Prop 38: Borrows $8.4 Billion to Fund Immunology Research

Ericka Cruz Guevarra: [00:00:00] Immunotherapy has been around for a really long time. Things like vaccines are considered part of immunology, but it also includes more recent innovations like newer treatments for blood and skin cancers.

Olivia Allen-Price: [00:00:15] In simple terms, immunotherapy is individualized treatment designed to harness a patient’s immune system to fight disease. For some, immunotherapy has been life-changing. And voters are being asked this November whether to fund immunology and immunotherapy research with one very specific beneficiary in mind.

Ericka Cruz Guevarra: [00:00:38] I’m Ericka Cruz Guevarra, host of The Bay.

Olivia Allen-Price: [00:00:41] And I’m Olivia Allen-Price, host of Bay Curious.

Ericka Cruz Guevarra: [00:00:44] And welcome to Prop Fest. A collaboration between the Bay and Bay Curious, where we break down all 14 statewide propositions on your ballot this year November.

Olivia Allen-Price: [00:00:54] And we’re back at it again with Proposition 38. Here’s how it reads on your ballot.

Reporter: [00:01:01] Prop 38 authorizes bonds for immunology medical research.

Ericka Cruz Guevarra: [00:01:08] Here to walk us through all of this is KQED Health Correspondent April Dembosky. April, first of all, what is Prop 38 all about?

April Dembosky: [00:01:16] Prop 38 is a bond measure that would fund immunology and immunotherapy research. It would allow the state to borrow $8.4 billion and distribute it to nonprofit research centers that are studying immunotherapy treatments for cancer, heart disease, and Alzheimer’s. The measure is expected to cost the state about $500 million a year for 20 years in bond repayments. And about $4 billion of that would be interest payments on top of the original 8.4 billion for a total cost of about $12 billion.

Ericka Cruz Guevarra: [00:01:58] There is sort of an interesting story about how this came on the ballot in the first place, right? Can you actually talk about why voters are even being asked to fund immunotherapy in this year’s election?

April Dembosky: [00:02:11] Prop 38 was the brainchild of a philanthropist named Gary Michelson. He raised the money to collect the signatures and put Prop 38 on the ballot. Something that’s really interesting about the initiative is how it’s worded. The language is very careful. It lists very strict criteria for the type of academic institution that should receive half of the money. This criteria is so specific. That only one university in the state meets the criteria, and that is UCLA. Half the funds would go toward launching a new immunology institute at UCLA, and the other half would be awarded through competitive grants to other institutes also in California. And so, as it turns out, Michelson has already donated $120 million of his own money to establish a new institute for immunotherapy at UCLA. It’s called the California Institute for Immunology and Immunotherapy. That same institution would also be the touch point for all the research. So the other half of the funding that would get distributed in competitive grants would all be sort of centered at UCLA. So it’s safe to say that this is on the ballot because a very wealthy philanthropist put it there as a way to finance a research institution focused on his interest, which is immunology and immunotherapy.

Ericka Cruz Guevarra: [00:03:50] Okay, April, so Prop 38 was put on the ballot by this wealthy philanthropist, Gary Michelson, and it’s written in this way that would, it sounds like directly benefit a research institute at UCLA that he’s helping to fund. So clearly he has some skin in the game here. Is Prop 38 getting much support from elsewhere? Like how else is the pro-Prop 38 side kind of shaping up?

April Dembosky: [00:04:18] There’s a long list of foundations and advocacy groups that have signed on in support of Prop 38, places like Blood Cancer United, the Melanoma Research Alliance, the Alzheimer’s Association, the ALS Association, the National Multiple Sclerosis Society, the Michael J. Fox Foundation for Parkinson’s Research. So these are groups that hope and believe that new immunotherapies could be developed to treat these specific diseases. Proponents also say this initiative is necessary because federal funding for this kind of research has become unreliable under the current administration.

Jillian McCool: [00:04:58] The big thing right now is that current CAR T therapy is really expensive. It’s not as efficient as we want it to be.

April Dembosky: [00:05:05] So I spoke to one researcher who was working on a project funded by the NIH, the National Institutes of Health. Her name is Jillian McCool, and she was working at Lawrence Livermore National Laboratory studying vaccines and a kind of therapy for cancer.

Jillian McCool: [00:05:20] We basically can take your immune cells and we can take them out of your body and we an alter them so they’re better fit and better suited to fight cancer cells specifically.

April Dembosky: [00:05:29] And then some of their grants ran out after they reached the end of the term, but then some of the funding was paused because of the most recent government shutdown.

Jillian McCool: [00:05:38] All of the sudden we have this weird rhetoric around vaccines and all of the sudden there’s this new administration coming in that’s kind of pushing that rhetoric.

April Dembosky: [00:05:47] McCool says about 100 scientists were laid off, including her. She was out of work for a year and a half.

Jillian McCool: [00:05:54] And then the public is no longer trusting scientists and what they have to say in the data we’ve collected, it kind of makes you question your whole career in general.

April Dembosky: [00:06:05] So it’s personal for McCool, but she says Prop 38 is a way to correct what’s happening at the federal level and protect the jobs of lots of other scientists. She also says, you know, California is a center of excellence in this kind of research, and so it makes sense to root it here. She also points out that the measure is designed to be cost neutral, with 10% of revenues generated from successful discoveries being funneled back to the state. Californians would also be entitled to a 20% discount on any new therapies that are generated from the bond money.

Ericka Cruz Guevarra: [00:06:41] And a big part of immunotherapy research is directed towards cancer research and you actually met a cancer patient who’s pretty gung-ho about Prop 38, right? Tell me about her.

Laurie Adami: [00:06:52] My name is Laurie Adami and I live in Los Angeles, California.

April Dembosky: [00:06:57] Laurie was diagnosed with non-Hodgkin’s lymphoma. It’s a kind of blood cancer, and this was 20 years ago.

Laurie Adami: [00:07:04] And when I got sick and I ended up losing my career as a result of my very long battle with cancer.

April Dembosky: [00:07:13] Several years ago, she enrolled in a clinical trial for an immunotherapy called CAR-T. So, Laurie had one infusion of this immunotherapy about eight years ago and her cancer has not come back since. Now, she’s only one person. You know, it’s important to point out there’s still a large proportion of patients who participated in these trials who did not respond in the same way. But as you can imagine, Laurie is pretty gung-ho for Prop 38. Because of the prospect that it could fund more research and develop more treatments like this to fight other kinds of cancers and other diseases and help more people.

Laurie Adami: [00:07:54] You know, not every family is gonna be affected by cancer, but every family is gonna affected by these other diseases. And so I am a huge proponent and supporter because immunotherapy saved my life. So why wouldn’t I believe? And why wouldn’t I want more patients to be able to access the type of treatment that finally saved my live?

Ericka Cruz Guevarra: [00:08:23] We’ll have more on Proposition 38 right after this. By the way, if you appreciate the work we’re doing here on PropFest, consider becoming a sustaining member of KQED. We can’t do this work without you. Just go to donate.kqed.org slash podcasts. We’ll be right back.

Ericka Cruz Guevarra: [00:08:47] And we’re back breaking down Proposition 38 with KQED’s April Dembosky. April, you talked about the various different groups supporting Prop 38, including a patient who really believes in the power of immunotherapy research to potentially save lives. So who’s coming out against Prop 38 and what is their argument?

April Dembosky: [00:09:10] Yeah, so there’s a very small group of opponents. They’re pretty much all volunteers. It’s very grassroots. And they have organized to point out what they see as the weaknesses and even what they might call the dangers of Prop 38.

Robert Kaplan: [00:09:26] I just think that there are inherent conflicts of interest.

April Dembosky: [00:09:29] The main one is Robert Kaplan. He’s a biomedical researcher and administrator at Stanford University School of Medicine. And he also worked at the NIH, the National Institutes of Health. So he has a lot of experience coordinating the kind of research that we’re talking about and at a really grand scale. So he says he supports biomedical research. He’s in favor of science, including immunotherapy. But he says this proposition is not the way to fund it.

Robert Kaplan: [00:09:58] If you look at NIH support for biomedical research in general or immunology research, there are several institutions in California that are the national leaders, but because of the sort of arbitrary criteria in Proposition 38, they’re not eligible to compete. And we think that’s not right.

April Dembosky: [00:10:17] So science grants are usually awarded based on an open, competitive process. People have to have a proven track record. He says it’s a good idea to spread that kind of research across different institutions, so you have different people with different ideas and different methodology. But half of the money for Prop 38 goes directly to one brand new institute that is barely off the ground yet, and it has zero track record.

Robert Kaplan: [00:10:47] I think [if] taxpayers are going to have to repay these bonds. We think that should be a fair competition that allows all of these excellent institutions in California to have an opportunity to be in that competition.

April Dembosky: [00:10:59] The opponents would really point out it’s only for immunotherapy and immunology research. So if you think that there are other kinds of health priorities, like mental illness or kidney disease or other kinds treatments, those are not included here. The other people speaking out against Prop 38, they’re a very interesting group. They are financial analysts who used to work at the LAO. That’s the Legislative Analyst’s Office. And this is a nonpartisan state agency. It’s tasked with evaluating proposed legislation and ballot measures like this one. And they are trained to never take a stand on political issues. And in this case, three retired analysts from the LAOs are breaking that wall, because of their concerns on Prop 38.

Dan Carson: [00:11:56] Hi. I’m Dan Carson. I’m here today as a cancer survivor myself, who is obviously not against good medical research.

April Dembosky: [00:12:05] So one of them is Dan Carson. He ran the health section of the LAO back in 2004 when another bond measure was on the ballot to fund stem cell research. So proponents said the $3 billion for that initiative would be paid back by all the new stem cell discoveries that researchers made with the money.

Dan Carson: [00:12:26] In fact, as our analysis at the time made really clear, the state eventually received only a tiny fraction of the billions of dollars we were promised. So here we go again with Prop 38.

April Dembosky: [00:12:41] The opponents of Prop 38 take issue with one of the main claims that the supporters of Prop 38 have, which is they say that the proposition will be cost neutral, that the money that California borrows and spends on the research will be made back by revenues from all of the scientific discoveries that they made. The LAO analysts say the math just doesn’t add up.

Dan Carson: [00:13:08] Oh, once again, we’re being promised in this initiative and by its advocates that will quote, pay for itself with no net cost to the state or taxpayers, closed quote. I’m here to tell you that after reviewing the fine print of this ballot measure, that won’t happen.

Ericka Cruz Guevarra: [00:13:32] April, what’s spending on Prop 38 looking like on either side, the yes and the no side?

April Dembosky: [00:13:38] So the Yes on Prop 38 campaign has raised about $27 million so far, and that comes mainly from Gary Michaelson and another billionaire who have donated to the same institute that would be the main beneficiary of the Prop 38 funds. The no side has not raised any money so far.

Ericka Cruz Guevarra: [00:13:59] It seems like we as voters are sort of being asked to decide how scientific research should happen almost and the best way to go about that. How do you think voters should sort of navigate the question being asked before them?

April Dembosky: [00:14:15] It’s such a tricky one to put voters in a position of having to become experts on a field of science that maybe they haven’t even heard about. Totally, that’s how I feel. Right. You know, I think on its face, Prop 38 is very appealing and we’ve seen various ballot measures over the years that are healthcare oriented and we find that they often play well. For people who feel really strongly about this area of research, they may feel happy to have the opportunity to vote on something like this and set aside a pot of money that is just for this kind of research. On the other hand, the way that this proposition is worded and the way the money would be distributed looks very, very different from the kind of process that’s used at the federal level. So you’re not just creating a new fund for stability, you’re actually creating a new way of how that science gets funded and how the money gets distributed. Propositions like this, you could say are direct democracy, but in another way, they also circumvent that other democratic process.

Ericka Cruz Guevarra: [00:15:35] Well, April Dombosky, thank you so much for breaking this down. Appreciate it.

April Dembosky: [00:15:40] Thanks, Ericka.

Ericka Cruz Guevarra: [00:15:42] In a nutshell, a yes vote on this measure means the state could borrow $8.4 billion to support medical research in immunology and immunotherapy. A no vote means the state cannot borrow 8.4 billion for immunology, and immunotherapy research.

Olivia Allen-Price: [00:16:02] And that’s it for our latest episode of PropFest, a collaboration between The Bay and Bay Curious. If this series is helping you get educated on all the statewide props, we sure hope that you’re going to share them with your friends and family.

Ericka Cruz Guevarra: [00:16:16] The link is kqed.org slash propfest and we’ll be dropping new breakdowns until October 9th.

Olivia Allen-Price: [00:16:24] PropFest is made possible thanks to Katrina Schwartz, Pauline Bartolone, Anna Casalme, Ericka Cruz Guevara, Gabriela Glueck. Christopher Beale, Alan Montecillo.

Olivia Allen-Price: [00:16:35] And me, Olivia Allen Price.

Ericka Cruz Guevarra: [00:16:37] We get extra support from Maha Sanad, Katie Springer, Jen Chien. Ethan Tovan Lindsey and everyone on Team KQED.

Olivia Allen-Price: [00:16:46] Our show is made in San Francisco at member-supported KQED.

Ericka Cruz Guevarra: [00:16:51] Support for The Bay is provided in part by the Osher Production Fund. Some members of the KQED podcast team are represented by the Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco, Northern California Local. I’m Ericka Cruz Guevarra.

Olivia Allen-Price: [00:17:08] And I’m Olivia Allen-Price. Have a good one.

Some members of the KQED podcast team are represented by The Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco-Northern California Local.