California’s Stem Cell Agency “Stacks the Deck” at a Key Hearing
The California Institute for Regenerative Medicine (CIRM), the agency established by a 2004 ballot initiative to fund stem cell research, has now handed out almost half of its earmarked and bullet-proofed $3 billion of public money. Its leadership has been pondering for some time what to do when that sum runs out. Back in 2010, the agency's governing board commissioned the Institute of Medicine (IOM) to study its performance, a move that many speculated was meant to garner a positive review in anticipation of a new ballot measure with which CIRM would ask Californians to give it another $4 or $5 billion.
As part of the study, which cost CIRM $700,000, the IOM is holding a two-day hearing in San Francisco this week. Unfortunately, it seems that all the testimony is coming from people who work for CIRM, either directly or as grantees.
The IOM reviewers are thus unlikely to hear about the many criticisms about conflicts of interest, governance, and accountability that have dogged CIRM for years. These concerns have been pressed by public interest groups including the Center for Genetics and Society, the Pro-Choice Alliance for Responsible Research, and Consumer Watchdog, and also by the state's official good government agency, the Little Hoover Commission, which in 2009 issued a highly critical report [pdf] on CIRM.
Pulitzer Prize-winning columnist Michael Hiltzik of the Los Angeles Times titled his column on the IOM hearing "Stacking the deck on the stem-cell program." He began with a question:
What are the chances that the prestigious Institute of Medicine will get an objective and balanced view of California's stem-cell program when it takes public testimony about the program at a hearing Tuesday in San Francisco?
His answer: "About 418 million to one." That number is the value, in dollars, of the grants received from CIRM by the IOM panel's witnesses or their employers.
As Hiltzik notes, these numbers were gathered by David Jensen of the California Stem Cell Report, probably the most knowledgeable independent observer of the stem cell agency. Jensen reports:
Eleven witnesses are scheduled for next Tuesday's meeting. Five are CIRM employees or members of the CIRM governing board. The remaining six come from institutions that have received $418 million from CIRM: Stanford ($193 million), UC San Francisco ($115 million), UC Davis ($62 million) and UC Berkeley ($48 million). Five of the witnesses have received grants directly from CIRM: Alice Tarantal of UC Davis ($5 million), Howard Chang of Stanford ($3.2 million), Irina Conboy of UC Berkeley ($2.2 million), Helen Blau of Stanford ($1.4 million) and John Murnane of UC San Francisco ($1 million).
Jensen queried the IOM about whether it "actually expected to receive forthright assessments of CIRM from individuals linked to institutions that have received hundreds of millions of dollars from the agency." He specifically asked why no witnesses from the Little Hoover Commission or the Center for Genetics and Society had been invited. You can read his account of the run-around response to which he was treated here.
In a conversation today, IOM spokesperson Christine Stencel told me that this week's hearings are just the beginning of the institute's review. "One meeting is not the end-all or be-all of who the committee will hear from," she said. "This isn't the only way we will gather information."
Let's hope so. With key questions about the future of CIRM unresolved, a meaningful review by the IOM could make an important contribution to needed changes at the agency.
That may not have been what CIRM's leadership intended when it commissioned the IOM report in 2010. At the time, Robert Klein, the mastermind behind the 2004 campaign that created CIRM, was still leading the agency, and had just begun floating the idea of going back to the voters for more billions. As recently as this past December, he told Steve Johnson of the San Jose Mercury News that he had stepped down as chair of CIRM's governing board in part to help raise money for another stem-cell proposition, perhaps in 2014.
California voters passed the 2004 proposition establishing CIRM after a $35-million campaign that all but promised stem-cell cures by Christmas, and that relied on the backlash against the Bush administration's restrictions on funding for the research. Now, in the context of deep and painful cuts to state funding for education and myriad other social programs, Klein's vision of a repeat performance seems bizarrely misguided.
In addition, of course, the Obama administration has lifted the federal funding limits that galvanized the 2004 campaign. And it's hard to imagine Californians agreeing to pony up additional billions with CIRM's "Countdown to Cures" promises predictably (though sadly) unfulfilled. As the Mercury News editorialized recently, "it would be wrong to ask for more public financing from California."
It's possible that Klein's replacement, CIRM board chair Jonathan Thomas, is trying to back away from Klein's ballot measure redux plan. A presentation by Thomas, posted online in connection with a meeting of CIRM's governing board earlier this month, included the comment that "it would be premature even to consider another bond measure at this time." (The comment has so far been noted only by David Jensen.)
But ballot measure or no ballot measure, CIRM will continue to disperse the public money it controls - another billion and a half dollars. This is a public agency spending increasingly scarce public resources. It is funding a field of research in which we place great hopes for medical and scientific advances. These factors make it all the more crucial that CIRM follow the basics of good governance and public accountability, and eschew the hyperbole and exaggerated promises that have tainted stem cell research for so long.
The IOM is accepting online public comments until August 2012. Scroll to the bottom of the form and click on "Feedback," or email study director Adrienne Butler.
Previously on Biopolitical Times: