Global Health and the Role of Universities: Access to Essential Medicines
Access to Essential Medicines The problem
However, the private sector is not the only engine of biomedical R&D. Many drugs are
Essential medicines are drugs and vaccines initial y discovered at universities.
that the World Health Organization considers necessary for a basic health care system1. The A researcher at a university who discovers a list of essential medicines includes drugs for molecule that may become an effective drug the treatment of HIV, malaria and tuberculosis, files a patent on that molecule. (Again, a but also non-communicable diseases such as patent grants exclusive rights over control of diabetes, cancer and cardiovascular disease.
an innovation.) Since universities typical y do not have the capacity to develop drugs for
One third of the world’s market (clinical trials in particular are
population lacks access prohibitively expensive), they license the
to these medicines2. The patent to a pharmaceutical company,
this transferring the patent rights. This allows the
commonly company to further develop and exclusively
referred to as the access manufacture and sell the drug to people who gap, is that 10 million people die every year of can afford it. Some of the profit returns to the The causes
Unfortunately, the typical y high prices set by
The reasons for the lack of access to manufacturers frequently put the drugs out of medicines are diverse, and include: high the reach of poor people. For instance, prices, lack of infrastructure (e.g. refrigerated treatment of HIV-positive patients with the storage for drugs, transportation to the clinic, antiretroviral drug stavudine, developed at clean water), medical staff, and a lack of Yale and then licensed to Bristol-Myers-Squibb, political will. Universities Al ied for Essential initial y cost $15,000 per Medicines (UAEM) focuses on eliminating person per year. the high price barrier to accessing needed Our solution
The reasons leading to the high prices of university (for example)
medicines are also complex. Biomedical simultaneously license the
research and development (R&D) is expensive. drug to generic drug companies, who are able
Countries grant patents on new medicines in to produce the drug for people living in low
order to make it economical y feasible for and middle-income countries, at a lower price.
private companies to develop these medicines. Under these conditions, brand name
A patent is an exclusive right to manufacture pharmaceutical companies can still make a
profit sel ing to high income countries, while
This exclusivity enables the owner of a patent generic producers ensure access in low and to recoup the money they spent on R&D, by middle-income countries. For instance, the charging whatever they like for the medicine – cost of treatment of HIV-positive patients with i.e. much more than the actual manufacturing stavudine decreased more than 30-fold, to cost. Unfortunately, since new medicines are $350 per patient per year, after activists from typical y sold at such a high price, only wealthy the humanitarian organization Médecins Sans countries or individuals have access to them.
University and Bristol-Myers Squibb (the patent
holder and license partner) to allow generic
Universities Allied for Essential Medicines (UAEM) – uaem.org
Ultimately, universities must use their rights as Further Reading patent holders to ensure prices remain within
reach of people living in low- and middle-income countries. Simultaneous generic Chokshi DA (2006) Improving access to medicines licensing (above) is only one way a university in poor countries: The role of universities. might accomplish this. UAEM members are PLoS Med 3(6): e136. DOI: 10.1371/journal. committed to the idea that preventable deaths pmed.0030136 due to lack of medication is a problem that can
This is one of the first scholarly articles
be solved. We cal upon universities to become
published about UAEM, in the open-access
part of the solution – to uphold their
journal Public Library of Science (PLoS). It’s
relatively easy to understand, and describes
ensuring that the products of their biomedical
both the access gap and the research gap
research efforts are accessible to people
(referring to a lack of research into treatments
regardless of their income and where they
for neglected diseases). It also cites other useful resources. You can look it up through PLoS
Frequently Asked Questions
Kapczynski A, Crone ET, Merson M (2003) Global
Won’t paral el importation hurt the profits of
health and university patents. Science 301: 1629.
pharmaceutical companies and of universities?
This editorial in the prestigious journal Science (www.sciencemag.org) describes licensing
[Paral el importation, also known as drug
and patenting strategies universities could use
diversion, refers to the sel ing of generical y
to ensure that people living in low and middle-
produced drugs intended for low and middle-
income countries, in high-income countries,
inventions. It also addresses concerns about
where pharmaceutical companies still hold
possible decreased revenue to universities.
The short answer is: not to any significant
extent. For more information, refer to the Journal of the Association of University Annandale R (2007) Idea #5: Cheap Meds for the Technology Managers, Volume XVIII Number 2 - World's Poor. The Tyee.
Here’s a real y fun read! It il ustrates, in simple
This proposal sounds a little idealistic. Has any
language, the notion of affordable access to
essential medicines. It also describes the successes of the UAEM chapter at the University
Yes! The University of California at Berkeley has
of British Columbia, which has recently adopted
adopted social y responsible licensing, which you
a set of principles of global access to UBC
The University of British Columbia, in Canada,
has also adopted a set of global access principles, available online:
References
1 http://www.who.int/medicines/publications/ essentialmedicines/en/
2 Habiyambere V. Progress of WHO Member States in developing national drug policies and in revising essential drugs lists (WHO/DAP/98.7). World Health Organization: Geneva, 1998.
3 http://whqlibdoc.who.int/hq/2004/WHO_EDM_2004.4.pdf
Medications Associated with the Onset of Tardive Dyskinesia Nicte I. Mejia, M.D., Kevin Dat Vuong, M.A., Christine B. Hunter, R.N., and Joseph Jankovic, M.D. Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas ABSTRACT RESULTS Figure 2. Medications associated with the onset of TD in 89 p
Journal of the American Association for Laboratory Animal Scienceby the American Association for Laboratory Animal Science Overview Biologic Effects of Fenbendazole in Rats and Mice: A Review David Villar, Carolyn Cray,* Julia Zaias, and Norman H Altman This review summarizes fi ndings from toxicologic, carcinogenic, immunologic, and metabolic studies on fenbendazole (FBZ). Cu