergo invasive procedures, merit more attention and consideration before the ICOC acts on this draft provision."

She said that ethical questions exist about whether reimbursement of wages "constitute inducement or coercion for some women."

Ortiz did not send a representative to the Oversight Committee meeting on Friday, nor were her objections discussed in any detail. We may have missed it, but we don't think they were even mentioned. Given the nature of the bureaucratic process, the committee may not have even been aware of them, although there was more mention of cooperating with the legislature than sometimes is heard at Oversight meetings.

Ortiz' bill, SB1260, is a variation of a measure vetoed last year by the governor. SB1260 would ban the sale of human eggs. It would also establish informed consent standards for donors. The bill goes beyond the stem cell agency to regulate all egg donor operations in the state. Ortiz indicated that her bill, which will come up for a hearing sometime this spring, is likely to be altered to include more protections for egg donors. As it now stands, it does not offer as much protection in terms of informed consent procedures for donors as do CIRM regulations.

The sections on egg payments reads:

"No human oocyte or embryo shall be acquired, sold, received, or otherwise transferred for valuable consideration for the purposes of medical research or development of medical therapies. For purposes of this section, 'valuable consideration' does not include reasonable payment for the removal, processing, disposal,preservation, quality control, storage, transplantation, or implantation of oocytes or embryos.

"No payment in excess of the amount of reimbursement of expenses shall be made to any research subject to encourage her to produce human oocytes for the purposes of medical research."

The measure does not specifically mention the "lost wages" issue at this point, but it could easily be added. One could argue that the bill, as it already stands, would ban reimbursement of lost wages.

CIRM's policy requires that only "permissible expenses" can be reimbursed under CIRM-funded research. Those are defined as necessary and reasonable costs directly incurred. They may include, but are not limited to, actual lost wages, travel, housing, child, medical care and health insurance.

Ortiz' letter to Klein said,

"The National Research Council and the Institute of Medicine of the National Academies have recommended that women who undergo egg extraction for research purposes should be reimbursed only for direct expenses incurred as a result of the procedure, as determined by an Institutional Review Board.... This recommendation of an established, credible authority should be carefully considered before opening the door readily to compensation for lost wages in CIRM-funded research, which may set an undue precedent."

Ortiz additionally said that CIRM's policies "should be tightened to more explicitly require eggs procured outside of CIRM-funded research, but used for this research, to meet the guidelines as adopted."

She said that the section "on fairness and diversity in research (should) include the collection of demographic information, including, but not limited to race, ethnicity, language, age, zip code, income bracket, and state that these records need to be made publicly available. This demographic information is important in the continued assessment of who is involved in the research and who may be affected by it."

Bernard Lo, co-chair of the Standards Working Group that developed the ethics policy over months of hearings, on Friday said that CIRM's policies were a starting point and subject to modification as more discussion and evidence are considered. He went out of his way to express public appreciation for input from all parties, including some who have received a more unfriendly reception from others at CIRM in the past.

At the time of the meeting, it was not clear whether he was aware of Ortiz' concerns in her letter from the previous afternoon.

Some might argue that CIRM's status as a separate entity in the California Constitution allows it to chart its own course on "lost wages." That argument might make a fine point for lawyers, but the practical effect of Ortiz's legislation, should it become law as opposed to CIRM's regulations, would seem to nullify the agency's efforts.

Ethics and IP Coverage Mostly Favorable To CIRM

The California stem cell agency can chalk up a plus on coverage of its Friday decisions on ethics and intellectual property.

Generally, California newspapers described the actions as setting standards that go beyond any in the United States, an assertion that not even the critics dispute. Nonetheless, say the critics, the agency could do more.

The meeting also attracted coverage by at least one Bay Area television station (KGO), NPR and the California public radio organization. But coverage by major newspapers elsewhere in the country was nonexistent. We expect to see some coverage over the standards and IP rules in the next couple of months by news organizations outside of California as the news slowly filters east.

The stories also demonstrated some confusion. One example involved a decision by the Oversight Committee concerning financial accessibility of therapies. The committee approved language to make the therapies available to California public agencies at the price paid by Medicaid, a program aimed at the poor. Some reports said Medicare, the health care program for all persons above 65, instead of Medicaid. Another report said the policies approved would become "law." In fact, they will become regulations that have the force of law. The difference is that laws require action by the legislature or voters; regulations can be enacted and changed by the agencies that issue them.

Reporter Jim Wasserman of The Sacramento Bee, who is a relative newcomer to CIRM coverage, described the impact of adoption of the Medicaid language, which replaced language that said the public agency price should be the lowest commercial US price.

"Those discounts are generally 20 to 40 percent, compared with the 40 percent for the federal government's lowest Medicaid price," Wasserman wrote.

He and other reporters noted that some of the Oversight Committee members representing patient groups were concerned about taking actions that might create economic disincentives. To put their point another way, higher potential profits will spur development of therapies that will help those represented by the patient groups.

Other members of the Oversight Committee noted that the low prices apply only in California, implying that prices paid outside of the state will subsidize care for California poor.

Reporter Terri Somers of the San Diego Union-Tribune carried a tidbit also dealing with economic disincentives. It was mentioned in terms of policies requiring the sharing of information from California-funded stem cell research.

"Joydeep Goswami of Carlsbad(CA)-based Invitrogen said such broad sharing of discoveries is eliminating avenues for commercialization. Invitrogen is a major biotechnology tool company that sells to academic research institutions," she wrote.

Sabin Russell of the San Francisco Chronicle reported some criticism of a requirement that egg donors have an adequate period of time to deliberate about their decisions. He wrote that the comment came from "Shannon Smith-Crowley, a lobbyist for the American College of Obstetricians and Gynecologists, who said that the language is evocative of the 'waiting period' rules that are advocated by opponents of abortion. She said such language in the stem cell arena was 'undermining' years of work to establish that women are capable of making important reproductive decisions on their own."

The Los Angeles Times story by Rong-Gong Lin II focused on the delay in CIRM funding caused by the lawsuits against it. The decisions on ethics and sharing revenue was reported in the last two paragraphs.

The Associated Press, which distributes its product nationally and internationally, carried a non-bylined report that appeared to be a rewrite of the Los Angeles Times, to the point of using the Times phrase "in earnest" in the first paragraph. Rewriting news from "member" papers is common at The AP, and a practice they are legally entitled to under their arrangements with the papers.

Both Steve Johnson of the San Jose Mercury News and Wasserman of The Bee wrote stories Thursday and Friday mornings, laying out the issues, as well as reporting for Saturday's editions. (Johnson's story here, Wasserman's here.)

Reporter David Louie of San Francisco TV station KGO prepared a rare TV report on the agency's action. It was a middle-of-the-road piece that did say the policies reflected "best practices." Without seeing the images and hearing the tone, however, it is impossible to make a complete assessment.

Because of the nature of TV news, CIRM has attracted little coverage from those outlets. But TV remains extremely important in terms of public perception since most people get their news from electronic media – not print.

The morning of the meeting -- before action was taken -- opened with a couple of op-ed pieces as well. One was written by Sherry Lansing, Bernard Lo (co-chairs of agency's standards group) and Zach Hall, president of CIRM. The article in the San Francisco Chronicle described the agency's new policies as "the strongest embryonic stem-cell regulations in the country," going "well beyond current national standards for stem-cell research."

On the other hand, Jesse Reynolds of the Center for Genetics and Society wrote in the San Jose Mercury News that "some essential gaps remain to be filled." One example from Reynolds:

"The proposal leaves the approval of research to local committees that will be formed by, and affiliated with, the institutions doing the research. These committees will consist largely of stem-cell researchers themselves and their scientist colleagues from related fields. With this composition, the committees' sympathies and loyalties will lie with their institutions and with the research.

"What's worse, there is no oversight of these committees. Not only would the fox be guarding the hen house, but no one would be watching the fox."

He concluded:

"Too much is at stake with stem-cell research to rely on what may amount to self-regulation. If women's health is to be protected, and misuses of these powerful new technologies prevented, the local committees must be overseen by a transparent and accountable body independent of the research institutions, the CIRM, and the insider's network of scientists."

Research and IP Policies Clear Oversight Committee

The California stem cell agency today approved far-reaching policies to regulate stem cell research and ensure that the state sees a return on its $6 billion investment.

Only minor changes were made to the draft regulations before they cleared CIRM's Oversight Committee. Robert Klein, chairman of the agency, said they went "above and beyond" national standards. While the proposed rules are likely to establish new bench marks across the country, critics were not entirely mollified.

We will carry more on Friday's events during the weekend. Immediately after the session(which ran from 8:30 a.m. to about 5 p.m.), I was pressed into work as a construction grunt by daughter, Karen, a building industry veteran who is running her own home remodel project (addition of a second story and more). I only began reviewing notes from the CIRM meeting at 10 p.m.

Karen, who prefers to be described as a "harsh taskperson" rather than as an "active taskmaster," has directed me to report to work at 6 a.m. Saturday, so full reports out of the Oversight Committee meeting will have to wait until later Saturday and Sunday.

We will tell you about plans to offer up naming rights to CIRM programs to grant donors who hit the $10 million level. We will tell you about a flap about CIRM's long overdue strategic plan. We will give you an update on the fundraising efforts at CIRM, report on a UK-CIRM stem cell conference, examine news coverage of Friday's meeting and more. Plus the latest from Sen. Deborah Ortiz, who has re-introduced her bill to regulate egg donations, and her criticism of CIRM egg policies.

CIRM has issued a press release on Friday's meeting but it is not on its website as the time of this writing and probably will not be posted website until Monday, so the full text is below.

Text of CIRM News Release on Approval of IP and Research Policies

Here is the text of the press release by CIRM on Friday's meeting. It was not available on the Web at the time of this posting.


ICOC RATIFIES KEY POLICIES FOR CIRM-FUNDED RESEARCH
Members Unanimously Approve CIRM Regulations and Intellectual Property Policy

STANFORD, Calif.—The Independent Citizens’ Oversight Committee (ICOC) today ratified two key policies for research funded by the California Institute for Regenerative Medicine (CIRM): the CIRM Regulations for ethical, medical and scientific accountability and the Intellectual Property (IP) Policy for Non-Profit Organizations. These policies were recommended by the Standards Working Group and IP Task Force after months of deliberations.

Developed with input from the California public and state legislature, the policies include provisions that enhance and surpass federal and state guidelines for scientific standards and intellectual property.

“These policies are representative of the ICOC’s commitment to ensuring that CIRM-funded research is conducted under the highest levels of public oversight and transparency,” ICOC Chairman Robert Klein said. “The working group and task force members went above and beyond the gold standards recommended by the National Academies to enhance those standards and policies, reflecting the leadership of California in protecting patients and advancing scientific research.”

“The CIRM Regulations and IP Policy provide CIRM with a strong foundation to carry out its mission of funding stem cell research in California,” CIRM President Zach Hall, PhD, said. “With the approval of these policies, CIRM has the most stringent ethical, medical and scientific standards in the country.”

CIRM is now the first agency in the United States to require specialized review by a Stem Cell Research Oversight (SCRO) committee and to provide for medical costs resulting from any immediate complications of egg retrieval. It also enhances state and federal policies in the areas of voluntary-informed consent and guarantees that all cell lines used by CIRM-funded researchers are derived without compensation to egg donors. The regulations were developed under the guidance of the Standards Working Group, which is comprised of nine nationally recognized scientists, four ethicists and five ICOC patient advocates. To view the full text of the regulations online, please visit: http://www.cirm.ca.gov/meetings/pdf/2006/02/021006_item_9.pdf.

The IP Policy for Non-Profit Organizations also sets a high bar for CIRM, surpassing the federal statute on the sharing of data and biomedical materials and allowing California research institutions to freely use all CIRM-funded patented inventions. Written by the 11-member IP Task Force, this subcommittee held four public meetings and twice reported to the ICOC with their findings. The full text of the IP Policy is available at: http://www.cirm.ca.gov/meetings/pdf/2006/02/021006_item_8.pdf.

In developing the CIRM Regulations and IP Policy for Non-Profit Organizations, multiple public hearings and meetings were held throughout California to gather input and incorporate public feedback into the final recommendations. Members of the California State Legislature personally contributed recommendations that included in the final policies.

With the ICOC’s approval, these policies will now enter into the formal rule-making process governed by the Administrative Procedures Act and have the force of California law.

Cryptic Agenda Not Good Enough

On Wednesday, we discussed the failure of CIRM to meet its commitment to the highest and best standards of transparency and openness. This item will offer more specifics on matters on which CIRM apparently does not want the public to be fully informed.

CIRM will deny that it is trying to keep important issues under wraps, citing staff shortages and other difficulties. But the fact is that if the agency had the will, it could make the information available. It has hired a nationally known PR agency, but none of those considerable resources seem to have been applied in the most fundamental of all PR efforts. And that is to provide the basic information about what CIRM is doing and why.

We have acknowledged CIRM has done a better job concerning the IP and research standards policies, although given their far-reaching implications, it would have been better to have seen the latest drafts posted a week earlier. They are the heart of the Oversight Committee's agenda on Friday.

Those two draft policy postings on the Web, however, are exceptions to the general obliviousness of CIRM to the need to inform the public well in advance about the issues it is considering. That means explanation and context online, not just cryptic one-line agenda items.

For the record, here are the cryptic agenda items. They are from the CIRM website less than 12 hours before the meeting at which they are going to be considered. If you would like to comment before the Oversight Committee, good luck.

Failure in Public Responsibility: Feb. 9th's Roll Call
(Items – quoted verbatim – from the Oversight Committee agenda on Friday that offer no explanation, justification or details.)

"Consideration of naming opportunity for CIRM training grant program." (Our comment: This may involve the sale of the naming rights to the program, as the naming of sports arenas are sold to such companies as Staples.)

"Informational report on plan/process for development of Scientific Strategic Plan."(Our comment: This involves important issues concerning priorities of the patient advocates vs. the pure research folks on the Oversight Committee.)

"Consideration of scientific meeting: Assessing the Medical Risks of Human Oocyte Donation" (Our comment: This is likely to involve significant expenditures, not to mention the important nature of the topic.)

"Consideration of joint venture with Public Library of Science and New York City Stem Cell Research Foundation."(Our comment: This may be some sort of open access arrangement, which could have national implications.)

"Chairman’s Report" and "President’s Report" (Our comment: These usually contain significant information, including Power Point presentations prepared in advance. But on at least one occasion the president of CIRM was surprised by a significant proposal in the chairman's report.)

Does CIRM Have a "Secret" Proposal on Openness?

We are sad to report, once again, the failure of the California stem cell agency to comply with its own promise of the highest standards of openness and transparency.

We have written repeatedly about the failure of CIRM to provide adequate background material in a timely fashion on the important matters on its agenda. Even some of its own directors have complained publicly.

The most recent example is Friday's meeting of the Oversight Committee. For example if you care about open access to CIRM-funded findings, you would be hard pressed to determine whether that is a subject to be considered at the session -- aside from the IP draft rules.

But apparently it is. There is a brief mention on the agenda of a proposed venture with the Public Library of Science. If you dig into that enterprise, it is all about making scientific findings widely available. Why isn't there additional information available from CIRM about the venture? There is a bit of irony in all this – an apparent openness proposal that is basically being advanced in secret.

Is CIRM going to sell naming rights to its stem cell scholar program? In other words, are we going to have something known as the World Savings Stem Cell Scholar Program. The quid pro quo may be purchase of CIRM bond anticipation notes. Maybe that is on the agenda(item 13) as well. It is impossible to tell from the document online. But we heard stem cell chairman Robert Klein broach the idea in September at a meeting of the Oversight Committee.

More details may be posted on these matters as the day progresses on Thursday. But most interested parties, if they wish to make their views known, cannot simply abandon all other plans on a one-day or less notice to appear at Friday's Oversight Committee meeting.

That said, we should give credit to CIRM for posting the IP policy and research standards earlier this week. In the case of IP, it was on Saturday. An excellent example to be emulated for all agenda items.

Disclosure From the California Stem Cell Report

As many of you have noticed, the information about how this blog is produced states that it is written from a sailboat on the west coast of Mexico. For the record, we do make occasional trips back to the Old Country. Most recently, we have been in California since the beginning of December for a variety of reasons, including the birth of a grandson in Santa Barbara on the Winter Solstice (also the date of the biggest surf of year) and the remodel of our daughter's home in San Mateo. She is an active taskmaster. We have worked as a day laborer, electrician, child care provider, cook, personal shopper, project consultant and handholder under her direction. The same can be said for our son, the surfer, who was tending to birthing matters instead of breaking waves on the day of his child's arrival. We have had the opportunity to demonstrate plumbing, carpentry, gardening and solar power skills at his home, in addition to dealing with the usual conundrums of newborns and parents with their first child. These are not novel experiences, we might add, as any grandparent can attest. We salute them all.

What that means for this blog is that we have attended some CIRM meetings, toured the headquarters and discussed matters with both the agency staff and the regular observers, critics and supporters of CIRM. A visit late last summer also permitted such indulgences. On the other hand, that does mean we snatched precious time away from grandchildren, not to mention their parents, who are nearing the dreaded age of 40.

But on the issue of disclosure, we want to let our readers know that we have no investments in biotech firms or any other organizations that could benefit from stem cell research, except through mutual funds, which, of course, we have no control over. We do not hold any mutual funds that are industry specific to biotech.

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

We also have no financial connections with organizations critical or opposed to CIRM.

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

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

We also believe in maximum disclosure; when it doubt lay it out. Specifically all significant persons within CIRM, including members of CIRM working groups, should publicly disclose their economic interests in more detail than required by state law.

If you have any further questions about our basic assumptions or potential conflicts, please send an email to djensen@californiastemcellreport.com or use the "comment" function at the end of this item.

Are Women Ready to Donate Their Eggs for 'Nothing?'

Ready to dig into the question of whether women should be allowed to sell their eggs or, put another way, how much should they be allowed to receive?

The latest version of proposed CIRM rules dealing with such questions is now available online for your reading pleasure. Basically CIRM is ready to answer that if women want to sell their eggs, none of its researchers are buying. And it wants to put limits on what the women can receive – no more than expenses, including lost wages. Of course, women who want to sell their eggs can go elsewhere, where CIRM standards are not applicable.

But what CIRM decides at the meeting of its Oversight Committee on Friday is likely to establish a national model for stem cell research standards. As CIRM points out in a press release, the rules would make CIRM the first agency in the country to:

"legally mandate specialized review by a Stem Cell Research Oversight (SCRO) committee;
"enhance state and federal policies in the areas of voluntary-informed consent;
"protect health of women donating eggs for research;
"guarantee that all cell lines used by CIRM-funded researchers are
derived without compensation to egg donors."

It is impossible to cover all eventualities when drafting such ethical standards. It is also impossible to stop all persons determined to violate ethical codes or the law, but some questions appear to remain in the draft.

One involves the use of eggs from distant sources. It is relatively easy to check out procedures used by egg providers in the United States. This country has a relatively uniform ethical approach in science, although there are always a few rogues. But distant locations such as Thailand, which already is notorious for its sex industry, are harder to assess. To what lengths are California researchers going to go to ascertain whether an egg supplier in Thailand has similar informed consent procedures to those here? How will payments to foreign donors be evaluated? "Necessary and reasonable costs directly incurred" could mean something far different in another culture than in California.

The proposed rules put much of the burden of answering these questions on the recipients of the grants, both the individual and institutions. How well the standards will be applied will depend, in many ways, on the rigor of the recipients. CIRM proposes penalties for failure to comply. Of course, if problems arise, the ethical standards can be strengthened.

The proposed rules additionally require that unspecified "steps shall be taken to enhance the informed consent process. " They require the researcher to ascertain that the donor understands the "essential aspects of the research." Couple that with reimbursement of donor expenses, it could lead to the hiring of expensive consultants for donors or creation of costly donor education conferences, both of which could be deemed a reimbursable expense. Such activities may well be appropriate but they do open the door to potential abuse. Again the recipients and their institutions will play a critical role in regulating activities. They are likely to want to play it safe in terms of ensuring informed consent, both to comply with CIRM rules and ward off potential lawsuits. That comes at a price. Not to mention the possibility of kickbacks by unprincipled consultants to donors who hire them.

Again, these are difficult issues to address, and any set of rules can be circumvented or abused. Oversight of the ethics standards should be a top priority for the CIRM.

While we are on the subject of standards, reporter Dan Levine of the San Francisco Business Times put together a good overview of many of the issues involved.

Levine quotes David Magnus, director of the Stanford Center for Biomedical Ethics, as saying, "If Massachusetts decides they are going to allow payment of egg donors, and California decides they aren't, then we won't be able to share cell lines derived from one state to another. Whatever policies wind up getting put in place for this kind of an issue, it's really important that everybody be on the same page and have the same policies."

Levine also quotes Ronald Green, director of the Ethics Institute at Dartmouth College and chair of the ethics advisory board of Advanced Cell Technology, as saying, Our experience is that they (women) are not willing to step forward and donate eggs for nothing. It is not enjoyable to be injected with powerful drugs that alter your mood and hurt you, and the whole process and potential for organ failure, all culminating in a transvaginal needle harvest through the back wall of the vagina. How many women are going to do that to assist research to understand diabetes?"

Free Parking for Friday CIRM Meeting

Free parking is available for Friday's meeting of the Oversight Committee at Stanford University. The parking area is located in Galvez Field Parking & Frances C. Arrillaga Alumni Center, according to CIRM. For directions, see: http://forum.stanford.edu/visit/directions/arrillaga.

Bad Link on IP Policy

A reader reports there was a bad link to the IP draft to be considered at Friday's meeting. Thanks to the reader for pointing it out. It has been fixed. Here it is for those who need it right now: http://www.cirm.ca.gov/meetings/pdf/2006/02/021006_item_8.pdf

CIRM and the $40 Million Matter

God and the Main Stream Media – they both move in mysterious ways.

The case in point is whether the California stem cell agency is broke. Lawsuits have prevented it from issuing the bonds that were designed to fund it. So the agency has been living on the dole with loans and handouts, although that is a less than a positive way to describe the $5 million the Dolby Foundation gave to CIRM.

Last month reporter Marisa Lagos of the San Francisco Examiner reported that the agency had raised $40 million, basically solving its financial crisis. That is a big story. On a slow day, it might even be front page news for many California newspapers -- properly told.

Lagos' Jan. 17 report was based on a speech by stem cell chairman Robert Klein that none of the Main Stream Media covered. In covering that speech, she was following some of the basic rules for good reporting – be on the scene, cover the principal, don't assume. She deserves considerable credit for even knowing about the speech. It was not publicized by CIRM and did not surface in advance with any of the usual Web search engines. So why has her report been widely ignored?

For those of you who do not keep up with the twists of the newspaper business, the Examiner is a shell of its former self. It has found itself in a situation where it cannot charge for circulation and is distributed free, including home delivery, in some San Francisco area communities.

That means that other newspapers with paid circulation do not pay much attention to it. They sniff at a story in a free newspaper, weekly or daily as is the Examiner. So the Main Steam Media do not try to match stories in these ragtag rags even when they enjoy greater economic success than the conventional dailies, which many of them do.

The California Stem Cell Report (this thing that you are reading) did confirm that CIRM has raised $40 million. But what may be more interesting is that the figure has now been reported in the Main Stream Media. Say what you will, having information published in a newspaper is still more important than having it published on the Web. It probably has to do with the smell of the ink, but if you want to know more, send me an email and I will explain.

Reporter Terri Somers of the San Diego Union-Tribune, which is very definitely Main Stream Media, reported the $40 million figure once more in a story during the weekend. She said that Klein, at an appearance Friday at the Stem Cell Research Center at the Burnham Institute for Medical Research in La Jolla, basically confirmed the amount. Somers deserves kudos for pursuing the $40 million matter, which all of the other major newspapers in California have ignored.

The mysteries of the Main Stream Media are deep and complex. In discussing coverage of the $40 million matter, we have touched on only a sidelight of the media's arcane and byzantine world. Next week we tackle God.