We are now in the midst of AIDS Week, an opportunity to recall the bold steps our university has taken to fight this disease but also to focus on the leadership role Yale has yet to embrace. In particular, it is a timely moment to make an open call to President Levin to take the lead on AIDS issues — by committing Yale to a policy that guarantees access to treatments discovered right here on our campus.
Yale is primed to set the standard for other universities, in part, because it has shown the way before. As an innovator, our university has turned out some of the most potent AIDS therapies on the market, including d4t, a life-saving AIDS drug sold by Bristol-Myers Squibb under the name Zerit. In 2001, Yale and BMS made an unprecedented decision to increase access, agreeing to allow generic manufacturers to sell their drug in South Africa. This decision lowered the cost of Zerit from $1,600 to $55 per patient per year and made the drug significantly more accessible to AIDS victims in the country with the worst HIV/AIDS problem in the world.
In the last week, the News has published a number of articles on Yale’s newest AIDS-related compound, ed4t (“Elis stress local HIV impact,” 12/1; “Univ. not to patent chemical,” 12/4). The articles quoted Universities Allied for Essential Medicines as pressuring Yale to ask its pharmaceutical partner, Oncolys BioPharma, not to enforce its license on ed4t in developing countries. If Oncolys BioPharma were to agree, then ed4t, like d4t before it, could be produced and marketed at dramatically lower cost in many of the places it is needed most.
We would of course enthusiastically applaud a decision by Oncolys BioPharma not to enforce its license in low-income countries. AIDS drugs can only be effective to the extent that they are affordable, and patents give companies wide latitude over the pricing of a drug. Yet recent articles miss the point of how Yale, and President Levin in particular, can play a wider leadership role in promoting access to essential medicines.
To ensure that these treatments reach those who need them, universities will have to do more than increase access to a few isolated drugs. Rather, they will need to wield their substantial bargaining power as the originators of increasingly valuable research. In practice, this means inserting specific terms into every licensing agreement Yale signs with pharmaceutical companies, allowing the drugs to be produced more cheaply in the developing world. Insisting on such terms before the agreement is signed — the time when universities have the most leverage — would allow Yale, in keeping with its public mission, to see that campus discoveries yield the greatest public benefits.
Such a request is both reasonable and well within universities’ power. Drug companies’ internal research pipelines are drying up, and they increasingly depend on university innovation for new blockbuster drugs. Just as important, these new licensing agreements would not cause pharmaceutical companies to lose substantial profits. Developing countries currently represent a largely untapped market for these companies, and companies would continue to hold full patent rights and earn full profits in lucrative developed country markets. In short, if universities assert their power to determine how their research reaches the market — and, in particular, if several universities step forward together on this issue — pharmaceutical companies will have little choice but to accede.
Here at Yale, President Levin has a unique opportunity to be a leader on this issue. Levin is the longest-serving president in the Ivy League, and his experience and stature can play a vital role in setting the agenda for other universities. Likewise, as a recognized expert in the economics of patenting, President Levin has particular expertise to contribute; his previous public comments on this issue only underscore the importance of getting drugs into the public domain.
At a time when other universities have led on issues like financial aid and early admissions, now is a perfect opportunity for Yale to get out in front of a truly global issue. Access to medicines touches on the very heart of what a research university is about, and President Levin should step forward and say so.
In the meantime, the Access to Essential Medicines movement is growing by leaps and bounds. UAEM now exists at 35 campuses across the country and can count among its ranks thousands of students committed to this cause. Earlier this year, UAEM helped persuade Sen. Patrick Leahy (D-Vt.) to introduce the “Public Research in the Public Interest Act” (S. 4040), legislation that would require universities receiving federal research money to guarantee access to their discoveries in low-income countries. Likewise, UAEM’s Philadelphia Consensus Statement has allowed many luminaries to express their support for the various solutions to the access to medicines dilemma. Yale students and faculty can sign the petition alongside four Nobel Laureates; nine distinguished intellectual-property law professors; and the head of the Technology Transfer Office at the University of California, Berkeley.
This movement is gaining both speed and support, and the availability of crucial AIDS drugs will grow with it. Given its contributions past and present, Yale is today in a unique position to decide whether to lead or to follow. President Levin, this is your chance. We — and the 8,000 people who will die tomorrow of AIDS — are watching to see what you will do.
Shayna Strom, who graduated from Yale College in 2002, is a first-year student at the Law School and a member of Universities Allied for Essential Medicines.