[Ip-health] Voluntary License Scorecard

Priti Radhakrishnan priti at i-mak.org
Sun Sep 9 20:30:26 PDT 2012

Dear Friends,

In the last year, a number of public health organizations -- including the
HIV Medicines Alliance, UNAIDS, Clinton Health Access Initiative, UNITAID
and the Medicines Patent Pool -- have taken steps to enter the voluntary
licensing space. In our latest report, "Voluntary Licensing: Optimizing
Global Efforts and Measuring Impact", we comment on the efforts taken by
these global health institutions and offer suggestions to ensure that
licenses are pursued in a strategic, access-maximizing manner. We note that
the stakes are particularly high when it comes to creating normative
standards, as pharmaceutical companies are unlikely to agree to terms more
generous than those endorsed by these agencies, which are seen as
representing the entire HIV community.

In examining our collective commitment to universal access, we note that
accepting access to affordable ARVs for some while endorsing the exclusion
of others is an abdication of our collective responsibility to the global
patient community. We acknowledge that concessions may be necessary to move
a specific negotiation forward; however, to endorse a framework of
exclusion is a breach of our community's mandate to promote universal

In our report, we highlight that existing originator access programs
already cover on average 75% (and at best, 90%) of people needing
antiretroviral therapy. We argue that the true value-add of global health
institutions is to close this gap, and to advocate for coverage of the
middle-income countries that are being systematically left behind,
particularly for second-line ARVs which are often priced out of reach.
These countries account for one fourth of total patients needing ART, or
roughly 3.5 million people. The HIV epidemic in these countries is often
concentrated in vulnerable communities plagued by stigma and discrimination
and ignored by governments.

It is these communities that struggle the most to access treatment and need
the intervention of public health institutions to make access a reality.

For this reason we propose recommendations for the Medicines Patent Pool,
who aims to act as the lead negotiator for all future ARV licenses.  We
also offer a new measurement tool applicable to all public health
organizations working in the licensing arena, which can assess licenses
facilitated or endorsed by these institutions. This "Voluntary License
Scorecard" offers a set of indicators for both structuring license terms
and standards and monitoring their impact on an ongoing basis. The
indicators are categorized as follows:

- Global Patient Coverage (measured as compared to the status quo, and as
compared to the goal of 100% universal access)
- Financial Impact (including tracking actual purchase volumes and prices
on an ongoing basis)
- Market Impact (assesses the extent to which the licenses foster a healthy
and competitive marketplace)
- TRIPS flexibilities (the impact of the license on the use of safeguards
in national law, examination, opposition, compulsory licensing)

The Voluntary License Scorecard is available within our 4 page report here:

In solidarity,

Priti Radhakrishnan, I-MAK (www.i-mak.org)
Sarah Zaidi, ITPC (www.itpcglobal.org)

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