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AAMC Reporter: December 2007
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Claire Pomeroy, M.D., M.B.A., Vice Chancellor, Human Health Sciences, University of California, Davis; Dean, University of California, Davis School of Medicine
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Viewpoint:
"The Outlook for Stem-Cell Research in California and Beyond"
California's $3 billion initiative to advance stem-cell
research remains the largest, most ambitious of its kind
in the world. The state's public referendum, Proposition
71, passed in 2004 with 59 percent approval, creating the
California Institute for Regenerative Medicine (CIRM). I
serve on its governing body, the Independent Citizens
Oversight Committee (ICOC).
Immediately upon passage, Proposition 71 became tied
up with lawsuits. With a loan from the state and backing
from philanthropists, however, CIRM was able to
move forward. It has awarded more than $200 million
for grants to train new researchers, construct shared
research facilities, and fund research projects led by
both emerging and seasoned investigators.
Then in May, California's highest court upheld Proposition
71, allowing CIRM's Scientific Strategic Plan to proceed
with public funding. This month, CIRM plans to award
$85 million to support young faculty researchers at nonprofit
and academic institutions. And, in 2008, an unprecedented
$227 million will be awarded for construction
of major stem-cell research facilities around the state.
Notably, Proposition 71 emphasized support for projects
and studies that would be "unlikely to receive federal
funding," including research involving human embryonic
stem cells (hESC). These cells have the potential to differentiate
into any type of human cell. The emphasis on
hESC proved to be crucial given the current ban on federally
funded hESC research using cells other than a small
number of hESC lines, exhibit limited degrees of affordability,
accessibility, and genetic diversity. (Federal legislation
to remove these restrictions has been vetoed twice by
President Bush.)
CIRM-funded researchers can utilize newer and more
viable hESC lines, which harbor greater scientific potential
for discovering treatments and cures. At the same
time, CIRM has endorsed a balanced, scientific approach
to also fund researchers whose studies involve umbilicalcord-blood stem cells and adult stem cells, the latter having
been successfully used in bone marrow transplants
for decades.
As a result of this supportive environment, California's
leading medical research institutions have seen an influx
of about 50 prominent stem-cell researchers since the
passage of Proposition 71. Other regions in the United
States have watched these developments in California,
and, with public support, new funding commitments
have materialized in about 10 states; most significantly,
New York, with $600 million over the next decade.
These developments bring a key question to the forefront:
As leaders of our country's academic medical institutions,
how can we continue to support a strong public dialogue
on the complex legal, ethical, and societal implications of
stem-cell research?
One option has been to put the issue directly in front of
voters. Missouri did just that with "Amendment Two"
in 2006. Millions were spent by both supporters and
opponents. The amendment narrowly passed, providing
protection for hESC research but no immediate public
funding. With the notable exception of personal attacks
waged against Parkinson's disease patient Michael J. Fox,
this statewide democratic process could generally be
described as robust and healthy, further advancing public
understanding of modern science both in Missouri and
across the country.
In states where hESC research is already widely supported—such as California—the responsibility to
maintain such a dialogue is equally important. I believe
that academic leaders in particular are rightfully expected
to embrace an evidence-based and respectful public conversation
regarding this issue.
At UC Davis Health System, we have reached out by hosting
"Stem-Cells 101," a forum in which the public was
invited to hear researchers, ethicists, and patients discuss
the current scientific facts and ethical challenges surrounding
stem-cell research. We also have hosted our U.S. Congressional
Representative Doris Matsui and members of
the local media for a tour of our current stem-cell facilities
and a viewing of our plans for a possible new CIRM-funded
Stem Cell Research Institute. And, we continue
to reach out to our community leaders, faculty, and
medical students.
CIRM, too, has placed a strong focus on the need for public
education. For example, each meeting of the ICOC
begins with a "patient spotlight." Researchers review
the latest discoveries and technologies in a specific area of
stem-cell research. Then, we hear from a local patient
who could benefit from continued advances in the field.
Indeed, stem-cell research and the public discussions surrounding
it are both expanding. In my opinion, this
requires academic leaders and our community partners
to meet a compelling social responsibility by continually
reinvesting in this important dialogue at all levels: local,
state, national, and global.
It's no small charge, but we should have confidence.
Already, I am encouraged by the increasing number of
well-informed individuals who provide insights on stem-cell
research and medical research in general.
In the coming election year, it will be interesting to see
how states, candidates, legislatures, and the public become
involved in this issue. Leaders in academic medicine
will undoubtedly have opportunities to help keep
the discussion both respectful of diverse perspectives and
grounded in science. I urge all of us to understand and
embrace our obligation to fully engage in and promote
the dialogue needed to advance medical research in a
socially responsible and ethically sound way to benefit
patients everywhere.
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