[Ip-health] UCSF Synapse: Our Labs, Our Drugs, Our Responsibility

[Matt Price]

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[ Picked text/plain from multipart/alternative ]
http://synapse.ucsf.edu/articles/2008/december/04/hivcare.html

Our Labs, Our Drugs, Our Responsibility

*By Michael Lin
**Contributing Writer
*

*Commentary
*
Monday, December 1st, marked World AIDS Day, when we pause to remember the
more than 25 million individuals who have died of HIV since 1981. Though 33
million people remain infected, we have come a long way in the past three
decades. With the advancement of antiretroviral therapy, AIDS has been
transformed into a manageable chronic disease permitting patients in the
developed world to enjoy full and healthy lives.

Despite the miracles of modern science, 6.7 million people, mostly in
developing countries, are denied the lifesaving HIV drugs that they
need.(1<http://synapse.ucsf.edu/#1>)
This number will only rise as patients already on therapy develop resistanc=
e
to the cheaper first-line HIV drugs, forcing them to turn to costly second-
and third-line drugs. The prohibitive prices of branded drugs remain a
primary barrier to drug access, severely restricting individuals and
providers from accessing essential medicines.

As we celebrate the scientific advancements in the fight against HIV, we ar=
e
called to reflect upon and discuss the enormous role that University of
California students and faculty can play in closing this global health
disparity through transparent and socially responsible drug-licensing
policies. Reform right here at home will bring hope and equality to million=
s
around the world.

University of California labs churn out hundreds of cutting-edge biomedical
inventions every year. For fourteen consecutive years, the UC system has
been the largest academic recipient of new patents with a portfolio of over
8,200 active patents. UCSF in particular has a history of producing landmar=
k
biomedical advancements, such as insulin and the hepatitis B vaccine, and
holds over 1,300 active inventions.

UCSF's prolific patenting activity puts it in an excellent position to
advance the global fight against HIV. In 2000, the university was awarded a
patent for the drug Fuzeon (enfuvirtide) based on work done in the
Biochemistry Department at UCSF. The first in a novel class of viral fusion
inhibitors, Fuzeon quickly became a critical last-line HIV drug used to
extend the lives of patients when all other therapies had failed. The drug
was licensed out to Roche and Trimeris for development and production and
now brings over $250 million in revenue per year.

Fuzeon is a miracle lifeline to the thousands of HIV patients who can affor=
d
it. However, at a cost of over $20,000 per patient per year, Fuzeon is
completely out of reach for the world's poor. Each year, over 10 million
people die of treatable diseases because they lack access to essential
medicines. Of these, 3 million die of AIDS-related complications. The drugs
these patients need exist, yet they die needlessly.

The students and faculty of UCSF must not stand by and watch as millions ar=
e
denied access to Fuzeon and the other fruits of their labor. As Sir John
Sulston, winner of the 2002 Nobel Prize, described, "Biomedical knowledge
and achievement is growing at a tremendous pace, but is unmatched by ethica=
l
thinking about how to apply the results equitably, humanely and wisely. The
universities are forgetting their role as guardians of human wisdom, and
instead are selling out to the highest bidders." UCSF is a public
institution whose mission is "advancing health worldwide" as to "serve our
local, regional and global communities and eliminate health disparities." I=
n
order to achieve this, the university must ensure that its lifesaving
advancements are made equally accessible around the world.

Last year, the UC system joined over fifty peer institutions in proclaiming
that "Universities should strive to construct licensing arrangements in way=
s
that ensure that these underprivileged populations have low- or no-cost
access to adequate quantities of these medical innovations."

While this declaration is a step in the right direction, the UC system has
yet to implement a concrete global access policy that will ensure that
fruits of our research are actually available to the world's poor. In
comparison, many of our peer institutions such as Emory and the University
of Washington have signed principled commitments prioritizing global access
and recognizing generic production as preferred vehicle for ensuring access
in their licensing agreements. It is time for the University of California
to follow suit.

Progress has been hindered by fears of loss of revenue =96 and thus incenti=
ve
=96 for drug companies to develop new therapies. However, very few branded
drugs are sold in low- and middle-income countries anyway due to their
prohibitive prices. Africa only accounts for 1% of the world's drug market,
so allowing African patients access to generics would result in only a
negligible decrease in revenue. Furthermore, research suggests that the sal=
e
of generics in developing countries does not impact drug revenue in
developed countries through illegal parallel importation.

History shows how we as students and faculty can hold our university
accountable for fulfilling its mission statement. In 2001, Doctors Without
Borders requested a license from Yale University to buy generic stavudine
(Zerit) to treat patients in South Africa. Though Yale was its key
patent-holder, Bristol-Myers Squibb (BMS) held an exclusive license to sell
branded stavudine. Though Yale initially balked at the offer and blamed BMS
for tying its hands on the issue, a student campaign, an appeal by the
drug's inventor and a front-page story in the *New York Times* quickly
convinced Yale to pressure BMS into allowing generic production of stavudin=
e
to proceed. Within a year, the price of stavudine fell thirty-fold =96 from
$1,600 to $55 =96 for governments and NGOs in sub-Saharan Africa.

Twenty-seven years after HIV was first characterized, we have made
incredible progress in our understanding and ability to treat the disease,
but our global management of HIV has fallen short of our moral
responsibility toward our fellow humans. To mark this World AIDS Day, join
your fellow students and faculty in taking ownership of the research we
produce and the institution we represent. Sign an online petition at
http://uaem.berkeley.edu/lettertoyudof.htm, or write the UC President Mark
Yudof (president@ucop.edu) and the Chairman of the UC Regents Richard Blum =
(
regentsoffice@ucop.edu) urging them to implement global access and
transparency in their licensing policies. These are our labs, these are our
drugs, and this is our responsibility to the world.

References:
1 http://www.avert.org/worldstats.htm
2 http://www.essentialmedicine.org/article.pdf, p. 1036

*Michael Lin is a first-year medical student representing Universities
Allied for Essential Medicines, an international student advocacy group
seeking to increase access to basic medicines around the world. For more
information about this campaign, contact him at Michael.Lin@ucsf.edu or
visit www.essentialmedicine.org.*