Sunday, March 18, 2007

Beyond $131 Million: Looking Ahead at CIRM

You could call it the pipeline and presidency issue. Even before the directors of California's stem cell agency approved an unprecedented $75 million in grants, some of them were worrying about what happens next.

Brian Henderson, dean of the USC medical school, told his fellow members on the CIRM Oversight Committee, "We do not want to congratulate ourselves too much."

CIRM, however, does have something to congratulate itself about, as Los Angeles Mayor Antonio Villaraigosa reminded them during a Friday morning news conference. "Put a smile on your face," he said.

CIRM has pumped out $131 million in grants so far this year, making it clearly the largest single source of embryonic stem cell research funding in the world. More millions will come later this year. And before the end of the year, with a little luck, they will see even bigger bucks flowing in through the sale of state bonds that have been delayed because of litigation.

However, the 22-member staff of the agency has been working extraordinarily long hours. "Heroic" was a word that came up often during last week's two-day meetings to describe the work of the staff. One example that was cited was the case of one staffer, who was up until 4 a.m. readying documents for the first day of the meetings. While that may be a tad exceptional, Oversight Committee members for some time have expressed concern about the workload of the agency.

As Michael Friedman, president of the City of Hope, put it last week, the agency has been sprinting, and "we are in for a marathon."

The "challenges" facing CIRM include the loss of President Zach Hall in June, the search for his successor, the void until the new president comes aboard and the need to fill the pipeline with more grants as well as administering the ones already approved.

Several board members said momentum needs to be maintained to provide opportunities for the new scientists that have been arriving in California to tap CIRM's $3 billion research effort. They urged Hall to fill staff positions as rapidly as possible to maintain the workflow. "Please don't scrimp," Friedman said.

CIRM is not likely to have a new president on board by the time Hall leaves, which will accentuate the normal uncertainty that arises with the arrival of new CEOs, especially in small, new organizations. However, something of a model exists for working through that period. Hall will take a vacation this month and has designated two persons to act in his stead, Arlene Chiu, scientific program director, on scientific matters and Lorraine Hoffman, chief financial officer, on other issues. How they fulfill their responsibilities will be a good test for June and later in the summer.

The 29 members of the Oversight Committee hold an important key to CIRM stability and momentum. They should curb their micro-management urges, some of which are possessed in abundance by some members of the board, and focus on filling the presidency as quickly as possible. Twenty-nine busy fingers in the CIRM pie are likely to leave a pretty mess.

Henderson and the others are right to worry about a letdown, which can easily happen during or following periods of intense effort, which has been the story since January 2005. Avoiding a letdown and leaving a healthy organization may be one of Hall's most important tasks in the next few months. But much of the burden will fall on senior CIRM management, the folks who will ride through the transition. After all, they are the ones who will be left to engineer the giveaway of a piddling $2.8 billion or so over the next 10 years.

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