The recent close-call US presidential election grabbed headlines, but no less closely-fought was California's Proposition 14, also on the ballot in October, which will have a huge impact on the future of stem cell research in the state.
The Stem Cell Research Institute Bond Initiative (Prop 14),which was on the ballot in the initiated state statute will allow the state to issue billions of dollars in bonds for its stem cell research programme. The vote could not have been closer, with 51 percent of ballots for and 49 percent against.
This initiative will enable financiers to lend US $5.5 billion to a stem cell agency, the California Institute for Regenerative Medicine (CIRM) which the state's taxpayers will repay with interest over the next three decades. The sizeable bond fund will be allocated to research, human clinical trials and programmes and also for start-up costs for facilities in the stem cell field. About US $1.5 billion of the money will be spent researching neurodegenerative conditions, including Alzheimer's, Parkinson's and dementia. Some of the funds will be allocated to the shared labs programme: state-funded facilities dedicated to conducting studies on human embryonic stem cells. A working group focused on improving access to medical treatments will be established, as well as training and fellowship programmes for undergraduate and postgraduate students.
Stem cell research is in its infancy, with some treatments that have worked in animals now progressing to human trials. The research is promising, as the ability to generate specialised cells could eventually be used to repair or replace damaged tissues and organs. However, there are ethical controversies surrounding stem cell research, especially regarding embryonic stem cells derived from early human embryos.
In 2001, the conservative Bush administration prohibited federal funding for stem cell research owing to the ethical concerns. This prompted real estate developer and investor Robert Klein to initiate the original Proposition 71 which aimed to establish a state constitutional right to conduct stem cell research in California in 2004. It was believed that Prop 71 would propel California as a world leader in stem cell research and 59 percent of Californians voted in favour.
The proposition also established CIRM – the only state-funded stem cell research agency in the USA – in the California Constitution. Since its inception, it has granted research funds to various institutions and companies including Stanford University and the University of California. So far, it has funded 68 clinical trials (phases 1-3) for a wide range of diseases and conditions, including cancer, diabetes and many rare disorders.
In 2019, CIRM started to run out of funds, and by 2020 had suspended applications for new projects except US $5 million in emergency funding for COVID-19 research. The Californians for Stem Cell Research, Treatments and Cures political action committee (PAC) responded with a campaign to boost funding via Prop 14. Supporters included US House speaker Nancy Pelosi, California governor Gavin Newsom, LA mayor Eric Garcetti, the California Democratic Party and several organisations such as ALS Association and the Michael J Fox Foundation for Parkinson's research and Huntington's Disease Society of America.
There is also resistance to Prop 14: dissenters feel that the initiative has not delivered its promises after 16 years. Furthermore the original rationale no longer applies as federal funding is no longer blocked. Former President Barack Obama then removed the restrictions on embryonic stem cell research (a position unchanged by the Trump administration) which means California scientists can apply for (highly competitive) federal research grants.
In the current climate, Prop 14 will exacerbate California's already colossal budget deficits. The coronavirus pandemic has worsened housing crises and unemployment rates, highly visible in cities like San Francisco and Los Angeles.
As Marcy Darnovsky, executive director of the Center for Genetics and Society, said: 'It does nothing to address CIRM's built-in conflicts of interest, or its lack of legislative oversight – despite it being an agency supported wholly by public funds. The new proposition makes some things worse; for example, it outsources critically important decisions about ethical standards to an unaccountable national committee... In the meantime, that campaign's shameless over-promising and hype set the stage for the hundreds of under-regulated commercial stem cell clinics now offering unapproved 'treatments' that have caused tumours and blindness...'
It is not surprising that Californians were so torn. Perhaps it's wiser to allocate the pot to more pressing matters like job creation, housing and other urgent needs?