Why clinical translation is key to CIRM’s quest for more funding

Author: Nick Dragojlovic, 12/02/13

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As the expiration of the California Institute for Regenerative Medicine’s (CIRM) funding approaches, the fate of CIRM after 2017 is top of mind for stem cell researchers in the state. While the agency’s leadership appears to be leaning towards some form of public-private partnership, planning for its financial future has reportedly assumed the future availability of $200 million in public funds. Additional state funding could be raised by appealing directly to state legislators or launching a second initiative campaign modeled on Proposition 71, which passed with 59% of the vote in 2004. Either way, any effort to secure continued public funding will require support from those Californians who supported the creation of CIRM in the first place.

With this in mind, CIRM’s scientific advisory board recently recommended that the agency begin to focus on translating stem cell research into therapies by concentrating a significant proportion of its remaining grant funding on 6-8 projects with the potential to deliver therapies in the near-term. This is likely the right strategy for the agency to take at this point because the evidence suggests that the perceived benefits of future stem cell therapies were the dominant message used by Proposition 71’s supporters and played a significant role in securing its passage. The hope of curing serious chronic diseases, moreover, helped to overcome opposition from the significant minority of Americans who are morally opposed to human embryonic stem cell (hESC) research.

According to Gallup, 32% of Americans found hESC research to be “morally wrong” in 2013, only 5 percentage points less than the 37% that expressed that sentiment in 2004. In a new initiative vote in California in, say, 2016, many of those who voted for Proposition 71 in 2004 may well oppose additional state funding to support CIRM in the new budgetary environment in which public services like education have suffered from steep budget cuts. Appealing to those who find embryonic stem cell research ethically troubling may therefore well be crucial to building a winning coalition in support for a new initiative, and is not necessarily a lost cause

Indeed, several lines of evidence suggest that the perception of large potential benefits can overcome Americans’ moral concerns about the use of hESCs. A July 2001 Gallup poll, for example, found that while 54% of respondents believed hESC research to be “morally wrong,” 34% found that the research may nevertheless “be necessary”. Similarly, in a 2011 survey Evans and Kelley found that the seriousness of the condition treated by hypothetical hESC therapies was a key determinant of Americans’ approval, with treatments for heart disease and cancer receiving overwhelming support.

I explored how this dynamic actually played out in Californians’ voting behaviour in 2004 in a recent article. Using several Field Poll pre-election surveys, I focused on the voting intentions of born-again Protestants, who other research suggests were the key constituency opposing Proposition 71 on moral grounds. As a way of indirectly measuring how respondents’ perceptions about the potential benefits of funding stem cell research varied, I combined the voting intention data with census data on the proportion of the population in each respondent’s county that was over the age of 65 and with data from the CDC’s Behavioral Risk Factor Surveillance System survey on the prevalence of chronic diseases like diabetes and heart disease in each county. The logic behind this approach was that born-again Protestants living in counties where the suffering caused by age-related and chronic diseases (i.e., the conditions most cited by Proposition 71 supporters as the likely targets of stem cell therapies) was more salient would perceive a greater potential benefit from funding even hESC research than their counterparts living in counties with low chronic disease burdens.

While I found that born-again Protestants were more likely to indicate an intention to vote against Proposition 71 than respondents who espoused other religious views, this trend appeared only for those living in counties with low chronic disease prevalence. Born-again Protestants living in high-prevalence counties, in contrast, did not oppose Proposition 71 at different rates than other respondents. In other words, even in a context in which respondents’ attitudes could have a direct impact on stem cell policy, the perception of large potential benefits from stem cell research helped to overcome moral opposition to the use of hESCs.

This provides further support for CIRM’s effort to highlight the benefits of stem cell research by bringing at least a handful of therapies to the clinic before its funding ends in 2017. Not only would this generate positive PR, but a focus on the clinical benefits of CIRM-funded research would likely help to overcome any remaining ethical concerns about the use of hESCs among Californian voters, and would boost CIRM’s chances of securing continuing public funding.

References cited:
Evans M.D.R. & Kelley J. (2011). US attitudes toward human embryonic stem cell research, Nature Biotechnology, 29 (6) 484-488. DOI:
Dragojlovic N. Voting for stem cells: How local conditions tempered moral opposition to Proposition 71, Science and Public Policy, DOI:

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Nick Dragojlovic
Nick Dragojlovic is a health services researcher at the University of British Columbia's Faculty of Pharmaceutical Sciences. He has previously held postdoctoral fellowships at the University of Calgary and at UBC, and has received funding from the Canadian Institutes of Health Research and the Michael Smith Foundation for Health Research. He holds a BA from Yale University and an MA and PhD from UBC. Nick is particularly interested in the use of alternative finance mechanisms to support scientific research, and covers the topic on his blog: Funded Science
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