Big investment, too little oversight
Like MySpace, the Martha Stewart prosecution and American democratic norms, spending gobs of state money on stem cell research might sound like an artifact of the Aughts. And yet 16 years after voters agreed to borrow $3 billion to explore a promising new area of medical research, stem cells are back on the California ballot.
The state’s voters passed Proposition 71, which created the California Institute for Regenerative Medicine, in a fit of hope that stem cells could treat an array of diseases and injuries. President George W. Bush’s order limiting federally funded embryonic stem cell research on religious grounds added urgency and politics to the cause. Celebrities such as Michael J. Fox and Christopher Reeve urged Californians to step into the breach for them and countless others with incurable, often heartrending conditions.
Now the Oaklandbased agency’s backers want voters to approve an additional $5.5 billion under Proposition 14 to sustain not just a limitless possibility but also the more mundane and complex reality of the institute’s experience. Especially in a field as nascent as stem cells, science is slow, incremental and unpredictable, largely incompatible with the leaps forward touted in 2004. While the unique state of the science and politics drew broad support for Prop. 71 — including The Chronicle’s — we shouldn’t make a habit of setting science policy and budgets by state plebiscite.
Stem cells encompass early embryonic and certain mature cells that can produce a range of tissues, hence their assumed potential to repair the ravages of disease and injury. The field’s staunchest advocates are motivated by the possibility of treating what afflicts them and their loved ones.
While state funds helped support the research that led to two approved cancer drugs and a host of prospective therapies in various stages of development, farreaching breakthroughs attributed to the stem cell agency have been scarce so far, as a Chronicle investigation found. More than half the original funding went to buildings and other infrastructure, education and training, and the sort of basic research that, while scientifically valuable, is a long way from medical application. There’s nothing inherently wrong with that, but it is at odds with the vision of dramatic advancements put to voters.
The institute’s oversight raises more questions. Its top beneficiaries, among them Stanford and the University of California system, have been represented on CIRM’s board. While members recuse themselves from final funding decisions affecting their institutions, the appearance of rampant conflicts is inescapable. Meanwhile, the institute is insulated from outside oversight by a provision that prevents the Legislature from imposing changes without a steep 70% supermajority.
The case for California as a major patron of stem cell research was also diminished by President Barack Obama’s reversal of the Bush limits on research more than a decade ago. One analysis found that federal funding supported more than three times as many clinical trials in the field as California did.
CIRM’s original funding will cost the state about $6 billion with interest, to which the current proposal would add $7.8 billion. While both initiatives provide for recovering income from approved therapies, the fiscal benefits are a matter of speculation. And with the pandemic, wildfires and more stretching the state’s resources, stem cell research looks like an even more unlikely gamble for a government with more pressing priorities.
As The Chronicle also found, alongside the legitimate but halting progress toward effective therapies to which California has contributed, a whole industry of opportunistic quacks hawking stem cell snake oil has flourished across and beyond the state. That’s not the institute’s fault, but it is a byproduct of the aggressive promotion of theoretical medical treatments directly to the public — and another reason to vote no on Prop. 14.