blog.bioethics.net

Bush and iPS cells: another "Mission Accomplished"?

By James Fossett

The White House, Charles Krauthammer, Wesley J. Smith and other Bush Administration apologists have been working hard the last few days to spin the announcement of the development of induced pluripotent stem cells (iPSC’s) as a scientific silver bullet that wouldn’t have happened without the Bush Administration’s principled opposition to human embryonic stem cell (hESC) research that induced scientists to find a “moral” means of producing stem cells.

All politicians spin, but this one’s a doozy, on a par with Iraq’s weapons of mass destruction and "I did not have sex with that woman."

First, the primary short run impact of iPSC’s will almost certainly be political rather than scientific or clinical. Informed scientific opinion has been more or less unanimous -- iPSC’s are NOT a silver bullet replacement for hESC’s, at least not yet, and it makes no sense to dump hESC research until there is evidence on what can and can’t be done with stem cells developed this way. The biotech industry has been even cooler to iPSC's, noting that customized individual therapies will almost certainly be subject to unusually lengthy FDA review before being allowed on the market. This may mean that hESC derived therapies will get to market sooner than those based on iPSC’s.

This scientific and regulatory uncertainty, however, will not stop hESC detractors both in Washington and state capitals from pressing strong political claims that funding hESC research is unnecessary as well as immoral. The iPSC developments provide “rhetorical parity” that gives hESC detractors the ability to claim that they support stem cell research now that we don’t have to kill embryos to do it. These claims may have little impact in Washington, where there are currently insufficient votes to override another veto of a bill to expand the hESC lines federal funds may be used to support, but they may have more impact in some states. None of the states currently funding hESC research is likely to stop doing so, but some may start supporting “reprogramming” research. Other states that have been scared away from starting their own stem cell programs may now find iPSC’s more politically palatable.

The claim that Bush’s opposition to hESC drove scientists to uncover “moral” means to make stem cells is just silly. One of the groups that developed iPSC’s is Japanese and didn’t need to worry about the Bush restrictions at all. Scientists also had a strong economic incentive to look for simpler and cheaper ways to make stem cells than hESC provides and would very likely have done so irrespective of what the President’s position was.

The real Bush Administration legacy around stem cell research is not nearly so praiseworthy. Paradoxically federal attempts to restrict funding for hESC research have had the unintended effect of significantly increasing overall support for stem cell research from many other sources. We’ve noted at length the significant financial support provided by states and private donors, but research financing has come from overseas as well. Singapore and Britain, among other countries, have been aggressive, visible supporters of this research in a number of ways.

As we’ve said before, all these developments make federal policy and funding more or less irrelevant to the size and direction of the embryonic stem cell research enterprise. Researchers who don’t wish to obey the Bush Administration’s funding restrictions or want to stay clear of legislative efforts to brand them as felons increasingly have choices about sources of funding and stem cell lines, and increasingly, the kinds of rules they work under. Some have already moved to more hospitable environments, and probably many that haven’t moved want to. The federal government is now only one among many funders, and not even the largest one at that.

Current federal policy has, however, probably had adverse short term effects. One is that American scientists have been less active in stem cell research than researchers in other countries. Aaron Levine of Princeton has done some fascinating research (pdf) that shows that, in fact, scientists at American institutions have published less on stem cell questions than on other cutting edge scientific issues. Complaints that America is losing its edge in biomedical research in this area appear to have some substance . A lot of money has been wasted as universities have spent money on new labs and equipment to avoid “contaminating” federally funded activities. Levine has also published a second piece that indicates stem cell principal investigators have been significantly more likely to receive job offers, both from institutions in American and overseas, than investigators in other scientific areas. Whether this is evidence of a “brain drain” to more permissive and better funded research environments isn’t entirely clear, but it seems like a pretty good bet that the price of stem cell investigators in salary and other research support has probably gone up as medical school deans attempt to hold onto productive researchers.

Current federal policy has also probably skewed the stem cell research agenda in potentially undesirable ways. NIH funding has been perhaps the primary source of support historically for basic biomedical research. While California has reserved significant funding for basic research, private funding and that supported or influenced by disease advocacy groups tends to focus on therapeutic research that can be commercialized in the short run. By limiting NIH funding -- a trend which recent budgets have exacerbated -- current federal policy may well have increased the commercial orientation of most funded stem cell research at the possible expense of longer term scientific progress.

So let’s review: current federal policy has had the short run effects of slowing up research in this country (but not elsewhere), wasting a fair amount of money, and forfeiting influence over how research gets done. In the longer run, it’s significantly increased spending on embryonic stem cell research, provided major commercial opportunities for entrepreneurial governments both here and overseas, and likely raised the average salaries of stem cell researchers. As Mr. Rogers might put it, can you say shoot yourself in the foot, boys and girls?

James W. Fossett co-directs the Rockefeller Institute of Government/AMBI states and bioethics program. He is also responsible for the Rockefeller Institute's health and Medicaid studies and is Associate Professor of Public Administration and Public Health at the Rockefeller College of Public Affairs and Policy, University at Albany.

Earlier coverage of induced pluripotent stem cells on blog.bioethics.net