Role of UC in Fight Against AIDS

If universities are serious about aiding the global fight against AIDS, we need to revamp the way we license our inventions to pharmaceutical companies. Our newest treatments are now off limits to poor patients. The University of California can lead the movement to change this.

Berkeley and the UC system have special reason to mark World AIDS Day: It was in a UCLA hospital that the first AIDS cases were reported in 1981. It was the UC system that outpaced the Reagan administration in funding research into the disease. It was UCSF that pioneered the clinical management of HIV.

UC researchers continue to break important ground in their labs: In 2001, UCSF scientists invented a vaccine that prevented vaginal transmission of a virus very similar to HIV. In 2003, UCSF researchers patented a crucial component of an entirely new class of HIV therapy. And today, Professor Adam Arkin, a theoretical biologist at UC Berkeley, is working to build a virus that could prevent HIV from replicating.

Millions reap the benefits of our discoveries: Funding for HIV medicines has increased dramatically since 2000. But more importantly, the price of first-line antiretroviral drugs fell from $10,000 to $87 per patient per year. This astounding price drop was made possible by the introduction of generically produced drugs in developing countries. In 2007, for the first time ever, fewer people died of AIDS than contracted HIV.

However, only a third of the 10 million people living with HIV/AIDS who need treatment are getting it. This gap must be closed.

HIV is a lifelong disease. People need newer drugs when they experience side effects and resistance to their drugs. Stavudine remains the most commonly used first-line treatment in developing countries. It can cause nerve damage and wasting of the body, and the World Health Organization has recommended it no longer be used.

Switching to less toxic drugs currently costs between two and 11 times as much per patient. When resistance becomes a problem, switching to a second-line drug can cost upwards of $1,500 per patient per year. MSF (Medecins Sans Frontieres) reported in 2008 that as many as 22 percent of patients on treatment for five years need to be switched to a second line-drug. Skyrocketing costs threaten to choke off progress in the global fight against AIDS.

These rising costs are due to patents. Until recently, Indian generic drug companies competed with each other on price and supplied the developing world with affordable medicines. Second-line AIDS drugs are patented in India and many developing countries, and Indian companies cannot produce generic versions, leaving the developing world dependent on the charity of major pharmaceutical companies to set the price and provide sufficient supply.

There is evidence the prices being offered are not low enough. Facing a public health crisis, in 2007 Brazil and Thailand triggered a safeguard provision in international law to enable generic production of some second-line drugs, bringing prices down by 55 to 75 percent.

In licensing our inventions, we can ensure that the products of our publicly funded research are accessible at affordable prices.

The UC system is the largest biotech patent holder in the nation, and our research continues to form the core of important new therapies for AIDS and other diseases that afflict the world's poorest. The UCSF/Duke drug Fuzeon is-at about $22,000 a year-the most expensive AIDS drug ever marketed, and our licensee Roche had no plans as of this summer to reduce the drug's price in developing countries. Fuzeon is so expensive that 30 percent of American states refused to purchase it for their AIDS programs.

Last year, the UC system joined other prominent research universities in issuing a joint statement on licensing policy, which reads in part:

"The principle ... is simple. Universities should strive to construct licensing arrangements in ways that ensure that these underprivileged populations have low- or no-cost access to adequate quantities of these medical innovations."

It is time to put this aspirational commitment to work and adopt a UC-wide policy that ensures every license that goes out our door is written to maximize access by enabling lowest-cost generic provision for the developing world. We need to make sure our work reaches the people.

Visit www.essentialmedicine.org for more information and to sign a letter encouraging UC President Mark Yudof to implement global access licensing.

Tags: WORLD AIDS DAY