The four words “California stem cell research” go nicely together and I hope they will continue to resonate in a special way to people around the world in the coming decade.
We are at a crossroads for stem cell research in California as the original form of the California Stem Cell Agency (CIRM) winds down. Will CIRM get a new infusion of billions in state funding via a ballot initiative a la Proposition 71 from more than a decade ago? Will CIRM instead find a different source, probably much smaller, of research funding such as via philanthropy? Could CIRM cease to exist within a few years?
CIRM has such strong clinical momentum right now, I hope it continues robustly for another 10 years.
Over at California Stem Cell Report, David Jensen has a piece on the possible new $5 billion California state ballot measure that may be in the works for next year to keep CIRM going. The article focuses a lot on Robert “Bob” Klein, who led the team that created CIRM originally. Jensen had a more than 1-hour interview with Klein, which includes some quotes that help clarify the ideas behind the potential next ballot initiative and future CIRM focus. For instance, there’s an interesting additional focus on patient access to new stem cell treatments down the road from Klein:
“The original initiative stated really a commitment to the idea of access….
“It’s my intention to actually put a directive in for funding the infrastructure to work on access, to work with insurance companies, to work with Covered California to work with Medicare, to make sure that there’s access, to make certain that public hospitals and public clinics in California get discounted prices.”
Klein also told Jensen about the need for emphasis on educating physicians about stem cells and regenerative medicine, a long-time focus of mine with my early publication that was a proposal for specific physician training in stem cells and regenerative medicine.
From Klein on this front:
“I’m looking at a directive section that deals with specifically broadening the doctors who are specifically educated. The only way you can do that is to buy a part of the residency time. Otherwise they don’t have time to do anything other than deal with current patients and current methodologies, which are radically insufficient as compared to the new cellular therapies.”
Klein’s potential emphasis on access is a smart one in terms of engaging voters and the training component including specifically of physicians also makes good sense.
Jensen’s piece indicates that insurance is a big part of the future stem cell treatment equation in California and more generally. In my view, a newly funded CIRM is also going to have to deal directly with the unproven stem cell clinic problem in our state. With more than 100 such clinics here, Californians are at risk but so is stem cell research funding from these rogue efforts. The new bill on stem cell clinics could be the ticket, should it become law.
What about other sources of stem cell research funding here in California?
I’m thinking primarily here of what many of us refer to as “Roman’s Law“, which is The Spinal Cord Injury Research Program law (and now new bill) named after amazing stem cell advocate (and the first winner of The Niche’s Stem Cell Person of the Year Award) Roman Reed. It’s looking promising that Roman’s Law will get a new influx of state funding for stem cell research in spinal cord injury and paralysis. This would be great news.
I’ve also been brainstorming about whether there might be other entirely different future paths for funding of California stem cell research. While California has been very successful in getting NIH research funding for stem cell research by individual labs, the feds don’t fund state-wide efforts. The stem cell-related biotech industry in California is robust and should there be a few blockbuster successes from ongoing clinical trials here, which I expect will occur in the coming decade, this will likely draw in much more funding in that area.
If President Donald Trump takes action against embryonic stem cell research and there are more efforts against fetal tissue research, this could actually end up helping CIRM’s cause for additional funding. As many of us have noted, Trump could be an effective foil for the case for a future CIRM in a sense.
Overall, California’s stem cell future looks positive, but just how bright?
When I coined the phrase “CIRM 2.0”, I was already thinking about the post-Prop 71. future of CIRM. What will “CIRM 2020” bring? By the end of next year, we’ll have a much clearer sense of it. Jensen in a separate new post also directed readers to CIRM’s own newly-released brainstorming material for how to enhance itself for the future, which is a very interesting read here.
In terms of access, I think a CIRM-sponsored vetting system using an IRB approach may help. Kind of self-policing to ensure potential clinical work is going to be safe and mitigate patient risk.