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CHAPTER NO. 1.4 Nelsen L and A Krattiger. 2007. Ensuring Developing-Country Access to New Inventions: The Role of Patents and the Power of Public Sector Research Institutions. In Intellectual Property Management in Health and Agricultural Innovation: A Handbook of Best Practices (eds. A Krattiger, RT Mahoney, L Nelsen, et al.). MIHR: Oxford, U.K., and PIPRA: Davis, U.S.A. Available online at www.ipHandbook.org. © 2007. L Nelsen and A Krattiger. Sharing the Art of IP Management: Photocopying and distribution through the Internet for noncommercial purposes is permitted and encouraged. Ensuring Developing-Country Access to New Inventions: The Role of Patents and the Power of Public Sector Research Institutions
AbstractIf universities adopt sound licensing practices, the universities will not only help stimulate investment in research on diseases that primarily afflict the poor in developing countries, but also ensure that the products of the research are affordable and widely available in those countries. Ensuring global access is one of the central goals of intellectual property management. But universities confront two main obstacles in their efforts to achieve the goal. First, university administrators, technology transfer officers, and business people are too often unaware of both the need to ensure access to new health technologies in developing countries and the manner in which patenting and licensing practices can be an integral component of global access strategies. Second, there is only a short history of experience in incorporating such concerns in negotiating licenses, so no best practices have yet evolved. This chapter offers a few possible approaches to ensuring broad access to university inventions while preserving incentives to development, including patenting inventions in a select list of developing countries. The chapter concludes by urging all of the players in this field to build upon their own experience and to take creative risks in the pursuit of new solutions. 1. IntroductionFrom a humanitarian point of view, a patent system presents a paradox. How can a system designed to restrict access to technologies, including medical technologies, also be used to maximize availability of needed medicines and vaccines at affordable prices? One way of looking at that paradox is to consider an extreme case: if all the medicines and vaccines needed for diseases in developing countries existed today, the patent system might be unnecessary. The absence of patents, some experts suggest, would presumably allow for maximum competition, driving prices down and thereby maximizing affordability and availability. But for many of the diseases of developing countries, few drugs or preventatives exist; in some cases none exists. Patent protection can provide the necessary incentive to encourage industry to use its skills and resources to discover, develop, test, ensure quality control of, manufacture, and distribute new drugs and vaccines. Few companies—if any—would embark on the long trail of new-drug discovery and development, if they could not be protected by patents from competitors. Thus, patents are neither inherently bad nor inherently good with regard to this purpose, but—like all tools—must be used wisely. Research institutions, such as universities, medical schools, and other nonprofit institutions engaged in biological and medical research (collectively referred to as “universities” in this chapter), have a special role to play regarding the use of patents for developing and distributing drugs and vaccines for developing countries. These institutions are often the source of the core technology and, occasionally, lead compounds that could be developed into drugs and vaccines. Despite the avowed public purpose of their technology transfer activities, universities have recently come under criticism for using patents in a way that could inhibit (and in very few cases, has inhibited), the distribution of medicines at accessible costs to developing countries. Critics argue that by granting exclusive licenses to developed-country pharmaceutical companies, the universities are allowing the pharmaceutical companies, sometimes, to prevent local companies from producing and selling drugs, potentially at affordable prices—thus effectively denying life-saving drugs to poor people in these countries. Although nonprofit research institutions are not often involved in these issues, (in part because the fraction of medically related patents owned by these institutions is small), their visibility, coupled with the universities’ public responsibility, is causing university technology transfer offices to modify their licensing practices for patents relevant to healthcare in developing countries. Some thinkers have suggested that the best thing universities can do to ensure access is to cease patenting medically related inventions and place everything in the public domain. But doing so would be both unrealistic and counterproductive. Patents have been shown to be a powerful tool for directing investment into the development of technologies that would otherwise lie fallow. University inventions are usually at such an early stage (embryonic is a term commonly used to describe them) that investment in development involves substantial risk. Neither the technical practicality nor the market acceptability of the invention is proven. And many more inventions fail to reach than do reach the market—particularly in the medical field. Patents are an essential way for companies to manage the risk, and the use of patents is even more important for medicines and vaccines, where the costs of development and particularly of clinical trials require much larger investments and much greater risk. Universities and research institutions hope for some financial return from their patents, but contrary to widely held beliefs, this return is seldom large. On average, U.S. universities receive licensing royalties equivalent to only 2%–4% of their research budgets. Most universities believe that the primary purpose of their technology transfer activities is either (1) to induce investment in developing technologies to bring products to public use, (2) to aid local economic development through spinout companies based on licenses to their technology, or (3) both. Given their commitment to encouraging the development of new technologies via patenting, universities need sophisticated policies and procedures in licensing to ensure that the poor will have access to medicines based on the universities’ technologies. Potentially, the access policies developed by universities may—if the policies are practical, properly implemented, and publicized—become “norms” that will be more widely adopted by the private sector. Awareness about these issues is new; techniques for addressing the problem are only just emerging, and there is no consensus yet on best practices. The remainder of this chapter addresses some potential solutions. 2. Raising AwarenessThe first task in encouraging effective licensing policies and practices is to raise awareness of the issues (discussed in section 1 above) in the research institution community. Technology transfer officers need to become aware of developing country health-care needs and the universities’ responsibilities with respect to those needs. Given the general commitment of universities to transfer technology to promote public welfare, this awareness alone will go a long way toward preventing the inadvertent granting of licenses that lack consideration for the health needs of developing countries. Senior administrators and researchers also need to become more aware of the issues involved so that these professionals will acknowledge the broader value of licensing terms that may be somewhat less profitable from an economic standpoint, but that may address urgent medical problems in poor parts of the world. Finally, consistent university policies on these issues will raise awareness inside the companies universities work with, making such companies more readily accepting of licensing terms that address these issues. Awareness is already growing. In the United States, the Association of University Technology Managers (AUTM) began to publicize this issue to its members in 2003. This organization is having a substantial impact on the understanding of technology transfer professionals with respect to these concerns: more than 90% of technology transfer professionals from nonprofit research institutions in the United States and Canada belong to AUTM, along with several hundred professionals from other countries. An AUTM Special Interest Group, formed in 2003, has evolved into the Technology Managers for Global Health (TMGH),1 which is partially supported by MIHR (the Centre for the Management of IP in Health Research and Development). TMGH’s purpose is to raise awareness about global health issues and, with AUTM, to compile a collection of best-practice policies and licensing terms that can be distributed to AUTM members and others. The interest shown on the part of the greater AUTM membership is especially encouraging. At its 2006 annual meeting, the opening plenary session of AUTM was on “Innovative Policies and Practices in Technology Transfer: A Global Health Perspective.” The meeting agenda included a program of education with several workshops on global-health technology transfer issues. Through its guidelines on the patenting and licensing of research tools, the National Institutes of Health (NIH) have helped alert universities to the need for thoughtful policies in exclusive licensing.2 The NIH wants to make certain that researchers in the health arena have access to research materials without undue hindrance by patents, and so NIH has issued guidelines for patenting and licensing research tools. The two objectives—fostering access to medicines and making research materials widely available—often merge in the minds of technology transfer professionals, making them more aware of the need to exercise care when licensing university technology. 3. Suggested Approaches3.1 Considering where to file patentsWhen a research institution patents and licenses out a technology, usually the institution can—if it insists—continue to own the patent after licensing. (This is the practice in most U.S. universities.) The institution can then control, by contract with the licensee, which countries the patent will be filed in. Determining a strategy of where to file, however, is not easy. 3.1.1 Prohibition-of-filing strategyWhere a drug or vaccine in question has a large developed-country market, one possible strategy is to prohibit the patent from being filed in developing countries. Most of the licensee’s profits would presumably come from markets in developed countries—with or without developing country patents. The loss of potential revenue from developing countries (which in any case could not afford to purchase large quantities of the medicines at developed country prices) would be negligible, and the licensee mostly likely would not be substantially disadvantaged by this approach. The absence of patents in the developing world, however, could allow “generic” competitors to produce the drugs in those countries at low prices. This strategy will be effective only if:
3.1.2 When patent filing in developing countries may be beneficial for accessWhen the demand for a drug or vaccine is primarily (or exclusively) in developing countries and there are no alternative products, the primary problem is to develop a sufficiently profitable market to provide an incentive for the private sector to invest in R&D. The only other alternative is for governments or nongovernmental organizations (NGOs) to fund all of the research, development, clinical testing costs, and manufacture. But having a public sector entity develop a commercially viable product is usually impossible. Patents may provide an incentive to the private sector to invest by aggregating the developing world market into a single, larger market. To be successful, this strategy relies on:
3.1.3 Licensing strategiesResearch institutions have the most control over optimizing the use of their inventions at the time of licensing. It is before the invention is licensed that the university can best ensure that the invention will be used to advance—or at least not hinder—solutions to developing country health needs. The first decision is whether to grant (1) a fully exclusive license, (2) an exclusive license limited by product type, (3) an exclusive license limited by geographical territory, or (4) a nonexclusive license.4 Considering two extreme cases is illuminating:
Exclusive licensing places a large responsibility on the university to negotiate license clauses that ensure both development of the product and rapid distribution to developing countries at affordable prices. Not every member of the university technology transfer community is yet conscious of this requirement. Best practices have not yet been established for such negotiations, and so strategies need to be based on evolving experience. A few situations, we know in retrospect, were clearly mistakes—experiences we can now learn from. Some better, but still experimental strategies include:
4. ConclusionUniversity technology transfer professionals are becoming more aware of their obligations to ensure that the poor have access to medicines based on university technologies. To a large extent, universities are embracing this obligation in the hope that well-crafted patent and licensing policies can be powerful tools to provide such access. But there are no clear-cut mechanisms, nor many precedents to guide professionals in this endeavor. This chapter presented just a few of the strategies that research institutions can pursue in their quest to provide developing countries with access to new medicines. Each of these strategies has been tried, but they are all relatively new and will need further refinements. This can only be achieved, however, in actual negotiations between research institutions and companies. New approaches will also certainly develop in the future. None of these efforts will be effective unless both research institutions and companies first become more aware of their obligations to the poor in developing countries. Awareness is only the first step, however, for none of these strategies will thrive unless they meet the needs of both the research institutions and the companies that are developing new technologies to improve human health. Building upon the knowledge and successes we already possess, we must not only strive for novel, creative solutions but also take reasonable risks in the pursuit of these much-needed solutions. EndnotesAll referenced Web sites were last accessed between 1 and 10 October 2007. 1 See www.tmgh.org. 2 NIH. 2005. Best Practices for the Licensing of Genomic Inventions: Final Notice. Federal Register 70(68): 18413–415. www.ott.nih.gov/pdfs/70FR18413.pdf. 3 See, also in this Handbook, chapter 15.4 by D Matthews and V Munoz-Tellez. 4 See, also in this Handbook, chapter 11.8 by SL Shotwell. 5 See, also in this Handbook, chapter 2.7 by J Oehler. 6 Trickle-down theory relates to a product that may at first be so expensive that only wealthy people can afford it. The theory states that over time, however, the price will fall until it is available to the general public. In other words, the benefits trickle down. 7 Friedman MA, H den Besten and A Attaran. 2003. Out-Licensing: A Practical Approach for Improvement of Access to Medicines in Poor Countries. Lancet 361: 341–44. www.fightingmalaria.org/pdfs/Lancet%20Article.pdf. Nelsen L and A Krattiger. 2007. Ensuring Developing-Country Access to New Inventions: The Role of Patents and the Power of Public Sector Research Institutions. In Intellectual Property Management in Health and Agricultural Innovation: A Handbook of Best Practices (eds. A Krattiger, RT Mahoney, L Nelsen, et al.). MIHR: Oxford, U.K., and PIPRA: Davis, U.S.A. Available online at www.ipHandbook.org. © 2007. L Nelsen and A Krattiger. Sharing the Art of IP Management: Photocopying and distribution through the Internet for noncommercial purposes is permitted and encouraged.
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