California votes to give record $8.4 billion to medical research

Voters in California have approved US$8.4 billion in funding for immunology research — the largest ever infusion of cash for science authorized by a public vote in US history.

The funding proposal, known as Proposition 38, appeared on the ballot for voters in California in last week’s US mid-term elections, but it has taken nearly a week for officials to count enough ballots to declare its success. The state government will pay for the research — which aims to find treatments that harness or re-engineer the body’s immune system to fight illnesses such as cancer and Alzheimer’s disease — by selling state government bonds. (This is unusual for science funding. Bonds are typically reserved to pay for infrastructure projects such as road construction and require the state to pay back its debt with interest.)

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Supporters of the proposal say that the funding will provide stability for researchers in California, who have been affected by political turmoil. The administration of US President Donald Trump has pushed for massive cuts to science funding; put political appointees in charge of grant decisions at federal science agencies, such as the US National Institutes of Health; and forced policy change at US universities that receive federal funding, including those in California.

The $8.4 billion “is an advantage to California that is unprecedented”, says Antoni Ribas, a cancer researcher and physician at the University of California, Los Angeles (UCLA), who supported Proposition 38. It will make the state “even more of a global hub for immunology research”.

But the proposal has sparked debate. That’s because it calls for giving about half of the funding directly to research institutes — and the only institute that matches the criteria called for in the proposal is one co-founded by Gary Michelson, a billionaire medical-device inventor. He wrote the proposition and donated about $45 million of his own funds to get it placed on the ballot and to campaign for its passage.

“I feel like the voters have been taken advantage of,” says Sarah Hill, a political scientist at California State University, Fullerton, who tracks the state’s ballot measures. Michelson did not respond to Nature’s request for comment before this story was published, but has said elsewhere that he will not personally profit from the bond revenue.

State funding

In California, citizens can place proposed laws directly on the election ballot by collecting hundreds of thousands of voter signatures.

The state has funded scientific research through this process before. In 2004, after then-president George W. Bush restricted federal funding for human embryonic stem-cell research, voters in California approved a $3-billion bond to establish the California Institute for Regenerative Medicine, which they then voted to replenish with another $5.5 billion in 2020.

“The model works,” Ribas says. Immunologists have been making great strides with medicines, such as personalized treatments called CAR-T therapies, that are revolutionizing care, he says. There has also been a flurry of research into developing vaccines, such as the mRNA shots that have been the target of funding cuts by the Trump administration. Proposition 38 will ensure such research can continue regardless of the political headwinds, Ribas adds.

Around $4 billion from Proposition 38 will fund grants for researchers at select public universities and non-profit institutes in California through a competitive review process. According to the proposal, any commercialized therapies developed through funded research must be sold at a 20% discount to people in California, with 10% of drug royalties returning to the state’s general fund.