A YES vote on this measure means: The state could borrow $8.4 billion to support medical research in immunology and immunotherapy conducted by California research institutes and universities.

PATIENT ADVOCATES, DOCTORS, NURSES AND MEDICAL RESEARCHERS URGE YES ON PROP. 38 Leading patient advocates including the Alzheimer’s Association, Michael J. Fox Foundation, American Nurses Association\ California, ALS Association, National Multiple Sclerosis Society and Prostate Cancer Foundation all urge YES on PROP. 38 because it could save your life and the life of someone you love. “I was just weeks away from losing my life when a breakthrough immunotherapy gave me a second chance. Vote YES on PROP. 38 because every family facing a devastating diagnosis deserves this same hope.” —Laurie Adami, Cancer Survivor and Patient Advocate, Los Angeles YES ON PROP. 38—TO CURE AND PREVENT DISEASES THROUGH LIFE-SAVING IMMUNOLOGY RESEARCH PROP. 38 accelerates development of breakthrough treatments and cures for the diseases that impact nearly every family. At least half of all funds are specifically dedicated to cancer, heart disease and Alzheimer’s research. “Immunology harnesses the body’s immune system to detect and stop diseases. Today, breakthrough immunotherapies are already curing cancers like melanoma, lung cancer and leukemia. Promising research is underway to prevent diseases including Parkinson’s, heart disease, diabetes and more.” —Mark Davis, Ph.D., Member of the National Academy of Sciences and the National Academy of Medicine “One in nine people over 65 are living with Alzheimer’s, but there are currently no effective cures. YES on PROP. 38 provides real promise to find treatments and cures for the millions of patients and their families living with Alzheimer’s and dementia.” —Susan Disney Lord, Board Chair of Alzheimer’s Los Angeles HELPS OFFSET FEDERAL FUNDING CUTS TO MEDICAL RESEARCH Massive federal funding cuts and uncertainty are disrupting vitally needed medical research at nonprofit research institutes and universities, delaying progress toward life-saving cures. PROP. 38 creates a stable source of funding for breakthrough immunology research. All funds are dedicated exclusively to California-based nonprofit universities and research institutes— helping California lead the nation in medical innovation, fostering collaboration among top scientists and universities, and creating tens of thousands of good-paying jobs. “Immunotherapy is transforming the future of cancer care. PROP. 38 will help accelerate life-saving cures while strengthening California’s role as a global leader in medical innovation.” —Gina Carithers, President and CEO, Prostate Cancer Foundation LOWERS HEALTHCARE COSTS FOR CALIFORNIANS Any cure or immunotherapy developed through PROP. 38 must be provided to California patients at a 20% DISCOUNT. Preventing and curing the most pressing diseases will also reduce long-term healthcare expenses and save the state and families tens of billions of dollars in avoided medical expenses. STRONG ACCOUNTABILITY & TAXPAYER PROTECTIONS PROP. 38 is designed to pay for itself WITH NO NET COST TO THE STATE OR TAXPAYERS. Ten percent of revenue from the licensing of successful immunotherapies must be returned to California to offset the costs of the bond, including interest. PROP. 38 also includes strict accountability requirements, including: 2% Cap on State Administrative Expenses Public Disclosure of Spending Independent Financial Audits For-profit corporations are not eligible for grant funding YES ON PROP. 38: SUPPORTED BY DOCTORS, NURSES AND PATIENT ADVOCATES • ALS Association • Alzheimer’s Association • American Nurses Association\California • Blood Cancer United • California Colorectal Cancer Coalition • Liver Coalition • Michael J. Fox Foundation • National Multiple Sclerosis Society • Parkinson Association of Northern California ... and many more. YES on PROP. 38 could save your life and someone you love. Please, vote Yes. www.YesOn38.com Susan Disney Lord, Board Chair Alzheimer’s Los Angeles Eugene P. Brandon, Ph.D., Board of Trustees ALS Association Dr. Brian Shuch, M.D., Board of Directors Member Kidney Cancer Association REBUTTAL TO ARGUMENT IN FAVOR OF PROPOSITION 38 California should continue supporting biomedical research. Everyone hopes for new treatments for heart disease, cancer, Alzheimer’s disease, and other serious illnesses. I do too. But Proposition 38 is the wrong way to achieve that goal. The claim that Proposition 38 will pay for itself is speculative. Audits, public disclosure, and limits on administrative costs promote accountability, but they cannot guarantee that research investments will generate enough economic returns to offset billions of dollars in bond repayments. California faces a continuing structural budget deficit. Proposition 38 would require approximately $8.4 billion in bond repayments. According to the nonpartisan Legislative Analyst’s Office, taxpayers would be committed to roughly $500 million in annual debt payments for the next 25 years. That long-term obligation would further reduce the state’s fiscal flexibility to respond to changing priorities. Meanwhile, recent actions by the Trump administration have placed funding for essential California public health programs at risk, including disease surveillance, emergency preparedness, HIV prevention, vaccination infrastructure, laboratory capacity, and community prevention. These challenges extend well beyond biomedical research. If California chooses to replace declining federal support, elected officials should be able to consider all health priorities together. Proposition 38 instead earmarks billions of borrowed dollars for one scientific field, regardless of future needs or discoveries. Research priorities should be guided through the normal budget process—not by ballot measures that lock taxpayers into decades of debt. Vote No on Proposition 38. Robert M Kaplan, Ph.D.