A Call To Universities To Help Increase Global Medicines Access

By Rodrigo Cerda

In the intellectual environment of universities, we have long discussed the tragic loss of life that occurs daily because sick people around the world cannot afford the drugs that could cure them. Indeed, we have reason to be worried: ten million people each year die from diseases that are treatable with existing drugs, according to the World Health Organization (WHO). Unfortunately, we have had unacceptably little progress from that discourse towards action to change the situation. New national legislation and student action have the potential to change that.

On the last Friday in September, Senator Patrick Leahy (D-Vermont) introduced a bill entitled Public Research in the Public Interest Act of 2006 (S. 4040). The bill would require federally-funded medical research institutions to grant nonexclusive licenses to generic producers for the purpose of supplying developing countries with the medical products of their discoveries. The bill also extended the licensing requirement to any party conducting neglected-disease research (research where the potential for marketplace profit is too small to make large investments developing a drug for that market). Tragically, while neglected diseases often represent a large market in terms of people, those people are predominantly too poor to afford medications.

Senator Leahy’s bill is truly a leap forward in ensuring that research paid for with public money is focused on benefiting the public. The proposals would make medications available in developing countries that do not have access to them, and lower the cost burdens for those countries that spend the majority of their health budgets paying for branded medications. With the new availability of medications and the ability to spend scarce government health resources in developing new health infrastructure, the health of the developing world could see an incredible improvement.

Importantly, the bill would not hurt the bottom lines of the pharmaceutical and medical device industries. Developing countries represent less than 5 percent of the worldwide pharmaceutical market and practically none of its profits. Furthermore, current trade and production regulations have been successful in preventing re-importation back to the developed world.

As members of the academic community, however, we cannot be satisfied waiting for this bill to pass. Senator Leahy’s proposal is a commendable display of leadership that put the issue on a nationwide platform, and may have even greater potential under his chairmanship of the Judiciary Committee in the next Congress. Nevertheless, regardless of the bill’s chance to become law, it is in the interest of universities to address the problem on their own terms before the federal government forces them to adhere to national guidelines. By pre-empting legislation, universities will be fulfilling their mission to improve the public good while preserving the flexibility to do so in a way that best fits their particular situation.

The weekend after the bill was introduced, a group of over 150 students from all over the country gathered in the University of Pennsylvania’s School of Nursing for the national conference of the international student group Universities Allied for Essential Medicines (UAEM). There, they released the Philadelphia Consensus Statement (available at www.uaem.org), which argues that universities – the originators of over 50 percent of all pharmaceutical innovations – are an important place to address issues of access to medicines and neglected disease research. Included in the consensus statements are specific feasible proposals to improve research and technology transfer policies at universities.

The growing list of signatories include such prominent public health advocates as Paul Farmer, the founder of Partners in Health immortalized in the book Mountains Beyond Mountains; Jim Kim, the former director of the WHO’s HIV/AIDS department; Judge Edwin Cameron of the South African Supreme Court; and Jonathan Quick, the former director of Essential Drugs and Medicines Policy at the WHO.

A fresh approach to intellectual-property transfer can make a difference in refocusing the purpose of federally-funded medical research in order to achieve the greatest benefit to all. Many of our universities have an avowed mission to serve the public good. We must help them to realize that mission.

University action on this issue could be a landmark shift from merely discussing the health issues of the developing world to taking proactive measures to change the system that ignores those problems.

Rodrigo Cerda is a second year medical student at the University of Pennsylvania School of Medicine and a member of Universities Allied for Essential Medicines. He received his B.A. from Yale University, where he developed his interests in global health and neglected diseases. He has worked as an intern at the Stop TB Partnership Secretariat and conducted field research in Brazil and Peru.