July 5, 2004

Embryonic Stem Cell Research (part I):  A Cash Crop?

Advocates for human embryonic stem cell research (ESCR) have long claimed it has the potential to cure everything from cancer to Alzheimer's disease. But ESCR has also been stymied by a collection of federal funding restrictions based on the ethical and political questions surrounding such scientific inquiry, leaving the field long on promise and short on results. All that could dramatically change this year as CALIFORNIA and NEW JERSEY lead a new state-level push to sidestep federal funding limitations on ESCR by dedicating significant amounts of public money toward this controversial research.   

Although 14 states are currently debating some form of stem cell policy, only New Jersey and California have legalized ESCR, which entails harvesting cells from human embryos left over from the in-vitro fertilization process in hopes of those cells being transformed into other kinds of cell tissue. This differs from adult and human blood (umbilical) cord stem cell study because, in theory, the embryos, which would normally be discarded, yield unique cells which can adapt to any kind of body tissue and thus be used to replace damaged cells. Many -- but far from all --  researchers believe this could lead to cures for any number of degenerative diseases and spinal cord injuries. 

But many religious leaders, including Pope John Paul II, have spoken out against ESCR. They contend that embryos are a human life that should never be used as a scientific tool, no matter what the reason. Several have also voiced concern that ESCR will lead to human cloning. Others oppose ESCR on financial grounds, saying it is simply too expensive and has yet to yield any real medical breakthroughs. President George W. Bush tried to placate both sides in 2001 when he restricted new federal funding to only umbilical cord, placenta and adult stem cell study, and limited any publicly funded research on embryonic cells to only the 78 lines currently in existence. Although not a ban on ESCR, Bush's decision put a distinct crimp in its funding and left it to individual states to decide for themselves if they wanted to pursue the matter further.

New Jersey Gov. James E. McGreevey (D) struck first, on May 12 of this year allocating $6.5 million from the 2005 state budget to fund the Stem Cell Institute of New Jersey. McGreevey authorized a total of $50 million over the next five years to spur the facility, which would be a joint venture between Rutgers University and the University of Medicine and Dentistry of New Jersey. McGreevey also promised to deliver at a future date another $3.5 million in private funds to augment the plan. He later upped the ante by including various other grants and investments from the two medical institutions, bringing the state's initial planned investment this year to $11.5 million, which lawmakers approved June 30. 
 

California followed New Jersey's lead two weeks later by qualifying Proposition 71, a November ballot measure asking voters to endorse the California Stem Cell Research and Cures Initiative, a $3 billion plan that would, among other things, disperse an average of $295 million in grants over 10 years to fund ESCR at state universities and advanced medical research facilities. The money would come from the sale of general obligation bonds and be backed by the cash-strapped state's general fund. The act would also embed the right to conduct ESCR into the state constitution. 


    While advancing medical science is one goal, there is also a financial incentive for each state to use public funds to build state-of-the-art ESCR centers. In his announcement, McGreevey specifically noted that the state's biotech industry generates $1 billion annually, and that such research facilities "will augment the presence of our industry leaders, attract new companies to a critical sector of our state's economy and promote a forward-looking agenda to develop new medicines and therapies." 


    "The economics of this was clearly a part of our thinking," says McGreevey spokesperson Micah Rasmussen. "New Jersey has a strong economy in part because of its research and pharmaceutical industry. A stem cell research center is a natural fit." 


    Which means that, successful in finding cures or not, ESCR is big business. McGreevey also says he expects New Jersey's $11.5 million in seed money to attract more than $20 million in additional public and private funding over the next five years.

    Californians for Stem Cell Research and Cures, the group who gathered the signatures for the California initiative, also sees the growth of ESCR as a financial windfall for the state. The group sponsored a report by a Stanford University group that estimates the initiative will generate $70 million in new tax revenue in its first five years, a figure far in excess of the $56 million in debt service they project to be incurred from the sale of state bonds over that time.
    Such numbers have caught the eye of the state's money managers, including California Controller Steve Westly (D) and Treasurer Phil Angelides (D). Although both have been careful to praise ESCR's medical potential, each also cites the fiscal potential of having a cutting edge stem cell research program in the state. Angelides called the measure a "win-win for California, funding research into debilitating diseases while investing into the California economy to create thousands of new jobs." Westly said that if the measure does result in research that leads to cures for ailments like cancer, it could eventually result in a substantial reduction in the state's $118 billion annual health care costs and could also "help generate new state revenues from patents and royalties." 
    Not all the numbers are so rosy. The state Legislative Analysts' Office says the total cost of the principal and interest on the bonds over the 30-year payback period would total $6 billion. And while the analysis from Californians for Stem Cell Research and Cures shows anticipated tax revenues superceding interest on the bonds in the first five years, it also indicates future revenues would only cover 14% of bond debt interest after that, leaving the general fund to support the rest. 
    Some California medical professionals say those numbers are not acceptable. Dr. H. Rex Greene, an oncologist and medical director for the Dorothy E. Schneider Cancer Center in San Mateo, says ESCR is too unproven to risk adding billions more in bond debt so soon after the state was forced to sell $15 billion in bonds in order to restructure its enormous budget deficit. 
    "I am in favor of stem cell research, but anyone speaking in favor of this initiative must not have read it," says Greene, who is a spokesperson for a group of medical professionals called Doctors, Patients and Taxpayers for Fiscal Responsibility that is fighting Proposition 71. "This bond measure will add up to $6 billion in taxpayer indebtedness at a time when our healthcare infrastructure, among many other things, is in serious trouble."
    Greene says it will be decades before any real medicines from ESCR could be on the market, and that in the meantime it will be researchers who benefit the most. 
    "The people behind this proposal are presuming that [ESCR] is the highest priority of taxpayers to put all of this money into what is really a tiny sliver of the spectrum of stem cell research," Greene says. He also says it is telling that both Gov. Arnold Schwarzenegger (R) and former First Lady Nancy Reagan, strong proponents of stem cell research, have not yet come out in support of Proposition 71. 
    Proposition 71's backers, however, are not deterred by such criticism. 
    "California is the only state that can feasiblely do something this big," says Fiona Hutton, spokesperson for Californians for Stem Cell Research and Cures. "No state is as poised to take on this issue as we are."
    That might be necessary, as Rasmussen has made it clear that "It is definitely part of [Gov. McGreevey's] thinking to draw the top scientists to New Jersey," Rasmussen says. 
    Those words are encouraging to Dr. Wise Young, Founding Director for the W.M. Keck Center for Collaborative Neuroscience at Rutgers University and one of the two men tabbed to run the state's planned ESCR center. Young notes that after McGreevey authorized the center's funding, research facilities at Harvard, Stanford and Berkeley all announced plans to begin or enhance their own stem cell programs.
    "The number of scientists in the world who actually have the knowledge and training in this field is very, very small," he says. "We are also not just competing with other facilities here in the United States. There is great competition for scientific minds from England, Australia and Asia. If we are going to keep this in New Jersey, and in the U.S. for that matter, we need to have this kind of facility."
    That kind of competitive urgency rankles Greene, who argues that states have far more pressing needs than funding ESCR with public money.
    "California has 7 million uninsured people, and yet these guys have the unmitigated gall to want to put $6 billion more in debt on the taxpayers," he says. "If that's how states are going to address this, then maybe the ultimate decision [on ESCR] should not be at the state level." 
 

-- By RICH EHISEN