Power of Universities: Improving Access to Medicines
The World Health Organization predicts that 10 million people die annually from lack of vaccines and essential medicines (1). What role do universities play in such cases? By revising their policies and embracing an official resolution of improving human welfare, institutions could implement licensing provisions that facilitate access to their innovations in poor countries.
Convening across university campuses, student activist groups coordinate film screenings, invite guest lecturers, and organize benefit concerts to raise awarness of neglected diseases in developing countries. Spurred by the poignant images of emaciated children and destitute adults, attendees of such awareness campaigns are imbued with hope and optimism that their scientific research and innovations will help eradicate AIDS or malaria. Undoubtedly, the ethical stance that alleviating human suffering is necessary, embodies the principle for many university researchers across America. However, if an institution's pharmacology laboratory generates an effective molecule that targets HIV, the Office of Licensing and Ventures (which is responsible for development of technology ventures) would patent the discovery and grant an exclusive license to the commercial sector for subsequent drug development and marketing. Pharmaceutical companies are daunted by the notion that providing drugs free or almost at no cost to third-world countries would eventually undercut drug prices. Consequently, they often charge exorbitant prices or use legal maneuvers to restrict access in developing nations. Making drugs available to the developing world remains one of the major challenges in addressing health inequity.UAEM
Particularly, leading universities spearheading breakthrough research should adopt the Equitable Access Licensing (EAL) proposed by the coalition group, Universities Allied for Essential Medicines (UAEM). The UAEM group strives to build support for university-centered solutions for access to medicines by focusing on university medical technology licensing policy, neglected disease research funding, and promoting university research that is access-friendly. At Duke University, a group of medical students such as David Watkins, Richard Waters, Timothy Bouley, and Zach Reitman have strived to foster discussion and awareness of the access to medicine issue through UAEM. Bouley and Waters recently emphasized, "[Universities Allied for Essential Medicines] is a growing network of faculty, students, and staff at universities around the world that is united in holding our institutions of higher education to greater standards of public health responsibility, and we do this through encouraging improvements in licensing and patent practices to better serve the world's poor" (2).
Equitable Access Licensing promoted by UAEM would lift barriers on access to intellectual property. Modifications would enable organizations or corporations abroad to create and market generic replicas of vital medicines, such as HIV inhibitors. In addition, EAL calls for a reduction in drug prices, as well as the relaxing of patent provisions. For instance, a generic pharmaceutical plant in Cambodia wishing to produce a glaucoma ointment would be able to do so without transgressing legal boundaries. Universities harboring the willpower to advocate EAL strategies need to persuade companies that global health advancements can mobilize people to pursue meaningful lives. However, any solutions to the access gap must involve pharmaceutical industry partners.Potential Barriers
From a logistical perspective, implementing EAL may seem untenable, as universities need bargaining power to negotiate with the drug industry. Nonetheless, a recent review from the Senate Joint Economic Committee suggests that ownership positions of universities in pharmaceutical technologies have substantially increased over the past three years. In addition, the number of patents and licensing agreements executed by academic institutions has approximately doubled between 1993 and 2003. By exercising volition, universities certainly possess the capacity to alter access to intellectual property rights. In addition, companies that participate in EAL will improve their reputation as supporters of social well-being. An inspiring example at Yale University illustrates the viability of implementing EAL.
In 2001, the humanitarian organization Médecins Sans Frontières (commonly known as Doctors without Borders,) sought Yale's permission to use a generic version of Zerit (stavudine), an antiretroviral drug targeting HIV infection, to treat South African patients. Although Yale owned the patent for stavudine, the technology transfer office had conferred intellectual property rights to the pharmaceutical corporation Bristol-Myers Squibb. After vigorous bargaining, the first patent concession on an HIV drug emerged, and the generic stavudine was allowed to be marketed within South Africa at a 30-fold reduction, from $1650 to $55. Setting a precedent for the global community, Yale's proactive role in negotiating with Bristol-Myers Squibb should convince other universities to follow suit(3).
Moreover, granting access to intellectual property rights for global welfare, constitutes little financial risk for universities. According to a recent survey by the Association of University Technology Managers, licensing revenues typically account for only about 4% of an institution's research funding (4). As a promising locus for change, academic institutions harbor potential in actualizing equitable access to essential medicines, and the core of university activism lies in sustained support from the student population. For instance, Duke University's UAEM group has constructed a gigantic medicine bottle for display on the main plaza as an educational, outreach campaign.
UAEM activist Richard Waters, a Duke Medical School student, adds, "[Striving for a modified licensing policy] is more than just the ideal proposition of university students. Several of the world's leading research institutions, such as the University of California at Berkeley, the University of Washington, and Oxford University, have adopted policies that serve this very purpose."
In fact, a group of scientists and students issued a petition on November 15, 2006, called the Philadelphia Consensus Statement. The statement proposes three major changes to university policies on health-related innovations, such as promoting equal access to research, encouraging research and development for neglected diseases, and measuring research success according to impact on human welfare (5). Among the signatories of the Consensus Statement are nine Nobel Laureates, including Peter Agre, 2003 Nobel Laureate in Chemistry, and Kenneth Arrow, 1972 Nobel Laureate in Economics (6).
What factors may compel more universities to recognize the urgency and seriousness of the issues in the Philadelphia Consensus Statement? Duke medical student Richard Waters explains some goals of Duke's UAEM chapter, "[We need] better education of key policy makers at Duke. Changing licensing strategies will help improve access to medicines in poor nations and that it is not a symbolic action' with little consequence. Also, we need to generate support from biochemical researchers and demonstrate how much publicity this could create for academic institutions as centers for global health." After all, what better way to empower ailing humans than to fight for medicines - their vital lifelines?References:
1. World Health Organization. (2004) Equitable access to essential medicines: A framework for collective action. Geneva: World Health Organization. Available: http://whqlibdoc.who.int/hq/2004/WHO_EDM_2004.4.pdf. Accessed 25 March 2008.
2. Bouley, Timothy and Waters, Richard. "Our medicines. Our labs. Our responsibility." The Chronicle (Duke University newspaper) 4 April 2008.
3. Kapczynski A, Crone ET, Merson M (2003) Global health and university patents. Science 301:1629.
4. Association of University Technology Managers. (2002) AUTM licensing survey: FY 2001. Northbrook (Illinois): Association of University Technology Managers. Available: http://www.asm.org/ASM/files/LEFTMARGINHEADERLIST/DOWNLOADFILENAME/0000001066/autmsummarypublicversion.pdf. Accessed 28 March 2008.
5. Check, Erika. "Universities urged to do more for poor nations." Nature 444, 412-413, 23 November 2006.
6. Universities Allied for Essential Medicines. "9 Nobel laureates have signed on. You can too." http://www.essentialmedicine.org/9-nobel-laureates-have-signed-on-you-can-too/ Accessed 28 March 2008.
Written by Maria Huang
Reviewed by Pooja Ghatalia, Nira Datta
Published by Pooja Ghatalia.