'Universities could mandate generic production for poor countries'
Feb 1, 2010, 12.00am IST
Many drugs with great therapeutic impact, such as Gleevec for cancer, Stavudine for HIV/AIDS, and Zemplar for kidney failure, have come from university medical research. The Universities Allied for Essential Medicines (UAEM) is a non-profit organisation rooted in a university students' movement to change the norms of patenting and licensing of drugs discovered in universities to ensure their accessibility in developing countries. UAEM executive director Ethan Guillen spoke to Rema Nagarajan about the campaign.
How did UAEM come into being?
UAEM was formed in 2001 when AIDS patients were dying because they could not afford the cost of treatment, which was $10,000 annually. One of the medicines needed, Stavudine, cost $1,600 per year. As it turned out, Stavudine had been discovered at Yale University, which held its patent. Initial entreaties to the university and Bristol Myers Squibb (BMS) to allow generic production were turned down. So, Medecins Sans Frontieres (MSF), which was treating HIV patients in South Africa, mobilised a campaign with students at Yale. Eventually they were able to convince Yale and BMS to allow generic production of Stavudine, which brought down the price to just $55 per year.
How can universities help increase access to medical technologies?
Universities are key innovators in medicine and other health-related technologies. For instance, of the HIV medicines approved for use between 2001 and 2006, 36 per cent have patents from universities and public research institutions. Universities are also the originators of critical vaccines. Once a university makes a discovery, it often takes out a patent and passes that medical technology on to a pharmaceutical company through a licensing agreement. The university can put in clauses that require low-cost access to the final product, particularly in poor countries, through a variety of mechanisms. For instance, the university could mandate generic production for poor countries or price concessions. Happily, we're starting to see more of these deals after many years of advocacy on the issue.
How can university students make a difference?
Today, many universities in the US, Canada, and Europe consider offering affordable access to their discoveries in poor countries. These initiatives have been primarily driven by students by students doggedly advocating on the issue from individual campuses. From getting bills introduced in the US Congress to advocating on the role of universities as public interest institutions at the World Health Organisation, the students have also worked with the WHO to get medicines to treat heart disease onto the essential medicines list in light of the growing burden of non-communicable diseases in poor countries.
How much resistance does UAEM face from the universities or researchers? How does UAEM tackle it?
Initially, resistance to the concept of systematic access licensing was quite strong amongst many university officials, and in certain areas it still is. In the past 10 years our advocacy has ranged from having meetings to educate university leaders, where we always start, to protests in cases where simply explaining the importance of the issue hasn't been enough. Researchers have been somewhat different from university administration as they usually do their jobs to find a cure to change the world. Many have been great allies since the Stavudine campaign. In that case, the inventor wrote an opinion editorial in the New York Times that was key to the campaign's success. While we have moved a long way toward making access licensing to improve affordable access to medicines the norm, the new resistance we face is universities fighting for provisions to increase pharma company monopolies. We think that universities as evidence-based, public institutions dedicated to improving society, should not mindlessly fight on the side of the pharmaceutical or biotech industry.
What is UAEM's presence in the US campuses and outside the US?
UAEM now has a solid presence in approximately 70 universities in the US, Canada, UK, Germany, Norway, and Brazil (listed in the order in which the movement spread). Canadian chapters came on board very early. The UK came on board soon after and University of Edinburgh adopted a policy about a year ago, while other universities in the UK are now considering policies. In Germany, Bayh-Dole-style legislation (named for the US act that governs university patenting) was more recently adopted and the chapters there have worked closely with civil society to spread the word about access licensing. We've seen success from Charite, the largest research university hospital in Europe, based in Berlin, signaling a willingness to adopt a policy. The movement in Norway and Brazil is much newer, but given the energy of the student members, we have great hope for things advancing quickly. In each case we've worked hard to make sure that UAEM's model is adapted to the local context and have been lucky to lead off with major institutions who can set the tone for other universities. Recently, Jawaharlal Nehru University signed onto a statement on access, though till date we do not know how the policy is being implemented. We have recently made some contacts there and hope to find out.
What does UAEM have to say about the pressures universities face to become self financing and to raise finances for their research?
We need to ask ourselves as a society if we value independent organisations dedicated to both educating the next generations and serving society. If we do, then governments cannot back away from their commitments to fund universities. If we imagine a world where universities are funded heavily by industry, we will face a future where universities are no longer making breakthrough discoveries that arise from science for science's sake. Industry funding comes with a focus on commercial outcomes because, quite understandably, industry plays a role in society to create commercial goods. This is not to say that universities do not play a role in this. The entire biotech industry arose out of university discoveries. In order for universities to become self-financing, we will have to have outrageous unaffordable tuitions, huge infusions of cash from industry, or some other combination of policy changes that will gut the very role of what public universities and research institutions play in society. Markets have failed in creating new treatments for neglected diseases like Chagas or African sleeping sickness or tuberculosis. The few researchers who do toil away on finding new treatments are usually in university labs. If we replicate the failures of the market within our universities by pulling public funding I believe we will be in quite a sorry state as a society. It is worth noting that in the US, industry still funds well less than 10 percent of university research while the government funds around 70 percent.
Will universities be willing to forego the revenue they earn from licensing their drug discoveries?
Most university technology transfer offices (which deal with universities' patents) don't break even. They are often a drain on university finances. Technology transfer is an expensive affair and even now large revenues are concentrated on a few individual institutions, often for one blockbuster discovery. Making medicines discovered by universities available for generic production in developing countries will make little difference to university royalties given the small size of the market in the developing world. For example, Sub-Saharan Africa accounts for less than 1 per cent of the global pharma market. We need to ask if the revenues earned on a patent is worth restricting access to life-saving medicines for millions. This question becomes even more poignant when we consider that universities are public institutions funded by the public. Improving access in developing countries can be done at minimal cost while fulfilling a moral imperative.
Read more: 'Universities could mandate generic production for poor countries' - The Times of India http://timesofindia.indiatimes.com/home/opinion/interviews/Universities-could-mandate-generic-production-for-poor-countries/articleshow/7017063.cms#ixzz17qKYjgwL