[Ip-health] Universities Allied for Essential Medicines Conference in WaPo

Gloria Tavera gloria.tavera at gmail.com
Mon Nov 25 09:13:45 PST 2013

Dear Friends of IP Health,

Please see below the article that came out this week in the Washington Post
about UAEM Conference this past weekend at Case Western Reserve University
in Cleveland, Ohio.

*University patents limit access to medicine. These students want to change
By Timothy B. Lee
November 22 at 5:03 pm

*Last weekend, Universities Allied for Essential Medicines held its annual
<http://uaem.org/get-involved/annual-conference/2013-conference/> at Case
Western Reserve University. More than 150 undergraduate, medical, and law
students from nearly 100 academic institutions converged in Cleveland to
discuss how to expand access to life-saving medicines for poor people in
low-income countries.*

*College students are well positioned to make a difference on this issue
because many patented drugs are based on research conducted at Western
universities. While universities have traditionally licensed their drug
patents to the highest bidder, student activists are convincing a growing
number of universities to change their approach to patent licensing. In
this new model, universities require their pharmaceutical partners to
ensure that patented drugs are available at reasonable prices in developing
countries, even if that lowers the amount they are willing to pay for the

*Bryan Collinsworth is the executive director of UAEM. We spoke by phone on

*Timothy B. Lee: What are the student activists who attended last weekend's
conference trying to accomplish?*

Bryan Collinsworth: The key issue for us is basically making sure that
patients worldwide, particularly in low-income countries with neglected
health needs, are able to get access to medicines. We want to make sure
that the technologies are there at all. And we want to ensure they can get
them at an affordable price, and that governments and NGOs can do that

We have this big international medical research and development enterprise.
We hear about foundations like the Gates Foundation, and pharmaceutical
companies and funders like the National Institutes of Health. You don't
hear as much the role of universities in [developing medicines]. They do a
huge amount of basic research that gets developed for lifesaving medicines
for HIV/AIDS, or cancer, or many other maladies. Since we're a student
organization, we're really focused on universities because we're students,
many are law students [and] are particularly concerned about how their
campuses are doing work in this area.

Unfortunately, there is not as much going on at universities as we'd like
to see. In many many cases we see this pattern of universities prioritizing
lucrative research and revenues from licensing deals over research that's
accessible to global health needs that's then being made accessible to
people in poor places through their licensing approach.

*How did the organization get started?*

It started at Yale in 2001 with one group of students on that campus. Yale
had developed d4T <https://en.wikipedia.org/wiki/Stavudine>, one of the
first AIDS drugs. Folks working on the ground in places like sub-Saharan
Africa were seeing these immensely expensive prices. Pharmaceutical
companies said, "We aren't going to lower these prices. We're going to
protect our patents."

Students at Yale said, "Wait a minute, the university originally developed
this. Isn't the dynamic a little different with a university? Look at our
mission statement, look at the public funding we get. Shouldn't we reach
out to Bristol Myers Squib [the company selling the drug]? We're the ones
who licensed it."

The students started causing a ruckus about that. They worked with the
developer who [created d4T], William
Prusoff.<https://en.wikipedia.org/wiki/William_Prusoff>He said, "The
goal of my research was to save lives, not to bring licensing
revenue into Yale University."

Eventually Yale did renegotiate with Bristol Myers Squib. There was a
massive 90 percent price drop for HIV/AIDS treatment. You've seen this huge
expansion [of AIDS drug availability] over the past decade for people
largely due to these big price reductions. Programs like PEPFAR [George W.
Bush's program to treat AIDS in Africa] started buying generics. That
doubled the number of people they could treat overnight.

Our group expanded out of that initially. The students sat down after that
and said, "We don't want to have to have this same fight every time a new
drug or medicine is not accessible." [It was a coalition of] law students
and medical students. They sat down together and wrote a proposal: here's
how a university could do globally accessible licensing or socially
responsible licensing.

Instead of it being all about what royalties you're going to get from [drug
companies] if [universities] license their promising medical research, it's
a conversation about how can we have provisions for low-income markets,
where you allow them to produce it for sale at a much lower cost for those
areas. How will you find some kind of other carve-out or a tiered pricing
system. Or even just not have a patent outside of the high-income world.

*If the goal is to have have the drug widely available, wouldn't the best
approach be to not sign an exclusive license at all and let multiple
companies produce the drug?*

That's a really interesting question. In many cases, universities do
non-exclusive licenses, though it's for things they don't see as lucrative.
In the long run, we do need to think about a system where the revenue
consideration is not the main consideration of how these things are
licensed, particularly if they're funded with government resources.

In most cases, it's not like these licensing deals bring in a steady stream
of moderate licensing [revenue.] Many licensing offices actually spend more
to stay open than they bring in. Those that are lucrative have one or a
handful of blockbuster medications. Princeton has one blockbuster cancer
drug that generated huge licensing deals. That has put them in the nasty
business of suing people who are trying to build competing products to keep
revenues high.

*How did you become interested in this issue?*

My background is mostly in policy and advocacy. I did some work in D.C.
back in the day for Rep. Betty McCullum (D-Minn.). She did some work when
PEPFAR was being reauthorized to add Mali, Lesotho and Swaziland, three
countries that were overlooked. That extended HIV treatment to another
million people. That got me really interested in the opportunities for
really high-level advocacy at the structural level here in the U.S. to
impact global health abroad.

People sometimes come in with a conception that it's only about going to
that village in Uganda or Nicaragua [where people need medical care]. But
UAEM is also looking at the structural level to make sure the people
delivering treatment at the clinic have the medicine they need at an
affordable price. We have this conversation about how patent monopolies can
drive up the price and restrict access.

*The standard economic argument is that we need patents to incentivize the
creation of new drugs. Are there cases where that model doesn't work?*

There's very little money in areas where companies don't think they can
recoup their investment for high-price patented product. There's a concept
of neglected diseases. There's a specific list of those diseases.

This is what we're really focused on right now -- this conversation about
could you come up with an alternative innovation system that would drive
resources to those neglected areas. Obviously this couldn't be a system
that was reliant on intellectual property. But it would probably require
much more public investment. But you could also see how eliminating some of
those intellectual property barriers would make the research more efficient.

The Drugs for Neglected Diseases Initiative spun out of Doctors Without
Borders and some other groups. It develops treatments for things like
Chagas disease. We never hear about them but they are huge issues in the
developing world. DNDI has focused on a very open research model to develop
new treatments for these diseases and then get them produced at cost in the
most affordable way possible. They've had about six new treatment in six
years in a total expenditure of $100 to 150 million. Compare that to the
standard pharmaceutical talking point that it takes a billion dollars to
develop a new drug. That price doesn't take into account some of the
know-how they've brought in with universities and drug companies.

When they collaborate, they say, here are the open IP terms under which
we're going to develop this. We're going to share information, ensure that
the research is moving along as quickly as possible. If you have a big
library of patented compounds that you haven't developed into products, we
want to see if that's usable for neglected diseases.

Now there's a bigger conversation going on around this at the level of the
World Health Organization where they're looking at projects like the DNDI
and testing out demonstration projects around the world, models for
non-IP-driven ways to do research in these neglected areas.

*How large has this student movement for access to medicine become?*

This is the third conference I've run for us and it's the biggest while I
was there. It may have been our largest ever. Nearly 100 institutions were
represented. Typically there are student chapters on campuses. A good chunk
of those were from the U.S. That's where it started off with that Yale
story in 2001. There are probably 50 or so chapters around the U.S. There
were 40 students from five or six universities in Canada.

Over the past three years, we've been growing rapidly in Europe where we're
now in seven or eight European countries. [We're seeing increasing activity
in] what you call the BRICs [Brazil, Russia, India, China], rapidly
emerging economies. They still see this huge need for access to health care
and medicine, but these universities are beginning to develop their
research capacity. On the one hand you have representatives of the U.S.
pharmaceutical industry or big university licensing organizations offering
expertise on how to set up their licensing system. But that's emulating the
problematic U.S. model. So having student voices there talking about
alternatives is really key.

In places like the U.S., students are going in and negotiating with
administrators: "Will you adopt a policy that says you're going to
responsibly license globally-relevant health technologies to make sure
there are provisions for affordability?" The other side of that is having
the same conversation about, Yyou're a publicly funded non-profit research
institution, can you devote more of your research to these neglected
diseases that aren't getting for-profit investment." Universities shouldn't
have that same concern over patent incentives.

A few years back, there was a group of universities that got together and
issued a joint policies and principles
they would take steps to make licensing affordable. Harvard, Yale, the
University of Pennsylvania, [Brown, Boston University], and Oregon Health &
Science University [were the initial founders]. Many more universities have
signed onto that agreement or adopted similar principles. Harvard, one of
the original universities, has been putting this into practice. They meet
with licensing officials to talk about how these provision are being used
in agreements.

Harvard went through their licensing agreements and now 75 percent of their
licensing agreements included these global access provisions: a requirement
that the company allow generic versions to be sold in developing countries.
One of the other interesting provisions, Harvard has a requirement that if
a company they license in is considering suing for patent infringement,
they should have a discussion of whether it's legitimate or would just
restrict access, restrict lower-cost versions of these medicines form
reaching people.

The reason [universities] join with Myriad [a genetic testing company] in
these follow-up
patents to shut down competing] breast cancer tests is they're
contractually obligated to be a party to those infringement lawsuits. We're
working with universities to think really carefully about how they're
licensing and help them avoid these kinds of really nasty cases where
they're joining in these infringement suits.

Gloria Tavera
Medical Scientist Training Program (MSTP) Candidate, King Lab
Immunology Training Program
Case Western Reserve University, School of Medicine, T401
10900 Euclid Avenue
Cleveland, Ohio, USA, 44106
gloria.tavera at gmail.com

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