For years, numerous outside critics have urged lawmakers and the state's stem cell agency, the California Institute for Regenerative Medicine, to take a hard look at CIRM's internal structure and revamp it to avoid conflicts of interest and possible misuse of taxpayer funds.
Instead of listening, leaders of this institute a poster child of how ballot initiatives can be manipulated to create quasi-public institutions with little public oversight have been consumed by a siege mentality that has prevented any real introspection.
There's a chance that may change today. A blue-ribbon committee of the National Academy of Sciences is scheduled to formally present CIRM's oversight board with a report examining the agency's internal workings. Although the report by the academy's Institute of Medicine commends the agency for raising the profile of stem cell research nationally, it warns that the appearance and reality of built-in conflicts could undermine future support for CIRM's mission.
California should be concerned about this for at least two reasons:
(1) Stem cell research still holds the promise of potential cures and treatments for diabetes, spinal cord injuries, Parkinson's and other diseases.
(2) The agency will soon run out of money, limiting the potential from transforming basic research into real-world therapies.
A creation of Proposition 71, a 2004 ballot initiative that authorized $3 billion in state bond funding for stem cell research, the institute was the brainchild of Robert Klein, a bond financier and patient advocate. Klein, who served as institute chairman until 2011, wrote the initiative so CIRM would be insulated from political interference, whether it be opponents of stem cell research or taxpayers looking out for how their money is being spent.
Under the structure that Klein designed, ultimate decisions about researching funding are made by a 29-member governing board largely made of up representatives from California universities and hospitals seeking stem cell research funding. To date, this oversight board has doled out about $1.7 billion, with roughly 90 percent going to institutions with representatives on the board.
Over the years, the built-in conflicts have become all too apparent. In 2007, the CEO of the Sanford-Burnham Medical Research Institute in San Diego, a member of CIRM's oversight board, intervened to endorse a grant application to his institution. The incident brought to light by David Jensen, the dogged author of the California Stem Cell Report blog eventually led to the disqualification of grant applications from 10 institutions that were the focus of improper lobbying by oversight board members.
Although the Institute of Medicine report didn't go into specifics about conflicts, it recommended that oversight board members not be allowed to decide on specific grants. It also urged CIRM to create a new scientific advisory board composed of experts who do not have a stake in the funding to advise CIRM staff on scientific priorities.
In addition, the report also recommended a clear division of responsibilities at the agency, with the oversight board focused on policy and day-to-day operations handled by the agency's president and its senior management.
It is to CIRM's credit that it solicited the Institute of Medicine report last year. Although some taxpayers may blanch at the report's $700,000 price tag, it will be worth the cost if it leads to a restructuring of how CIRM operates.
Of course, if it fails in that task, it will only affirm the view of many voters that they should never again endorse a California research initiative, especially one like Prop. 71 that lacks proper controls and accountability over taxpayer dollars.
Find the Institute of Medicine report by looking under "recent reports" at www.iom.edu.