Promoting Equitable Access to Essential Medicines

by ursavoice

Harnik Shukla
J.D. Candidate 2012, UCI Law

In July 2010, the World Health Organization (WHO), World Intellectual Property Organization (WIPO), and World Trade Organization (WTO) organized a symposium to tackle one of the most important issues of our times—access to medicines. Each year, millions of people in low-and middle-income (LMI) countries die from preventable and treatable diseases. According to Dr. Margaret Chan, director-general of WHO, “roughly one billion people live on the margins of survival. A woman in sub-Saharan Africa faces a risk of dying during pregnancy and childbirth that is more than 100 times greater than a woman living in Europe. These are largely preventable deaths, in which lack of access to essential medicines play a major role.” This systematic inability of individuals in developing countries to obtain existing medicines is known as the “access gap.”

The main reason for this gap is cost. Many of the essential medicines are under patent protection, which increases cost by limiting access to medicines. Every member of WTO is required under the agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS) to enact minimum standards to protect intellectual property rights. Developing countries are incentivized to conform with TRIPS to obtain greater access to developed country markets. For example, ten years ago, the patented HIV/AIDS medicine cost $10,000 per patient yearly. Today, the same medicine is sold in generic form for $168 per year. While patent protection is important to promote innovation, it can also prohibitively bar access to essential medicines in developing countries.

A related problem to the access gap is the “research and development gap” —the massive underinvestment in medicines for “neglected diseases” that primarily affect the global poor. The scale of inequality is immense“only 10% of the world expenditure on health R&D is spent on health conditions that represent 90% of the global disease burden.”1

Universities can play an important role in addressing both the research and access gap. The 1980 Bayh-Dohl Act allowed universities to control and own patents on inventions derived from government funding; a significant development since universities are at the forefront of research. Approximately 40 to 50% of pharmaceutical companies’ profits depend on university research and, in fact, every vaccine produced in the last 25 years has involved university research.

Universities Allied for Essential Medicines (UAEM) is founded on the principle that universities have a social responsibility to pursue innovations that benefit humanity and implement procedures ensuring global access to these innovations. UAEM was founded in 2001 by a group of Yale University students with the specific intention of convincing Bristol-Myers Squibb to permit generic production of the HIV/AIDS drug d4T for distribution in sub-Saharan Africa. Their campaign resulted in a 30-fold reduction in the price of the drug. Subsequently, UAEM has grown to 85 chapters in 5 continents, 48 in the United States including 4 in the UC system.

How can law students help?

I am a member of the UAEM chapter at UCI. We have been successful in receiving support from the Dean of Medicine and are now in the process of collaborating with UCI’s Technology Transfer Office to develop humanitarian access licensing provisions—similar to what UC Berkeley and UC Davis have already implemented. We are hosting a conference in March to present these issues to the research community at UCI and gather their support on developing equitable licensing agreements. For more information, please contact me at and review the links below.


1.Addressing Global Health Inequities: An Open Licensing Approach for University Innovations, Amy Kapczynski, 20 Berkeley Tech L.J. 1031 (2005) 3.The Global Health Licensing Program: A New Model for Humanitarian Licensing at the University Level, Beirne Roose-Snyder & Megan K. Doyle, 35 Am. J. L. and Med. 281 (2009)