CIRM May Be on the Verge of Winning

Biopolitical Times
CIRM logo

Proposition 14, the California ballot initiative that, if passed, would continue and increase public financing for the California Institute for Regenerative Medicine (CIRM), seems to be on the verge of succeeding, though the voting results are not official. As of Friday the 13th, 93.1% of the state’s precincts have reported, and the Yes votes lead the No’s by 51.0%–49.0%, a lead of just over 320,000 out of more than 15.7 million ballots counted. According to the Los Angeles Times, it was the last Proposition to be decided but it has won.

The margin is remarkably close, given the financial disparity in campaign costs that we detailed two weeks ago: Proponents had reported at that time spending over $18 million, while the opposition had raised $250, or $0.00003 million. These are not final numbers, but the relative expenditure will remain remarkable after all is reported. It has been an expensive year for California initiatives: Proposition 22, which exempts companies such as Uber and Lyft from providing employee benefits to their drivers, broke records as those corporations and their business partners raised over $224 million, as compared with $16 million raised by their opponents. Still, that ratio of 14:1 pales in comparison with Prop. 14’s 72,000:1.

Unless there was a late surge in expenditures, not yet reported, the money raised and spent to ensure voter approval of Prop. 14 was significantly less than that spent in 2004 to pass its predecessor, Prop. 71. That ballot measure established CIRM with a total endowment of $3 billion plus interest, borrowed by the state over 10 years; Prop. 14 raises the stakes to $5.5 billion plus interest, also debt financed. 

This time there was just a bit of star power: Seth Rogan supplied the voice for a cartoon about “Stemmy the Stem Cell,” presumably as a volunteer — his wife, Lauren Miller, has been on the CIRM board for seven years, and the pair are active advocates for patients with Alzheimer’s Disease. That pales in comparison with the hucksterism displayed in 2004, when television ads blanketed the state. 

One of those ads featured Irving Weissman, a Stanford professor and biotech entrepreneur who is also a neighbor of Robert Klein, the man who wrote the initiative. Weissman appeared on TV wearing a white coat and describing himself only as a doctor (which he also was) whose sole concern was curing patients. Weissman went on to benefit greatly from CIRM’s grant-making. He received a total of $30 million for various research projects; one of the companies he co-founded, Forty Seven, got another $15 million. 

Fast forward to 2020. Forty Seven was purchased by Gilead Sciences for $4.9 billion, and Weissman scored a $191 million windfall. Stanford picked up $67.1 million from that deal. CIRM funding — taxpayer money — was a crucial element of the research behind this, and they are not shy about it. Forty Seven refunded its grant money to CIRM, with interest, after the sale, which is good, but do taxpayers get royalties? No. Or even the kind of chunk that Stanford got? No again. 

In fact, when all the royalties from CIRM-funded work are totaled, they amount to about $518,000. This is a lot less than the amounts being bandied about in 2004, when advocates of the original ballot initiative claimed that it would bring the state “royalty revenues of from $537 million to $1.1 billion.” That was on top of other pies in the sky, including “direct health care cost savings to the State government of at least $3.4 billion to $6.9 billion.” CIRM’s Kevin McCormack now admits that “the initial promises were a little optimistic.”

Oh, yes they were. Some may remember the paralyzed rats that supposedly walked again after a stem cell treatment. And were featured in the New Yorker three weeks before the election. They were such a hit that coverage continued for several years (1, 2, 3). To be fair, if we must, in 2006 Hans Keirstead, the researcher and entrepreneur who spread the video around, admitted to 60 Minutes that the rats were only “partially paralyzed” before they were treated, and insisted that “I think we could call this a dazzling success if we saw the smallest improvement in the ability of a human to do anything that they could not do. If they could move a single finger, I would call that a raving success.” 

Scientifically, that may be valid. Somehow, it’s not the impression voters took away. Funny that. Plus ça change …

This year’s campaign was lower-key and less expensive but still relied on some suspicious math and obvious hype, as David Jensen pointed out at California Stem Cell Report. The campaign never justified their eyebrow-raising claim that the proposition would cost the state about as much as a bottle of aspirin per person, per year. Nor did they explain their claim that CIRM was involved in 90 clinical trials, while CIRM itself said the number was 64. Stanford’s Hank Greely noted wryly that “Politics has a corrupting influence on everything — it pushes toward exaggeration.”

Assuming the current voting count trends continue, CIRM will get its cash, but with a considerably smaller victory margin than the 59–41 achieved in 2004.  Evidently in a time of looming state budget deficits and economic disaster, voters were much less willing to gamble on promises of future cures, despite proponents’ repeated assurances of huge future savings in medical expenses. Clearly the Californian public has grown more skeptical.

CIRM is still lumbered with a clumsy organizational structure that now includes an unwieldy 35-member board, and its built-in conflicts of interest that have been widely criticized since the agency’s inception. Over the last fifteen years, CIRM’s board members have tended to make awards to each other: 80% of grants have gone to institutions represented on the board. (The representatives recuse themselves of course, but they take turns doing so.) This is still crying out for reform.

The major impediment to reform all along — and still — is that it takes a 70% supermajority of both the Assembly and Senate, as well as the Governor’s signature, to force any changes at all on the agency, despite its being wholly supported by public funds. Until now, there has been scant evidence that California politicians are interested in that kind of heavy lift. Our elected representatives should take note that almost half the voting public opposed the continuation of CIRM. With public support apparently receding, will the politicians step up to the plate? 

This post was updated on 13 November to reflect the current vote tally.