“The University Report Card helps illuminate the effects of academic biomedical research on the health of the world’s poor, and hold universities accountable for the impact, or lack of impact, that their policies have on global health. I am grateful to the students of UAEM for creating the scorecard, and strongly encourage students, faculty, and broader university communities to call on their institutions to enact policies that increase access to lifesaving medicines and medical technologies for those who need them most.”
–Dr. Paul Farmer, Founder of Partners in Health
WHAT IS THE UNIVERSITY REPORT CARD?
UAEM’s Report Card project evaluates more than 50 top American universities on their contributions to neglected biomedical research and access to medicines.
A project of Universities Allied for Essential Medicines (UAEM), the University Report Card uses publicly-available and self-reported information to evaluate three key questions:
- How and in what ways are universities investing in innovative biomedical research that addresses the neglected health needs of low and middle income countries?
- When universities license their medical breakthroughs for commercial development, are they doing so in ways that ensure equitable access for people in low and middle income countries? Will these innovative treatments at affordable prices?
- Are universities educating the next generation of global health leaders about the crucial impact that academic institutions can have on global health and access to medicines through their biomedical research and licensing activities?
WHY IS THIS NEEDED?
Universities are major drivers of medical innovation. Between 1/4 and 1/3 of new medicines originate in academic labs, and universities have contributed to the development of one out of every four HIV/AIDS treatments.
This key research role gives universities huge potential to advance global health. But the size and scope of their impact depends on decisions about where to focus biomedical research, how to share new discoveries, and what to teach a rising generation of young leaders in global health and areas that impact upon global health.
More than 1 billion people worldwide suffer from “neglected diseases” – illnesses rarely researched by the private sector because most of those affected are too poor to provide a market for new drugs. Even worse, 10 million people die each year simply because they can’t get life-saving medicines that already exist – often because those treatments are just too expensive.
Universities can use their unique positions as public-interest, largely publicly-funded research institutions to address both challenges. By prioritizing research on global diseases neglected by for-profit R&D, they can pioneer new treatments that will benefit millions in low and middle income countries. And by sharing their medical breakthroughs under open, non-exclusive licenses or licenses that promote lower prices in developing countries, universities can help low-income people worldwide access new, life-saving treatments.
Some universities are already taking these steps – along with teaching students about the challenges of neglected disease innovation and treatment access. But few have tried to systematically measure universities’ contributions in this vital area. The University Report Card aims to fill that gap.
CHANGES SINCE 2013
Following the release of the first report card in 2013, we solicited feedback from universities on how to improve the process to make this year’s analysis more instructive. Based on the feedback we received, UAEM researchers who completed the 2015 iteration relied more heavily on the universities’ publicly available data, reducing the burden on institutions to self-report information. The change resulted in a response rate increase of 90 percent in the Access section in particular, with 19 schools responding in 2015 versus only 10 schools in 2013.
Other changes include a decision to evaluate Canadian and American universities separately due to the significant differences between the two school systems. There is interest from UAEM students to replicate the project for Canadian schools respectively, in a similar vein to the UK version of the Report Card that was launched in January 2015..
This iteration of the University Report Card also includes an expanded empowerment section as well as an additional question on open-access publications. As a result of these significant improvements it should be recognized that are considerable differences between the two Report Cards so year to year direct comparison of schools is not recommended.
WHAT ARE OUR FINDINGS?
Consortium of Global Health Members:
- Of the 59 universities we evaluated for the University Report Card, 49 are members of the Consortium of Universities for Global Health (CUGH), which is designed to facilitate knowledge sharing to address global health challenges. Disappointingly, only 21 of those 49 universities responded to our survey.
Given the intense global focus on Ebola in 2014 as a result of the devastating epidemic that swept West Africa, we chose to also review university travel policies regarding Ebola affected regions. The data collected did not contribute to the final scoring.
- Most universities (40 out of 59) had an official policy with regards to the Ebola response, and many of these cited a credible source (CDC or WHO)
- In general, most universities had a university-sponsored travel restriction (in accordance with CDC or WHO guidelines) to regions affected by Ebola.
- Several universities had a mandatory sequester or quarantine in place (8 out of 59)
IQ1 What is the university’s total biomedical research funding received from Fogarty International Center grants or Gates Foundation grants for global health research, training and collaborations? (Eq2 in 2013)
- On average, it was found just 3.46% of total biomedical research funding (received from Fogarty International Center grants or Gates Foundation grants) went to global health research, training and collaboration.
IQ2 What percentage of the university’s total biomedical research funding received from Fogarty International Center grants or Gates Foundation grants is devoted to projects focused on neglected diseases? (Iq1 in 2013)
- There is substantial variation among institutions in the percentage of biomedical research grants devoted to neglected diseases ranging from a low of 0% to a high of 28.1%. This suggests that universities can take independent actions to increase their ND research funding, despite potentially limited funding sources or external resources.
IQ3 What percentage of the university’s total medical PubMed publications is focused on global health? (new in 2015)
- On average, approximately 2% of total medical PubMed publications at the top 59 universities have a global health focus.
IQ4 What percentage of the university’s total medical PubMed publications is focused on neglected diseases, neglected aspects of HIV, TB, malaria, and/or access to medicines in the developing world? (new in 2015)
- On average, approximately 1.5% of total medical PubMed publications at the top 59 universities have a neglected disease focus.
IQ5 Does the university have a research center or institute dedicated specifically to neglected diseases? (1q3 in 2013)
- 10 of the top 59 universities evaluated have a research center dedicated specifically to neglected diseases.
Access/Global Access Licensing
AQ1 Transparency and Open Access (separate questions Aq1 & question Aq2 in 2013)
- PART 1: Has the university officially and publicly committed to licensing its medical discoveries in ways that promote access and affordability in developing countries?
- PART 2: Does the website of the university’s technology transfer office (TTO) make an effort to disclose, explain and promote access licensing commitments and practices?
- 17 of the top 59 universities have endorsed detailed, specific standards for socially responsible licensing, but only eight of those prioritize generic production of university-researched medicines for developing countries.
- Less than half of the 17 universities that endorsed detailed, specific standards for socially responsible licensing provide in-depth information about the licensing standards on their technology transfer websites.
AQ2 Open Access: What percentage of the university’s total medical sciences publication output is published in open-access publications? (new question in 2015)
- Of the universities with self-reported medical sciences publications, on average 31-40% of their medical sciences publications were published as open-access publications.
AQ3 Non-exclusive Licensing (same as Aq3 in 2013)
In the past year, what percentage of the university’s total research licenses were non-exclusive?
In the past year, what percentage of the university’s health technology licenses were non-exclusive?
- Of the universities that self-reported licensing data, on average:
- 51-70% of their research licenses were non-exclusive
- 31-50% of their medical technology were non-exclusive
AQ4 Patents (Same as aq4 in 2013)
In the past year, for what percentage of all health technologies did the university seek patents in developing countries where they may restrict access?
- Brazil, Russia, India, China, or South Africa
- All other Lower and Lower-Middle Income Countries
- Reporting universities rarely sought to patent their technologies in developing countries, at least within the first year of disclosure, meaning that generic drug manufacturers could develop affordable developing-world medical products from these discoveries without fear of patent restrictions. On average, in the past year around 22% of the top 59 universities sought patents for: 1-20% of all health technologies in Brazil Russia, China, South Africa, and fewer than 8% of the universities for all other low- and middle-income countries.
- For universities not already implementing global access licensing this result should encourage students to start a dialogue with their administrations.
AQ5 Access Provisions in Exclusive Licenses (same as Aq5 in 2013)
- In the past year, what percentage of the university’s exclusive licenses of health technologies included provisions to promote access to those technologies in developing countries?
- What percentage of those access provisions included the biggest developing-world economies (Brazil, Russia, India, China or South Africa) in their scope?
- Inclusion of provisions to promote global affordability in exclusive licenses was rare at reporting institutions: on average they were included less than 12% of the time. However, there was significant variation here, with a small group of universities (approximately 10% of the universities evaluated) regularly employing access terms in their exclusive licenses up to 90% of the time.
AQ6 Has the university shared its best practices for promoting access to treatment through licensing? (Same as Aq6 in 2013)
- Only 10% of the top 59 universities said they have shared best practices for socially responsible licensing with other universities
EQ1 Does the university offer its students access to global health engagement and/or education?
PART A: As indicated by the existence of a university center/institute, department, and/or non-degree program in global health.
PART B: As indicated by the existence of a university graduate degree, major/concentration, focus/specialization, certificate, and/or other academic track in global health.
- All of the universities evaluated offer at least one global health program or study track, but only 57% offer a global health degree and/or global health major/concentration or focus/specialization
EQ2 Does the university’s (a) medical school/residency program, (b) public health school, and/or (c) law school offer graduate courses that address the policy and legal context of biomedical R&D, and more specifically the impact of intellectual property policies on research priorities and global access to medical innovations?
- 95% of the institutions evaluated offer at least one general course and 66% provide access to medicines specific course
EQ3 Does the university’s (a) medical school/residency program, (b) public health school, and/or (c) law school offer graduate courses that address the prevalence of and/or lack of research on neglected diseases, including neglected aspects of HIV, TB, and/or malaria? (new in 2015)
- 93% of universities evaluated offer at least one general course and 59% provide Neglected-Disease specific courses
EQ4 Has the university hosted a conference, symposium or campus-wide event in the last 12 months on the topics of A) impact of intellectual property on global access to medicines or B) neglected diseases and health needs of developing countries? (EQ5 in 2013)
- 88% of universities evaluated hosted at least one event on A and/or B and 27% hosted at least one event on A and one event on B or one event on both A and B.
EQ5 Does the university offer any of its students accessible opportunities to study, work, or complete research abroad in global health? (new in 2015)
- 90% of universities evaluated offered students at least one clinic, practicum, or equivalent (defined as other) opportunity abroad in global health and 17% offered students all measured opportunities to study, work, or complete research abroad in global health.