This post was updated April 5 at 9:54 p.m.

California nonprofits are working to put an initiative funding immunology research on the November ballot.

The initiative would authorize $8.4 billion of state bonds to support the research – half of which would be required to support developing treatments for Alzheimer’s disease, cancer and heart disease – if 546,651 signatures are collected for it to appear on the ballot. California voters would also need to approve it in November.

California would repay the bonds over 25 years at an annual rate of about $500 million, according to the state Legislative Analyst’s Office.

The funding raised through the bonds would be allocated to a UC-affiliated nonprofit medical research institute, as well as a medical research grant program for public and nonprofit universities.

The cost of any cure or immunotherapy developed through the initiative-funded research would be capped at 20% below the national average for California patients.

Potential revenue generated from the initiative-funded medical research could help the state partially or fully make up for the costs, although that outcome is not guaranteed, according to the state Legislative Analyst’s Office.

Several nonprofit public health organizations – including Blood Cancer United, the Parkinson Association of Northern California and the California Black Health Network – are leading the effort to pass the initiative.

“Breakthroughs in cancer and chronic disease depend on sustained, reliable investment, and funding instability can delay lifesaving clinical trials for patients with few options,” said Adam Zarrin, the director of state government affairs at Blood Cancer United, in an emailed statement. “This measure will strengthen California’s research and clinical trial infrastructure, helping ensure patients can access cutting-edge therapies sooner while accelerating the search for cures.”

Blood Cancer United is the world’s largest nonprofit devoted to supporting blood cancer advocacy, patients and research.

The California secretary of state’s office cleared the proponents of the initiative to begin gathering signatures in January, with up to 180 days to circulate the petition. For the initiative to appear on the November ballot, the proponents must collect about 550,000 registered voters’ signatures – representing 5% of the total votes cast in the November 2022 gubernatorial race.

Signatures must be verified 131 days before the general election, in accordance with California law. The deadline for verification is June 25.

The initiative has garnered hundreds of thousands of signatures so far, and its supporters expect to be able to submit enough signatures in April, a spokesperson for the initiative’s coalition of proponents said in an emailed statement.

The UC sponsored a California bill in March that would put a $23 billion bond for research funding on the ballot in November. The bill, if passed, would establish the California Foundation for Science and Health Research, which would distribute the $23 billion – accumulated through the sale of state bonds – to fund research facilities and competitive research grants and loans.

[Related: UC sponsors state Senate bill that proposes $23 billion research bond]

The bill – which passed the Senate Health Committee in late March – is separate from the proposed immunology research ballot initiative.

The Trump administration froze more than $584 million in UCLA’s research funding from the National Institutes of Health, the National Science Foundation and the United States Department of Energy after alleging the university allowed antisemitism, affirmative action and “men to participate in women’s sports.” A federal judge temporarily restored most of the grants in August and September and prohibited the federal government from freezing, terminating or restricting funds for any UC schools in November.

[Related: Federal judge orders Trump administration to restore $500M of UCLA research grants]

Burt Cowgill, an associate professor in residence of health policy and management at the Fielding School of Public Health, said the initiative is an opportunity to continue supporting California-based research that informs public health decisions.

California has taken initiative amid the Trump administration’s cuts to research funding and pushback on certain immunization requirements, he added. In January, the Department of Health and Human Services reduced the number of vaccines recommended in its childhood vaccination schedule from 17 to 11, sparking concern among health experts.

[Related: UCLA health experts voice concern over CDC child vaccination guideline rollbacks]

“The ongoing response in California is, ‘Okay, if the feds aren’t going to do it, we’re going to do it ourselves,’” Cowgill said. “But that ultimately means then we the people are contributing more in terms of our tax dollars to support this, and if we’re still paying our federal taxes and now more state taxes, that can create a challenge, and this is something our political leaders will have to sell to, to the people as we move forward.”

Ryan Rivas, a California community college student, said he has spent the past couple of weeks collecting signatures for the initiative at UCLA.

Signing ballot initiative petitions is a way for students to have their voices heard, he added.

“It’s a good opportunity to bring awareness to registered voters on the premises here,” he said.

Robert Kaplan, a distinguished research professor of health policy and management, said he would vote for the initiative if it is on the ballot in November, but he is concerned about California’s ability to repay the bond within the given time frame.

“The assumption that there will be a rapid turnaround that will result in the repayment of this investment in the short term is completely unrealistic,” he said.

Kaplan, a former associate director of the NIH, said he believes the requirement that developments made through this initiative must be sold at a below market rate to Californians could disincentivize pharmaceutical companies from selling their products in California. He added that he does not know if the researchers developing the molecules that are the basis for medications can control the price of them.

The NIH is only able to fund 5% of grant applications received, so alternative funding sources are important to mitigate this scarcity, Kaplan added.

Kaplan said he supports expanding California’s – or any other state’s – budget for research funding.

“Having alternative funding sources is what science needs,” Kaplan said.