105 Alta Charo

>> Hello, welcome. I'm Margaret Lewis. I'm the Executive Director of the Wisconsin Academy of Sciences, Arts and Letters. We're just delighted that you're all here to have a conversation tonight with us with Bioethics and Law Professor Alta Charo, who will be speaking to us about the Tales from the Other Biotech Frontier. If you're joining us for the first time tonight at a Wisconsin Academy Evening event, this offers us a brief opportunity to tell you a little bit about who we are. We're a non-profit organization that's been around since about 1870, and governed by a statewide council and foundation board. I'm pleased tonight that we are joined by several of the Academy staff, Laura Dies, who I'll introduce in a minute. And I think that Barb Stanford is around. They'll collect cards that give us an opportunity to receive your feedback on tonight's event and give you an opportunity to suggest future topics or speakers that you would like to hear from. 

The Wisconsin Academy's mission is to bring to the public, together with leading thinkers in our state, to shed light on important issues in a wide range of areas, the sciences, arts and letters, as our name indicates. 

We try to offer the very best knowledge available in a respectful and agenda-free environment. On the table outside of the theater, as you came in, you can pick up a season schedule, or take a copy of our recent magazine, so that you can learn about all of our other programs. We have an exciting season before us, and we hope that you will all participate. As you might know, we do have four core programs. In addition to this lecture series, we have an art gallery next door, the James Watrous Gallery, that celebrates Wisconsin artists. We have an award-winning magazine that celebrates Wisconsin thought and culture called People and Ideas, that talks about the people behind the great activities that are going on in the state. And we have a public policy program called Wisconsin Idea, at the Wisconsin Academy, aimed at outlining solutions for a better Wisconsin. These public policy programs are multi-year projects that generate guidelines and recommendations that have a direct effect on legislation and education. One example is some groundbreaking ground water legislation that came out of the last project called Waters of Wisconsin. 

So you can see that our work crosses many boundaries. 

And as you learn more about us, I hope you'll think about becoming a member. There's a membership envelope that you may well have received on your way in, or you can pick up on your way out. The reason that I call that to your attention is that it has the old membership fee, which is only $25 for a new member. That will go up soon. But thrifty as we are, we're using up our own old envelopes, so take good advantage of that, and join tonight if you can. Very important, as I said earlier, we would love to have your input on future programs. So do help us out by filling out a card and if you'd like to win one of the prizes that's been donated by the University Bookstore and the Overture Center, help us out by putting in your email address, because we'll inform winners by email. Just one more thing before we begin. I'd like to thank our very generous sponsors, the Pleasant T. Rowland Foundation, the University of Wisconsin Research Foundation, the UW-Madison, the John and Sally Mielke Family Fund, and many individual donors and members that are here in the audience tonight. 

We'd also like to, on behalf of the friends and supporters that can't be here this evening, to thank Wisconsin Public Television, for making this available for the Internet and for rebroadcast to people around the state. So without any more adieu, we'd like to again welcome you to this wonderful program. If you'd like to be helpful in sponsoring future programs, please feel free to see me after this program. Now I'd like to introduce our special events director, Laura Dies, who will introduce our speaker tonight. Thanks, Laura. >> Thank you, Margaret. And thank you everyone for being with us tonight. Regarding tonight's program, there will be time for questions after Alta's presentation. Professor Alta Charo received her BA in Biology from Harvard University and her JD from Columbia University Law School. 

She is the Warren P. Knowles Professor of Law in Bioethics at the UW-Madison, where she is on the faculty of the Law School and the Medical School's Department of Medical History and Bioethics, and also serves on the faculty of the UW Masters in Biotechnology Studies program. Wow, that's a lot! Her public service career includes membership on the National Institutes of Health, Human Embryo Research Panel, and five years on President Clinton's National Bioethics Advisory Commission, where she worked on reports concerning research ethics, cloning and stem cell research. In 2005, she was appointed to the Ethics Standards Working Group of the California Institute for Regenerative Medicine. Also in 2005, she helped to draft the National Academy's Guidelines for Embryonic Stem Cell Research, which have become the national voluntary standard for ethical research in this field. In 2006, she was appointed to co-chair the National Academy's Human Embryonic Stem Cell Research Advisory Committee. She has been elected into membership in the National Academy's Institute of Medicine. And we at the Wisconsin Academy are proud that she was elected as a Distinguished Fellow, as well. And if all of that commitment to those work groups, commissions and fellowships isn't enough to keep her busy, and bring her neighbors out tonight, because they don't see her, I understand-- (laughter) Alta spent last year on the west coast as a visiting professor at the University of California-Berkeley School of Law, where she taught courses on pharmaceutical development and stem cell policy, and served as a faculty advisor to their new Stem Cell Fellows Program. 

Alta is a native of Brooklyn, New York, and has many outside interests, not the least of which are poker, roller coasters, Jane Austen novels and Star Trek.

We look forward to Alta's reflections on the Golden State, and how Wisconsin's policy makers can keep our state competitive. We are pleased she is with us tonight to discuss Tales From The Other Biotech Frontier. Please welcome Alta Charo. (applause) >> Thank you. >> You're welcome. >> I've got to tell you that she wasn't kidding about the neighbors. But she also didn't mention the colleagues and the faculty members all around the campus that actually do stem cell research. So for those of you who know everything I'm about to say, I excuse you, if you'd like to leave early. And I will address myself to the one or two people left in the room, who may not know all these things. 

It was a very valuable year that I spent in California, if only because it was a chance to be on the other side of those really irritatingly entertaining commercials that we've all come to know called the Happy Cows commercials. 

I'm sure you know about these commercials. Usually, with one or two bulls that are going, "Hey, baby," and some very cute looking cows. And always, of course, the guys do not quite get the cows, but nonetheless, they end by saying, that great cheese comes from happy cows. And happy cows come from California. My goal here tonight is to tell you that not all cows in California are all that happy. (laughter) Although all cows in California indeed are very well-off. So, I would like to spend my time tonight talking about the differences between being well-off and being happy, when it comes to stem cell research. I'm going to try to keep my comments relatively brief. That's in terms of a professor who thinks in 55-minute units. 

Because usually, the question and answer session is far more interesting than the main presentation. 

So I'm going to try to outline some things that might spark some interest in conversation following the talk. I think all of us here in Wisconsin are familiar with the fact that this is, of course, one of the great centers of embryonic stem cell research in the United States. And that, of course, is largely, not entirely, but largely due to the really path-breaking work that Jamie Thomson did in moving this field from what had been decades of work on the mouse model, where the embryos are easy to use, but morphologically distinctly different from the human embryo, and therefore posing different challenges. And then moving that research first into non-human primates and then from there into humans, so that by the mid and late-1990s, we in Wisconsin, had a real lead in this field. And embryonic stem cell research had been discussed for decades as potentially one of the most exciting developments in medicine. Because embryonic stem cells, which all of you probably know already, because they are so flexible, because they have the capacity for development into such a wide variety of human tissues, provide an enormously valuable laboratory tool for the study of human disease and the study of tissue development. They provide a platform for the study of drugs and their toxicities and their potential for therapeutic application. They provide and avenue for looking for ways to help our bodies heal themselves, or to replace the organs and tissues that have been damaged from disease. So for years there had been this discussion. 

Indeed, Laura very kindly mentioned my work on the NIH Human Embryo Research Panel, which dates back to 1993, before Jamie's work. 

And that report that we wrote at a time where there had been a short window of opportunity for federal funding of embryo research, a window that closed before the research ever did get funded, focused in large part, specifically on the possibility of using embryo research as a way to get to embryonic stem cell research. So in that sense, this had been long discussed. And finally here in Wisconsin was brought to the earliest stages of fruition. Despite the fact that we had therefore a tremendous, kind of psychological lead, we had a technical lead, we had at the time, under Governor Thompson, somebody who saw this as an avenue toward economic development for a state characterized by high literacy rate, nearly universally good education, and therefore a workforce poised to move into the knowledge economy. Despite that fact, Wisconsin has not been a leader in the social and financial mechanisms that are needed to really promote this work. And part of that is due to the fact that this state, like so many others, is somewhat paralyzed at the legislative level by the debate surrounding abortion. Because of a state legislature that is split between those who favor abortion rights and those who oppose them, because we had two Houses that were controlled by a party that was most closely aligned with those who opposed abortion rights, it really wasn't possible at the legislative level to see our leaders come together in order to provide some positive impetus for this field in the form of affirmatively funding it above and beyond the kinds of monies that are available through the usual governmental funding mechanisms. And that governmental mechanism is the federal government. The National Institutes of Health has a funding program that dwarfs the funding program of the entire collection of nation states in the European Union combined. 

When the NIH doesn't fund the field, it starves the field. 

And because of the politics around embryonic stem cell research at the federal level, that's precisely what happened. The NIH withdrew all but a small amount of funding for a subset of research possibilities in this area, and left researchers with no federal governmental body to turn to for work on any of the lines that had been developed after 2001. Our state did not walk into that gap with legislative funding. Certainly, the UW Foundation has actually put a lot of effort into developing a private donor base. And they've actually appointed people whose work entirely is about looking for private funders who will work to give grants to specific researchers, or to the stem cell program as a whole here on campus. Nonetheless, private donations cannot compete with governmental funding. In addition, Wisconsin's been characterized by occasional moments of what is perceived within the biotechnology sector as actual hostility to this field. Now cloning is not the same thing as stem cell research. Cloning research, which involves taking a cell, for example, from your skin, and using it as a template to create now a customized line of stem cells that will have the same genetic characteristics, is essentially a way of creating a specialized stem cell line. 

There are not a lot of experiments that need this particular technique. 

Most stem cell lines will come from embryos that would otherwise be discarded at the conclusion of reproductive efforts, like couples using In Vitro fertilization. But cloning has certainly caught the public's imagination, both because of its association with human reproduction, and because of the fact that it creates an entity that for many people is morally and biologically indistinguishable from an ordinary embryo. So twice our legislature has moved to pass bills that would criminalize, not the use of cloning to make a baby, but the use of cloning to make an entity that would be studied in the laboratory for several days, and used to create a customized stem cell line. So-called research cloning, or non-reproductive cloning was the focus of this effort to criminalize the research. Now, as far as I know, there is not yet anybody on this campus who is trying to do that work, nor anybody in the state that's actually trying to do that work. So these bills did not, at the time they were being debated, actually threaten any scientist in Wisconsin. But they did say something about the atmosphere for science in Wisconsin and the potential for a political judgment that science needs to be censored and restricted, not because of its ability to harm an existing individual who can feel and think, but instead because its association with arguments around embryo research and abortion. That created an atmosphere that can be read as hostile, or at least threatening for the world of science. And certainly, other states have moved to actually enact such laws. 

Such states including our neighbors, Michigan and Iowa, although Iowa eventually withdrew the law because of its effect on the scientific community. 

North and South Dakota, New Hampshire and a few others. So in Wisconsin, we had no legislative action to fund the research of any type. We had a history of efforts to criminalize at least one related area of research, which set up an atmosphere of at least some degree of fear on the part of either the scientist or the investment community. And with this, we also lost the opportunity to regulate this research. Now, most research in America is already regulated in many of its stages. Are you working with an animal? You're subjected to the Animal Welfare Act. Are you working with a human being in a clinical trial? A plethora of regulations that will apply before you can actually enroll that person. 

Are you doing genetic engineering in a way that creates a recombinant entity? 

That will also have to go to a special review board. Are you working on tissues that will ultimately be transplanted into a human being in some clinical capacity? Now the Food and Drug Administration gets involved. So science is already heavily regulated. But there are nonetheless gaps of regulation where it refers solely to laboratory work, on cell lines, that don't involve humans, and don't involve animals. And there were calls for regulation to fill this gap, simply because this field is so controversial. The absence of funding, and the move toward a blunt instrument of criminalization meant that Wisconsin lost its opportunity to take a more nuanced approach, which is to ask what would be the right kinds of regulations needed to foster the research, while allaying public concerns and protecting any entities that actually are at risk. Against this backdrop, the one affirmative action that has occurred in Wisconsin has been at the executive level, through the governor's office. Because, of course, the governor, like the president of the United States, has discretionary power over a certain amount of funding. 

And Governor Doyle has directed that certain funds be aimed toward the promotion of stem cell research. 

For example, he directed the Department of Commerce to allocate approximately $5 million toward stem cell research in general, in the form of business grants and general science development grants. And we have actually here in the audience Gabriela Cezar, who's the Chief Scientific Officer for one of our local companies, Stemina, which got one of the very first grants, just three or four weeks ago, that it was announced. A couple of months ago, sorry. I'm slow on getting my news. And so we now have examples of the governor using the limited power available in the absence of a legislative partnership, to try and promote this field. In addition, many of you are familiar with the announcement about the Wisconsin Institutes for Discovery and the companion private sector institute, the Morgridge Institute for Research, which will go beyond stem cell research, but certainly include that. Now by contrast, California has taken a far more aggressive approach in funding, in legislation, in regulation, in anticipating debates around social justice in the use of, or access to the benefits of this technology. All of which have made California the official leader in the United States in the world of embryonic stem cell research, not Wisconsin. That said, it is not a completely unmixed blessing to have all that money. 

Let me tell you now about what's going on, as you put it, on the other frontier. 

You know, before it burns to the ground, California represents the epicenter for both the computer and the biotechnology sectors. From southern California in a kind of corridor running from San Diego to Los Angeles, and in northern California from San Jose, through San Francisco and north up to Berkeley, you have two huge concentrations of both computer companies and biotechnology companies. And this kind of concentration has all sorts of ancillary effects. You draw in a workforce that is highly educated and ready to serve, whether it's people who do informatics, or it's people who are bench scientists, or it is people who are specialists in management or in intellectual property issues from the law firms, or in drug regulation issues as you move forward. So what you get is essentially a professional infrastructure for your biotechnology science companies. It's exactly why the Masters in Biotechnology Program was developed here in Wisconsin, to develop exactly that kind of professional infrastructure for our own biotechnology sector. California, though, did it simply through gravity. The sheer concentration of companies simply sucked talent from all over the country. It didn't hurt that the weather is the best in the world. 

(laughter) Although it doesn't help that to afford a place to live, you've got to usually move-- I'm not kidding, an hour to an hour and a half away from where you're working. 

And that's not that it's an hour and a half worth of miles, it's that you're on the side of the Bay Bridge. So California, despite some of the lifestyle challenges, has become this kind of force to draw talent in. California also has a legislature and a governor that, although driven like all legislatures, by the debate surrounding abortion, nonetheless tend to be a little more progressive when it comes to aggressive economic development. And the support for the Biotechnology Center has been extraordinary. In the area of stem cell research, California was the first one out of the box with a state law that specifically said what was already true, but said it so that everybody knew it and believed it. And that was that embryonic stem cell research is legal. Cloning research is legal. It's going to stay legal until the day that the federal government actually criminalizes it. You don't need to actually say this in law, because in law in the United States, everything is legal until it's made illegal, right? 

I'm serious. 

That is the presumption here, as opposed to-- There's an old joke about how in East Germany everything was illegal until you said it was legal, right? They also said that in Russia, everything was illegal, especially if it was legal. (laughter) This is my favorite. In Italy, everything is legal, especially if it's illegal. (laughter) And I always thought those four categories did capture political philosophy better than any number of college courses. But the California law was in some ways completely redundant. But it also gave the legislature a chance to also get out in front of some issues that concerned the public. So for example, they wrote into that law that all research that's done was also going to have to comply with certain protections for the human subjects of research. Now again, in many ways, somewhat redundant of federal rules, but not completely. 

Because the federal rules, and this is more detail than you need, actually had some interesting little gaps having to due with the people who donate tissue. 

And this clarified that those people, even though not typical research subjects, would nonetheless be guaranteed the opportunity to be fully informed before they voluntary gave up material, like excess embryos or eggs for research. And California, beyond legislation, moved forward with yet another and really dramatic initiative. This was 2003 and into 2004, when California debated Proposition 71. And one of the things that people, I think, kind of know, because they read about it, is that California's politics is really unusual. I mean, for all sorts of reasons, but particularly unusual in the way that they enact law. They are the kings and queens of referenda. They love referenda. They even-- You can't walk down the street in any one of these cities without somebody thrusting a petition in your hand because they want to get a referendum on the ballot. And this time, it was a referendum to provide state funding for embryonic stem cell research. 

Actually, all stem cell research, but with a preference to the kind of research the federal government was not funding. 

Now, Prop 71 was being sold as a path to cures for patients. And it was also being sold as sound economic investment. Because if Prop 71 passed, it would authorize the state government to sell bonds. And the bonds, essentially, are long-term loans to the government, to support this research. And eventually, it has to be paid back, with interest. The idea was that the research was going to pay off in so many inventions that could be patented, and then licensed for high royalty fees, that the royalty fees were going to cover the cost of paying off the interest on the bonds. This was, by the way, no pun intended, patently insane. But this was one of the ways it was being sold. And the proposition was heatedly debated before the 2004 elections. 

The opponents actually cut across a political spectrum that is not intuitive. 

Most of us are used to thinking about politics in terms of traditional left-right, you know pro-abortion rights, anti-abortion rights; pro-states rights, pro-federal intervention; whatever the kind of typical left-right divisions are. That's not how it played out in California. Surely, there were many people who opposed Prop 71 because they came out of the activist organizations who opposed abortion rights, and saw embryo research as an extension of the arguments around the moral status of the earliest forms of developing life. But there were also kind of left-of-center, what we used to call in New York, "Goo-Goo's" good government people, who saw Prop 71 as a give-away. State bonds, essentially the state now borrowing money to give it to biotechnology companies and wealthy universities like Stanford, who could do just fine on their own, thank you very much for a technology that had no guaranteed pay-off, either in cures or in royalties. So they saw this as self-dealing of the highest sort. So those people who criticize self-dealing in the military sector were also the same people who would criticize self-dealing in the scientific sector. There were also coming from the left-of-center, people I will call fringe women's health groups. I say fringe because they represented a distinct minority. 

But nonetheless, a very vocal and well publicized minority within the women's health community. 

The mainstream women's groups, Planned Parenthood, Federation of America, NARAL, National Organization of Women, the ACLU Women's Projects, they all stayed studiously silent throughout the years of debate on the human embryonic stem cell research for reasons that we can talk about in the Q&A if you'd like. But some women's groups actually actively opposed Prop 71 because they saw this as potentially leading toward the purchase of human tissues, and particularly human eggs, which would require stimulation of women's bodies with infertility drugs that they had been criticizing since the 1980s, when they were first introduced for use by infertile couples. So an old argument, dating back to the 1980s, about women who were infertile and exactly how many medical risks and inconveniences they should undergo to have children, obviously linked to lots of concerns about the ideology around women and childbearing, was now coming to bear on an argument 20 years later concerning embryonic stem cell research. So we had this interesting array in California of right and left wing alliances to oppose Prop 71. Supporters, on the other hand, also ranged across many different political groups. First you had universities. And the universities did in fact see this as a potential way of getting substantial money, not only for research grants, but also for the building of new research facilities. Not only is that just kind of generally a nice thing to do, but because the federal rules, as written, require that if you're taking any federal money for the limited area they fund, you need to have studious physical separation of your privately funded, or non-federally funded research. You often needed to have duplicate labs, duplicate material. 

And therefore, universities really did want to have additional grants specifically to build separate facilities that would guarantee their ability to work on those cell lines that needed to be kept separate from the federal lines. 

So the federal policy not only was starving the field, but it was actively draining money out of it, because of the need to create redundant facilities. And this is why the universities were so supportive of Prop 71. The biotech companies, which don't necessarily all vote left of center, also saw this as an avenue to significant funding. Remember, biotech companies, because they're companies have to worry about the time to return on investment. And much of this research is so preliminary that you cannot predict the time to return on investment, except to the extent to say it won't be soon. And therefore, grants become a very important way of keeping the technology moving forward until the day when you actually can get a full array of private investors to come on board, because they see a timeline to a point at which their money is actually making money itself. Patient advocacy groups. Patients were being sold on the prospect of cures. And this was parallel to what was going on in the federal government in 2000, 2001 and 2002, when the federal government was busily debating whether or not to criminalize whole sectors of research. 

That was one part of what was going on. 

And at the same time, debating whether or not to increase funding for it. Kind of a schizophrenic congressional moment. And in California, the same debate going on. So patient groups had been mobilized at the federal level for years in an effort to try and keep the federal government from criminalizing and hopefully in the future affirmatively funding this field. They were brought in again in California. Now, the patient groups were told that cures are not necessarily around the corner. Reputable scientists said over and over and over that there are all of these intermediate steps, and science is very serendipitous. And we don't know when you'll get a cure. But in the public campaigns that you saw in California, without question, the advertisements were generally misleading. 

The advertisements would show a little boy in a wheelchair, and talk about how much he wanted to walk, as if passing Prop 71 guaranteed that this boy, whose muscles were wasting away because he's currently using a wheelchair, would some day be able to have tissue replacement to repair his spinal cord, and then magically he was going to walk, despite all of the other kinds of accumulating problems that come with a long-term injury like that. 

We had children-- We had parents talking about the agonies of having a child with Type 1 Diabetes, and the need to constantly provide invasive medical care and the fear every day that this was going to lead to long-term, devastating problems like blindness. And indeed some of the most important supporters of this research came to it out of juvenile diabetes. The charismatic real estate developer, Bob Klein, who led the Prop 71 effort, had a child with diabetes. Jerry Zucker, producer in Hollywood, also with Wisconsin connections, also because of diabetes. Sherry Lansing, former head of Paramount Pictures. These advertisements about sick children and the prospect for cures, coupled with the promise that this research was going to payback in spades in the form of royalties allowed this Proposition to pass. Not by much, but it passed. However, in the process of writing the proposition, in order to fend off some of the critics, and in order to anticipate some of the political backlash, some interesting provisions were written in which have had an effect on whether or not this money is really going to be as usable as people would like. It created something called the California Institute for Regenerative Medicine. 

C-I-R-M, which I'm going to now refer to as CIRM. 

And CIRM's first challenge was to create a governing board. Prop 71 set up a governing board that was largely populated by the heads of major universities around California. So all the people who complained about self-dealing in the original debate around Prop 71 pointed to this and said, "Ah-ha!" How can this governing council possibly make unbiased, disinterested decisions when in fact they're talking about policies that will have a direct effect on whether or not their own universities are eligible to apply for grants. This meant that the good government groups were never quieted after Prop 71 passed. And they became the Gadfly of CIRM. Every meeting. All of them open, because like us, they've got open meeting laws. You can actually read the transcripts of every meeting if you really want to be in deep pain. 

You can read it on their Web site, which is cirm.ca.gov Every meeting, the good government groups were there, challenging who was at the table, challenging which pieces of paper had been distributed, or not, challenging whether or not certain people should be recused because they have a conflict of interest that should not or cannot be waived. 

It actually slowed meetings to a halt regularly during the first year of CIRM's existence. Second, because they had lost on the referendum, which is the voting mechanism, the next tactic used by those who opposed abortion rights and saw this as an extension of their campaign on abortion rights, turned to the courts and to litigation. And they sued CIRM, specifically over a provision that was written into Prop 71 to protect CIRM from legislative interference. See the Californians looked around the country and saw how many legislatures were debating things like criminalizing cloning, or criminalizing embryonic stem cell research, and said we can't afford to set up this entire structure, this governing body, issue these bonds and then six months from now have the legislature pass a new law that's going to restrict it all. So to protect themselves, they wrote into the proposition a provision that said the legislature can't make any changes, in any aspect of this, for at least three years, to give themselves some breathing room. Now, in theory that was an incredibly smart thing to do. In practice, it turned out to be a very dumb thing to do. Because the legislator who had originally passed state law to protect this research was not part of the Prop 71 effort. And now as a member of the legislature, she was formally cut out of any influence over CIRM and how it developed. 

And she got really T'-off at Bob Klein. 

And this conflict between one particular supportive legislator and Bob Klein then morphed into a general revolt on the part of many legislators at the idea that Prop 71 had disempowered them. And although legislators may disagree about abortion policy and they may disagree about the state budget and they may disagree about whether or not you can have a creche at Christmas on state grounds, the one thing they absolutely all agree with is that they should not be disempowered. Right? This is the one issue that draws them all together. So they themselves now began to look for ways to undermine Prop 71's independence from the legislature, regardless of what they might like to do to it if they had the opportunity to do so. The litigation over the constitutionality of Prop 71 and its removal of CIRM from a whole variety of government oversight mechanisms and legislative oversight, that litigation dragged on for two and a half years, during which time no bonds could be issued. CIRM ran first on leftover money from the Prop 71 campaign, then on individual donations from Bob Klein, then on individual donations from local biotechnology companies and private donors. Dolby, for those of you that have Dolby sound systems, if you're in favor of embryonic stem cell research, keep your speakers. If you're opposed, throw them away. 

Because Dolby single handedly kept CIRM alive during a crucial period when funding had really vanished, until they were able to actually win in the litigation, all on very technical grounds, having to do with the way the proposition was written, and therefore move forward toward funding. 

But this irritation with the legislature had another interesting side effect. And that was to empower what otherwise would be a really teeny weeny little group of people in Oakland, California, called the Center for Genetics in Society. CGS, which has a Web site you can find, is a very small operation with very tiny funding. It is a group that is, I don't know how to put it, I'd say it's highly skeptical of virtually every development in the world of biotechnology, whether it's medical or agricultural. And therefore, they are as concerned with genetically modified foods and with biotechnology to create pest-resistant crops as they are with the use of genetic screening for expecting couples, which they associate with a slippery slope into eugenics and the loss of rights for those of us who are disabled. Basically, CGS is left-of-center in its politics, in favor of abortion rights, but suspicious of business interests that they believe influence sound judgment when it comes to evaluating the risks and benefits of science. In Prop 71, CGS saw several themes intertwined. The first is the unintended effect of a 1980s law that has been at the core of Wisconsin's immense power in the world of science. And that is the BiDole Act. 

And for those of you that are not lawyers and haven't memorized the names of every piece of law that's been passed, BiDole, named after Senator Bi and Senator Dole, was a law that changed the rules about patenting. 

It used to be that if you got a federal grant that you didn't get a patent on this and the inventions that you made often went unexploited by the commercial sector, because commercial sector did not see the opportunity to get a monopoly, essentially, on the invention, which would then give them some hope of a return on the research and development investment they'd have to make. So what BiDole said is if one of our researchers here at Wisconsin invents something with money that he got from NIH, that the patent can belong to the researcher. Then we have WARF, and WARF existed long before BiDole, but this really increased the level of activity. WARF can then help the academic inventor to patent this and WARF can do the work of trying to flog this to the commercial sector, which they do extremely well. That's what they mean when they talk about technology transfer in the newspapers. And at that point, the invention, which was in its most rudimentary form in the academic laboratory, now goes to a place where the intermediate steps that move it from a really cool idea to something that's actually commercially viable, something that can be produced in quantities and with reliability, something that can be packaged and priced in ways that make it a viable consumer product, all that goes on off-campus. So BiDole was a great way to increase the rate at which technology moved from campus to commercial sector. And people who've studied this do agree that the rate of commercial use of academic inventions has absolutely increased with the BiDole Act. One of the unintended effects, however, has been to turn academic researchers into people who then are often going to be connected with the companies that are going to commercialize their inventions. 

Starting in the 1980s, particularly in the biotech sector itself, we saw more and more academic scientists becoming entrepreneurs. 

And having a portion of their time spent off-campus at a laboratory that was a commercial lab, trying to figure out how to move their invention another few steps down the road. And as a result, scientists who had this kind of Sinclair Lewis Aerosmith image of, you know, pure impoverished integrity, right? Suddenly were viewed with some degree of skepticism. Because now they had a combination interests in the good science, but also in making money, in producing something that could be moved off-campus. And whereas before they were somewhat immunized against criticism, at least with regard to conflict of interest. And were at risk only of the kind of mad scientist image that would periodically hit the American newspapers and television shows. Now they were also subject to a lot of suspicion about their true motives when they said this is safe technology, or this is a valuable technology. And the Center for Genetics in Society absolutely exploited that transformation in the image of the scientist. The second, as I alluded to earlier is that the CGS had people who were still fighting over the 1980s development of In Vitro fertilization. 

This was something that was in fact developed very rapidly. 

It was developed in the absence of large-scale, federally funded basic research, both on how to fertilize eggs efficiently and safely, and also how to manage that to achieve successful pregnancy rates. Why? Because the government, since 1980, has not been funding embryo research. So the field developed without the benefit of federal funding. It instead developed with research that was financed by private patient fees. It is a field that expanded beyond its initial indications for women with scarred fallopian tubes, and rapidly began to be promoted, actively promoted, to women whose infertility was from unknown causes, or for women who were perfectly fertile, but whose husbands had fertility problems. And because it is an expensive, inefficient, uncomfortable and not riskless procedure, many women in the 1980s in the health movement were very, very suspicious about the way the technology was being promoted. It also connected to something that maybe we can talk about during the Q&A, which is a long, complicated history between the women's health movement and the physicians who work in reproductive medicine. And a great deal of suspicion between the two communities about their reliability. 

IVF, despite that, however, became a part of the social norm of America. 

IVF is immune to political backlash at this point. No state in the United States, no matter how conservative, no matter how opposed to abortion rights, will ever pass a law that makes IVF, which results in hundreds of thousands of embryos that get destroyed, no state will pass a law that criminalizes it. The reason is that just far too many people have a daughter, or a niece, or a sister, or a mother, who used IVF to get pregnant. It has simply become too engrained in the fabric of our lives for it to be vulnerable to politics. But it is still a flash point for certain people in terms of their suspicion of doctors. And for CGS, the Center for Genetics in Society, that was certainly true. So the Center for Genetics in Society, as I said, being a tiny little group, nonetheless got enormous influence. They formed an alliance with the legislators who were particularly irritated with having been disempowered, and managed to get the legislature looking at ways that they could reign in CIRM despite the limitations. For example, to pass new laws that would absolutely ban payment in certain areas of this research. 

For example, a total ban on any payment, even the replacement of lost wages, for women who volunteer to give their eggs. 

Indeed at one point, there was a proposed ban on giving your eggs, even for free, because women are simply not capable of making an informed decision about taking on the medical risks and inconveniences of this. In addition, there were proposals to change the rules about the sharing of the benefits of the research in a way that would've essentially eliminated the financial potential of patented inventions, at least for commercial companies in California, which was going to probably strip away any incentive for private-public partnerships between private companies and CIRM. Now, CIRM's reaction to this was to take advantage of its funding status to create what is by far the most comprehensive, and in some ways, the most onerous set of regulations in embryonic stem cell research imaginable. And I have to take some degree of credit and blame for this, since I sat on that very group that wrote those rules. And I can only tell you that to the extent the rules are overly detailed, they are there as a reaction to the critics. Because each rule was adopted in order to allay the fears or quell the criticisms of these otherwise supportive groups, these people who otherwise would be supportive of the research, but who came with either good government, or suspicion of scientists, or suspicion of reproductive medicine concerns. So California's regulations begin with the template of our National Academy guidelines that we wrote in 2005. Those guidelines were deliberately kept fairly broad. And they basically called for some very simple things. 

First, some additional institutional oversight of the research, so that every university, every company had a body that actually kept track of what was being done and who was doing it, to make sure they were complying with the guidelines that they're now adopting. 

Second, that there be special care taken in obtaining human materials, whether it's eggs, or it's cells like from your cheek or it's embryos, to make sure that none of these things are ever given without people fully understanding what they're doing, what kind of research might be done in the future, and that they have no obligation to do this. In addition, to regulate the guidelines suggesting people shouldn't make such a decision with regard to embryos until after they had already decided they were going to discard the embryos. In other words, they never get to see research as an incentive to discarding embryos. Simply, once having decided to discard, you can discard either by simply tossing them away or you can discard by giving them to research, which will destroy them in the end, as well, but maybe you find that a better way of doing it. The National Academy guidelines said that there were categories of research that ranged from totally non-problematic, having to do with purely, you know, laboratory research on cell lines; to somewhat problematic, that just required more conversation, anything that involved a combination of human and non-human materials, something that we need to do at certain stages of research in order to test whether or not these cell lines and those things that we derive from them can function properly in the body of an animal; and some things that really shouldn't be done now at all, a kind of self-censorship of science because of the uncertainties. An example was don't do an experiment that would use human embryonic stem cells in conjunction with a non-human primate, like a monkey or a chimp or a baboon, in a way that would result in a brain that was a complete mixture of human and non-human primate cells. Why? Because at a biological level, at a psychological level, and a philosophical level, we don't actually know what we've created. And we don't know how to evaluate whether it's bad for the entity, bad for society, dangerous, whatever. 

So let's just not do it yet. 

A kind of self-censorship moment, akin to what was done in the 1970s when we slowed down in the area of recombinant DNA research in order to move that forward more methodically, and guard against ecological risk. That was pretty much the guidelines. What California did was to take those and embroider upon them in extraordinary detail. For example, very elaborate conflict of interest rules above and beyond the notion that you should only give up your embryos for research after you've decided to destroy them. So now very difficult conflict of interest rules that might make it almost impossible for an IVF doctor to participate in this research. And yet, IVF doctors are crucial partners in this research, because they are the people who are the bridge between the embryo donors and the investigators who need to derive new lines. Or for the consent to give your embryos or your eggs. Long lists of things you have to tell people about all the different kinds of research that might be done off into the future. Long debates about whether or not anybody can donate ever because how can you be informed since we don't know all the kinds of research that might be done in the future. 

With regard to egg donation, long lists of medical risks, by the way, which have not been proven, that you need to acknowledge as real before you can donate your eggs. 

And all of these embodied in regulations which can't be changed without an elaborate procedure under California administrative law. So for example if it says that you must tell people that there is a risk of ovarian cancer associated with the hyper-stimulation for egg donation, something that has not yet been proven, what if next year we actually get definitive information to disprove it. It can take two years to change the regulation. And meanwhile, you're obligated by law to give medially inaccurate information. It's one of the challenges of using regulations, is that they can't be changed as fast as science and medicine. And it's one of the reasons why other states are looking for ways to use best practices and guidelines and explanatory documents to elaborate on more general rules. But in California, this couldn't be done, because you could not allay fears without burning things into stone when it came to things like informed consent and conflict of interest. I should also tell you that California is not the only place that's doing this. We have a whole lot of states that are now going to be funding in this area. 

Following in California's footsteps with various kinds of funding mechanisms we have: New York, New Jersey, Massachusetts, Maryland, Illinois, Rhode Island shortly to join that pack. 

Every time a state enters the field of funding, they have to write a set of rules for their grantees. And every set of rules will differ somewhat. Every set of rules will have a different oversight body made up of different kinds of people. Every one will have slightly different rules about what you can do and what you can't do with your cell lines, how you have to get consent, how you have to manage the materials. And then we are set up for something really quite unusual in the world of science. Because we're used to science operating on a national level in the United States. We're used to science being funded by the federal government with a single set of rules and with standardized oversight committees and standardized ways of evaluating what you can and cannot do. Sure, there are individual variations in the interpretations of those rules, but by and large, we all operate under the same set of rules. So we can collaborate with one another. 

We can exchange materials. 

I can send you a cell line. You can come to my lab. Now, however, what we have are 50 individual states writing their own sets of rules. What happens if I, in Wisconsin, want to send my line to my collaborator in California? But my line came from an embryo that was donated four years ago in Missouri. And in Missouri, the way they got consent did not actually require reciting all the 26 elements that were listed in the California regulations. Can the California researcher use that line, or is that line stopped at the California border? Embryonic stem cell customs control at the California border, just like the medfly, they're going to shake your truck. (laughter) You laugh, but this is actually quite serious, because this means that we have to now make a second order set of regulations, not about how we want to do things when you're using our money, but also which states and which rules are so basic that if somebody else hasn't followed them, we won't let you use their stuff. 

And which ones are good enough, mutual recognition and respect. 

Some people call this comity among the states. Other people call it moral relativism, which they use like a dirty word. And every time you say that only these rules are at the core, and everything else is kind of, you know, icing on the cake, you re-open the debate around why you have those icing rules to begin with. Why not just the core rules of what makes something acceptably derived. So in fact what we now have is a really unusual situation in science of tremendous conflict. And California, by adopting such a strict and complicated and comprehensive set of rules, and yet also being the 800-pound gorilla in the country, with more research universities, more investigators and more money, means everybody else in America has to pay attention to the California rules. Because if you can't play with the Californians, you can't play with about half the people in the country doing this research. In that sense, California has engaged in the exportation, not only of its regulations, but of its particular California political problems. And we are all going to have to live with it. 

Now, I want to conclude by simply mentioning that this problem is-- Conclude this section. 

I'm going to conclude everything pretty soon, I promise. By simply mentioning that there is some little hope on the horizon. Because under the auspices of the National Academy of Sciences committee, the Human Embryonic Stem Cell Research Advisory Committee, we have now worked to create something called the Interstate Alliance for Stem Cell Research. And Connecticut, which fancies itself a major leader in this field, has taken the lead for the Interstate Alliance. But it has a serious purpose. And that is for every new state getting into this field, to try and encourage the states to adopt uniform statutes, uniform regulations. And where they can't make them uniform, to limit the variations to one of two or three options. So that we can begin to at least reign in what otherwise might be an ever-expanding plethora of minor differences that could drive our research community crazy for years to come. Now, what for the future, and what in Wisconsin? 

For sure, Wisconsin continues to work outside the hothouse of political debates around regulation, political debates around funding, and political and litigation challenges. 

And that's no small thing. I mean, in a kind of be careful what you wish for moment, once it became clear California really was going to be able to have the money, people began to fight so bitterly it actually drove the head of CIRM out of the organization. Patient groups fought over which disease group was going to get the first funds. Universities began battling over who was going to get the biggest mega-grants. Disagreement about the theory of funding. Should you give everybody a little bit, because that's how you achieve political peace? That's why, by the way, we've got military installations in almost every congressional district, right? Or should you try to figure out what's going to be the area of research that's going to give you the cures the fastest? Or maybe you should give your money to basic research, which won't give you any progress, any visible progress soon, but will pay off in spades in ten years because it's at the base of 12 diseases and 13 techniques. 

This debate, vicious, vociferous and never ending once the money was real. 

And litigation. I mean, once the money was really there, more law suits. The most recent one being filed by somebody who is representing an organization called the NAAPC, the National Association for the Advancement of Pre-born Children. And they are suing California for having passed Proposition 71, which they say is banned by the U.S. Constitution because of the 13th Amendment, which bans slavery, on the theory that it is enslaving embryos that will be used for research. And the new head of CIRM simply said, yes, they're suing us, but we now consider continually defending law suits as simply a cost of doing business. Again, not something that happens here in Wisconsin. So with the advent of federal funding, which might happen if there were a change in position with the next administration, whether republican or democrat in Washington, will come a lessening of the relative advantages of California over Wisconsin. And while not having the advantages of legislative funding programs can be frustrating, we also have the opportunity to work somewhat outside the spotlight, under the radar. In other words, small can be beautiful if it is properly nurtured. 

If it means freedom from onerous, complicated regulations adopted, not so much for their substance but because it is political defense. 

If it means that you are free to work without the constant threat of legislative backlash. And if it means that you're working in a town that is both talented enough to have depth of expertise and small enough to facilitate real collaboration, then actually small can be beautiful. And it might be that it makes Wisconsin in fact a place that has advantages in some ways over California. I think basically, that great research comes from happy scientists. (laughter) And I think properly nurtured, that happy scientists can come from Wisconsin. Or as Marie Antoinette might say to the Californians, "Let them eat cheese." Thank you. (applause) >> We will let Alta rest while you all think of your questions. If you want to just raise your hand, she'll call on you. 

And we'll get to as many as we possibly can this evening. 

Thank you. Here you go. >> Yes, sir. (inaudible) Okay, I'm going to do my best to answer briefly. It'll be brief, not only for the sake of the audience, but because I'm not a patent lawyer, so I'm going to exhaust all my knowledge of patent law very fast. And for further information, I'm going to refer you-- I told you I was going to do this. Where is he? He's in the audience somewhere. Grady Frenchick, from Whyte, Hirschbeck, Dudek, who is a patent attorney. 

There you are. 

And I told him I was going to refer people to him. So yes, WARF irritated a lot of people around the United States over Jamie Thomson's patents. Some of that irritation is due to a fundamental misunderstanding on the part of people. Because indeed the lines that were made here by Jamie came from embryos that were donated in Madison and Israel. Those lines were donated by couples who had been told certain things about would and would not be done with those lines in research. So, when WARF would license other universities to use those lines, and then transfer those lines, WARF would insist that certain things not be done with the lines in their research, and would also insist that the people getting these materials not transfer them to a third party without notifying WARF. WARF wanted to be able to track who had them and make sure everybody knew about the limitations. This was not commonplace in the world of academic research. Second, there were licensing fees being charged in California to CIRM. 

And this outraged people. 

How can you charge a government agency? But remember, CIRM had sold Prop 71 on the notion that they were going to make a fortune off of all their inventions. So from WARF's point of view, they were a commercial entity, not an academic, non-profit entity that deserved to have the free or cheap licenses that they were offering to other academic researchers. So there was a lot of fussing around the WARF patents. Then there are other things I don't know about the details of the particular negotiations. One of the results has been that there are some people in the scientific community reacted very badly to the whole notion of a patent in this area at all. They've claimed that Jamie Thomson's work is an obvious development from the previous work on the mouse. And they sued, saying that the patents should not have been granted, because it was not a true invention, it was simply an obvious development. The patent office has an appeals process. 

In the first two steps, it's very common that they will then kind of back off the patent, and that in fact has happened. 

What will happen at the last stage, we don't know. WARF has already slightly altered the claims on the patent to narrow and specify in a way to make them more precise. Whether they get narrowed further, I don't know. Your second question had to do with the business of first to file. And this may be a little too technical, because it's not about stem cells. It's about the basic difference between U.S. and European patent law. You can have a patent law that says the first person to invent gets the patent. And you can have a patent law that says the first person who rushes in with a piece of paper describing the invention gets the patent. The advantages of the latter system is it's easier to know who filed the first paper than it is to know who first invented it. 

Who first invented takes investigation and a lot of fussing around with lawyers, and investigators, and discovery, and interrogatories, and it's messy. 

On the other hand, if you have first to file, it means that people who have invented something may not want to talk about it openly until they've gotten all their paperwork in order to file. That may slow down public discussion and academic discussion of these inventions. And as I understand it, WARF and UW, and major research universities around the United States have taken the position they want to continue with the first to invent position that we currently have in the United States, rather than moving to a first to file. Grady, did I get it? (laughs) (inaudible) That's, yeah-- Yes, in the back in the red. (inaudible) Globally, there's tremendous variation around the world. So there are some countries that have made themselves extremely attractive for stem cell research because they fund it. And that would be the United Kingdom, first and foremost. The United Kingdom also has a long history of funding embryo research and reproductive technologies. 

They have a robust regulatory system. 

Many people complain that it is cumbersome. It requires licensing of every facility where some of this work is going on. And it does have more control over, kind of, the morality based restrictions on some of the applications than you might get under U.S. Constitutional law, depending on who's on the Supreme Court. But nonetheless, it's probably pointed to as the best example of regulation and funding. But remember, it's against a backdrop of a polity that is basically supportive. There are critics, but they are not sizable. And the country certainly isn't polarized. Also very supportive, you've identified Singapore. China, India, those are places that are basically funding, but not regulating at all, pretty much. 

Israel, also supportive, with more rudimentary regulation, and a smaller player, but a very active one in their own community. 

Australia, like the United States, is a federal country. And therefore, each state has different policies. They've been going through agonies in Queensland, Victoria, and New South Wales as they debate embryonic stem cell research and then they debate cloning. And they continually keep trying to maneuver between wanting to be a leader, because they were very much a leader in the early development of IVF, and wanting to be attentive to the concerns of the conservatives in their constituencies. Although Queensland, one of the most conservative states in Australia, just recently now has moved toward liberalizing its attitude on things like cloning research. In Europe, we have again a patchwork. Germany, out of its, you know, unique history from World War II, has for decades been very skittish about anything having to do with genetics, and that means biotechnology. So they tend to have the most conservative attitude about anything to do with recombinant DNA, anything to do with genetic screening, and anything to do with embryos. So Germany has been the most restrictive, not only in terms of what you can do in Germany, but even exporting the criminal law, by saying that a German scientist working in England, where it's perfectly legal, would be violating German criminal law if she went there to do her work. 

That's very unusual in the world of criminal law. 

Usually, criminal law only applies to what you do within your jurisdiction. But here they're applying it to the people who are citizens. France is very strange. And I say this with love, because I did my Fulbright there and I really do love France. But I cannot figure out what they mean when they endlessly repeat the phrase, "la dignite du la humanite." Because the dignity of the human is something that can mean anything to anybody, depending upon what you want it to mean. For the moment, it seems to mean a generally nervous attitude about anything involving the destruction of an embryo. But they're not willing to go and actually criminalize it all. So they're slowly moving toward being more open about it. 

Interestingly, places like Spain are remarkably open. 

You might think Spain would be very conservative. But in fact, in the post-Franco era, the backlash was such that they actually opened up more than many other countries in Europe. So lots and lots of variation. Yeah? (inaudible) Congress has now twice voted to increase funding for embryonic stem cell research beyond the current administration policy. For those that are a little bit fuzzy on it, the current policy is to allow researchers to use federal money to work on the lines that existed before the policy was declared. The theory being in no way is the federal government somehow condoning, or promoting, or giving a stamp of approval to the destruction of embryos that went on long ago, before they announced their policy. That means lines that were created between 1998 and 2001. But you cannot use federal money for any lines that were derived from embryos destroyed after August, 2001, which of course, every day that goes by, it's an increasing number of lines, many of whom have characteristics that researchers would like to study. 

So Congress has now repeatedly voted to expand the funding and get rid of that limitation. 

And President Bush has vetoed those bills twice. The latest suggestion has been to put a rider on the authorization or the appropriations bill for Labor HHS, and to put in a rule that would say we would expand federal funding again to allow funding for work on lines up to the date at which the bill passes. In other words, they would use the same trick that the Bush administration did, right? Hey, we didn't encourage anybody to destroy these. They did it on their own. They never had a promise of money. But now, retroactively, we're going to let them use our money on those lines. And the bills that are going to be held hostage are bills that have more general application in the areas of Labor, Health and Human Services. I don't think anybody seriously thinks this is going to happen. 

It's more now a political tool, to try and force members of Congress who are up for re-election to take positions and make it obvious to their constituencies. 

So I think now it's just political football, and that's all that we can really expect. Keep in mind, too, if there is a change in federal policy with a new administration, you might get funding to work on lines, but you will still not get federal funding to derive new lines, because that involves manipulating the embryo itself, not just the stem cell lines in your dish. And manipulating the embryo itself is a whole separate thing. It's limited by Congressional action years ago. And unless Congress wants to overturn that limitation, we'll still need private money or state money to derive new lines, or make lines through cloning. And only then could you use your federal money to work on the resulting laboratory supplies of stem cell lines. You had your hand up? (inaudible) $3 billion. So it's $300 million a year for ten years. 

(inaudible) Well the only absolute kind of targeted allocation is $5 million. 

And that's the Department of Commerce allocation. The Wisconsin Institutes for Discovery is a $750 million commitment, but that covers a lot of things above and beyond stem cell research. And we don't know what proportion of that money will ultimately go to embryonic stem cell research. And Clive and Tim probably know better than anybody else what kind of money we've got coming in from private donations through the Foundation. I don't know if you've got any estimates. (inaudible) Please give generously! (laughs) (inaudible) All right. Until now. And meet Clive and Tim, who are the heads of that stem cell center. 

(inaudible) Other questions? 

Or have we worn you out? Yeah? (inaudible) They are, actually. CIRM first distributed training grants. Before they even had the bonds issued, they used money from their private donations to do this. Training grants to train graduate students in laboratory techniques. And some of that money went for the Stem Cell Fellows Program that Laura had mentioned in the introduction, which was a program to bring people into graduate school, or law students and business students into the world of stem cells. So some of that money was used to support, for example, some of the law students at the Berkeley Law School that I was advising. Then after the stem cell training grants, they then had another round of grant making, which went for actual substantive research. 

And that was a total of $46 million, I think, that they allocated. 

And it went to researchers up and down the California coast, researchers all over, from not only the major centers like UCLA, and Stanford, and Berkeley, but also at places like University of California Santa Barbara. And indeed, Jamie Thomson now having a part-time appointment there then becomes eligible to become a grantee. It certainly enhances UCSB's ability to attract grants. UC-Irvine, another university trying to become a major player. And the quality of those grant proposals really varied a lot. They were put together very quickly. And something like 70% or 80% were actually approved, which is an incredibly high rate, compared NIH, which approves maybe 6% to 15%, depending on the cycle. Everybody expects that the next round of grants will probably be far more competitive. But they really wanted to push some money out the door. 

As one would say, these are facts on the ground. 

These are dollars on the ground, and they create a kind of precedent, in terms of funding. The big, big funding is about to happen. So this governing council, the ICOC, the Independent Citizens Oversight Committee, is meeting and just had a big fuss about whether or not it was going to be open or closed, and whose conflicts were going to be waived. So those of you that are really interested in getting a somewhat biased view, but you know, sassy view, should go and Google California stem cell report. This is a guy who's obsessed with CIRM, and basically blogs everything that happens. And they are now about to sit down and begin to make the grants for the actual buildings and infrastructure grants. I mean, these are the mega-grants. Rumor has it that Stanford might be a very happy recipient of substantial funding, which raises some eyebrows, because of course, Stanford has more money than God. But they also have a really first class set of researchers. 

And so along with places like UCSF, make a very credible claim to being able to use the money well. 

(inaudible) I don't think you can point to any one thing. But there are lots of individual factors that help. For one thing, they already had a very robust computer sector, which meant they already had an atmosphere which was very comforting to people who are high-technology, high-knowledge industry based, and catered to that sensibility. The fact that their weather is phenomenal doesn't hurt. The computer sector also provided key support in terms of informatics for parts of the genome project, which played into this. You've got a concentration of high-quality research institutions there that you can't have here. University of Wisconsin-Madison stands alone. We are one university. We are phenomenal. 

I mean, we're way better than we should be. 

But we're alone. And there, you've got Berkeley. You've got UCSF. You've got Stanford. All within an easy car ride, well, it depends on the time of day. (laughter) For parts of the day, an easy car ride from one another. And people socialize with one another. So there is this kind of overlap among the institutions. You also have a variety of first class hospitals that provide the end point for your clinical trials. 

So, you've got all of those things going for you. 

And then, because of the computer sector having attracted a lot of venture capitalists, who then settled there, you also had access to the money people, right there, right away. And one cannot overestimate the value of these personal connections that are forged over years worth of wine and cheese parties. Mostly wine, a little bit of cheese. And Wisconsin cheese, yeah! So there are many things that help them. Many, many things that help them in terms of having a concentration of talent. So it's synergy. In the back in the pale green shirt. I think that's pale green. 

(inaudible) I don't believe they're doing much funding in this area. 

I think their focus has really moved to HIV-AIDS and work in developing countries. I don't recall the Gates Foundation doing much in this area at all. I don't remember anybody talking about approaching them. Now, if some day it turns out that somebody has a credible proposal for wide use of embryonic stem cells might help in, for example the drug discovery process for diseases they care about, like malaria and HIV, that might attract their attention. I see her getting up. I saw there was one other hand up, so I'll take one last question. There was somebody in the middle? Yeah? (inaudible) Compensate in what way? 

(inaudible) I think they already do. 

I mean, let's face it. The thing that people know about the University of Wisconsin, besides the football team, and besides the Sociology Department, is the Life Sciences campus. If you ask people around the country what do they think of when they think of the University of Wisconsin, they think of Life Sciences. They think of this as a research university. And that encompasses everything from ecology to genome work to biomechanical engineering to computing. It's all of a piece. So for sure, this campus has the capability in terms of talent and interdisciplinarity, and the lack of bureaucratic obstacles to collaboration, which by the way, is unusual here, as compared to places like Stanford, where walking across to another building is like traveling to another country. That means that we absolutely can become very active and players in things like synthetic biology, which is coming down the pike as a big thing, or nanotechnology, which is already a big thing. Or a small thing! 

(laughter) There's no limit to what we can do. 

But we also operate on a smaller scale. And we have to figure out how to turn that to our advantage, rather than bemoaning its disadvantages. Thank you very much. (applause)