Patient advocates are dismayed, but the word from the world’s best funded stem cell institute is that there will be no cures for at least 15 years. A proposed strategic plan recently released by the California Institute for Regenerative Medicine predicts that, at best within 10 years it will achieve proof of principle of a stem cell treatment for at least one disease, with another two to four treatments in early clinical trials. (Nowhere does the report even mention adult stem cells.) At that point funds for the Institute dry up along with projections. However, the institute’s president, Zach Hall, has predicted that it might take 15 years before a medical product emerges.

Despite inspirational calendar quotes — "A man’s reach should exceed his grasp, or what is a heaven for" — the report’s message for patients waiting to be cured is gloomy candour. The task of developing the cures is incredibly complex. "Curing a disease like Type 1 diabetes, doing embryonic stem cell research, or doing cell therapy is not rocket science; it’s a lot harder," in the words of Allen Spiegel, of the Albert Einstein College of Medicine.

In fact, scientists’s grasp of the basic science of stem cells is feeble at this stage. "Neither stem cell self-renewal nor differentiation is well-understood," the plan acknowledges. "The two characteristic features of embryonic stem cells are their almost unlimited capacity for self-renewal and their ability to differentiate along multiple lineages to produce the wide variety of specialised cells found in the adult. Our understanding of the cellular and molecular basis of each of these important properties is incomplete."

Californian voters approved a US$3 billion bond issue to finance the institute in 2004. With interest, the cost to the state will be about $6 billion. Now, it appears, that the Institute may have nothing to show for its efforts in cures or in royalties by the time it folds its tent and silently steals away. (The word royalties is not mentioned once in the entire report.) Nonetheless, provided legal challenges are overcome, the strategic plan will probably be approved by the CIRM board.

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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