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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

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