“Canadian Universities play a critical role in addressing global challenges such as HIV/AIDS, Tuberculosis, and other neglected diseases. It is imperative that we continue to give priority to the lives of millions through licensing practices that allow our world-class research to reach those that need it most. This Report Card helps us measure the impact our universities have on global health. It clearly shows Canadian Universities are falling short: students, faculty and related communities must jolt the Universities into sanity.”
–Stephen Lewis, Co-Director of AIDS-Free World, Canada’s Former Ambassador to the United Nations
“The UAEM Canadian Global Equity in Biomedical Research Report highlights a worrying lack of transparency on publicly funded biomedical research carried out by Canadian Universities. With only a third of clinical trials data disclosed and only one university adopting global access licensing, this Report card proves once again that universities have a long way to go. It is time for universities to fulfill their responsibility to ensure that publicly funded biomedical research is available for the public good.”
–Rachel Kiddell-Monroe, ISID Professor of Practice McGill University
UAEM’s Canadian Report Card project evaluates 15 of Canada’s research-intensive universities on their contributions to biomedical research on neglected health needs, access to medicines, and education concerning access and innovation issues. The Report Card uses both publicly available and self-reported information to evaluate academic institutions on three key questions:
- To what extent are universities investing in innovative biomedical research that addresses the neglected health needs of resource-limited populations?
- When universities license their medical breakthroughs for commercial development, are they doing so in ways that ensures equitable access for all marginalized and vulnerable populations in high, middle and low-income countries? What steps are they taking to ensure innovative treatments are made available at affordable prices?
- What efforts are universities making to educate the next generation of global health leaders about the crucial impact that academic institutions can have on global health 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 1, and universities have contributed to the development of one out of every four HIV/AIDS treatments.2 There is enormous potential for universities to leverage their investment in biomedical research to advance global health. The size and scope of this impact, however, depends on decisions about where to focus research, how to share new discoveries, and what to teach a rising generation of young global health leaders.
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.3 Furthermore, 10 million people die each year simply because they can’t access lifesaving medicines that already exist – often because those treatments are just too expensive.4 With new global health challenges such as Zika and antimicrobial resistance, the lack of transparency in research, including for clinical trials, and the lack of alternative models for efficient and sustainable innovation, the gap between vulnerable populations and affordable treatment threatens to widen even further.
Universities can use their unique positions as public interest, largely publicly funded research institutions to address both of these challenges. By prioritizing research on global diseases neglected by for-profit research and development (R&D), they can pioneer new treatments that will benefit millions in low- and middle-income countries (LMICs). And by sharing their medical breakthroughs under open, non-exclusive licenses, or licenses that promote lower prices not only for LMICs but also underserved populations in high-income countries (HICs), universities can help poor patients worldwide access new, lifesaving treatments. Universities can also play a critical role in educating their students about these issues in order to empower them to take on these global health challenges in their own work.
Some universities are already taking these steps – along with teaching students about the challenges of neglected disease innovation and treatment access. However, few have tried to systematically measure universities’ contributions in these vital areas. UAEM’s University Report Card fills that gap. The first iteration of the Report Card, released in 2013, evaluated both American and Canadian institutions together. However, major Canadian universities differ in key respects to their American counterparts in regards to biomedical research funding. For example, the primary federal agency responsible for medical research in Canada is the Canadian Institutes of Health Research, and although it is comprised of 13 institutes focusing on specific areas of research, it is significantly smaller than the U.S. National Institute of Health, which is comprised of of 27 institutes and centers. Additionally, all major Canadian research universities (as defined by being a member of the U15) are public universities, whereas as a large majority of research-oriented academic institutions in the U.S are private.5 These discrepancies are difficult to standardize when evaluating resources being allocated to global equity in biomedical research across Canadian and American universities so we have chosen to evaluate universities within each country separately. This will be the first entirely Canadian iteration of the University Report Card, following the release of a U.S.-specific iteration in 2015. A detailed report of changes between the 2013 methodology and the new methodology provided below can be found here.
1. Kneller, Robert The importance of new companies for drug discovery: origins of a decade of new drug, Nature Review Drug Discovery, 2010
2. Sampat, Bhaven Academic Patents & Access to Medicines in Developing Countries, American Journal of Public Health, 2009
3. Hotez PJ, Molyneux DH, Fenwick A, Kumaresan J, Sachs SE, Sachs JD, et al. Control of neglected tropical diseases. N Engl J Med. 2007; 357(10): 1018-27.
4. World Health Organization. Equitable access to medicines: a framework for collective action. Policy Perspectives on Medicines, 8: 1-6. WHO, Geneva, Switzerland.
5. http://u15.ca/our-members