Patents, Universities, and Access to Essential Medicines: A need for the student voice

by Nathan Trayner and Jennifer Hasvold

With only 28% of HIV/AIDS patients receiving , all avenues must be explored to increase access to essential medicines. Starting in 2001 with the clarion call of Yale, d4t, and Bristol Myers Squibb, it has become evident that universities themselves can, and must, serve as part of the solution to the access puzzle by making the fruits of their research accessible to all. Sadly, despite the incredible impact generic production of d4t had on the lives of countless patients who were in dire need of treatment, universities have been slow to implement equitable access licensing policies. However, recent changes in university language provide some hope that the tide is turning, but this language must be followed by serious institutional commitment if we are to see any more success stories like d4t.

Last March, eleven of America’s top research institutions and the Association of American Medical Colleges issued a white paper entitled “In the Public Interest: Nine Points to Consider in Licensing University Technology”, publicly recognizing for the first time the responsibility universities have to implement equitable access licensing guidelines. The statement addresses the changing role of the university in an age where research is an enterprise requiring mass action and collaboration and the demand for its results is both urgent and global.

If implemented, the guidelines would have drastic and widespread results. With many of the most important AIDS drugs, including zidovudine, stavudine, zalcitabine, abacavir, and a number of protease inhibitors resulting at least in part from public research institutes4, the white paper delineates principles upon which universities may license innovations to the private sector while ensuring that intellectual property rights and licensing agreements do not prohibit access to the innovation in low- and middle-income countries. The white paper is in essence a signal of recognition: recognition that current intellectual property procedures are failing the most vulnerable among us; recognition of the voices of student activists calling for change; and recognition that universities must not stand by idly, doing nothing. For this, the white paper is exhilarating, insightful, and optimistic and yet, it is only a beginning.

For all the promise held in the white paper, it is for now only eloquent words on a blank page. Though endorsed by eleven research institutions, the white paper lacks any sense of commitment from its signatories. Without commitment, there will certainly be no implementation. Without implementation, there will be no change. The university community can, and must, do much better. At best it is a statement of principles which the universities will try and uphold whenever possible; at worst, it is a token gesture.

The cynical student activist might see it as the latter and become discouraged by what seems like an empty statement. This characterization quite plainly is not entirely off-base. Right now the white paper is a gesture. It lacks teeth. More action is clearly required— namely, the revision of university policy and protocol to include the recommendations of the white paper — if we are to see results. But cynicism can blind, and to adopt this view of the white paper would be to miss what the white paper represents in the movement to improve access to university technologies.

It is an invitation.

An invitation hinting that the door is open if only people would come knocking. The default nature of student activism is to point out what university administrations aren’t doing. This activism has historically taken place outside the conference room, on the quads and in the student unions with demonstrations, petitions, and powerful speeches. It has rarely, if ever, meant having a seat at the administrators’ table. The white paper is the invitation to this table, a recognition that administrators are willing to talk, a chance for students to recognize what university administrators are doing. We as students, the initiators of this conversation, must now seize the opportunity to engage our administrations in a professional dialogue. If we fail to do so, the white paper will quickly become obsolete, and we will have neglected our duty to make our voices heard.

Now, more than ever, students must find their voice in order to exert pressure on their universities to ensure that the policies delineated by the white paper are incorporated into university licensing practices. Universities are communities in which students serve as the primary voice for change. The white paper is a signal that administrators are waiting for their cue, waiting for pressure from students so that they can bring something to the table. Figuratively, the administrators are standing by the bleachers at a school dance, waiting for someone to take them up on the extended offer.

Medical students in particular must take the lead in this effort. There are many noble causes in need of medical student attention, but few are so central to what the goals of medical education are and should be. Our patients need these drugs. Our labs’ research leads to these drugs. We must have these drugs in our arsenal if we are to keep people from dying. We must take the time to walk over, to engage others in this important conversation, to build consensus, and to affect change despite our hectic schedules and rigorous academic load. Medical students must help build a movement on our medical school campuses, in our clinics, and in our hospitals—a movement for equitable access. Organisations such as Universities Allied for Essential Medicines (UAEM) and the American Medical Student Association (AMSA) are already involved in this movement and we must join them in increasing numbers, adding our voices to theirs.

The white paper has ushered in a new day of student activism—a day where we as medical students can sit down with faculty and administrators and dialogue civilly and professionally. Let us applaud the steps university administrators are now taking to address access to essential medicines, while at the same time continue to pressure them to make the recommendations of the white paper a concrete reality. Only by doing so will access to essential medicines become more of a concrete reality for the most vulnerable among us. 

Please click to see the white paper "In the Public Interest: Nine Points to Consider in Licensing University Technology" in pdf