Potential Solutions: Introduction to UAEM UBC UAEM Introductory Seminar UBC Medical Student Alumni Centre October 17, 2009 June Lai

Universities are major contributors to “health-related innovations” Includes but not limited to: drugs vaccines diagnostics monitoring tools know-how and technical expertise

What do universities currently do with their research? Potential for commercialization? Decision to patent Followed by licensing to industry Universities receive royalties and/or other payments in exchange for the license.

Universities’ patent rights in key HIV/AIDS drugs on the market · Emtricitabine - Emory Emtriva ®, component of Truvada ® & Atripla ® · 3TC - Emory Epivir®, component of Combivir ®, Epzicom ® & Trizivir ® · Staduvine - Yale Zerit ® · Abacavir - Minnesota Ziagen ® component of Trizivir ® & Epzicom ® · T-20 - Duke Fuzeon ®

Increase in Canadian Patenting and Commercialization: Momentum Report. 2005, AUCC.

UBC Mission Statement “The University of British Columbia…will prepare students to become exceptional global citizens, promote the values of a civil and sustainable society, and conduct outstanding research to serve the people of British Columbia, Canada, and the world”. Most other universities have very similar globally minded mission statements that support action to serve the people of the world.

How can universities ensure that their innovations reach low and middle income populations?

The case that started it all…

Yale-Stavudine Victory Most frequently prescribed antiretroviral in 1998 Yale earned $40 million (1999) and Bristol- Myers Squibb earned $443 million (2002)

UAEM Beginnings Group of students wanted an upfront and systematic way to ensure medicines are made affordable and accessible.

Your handy dandy PCS…

Philadelphia Consensus Statement Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa Paul Farmer, famous for his ground-breaking work in Haiti Jeffrey Sachs, Earth Institute at Columbia University and Director, UN Millennium Project, “ The End of Poverty ” Edwin Cameron, South African Supreme Court Justice James Orbinski, Former President MSF Nobel Laureates (Dr. John Polanyi, Sir John Sulston, and Dr. Harold Varmus, Archbishop Desmond Tutu, Dr. Peter Agre) Elizabeth May (Leader of the Green Party of Canada)

Philadelphia Consensus Statement Dr. Julio Montaner, Acting Director and Director of Clinical Activities of the BC Centre for Excellence in HIV/AIDS and Co-Director of the Canadian HIV Trials Network, recent President-elect of the International AIDS Society Dr. Bob Hogg, Director, HIV/AIDS Drug Treatment Program at the Center for Excellence in HIV/AIDS Dr. Bob Hancock, UBC infectious disease researcher, “ Gates Grand Challenges in Global Health ” funding Dr. Tom Perry, internist and clinical pharmacologist, MLA of British Columbia from 1989/96, Minister of Advanced Education, Training and Technology from 1991/93 Dr. David Ng, Advanced Molecular Biology Laboratory (AMBL),Michael Smith Laboratories, Director of Terry Project- UBC

What can universities do to promote access to essential medicines? Promote equal access to university research Require licensing terms in technology transfer agreements that ensure low-cost access to health-related innovations. Global Access Licensing Framework UAEM Policy Statement

Global Access Licensing Framework - Generic production of drugs is the best way to ensure that people in poorer countries can access drugs. If generic provision is infeasible, the drugs should be sold at cost - Transparency in licensing approach. Measure success of technology transfer by impact on access and innovation.

Gener-X Patent Global Access Licensing

Common Concerns about Global Access Licensing Hurts pharmaceutical companies: Black market Lost profit Industry won ’ t work with Universities, which hurts research

Lost Profit Fear: Generics take away from brand name sales In reality… -Consumers in High Income Countries comprise 93.2% of all pharmaceutical revenues -GAL would facilitate access for those too impoverished to afford treatment

Black Market - Some Useful Terminology Parallel importation - when buyers in lower- priced market re-sell the product to consumers in a higher-priced market

Parallel Importation -generic drugs flowing from Canada to US - If only a small percentage of Antiretrovirals were diverted = significant volumes

Parallel Importation : In reality… - Limited evidence of parallel importation. - April 2002, European Commission and pharmaceutical companies acknowledged parallel importation “still largely theoretical”

Preventative Measures -Product Modification -Consumer Marketing -moral and legal issue -Tight Border Controls at High Income Countries

What can universities do? Promote research & development for neglected diseases Promote in-house ND research Engage with nontraditional partners to create new opportunities for ND drug development; Ensure that discoveries useful for ND research are exempt from patents or licenses UAEM Policy Statement

Universities that are Changing the Way they License Berkeley (2005) UBC (2007) Emory (2008) Edinburgh (2009)

Universities have an opportunity and a responsibility to take part in these solutions Universities are dedicated to the creation and dissemination of knowledge in the public interest. Universities best realize their objectives when they promote innovation and access to essential medicines.