5) Description of health product/service offering: Universities Allied for Essential Medicines (UAEM) has a two-fold mission: first, to determine how universities can help to ensure that biomedical end products, such as essential drugs, are made more accessible in low to middle income countries, and second, to increase the amount of research conducted on neglected diseases, or those diseases predominantly affecting people who are too poor to constitute a market attractive to private-sector research and development investment. These problems are respectively summarized by the terms “access gap” and “research gap.” In both cases, universities are well-placed to make a difference. University scientists are often major contributors in the development of health-related innovations. At the same time, universities have an avowed commitment to advancing the common good. As members of these universities, our goal is to hold them to this commitment by advocating for socially responsible research and management of intellectual property.

UAEM grew out of a successful student campaign to lower the price of an HIV/AIDS medication known as stavudine (d4t), which was originally discovered at Yale University. Despite this initial success, students realized that a retrospective, drug-by-drug approach would have limited general utility. Instead, student advocates shifted their thinking to a prospective solution to the problem: inserting access provisions into university intellectual property before it is dealt out to biotech and pharmaceutical companies. The inception of UAEM as an international organization coincided with the release of model access provisions known as the Equitable Access License (EAL).

The EAL is a technical document—developed in consultation with intellectual property law and pharmaceutical distribution experts—that is organized around one solution to the access gap: engendering generic competition (and indirectly, lower prices) by lifting patent, data exclusivity, and production barriers.

6) Description of innovation: The access gap has attracted attention from a number of interested parties. While various proposals have been debated, no systematic solution has been agreed upon. One can think of three main categories of approaches to the access gap: compulsory licensing, voluntary differential pricing, and equitable access licensing. Voluntary differential pricing would rely on pharmaceutical companies to price their products more cheaply in poor countries of their own volition. Sadly, this will has been lacking. Compulsory licensing, on the other hand, would allow governments to import cheap generic drugs into developing countries. However, because of complex politico-economic realities, compulsory licensing has not proven to be a realistic solution. The alternative solution we seek to promote, equitable access licensing, takes advantage of the fact that universities lie upstream in drug development pipelines. This positioning allows universities to insert access provisions into their intellectual property to enable generic competition—and thereby, lower prices—in poor countries. Therefore, our organization’s mission is to give voice to the destitute sick in the halls of the ivory tower—an arena in which they are not represented, but by which they are profoundly affected.

7) Operational model: Targeted student recruitment has resulted in both strong member chapters and a developing national leadership structure. The UAEM chapter at the University of Washington, for example, was formed directly after a conference held at Columbia University during October of 2004. Since then, members at UW have developed a productive working relationship with the head of the university technology transfer office; have collected hundreds of student and faculty signatures on an online petition; and have given presentations on their work to audiences at the medical school, at a national global health conference, and for the general public. Their work has caught the eye of administrators as well. In November 2005, the university Intellectual Property Management Advising Committee invited the UW chapter of UAEM to present its proposals, which the Committee is currently considering along with other humanitarian licensing policies.

The University of California-Berkeley also has a UAEM chapter and has had numerous conversations with faculty and administrators about the EAL and socially responsible university licensing. In September 2005, the University announced a Socially Responsible Licensing Initiative, which was partially a response to heightened interest and advocacy by students. In November 2005, the Berkeley replied to a request from its UAEM chapter to make global human welfare the primary goal of university technology transfer.

Through advocacy and education, members of UAEM collaborate to implement equal access licensing and university commitments to research and development that serve the most marginalized populations. By seeking to affect change at the start of the drug-development pipeline, this structure can affect large-scale and wide-reaching positive change for low-income and marginalized populations of the world.

8) Human resources: More than 75 students from 28 universities across the country attended UAEM's most recent conference in 2005, and membership continues to grow with each year of advocacy and commitment to improving equal access licensing and neglected disease research and development on university campuses. In addition to the general chapter membership and leadership, UAEM boasts a 14-member national coordinating committee whose duties include planning and managing national initiatives; recruiting, supporting and assisting UAEM members and chapters in their university initiatives; and coordinating future strategy, direction and literature to increase awareness of UAEM's goals and mission.

9) Key operational partnerships: Because our chapters are based at universities, many of our organization's partnerships revolve around the research enterprise at academic institutions. Most of our chapters have productive working relationships with the technology transfer offices at their respective universities. These offices govern intellectual property management within the university and are a critical constituency for our advocacy. We are currently in discussions with the trade group of these professionals, known as the Association of University Technology Managers. We have also established partnerships with other organizations working in the field of access to medicines, including Medecins Sans Frontieres, the Consumer Project on Technology, and Health Global Access Project. Most recently, we have begun establishing relationships with scientists and executives at public-private partnerships organized around neglected-disease research (e.g., the Institute for OneWorld Health and Medicines for Malaria Venture).

10) Financial Sustainability

          • Fees charged to clients?: No

          • Earned incomes as a percentage of operating costs: 0

          • Other funding sources: Currently, UAEM activities are funded through a grant from the Ford Foundation. The organization is beginning to look for additional and other sources of funding through grants to sustain and grow UAEM's base of support and initiatives.

          • Strategy for long-term sustainability: The goal of our initiative is policy change across major research universities in the industrialized world. Therefore, we seek funding to conduct this advocacy until such time as that advocacy is no longer needed. The policies that we advocate for do not require administrative oversight or monitoring. Taken together, these conditions ensure that financial sustainability is only an issue in the short-term for our organization.

11) Current and Future Impact

          • Total number of clients: N/A

          • Clients in the past year: N/A

          • Percentage of low-income clients: N/A

          • Impact: Our goal is policy change at universities in the developed world for the end purpose of improving access to medicines in poor countries. Because of the long-term nature of our work, it is difficult to estimate the number of clients we directly benefit. We seek to create an alternative solution to segmenting the world pharmaceutical market by leveraging university intellectual property. An intermediate measure of our impact is the number of universities where we have active chapters. This number stands at over 25 in May 2006.

          • Overall "market": The potential impact of the policy changes we advocate for are staggering. The World Health Organization estimates that over 10 million people in low- and middle-income countries lack access to essential medicines. Universities are the incubators of basic science research that goes into creating many of those medicines.

12) Scaling up strategy

          • Stage of the initiative: Start Up stage.

          • Expansion plan: Our organization currently has student chapters at 25 major research universities in the United States, Canada, and the United Kingdom. We plan to double our active chapter membership in the next three years, targeting in particular major research universities drawing significant funding for biomedical research. For example, our goal for the United States is to expand to 20 of the top 25 universities as ranked by funding received from the National Institutes of Health.

13) Policy change: Because UAEM efforts focus on university policy change, the policies relating to research and development with regard to patenting and licensing are the key policies on which to focus when targeting universities’ responsibilities to improve access to medicines in poor countries. University administrators and students must collaborate to adopt as many of the model Equal Access Licensing provisions as possible to ensure that life-saving drugs and devices discovered by university researchers (with public funding) becomes quickly and readily available to vulnerable populations in need of these essential medicines at affordable prices. Because this change is somewhat of a collective action problem, simultaneous efforts at universities around the country to adopt these policy changes would be ideal.

14) Origin of the initiative: In 2000, while attempting to initiate a program to deliver HIV medicines effectively to a resource-poor setting, the humanitarian organization Doctors Without Borders faced obstacles because one of the anti-retroviral drugs (ARVs), stavudine, cost more than $1600 per year per patient. Although an Indian company offered to sell a generic version of the drug for only three percent of the brand’s cost, Doctors Without Borders could not accept the offer since stavudine was subject to a South African patent. Bristol-Myers Squibb (BMS) held an exclusive license to sell stavudine, and Yale was the key patent holder. However, because of activism from both students at Yale and the researcher who originally discovered the drug, Yale and BMS agreed to permit the sale of generic stavudine at $55 per year per patient. Our group grew out of that initial student movement at Yale University.

Contact Information:
Dave  Chokshi
Member, Coordinating Committee
Universities Allied for Essential Medicines
(NGO)
United States
Website: http://www.essentialmedicine.org