UAEM-Brazil Inaugural Event

On August 17 and 18, UAEM-Brazil celebrated its status as the first South American branch of UAEM by hosting its inaugural event at University of Sao Paulo (USP). The one-day conference was followed by a second day of strategizing on how to move UAEM forward in Brazil, beginning a deeper dialogue on North-South access to medicines issues.  Furthermore, UAEM-Brazil has brought a strong Southern perspective to UAEM and will continue to mold UAEM’s advocacy activities.

The first day of the inaugural event consisted of a number of presentations that set the background for the state of access to medicines in Brazil and globally.  Esteemed professors from USP, members of Brazilian civil society, DNDi-Brazil and UAEMers Rachel Kiddell-Monroe, Ethan Guillen and Louis Fazen (Yale), came together for the first time to discuss Brazil’s state of access to medicines.  The conference energized a wonderful group of students from across Brazil who have enthusiastically taken up the cause and put in place a plan for moving forward in establishing and growing chapters and setting and advocacy agenda. The five conference panels provided the participants with incredible insight into direction UAEM-Brazil would move in the years to come.

The first panel focused on access to medicines and the right to health. Dr. Sueli Gandolfi Dallari discussed the difficulties patients can face in Brazil with respect to accessing medicines despite a recognized right to health and noted the need for court intervention in some cases to ensure access.  Rachel Kiddell-Monroe, president of the board of UAEM, discussed the critical importance of improving access to medicines by focusing on the work done by Medecins Sans Frontiere in the field.  She also highlighted the important role of universities in discovering medicines and pointed out the tremendous success Brazil has had in battling HIV/AIDS due to its universal access program, which has resulted in a 40% reduction in mortality and 70% reduction in morbidity.  She finished by noting that an analysis of patenting at USP has shown a sharp increase, highlighting the importance of ensuring access to medicines patented at the university.  The panel finished with Dr. Vania Lindoso, a federal prosecutor of the Attorney General's Office in Fiocruz, a research institution connected to the Brazilian ministry of health.  Dr. Lindoso spoke at length about the problem of pipeline patents in Brazil that allowed medicines patented before the introduction of medicine patents in Brazil to gain patent protection retroactively.  According to one analysis, pipeline patents have cost an unnecessary expenditure of $US 519 million for just five medicines.  You can read more about the problem of pipeline patents here: http://www.msfaccess.org/main/access-patents/are-brazilian-pipeline-pate....

The second panel focused on intellectual property rights and access to medicines.  Kevin Outterson, a professor at Boston University, highlighted patent failures and impediments that patents create to affordable access.  He also highlighted a number of solutions that Brazil can take advantage of using TRIPS flexibilities and domestic legislation.  Prof Jorge Beloqui, a longtime HIV/AIDS activist, highlighted the spotty use of compulsory licenses by the Brazilian government, the lack of access to medicines in Brazil for patients who are used in clinical trials and the need for greater access to the HPV vaccine.  He also highlighted the role of universities and noted they should recognize they have students and professors who are also patients, the need to consider alternative mechanisms to monopolies and recognize the importance of the right to health. Dr Pedro Chequer, Coordinator of UNAIDS – Brazil, gave a history of IP rights and the changes in Brazil following implementation of TRIPS and noted that TRIPS is harming the public interest.  He also noted that many rich countries who oppose compulsory licenses when used by poor countries, regularly use them, particularly the United States.

The third panel focused on strategies for licensing to improve access and compulsory licensing.  Dr. Cristina Possas, Chief of the Research and Technological Development Unit at the Ministry of Health, National STD/AIDS Program, discussed the urgency with which we need to consider alternatives for innovation that do not rely so heavily on patent monopolies and those that de-link the cost of R&D from the cost of a final product.  She also discussed the important role compulsory licensing has played in Brazil, resulting in savings of hundreds of millions of dollars including cases where price negotiations were the final outcome.  However, the doctor noted, that compulsory licensing is not an ideal long-term strategy as poor countries face enormous pressure and legal uncertainty. Prof. Fabricio Pasquot Polido discussed his work on examining the intersection of IP and access to health products and alternative licensing mechanisms.  Ethan Guillen, Executive Director of UAEM, discussed the role of universities in discovering medicines and the lobbying universities due to influence policy.  He also highlighted the growing acceptance of global access licensing as a norm to ensure affordable access to medicines in poor countries and the key principles that should be a part of any such policy.

The following panel focused on the “Place of Innovation, Research, Social Responsibility and Transparency in our Universities.”  Dr. Maryanne Fenerjian, Director of Technology Transfer Policy at Harvard University, discussed the process of developing the Statement of Strategies and Principles (read more here: http://essentialmedicine.org/archive/uaems-reponse-sps) which was adopted in November 2009. Signatory universities agree to improve access to medicines by using certain access principles in designing licensing agreements.  UAEM campaigning helped to bring about the agreement.  Dr. Fenerjian discussed multiple strategies that Harvard is currently attempting to use including using mandatory sublicensing terms, reserving march-in rights and putting in due diligence clauses – all in order to ensure that medicines discovered at Harvard are available at affordable prices in poor countries.  Dr. Oswaldo Massambani, Director of the USP Agency of Innovation, highlighted the need to improve society through technology transfer and discussed the growth of the technology transfer process at USP in the previous years.  Louis Fazen, an MD/PhD candidate at Yale University and a member of UAEM, presented on the need for metrics to measure the social good universities can do rather than the current metrics that focus primarily on the number of patents a university has and the revenue from those patents.  He discussed metrics UAEM has developed and that are now in the pilot stage to measure the types of licenses universities are putting in place to improve global access.  Finally, Carolina Rossini, a Fellow at the Berkman Center at Harvard University and a founding member of UAEM Brazil, who argued that the amount of innovation is directly related to the amount of access to knowledge.  Given this, there needs to be a mix of “open cyberinfrastructure and open licensing” with a view of universities as open spaces in order to maximize innovation.

In the final panel, Prof. Calixto SalomãoFilho of USP Law School discussed the need for broader thinking on how to encourage innovation beyond patents.  He argued that patents cannot be the only answer to creating incentives and offered ideas on alternatives.  Bethania Blum of DNDi Brazil, discussed the work of DNDi in producing medicines for neglected diseases and recent progress made in Latin America.  She also discussed a number of recommendations for how UAEM could move forward in the country and key issues to keep in mind.  Finally, José da Rocha of the Carvalheiro, Vice President of Research and Technological Development of the Oswaldo Cruz Foundation also discussed the need for alternatives to the current innovation system.  He specifically proposed the idea of using “social offsets” as a model similar to carbon offsets currently used to combat global warming for a funding source for innovation for medicines.

UAEM would like to give a special thanks to those who made this conference possible. Carolina Rossini, a Fellow at Berkman Centre, Harvard University, along with Priscilla César and Ernesto Neto, two students at USP Law School, worked overtime in the weeks prior to the conference to organize the two days of meetings.  Similarly, UAEM extends its appreciation to Brazilian civil society – particularly ABIA, DNDi-Brazil, Conectas for their help in bringing speakers who have been advocates on the front lines of the access to medicines fight in Brazil to the conference and for participating in our strategy session. In the coming months, the members in Brazil will be organizing and sending representatives to the annual UAEM conference to connect with colleagues from other UAEM chapters. We look forward to their continued participation and are confident their perspective will only serve to strengthen UAEM’s work in the years to come.