2020 Proposition 14: Will California Continue Stem Cell Research?
A dozen proposals will be on the November ballot. Over the next few days I’ll endeavor to give readers a glimpse at the basic issues involved, along with links allowing for further study. Later on in the season I’ll post more materials on the higher profile measures under consideration.
One thing we can know for sure, tons of money will be spent to support or oppose the various propositions. Where that money comes from is, to me, more important than what the messages being pushed are. I'll get around to more specifics on funding as the election approaches.
Eight propositions earned a spot on the November 3 ballot via collection of voter signatures by interest groups. Four were added to the list by the Legislature last month, each proposing to amend the California Constitution.
Numbering on the ballot is reset every ten years, and we’re picking up where we left in March.
Proposition 14: Additional Bonds for Stem Cell Research
For: Patient advocates, doctors & scientists coalition. Primarily funded by Robert N. Klein II, a real estate investor.
Website | Facebook | Twitter | Endorsements | Text of Initiative
Against: No opposition identified as of yet, (See other side of the story below)
What: Asks voters to approve the issuance of $5.5 billion in bonds over a ten year period. Payments from the General Fund will be $310 million annually for a period of up to 25 years.
Final cost, including interest will be $7.8 billion.
Language in the proposition adds more rules for how research funds are spent by the California Institute for Regenerative Medicine, including a mandate to improve patient access to stem cell treatments. New grant awards would also be prioritized by projects using matching funds from outside sources. The governance structure of the institute would also be changed to improve public oversight.
Why: 16 years ago California voters approved borrowing $3 billion to finance a state government stem cell research program. It took three years to get the research underway, due to various lawsuits brought by entities fronting for “pro-life” groups concerned about using embryonic stem cells. That question is largely moot these days, as non-embryonic stem cells are more easily available.
The original pot of money has run out. If this measure is approved, it will provide continued funding to develop treatments and hopefully achieve cures for chronic diseases and conditions including cancer, Alzheimer’s, diabetes, heart disease, lower respiratory diseases, spinal cord injuries, blindness, multiple sclerosis, HIV/AIDS, kidney disease, infectious diseases like COVID-19, and many others.
Also: A huge amount of this research money gets spent in San Diego County. (See list at end of post) AND... did I forget to mention COVID-19?
How: Supporters have raised $6,573,974.51 to get this before the voters.
The other side of the story.
Proposition 71, passed in the wake of George W. Bush administration’s ambivalence about stem cell research was a bold attempt by a non-federal entity to fund basic research into promising therapies that should improve the quality of life for people with dozens of afflictions.
The San Francisco Chronicle did a deep dive into where the money went and what tangible results have come about since 2004. What they found was a mixed bag consisting of lots of fundamental science that has yet to translate into significant real world results.
There have been some successes, along with a lot of dead ends.
Here’s what the proponents of Prop 14 are touting as their accomplishments thus far:
A high school student who was paralyzed, regained function in his upper body and went on to college. More than 95% of patients in this trial showed motor improvements.
A mother who went blind from a genetic disease continues to experience improved peripheral vision. At the optimal dose, all the patients in this trial showed an average improvement of 2 complete lines on the eye exam.
Two FDA-approved treatments have been developed for fatal blood cancers.
More than 50 babies who were born without functioning immune systems have been cured of the once-fatal “bubble baby” disease.
When sufficient number of cells were delivered, all patients with Type I diabetes showed the capacity to regulate glucose levels.
The flip side of this concerns what must be frustrating attempts at applying the research. These challenges are not surprising, given all the things scientists have yet to figure out about the miracles of life.
About 900 patients have been involved in the 49 clinical trials CIRM has backed so far, The Chronicle’s review shows. Nearly a fifth of CIRM’s funds, about $530 million, has gone to support the trials. Most of those grants were awarded in the past three years, part of a deliberate effort by the agency to direct more money toward testing treatments.
“Every single project we have is spectacular, and just a couple of years ago may have been considered science fiction,” CIRM President Maria Millan told a state legislative committee in August as she outlined many of the clinical trials the agency has funded.
Only six of the clinical trials, though, have been phase 3 studies. Of those, two were terminated or suspended, three are still recruiting patients, and one — for a bioengineered blood vessel that can be used in dialysis — is under way.
Meanwhile, the National Institutes of Health, the primary federal funding agency for medical research, has far outpaced CIRM in supporting clinical trials in stem cell research. A 2017 analysis by STAT, a science and health news publication, found that, dollar for dollar, the NIH funded 3 1/2 times as many clinical trials as CIRM from 2006 to 2016.
The upshot of the Chronicle’s reporting is that the people involved in promoting state funding for stem cell research oversold the potential short range benefits in convincing voters to approve Proposition 71 in 2004.
I sympathize with the challenge they faced, selling basic research isn’t very sexy, even though many of the things we take for granted in every part of our lives have come from government funded exploration of basic science.
The more pure science approach of California Institute for Regenerative Medicine, the agency spending the money, faces competition from a host of private clinics in the U.S. and Mexico. Many of those operators are just rolling the dice, advertising that they can treat everything from arthritis to Alzheimer’s.
In a society where medicine wasn’t about making a profit, such therapies would have to undergo FDA approval, following real life clinical trials. Nowadays, not so much.
It’s likely that voters will approve this proposition, and they should. But they shouldn’t get their hopes too high when it comes to miracle cures. Science is hard.
Funding for research through this effort has gone to the following local entities:
University of California, San Diego -- $233,326,284
ViaCyte, Inc. -- $72,308,445
Salk Institute for Biological Studies -- $53,317,589
Scripps Research Institute -- $50,582,424
Sanford Consortium for Regenerative Medicine -- $43,116,439
Sanford Burnham Prebys Medical Discovery Institute -- $39,164,415
Poseida Therapeutics, Inc. -- $23,805,497
Angiocrine Bioscience, Inc -- $14,989,696
Lineage Cell Therapeutics Inc. -- $14,323,318
California Institute for Biomedical Research -- $12,422,058
Scripps Health -- $10,778,642
San Diego State University Foundation -- $9,058,049
Human BioMolecular Research Institute -- $7,403,428
Cellerant Therapeutics, Inc. -- $6,863,755
Ankasa Regenerative Therapeutics -- $6,083,026
Fate Therapeutics, Inc. -- $4,000,000
Ludwig Institute for Cancer Research -- $2,384,254
La Jolla Institute for Allergy and Immunology -- $1,464,446
The Scintillon Institute -- $1,103,185
Vala Sciences, Inc. -- $870,717
Zenobia Therapeutics -- $112,500
Samumed, LLC -- $99,110
Biocom Institute -- $50,000
Benjamin D. Yu -- $28,388
Mohammad Pashmforoush -- $27,949
Voter Guide - You've Voted for President, what's next?
I'll be writing about many ballot measures and candidates between now and the end of September. That work will be condensed into an handy-dandy voter guide just in time for your mail-in ballots to arrive. I'm the guy who coordinated San Diego Free Press's Voter Guides over the past decade, so this won't be my first effort. Stay tuned.
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