The meeting was almost over when Roman Reed steered his wheelchair to the microphone.
On the table before him sat a 149-page book of budget charts and timetables, the first concrete outline of what California's voter-approved stem cell institute plans to accomplish in its 10-year lifespan.
"I want to thank you from the bottom of my heart," Reed said to the institute's staff and 29-member oversight board in October. "I promised my son that one day I would be able to walk, stand next to him and go hold my wife's hand. And seeing this road map to cures, I know that this will come true."
The room at Los Angeles' Luxe Hotel thundered with applause for the Fremont resident, who broke his neck while playing college football in 1994.
Despite the enthusiasm of Reed and his audience, the book offered no promise of a cure for his paralysis.
Two years after California voters authorized $3 billion in bonds to fund stem cell research, the institute created to oversee the enterprise has just begun what experts see as a long and slow scientific journey. Even with the $150-million state loan approved recently to kick-start work stalled by legal challenges, there are no breakthroughs in sight. Gone are the allusions to healing such afflictions as spinal cord injuries and Parkinson's and Alzheimer's diseases that dominated the 2004 campaign for Proposition 71. In fact, scientists say, there is no guarantee of cures -- certainly not any time soon -- from the measure that was optimistically titled the California Stem Cell Research and Cures Act.
Set for final approval at UC Irvine this week, the draft plan is clear: "It is unlikely that [the California Institute of Regenerative Medicine] will be able to fully develop stem cell therapy for routine clinical use during the 10 years of the plan."
Instead, the top goal is to establish, in principle, that a therapy developed from human embryonic stem cells can "restore function for at least one disease."
That would be only the first step toward persuading pharmaceutical or biotech companies to fund expanded clinical trials, a process that takes years and millions of dollars. Fewer than 20% of potential therapies that enter trials make it to market.
In addition, the institute hopes to have treatments for two to four more diseases in development within the decade.
"We picked a goal that we thought was realistic, that, with some luck, would be achieved," institute President Zach Hall said. "The field will go on beyond 10 years. We want to have a whole pipeline of things that are in movement."
Honesty appreciated
Jesse Reynolds of the Oakland-based Center for Genetics and Society, a watchdog group that supports stem cell research but advocates better public accountability, called the goals "refreshingly honest."
"The Prop. 71 campaign went beyond the line of responsible political rhetoric," he said. "If there are therapies, they're decades out."
One TV ad, for instance, showed an unidentified young mother beside a child strapped in a wheelchair and breathing through a tube.
"I will vote 'yes' on Prop. 71, definitely," the woman said. "I believe that it's something that can cure spinal cord injuries."
State Senate Health Committee Chairwoman Deborah Ortiz (D-Sacramento), another research backer, was philosophical about the campaign's optimism.
"A campaign requires a message to be driven home," she said. "You can't raise those hopes and then say, 'Oh by the way, it may take us 10 or 15 years.' That's just the nature of campaigns."
California's attempt to cure diseases by referendum is unique. But touting dramatic cures in exchange for research dollars has become "the American way" of doing medical research, said Robert Blendon, professor of health policy and management at the Harvard School of Public Health.
The Nixon-era "war on cancer" suggested that a country that could put a man on the moon -- in less than a decade -- could surely find a cure within the same time frame. Now, Blendon said, "You can't just talk about investing in research without the equivalent of the trip to the moon."
Such campaigns appeal to an American public that expresses great faith in science but shows little understanding of the plodding nature of most scientific research. Blendon doesn't see downplaying the time frame as dishonest as long as the research truly holds potential.
Proposition 71 came about in response to President Bush's August 2001 mandate restricting federal funding to only a handful of human embryonic stem cell lines, prompted by moral concerns about destruction of embryos during such research. When the measure passed in November 2004, jubilant supporters had predicted that $350 million a year from bond sales would start flowing to scientists by May 2005.
The first reality check came in the form of lawsuits by taxpayer and antiabortion groups.
A loan from the state
