Passing exams and planning protests — the role of students in the access to medicines movement

Rhiannon Osborne, Sarai Keestra, and Flo Rodgers — lead organisers at Universities Allied for Essential Medicines UK

‘Universities Allied for Essential Medicines’ (UAEM) is a global campaign group of university students with branches in 20 countries around the world dedicated to improving access to medicines through student activism and changes at the university level.

Student activism, like everything else during a pandemic, is different. But the fact that we couldn’t take to the streets in person for the ‘Global Day of Action’ for ‘A People’s Vaccine’ back in December, didn’t dampen the enthusiasm of our members and our colleagues across the Access to Medicines movement here in the UK.

Global Day of Action: participants from a number of organisations took part and called up pharma companies to demand fair access to new COVID-19 vaccines for everyone. In this video, a member of the organisation ‘Just Treatment’ called up Pfizer.

Working alongside other organisations, Global Justice Now, Just Treatment, Oxfam GB and Health GAP, we targeted drug corporations Pfizer, Moderna and AstraZeneca with a day of mass phone calling, emails and social media messages, to make sure our demands for equitable access for COVID-19 vaccines are heard loud and clear by the companies.

Rhiannon is the current policy and advocacy director at Students for Global Health and an advisor for the UAEM UK National Committee. She is a 4th year medical student at the University of Cambridge.

It has been quite a journey for us over the last few months. We’ve managed to grow and mobilise our group of students here in the UK from modest beginnings (we had less than 10 members in January 2020 and today we number 60 and rising!) to now make our voices clearly heard in the UK parliament and beyond, and to campaign alongside other major global advocates for access to medicines.

We and MSF’s Access Campaign share a history together. We like to think of the Access Campaign as our older sibling!

UAEM was founded during the global AIDS crisis, when students at Yale University ran a campaign alongside MSF which resulted in a dramatic drop in the price of stavudine, an essential antiretroviral. We’ve been working on these issues ever since, but the pandemic has pushed the issues we deal with everyday front and central on the global stage.

But why do universities matter and how can students make a difference in opening up fairer access to medicines ?

When university scientists develop a potential new health technology, they usually look outside the university for a third party, like a pharmaceutical or biotech company, to finalise the technology, seek market approval, scale up manufacturing, and manage distribution. And to do this, they license their intellectual property and know-how to these third parties.

And the devil is in the detail of the deals that are struck between academia and private companies. Will the university license the new technology exclusively to just one company, giving them a monopoly, or will they share the IP more widely among several companies, leading to commercial competition that drives prices down and enables scale-up of production. Will the licence come with conditions that protect patients from price gouging, or will it allow companies to charge whatever they think they can get away with?

Flo is a final year medical student at Imperial College, London University. After completing an intercalated BSc in Global Health, she joined Universities Allied for Essential Medicines (UAEM) Imperial and is now the National Coordinator for the UK.

Unfortunately for far too long, we’ve seen universities hand over remarkable scientific discoveries* to companies without sufficient safeguards to ensure people can afford and benefit from them everywhere. And what’s the use of a new medicine, if no one can afford it?

So what is it we can do and have been doing to stop this happening?

At UAEM we have student groups across universities in over 20 countries. Students are uniquely positioned in the access to medicines movement — acting at the earliest stages when university labs generate their new discoveries and before innovation is handed over to the private sector.

Our core activity is to challenge the institutions where we study to examine the terms upon which they trade their IP with outside entities, to demand they include conditions that will ensure the medicines are made affordable and available to people in developing countries, and to be transparent about the deals that are struck.

We also want universities to publicly ‘own’ their unique role in the medical innovation system with the power they have to set conditions rather than to give in to Big Pharma’s tired and discredited narrative that IP is the best driver of innovation. With so much to contribute, why is it that universities and the public sector so often give their work over to private sector entities with no strings attached? To us, this power imbalance is unjust and illogical.

Sarai studies medicine at the University of Amsterdam and is also a research assistant at the Department of Global Health & Development at the London School of Hygiene and Tropical Medicine. She was UAEM UK’s national coordinator between 2018–2019.

The pandemic is shining a harsh spotlight on this damaging dynamic between academia and Big Pharma.

As a result, we already see scarcity ahead for new lifesaving COVID-19 medicines and vaccines — as a direct result of deals done with pharma companies that restrict other companies making the same tools that could increase urgently needed supplies. When public funding is used to create innovative health technologies in record time, the know-how and rights should be shared as a global public good, not given away exclusively.

Shifting up the gears

And that’s why in March last year we understood that we needed to really kick up a few gears here in the UK to increase and strengthen our membership base. Research on COVID-19 had started, funding was pouring in, and UK universities were developing vaccines, diagnostics, and therapeutics for global distribution. We know that the access to medicines movement isn’t easy to dive into, dealing with complex legal and medical issues, but we needed more people with the right knowledge and skills, and fast.

We recruited people to join UAEM through social media, with the offer of a free online training and capacity building course– no experience needed! We received many more responses than expected, probably because a lot of students were stuck at home feeling helpless, with a newfound interest in access to medicines and a desire to be useful. People can only campaign valiantly on issues they feel confident discussing, so we needed to empower our recruits and give them the knowledge and tools needed to go out and create change.

Our first online training session

Over a 10-week programme we asked our recruits to act as well as learn. Each week, addressing a particular subject and assigning action points for local university groups. We covered patents and IP, public funding of research, socially responsible licensing, and advocacy planning. By the end of the training, our new members had built the necessary foundations to confidently engage with their respective universities and demand transparency in COVID-19 technology access.

Since then, our much-expanded team has been campaigning to get as many universities as possible to commit to equitable licensing of COVID-19 health technologies. Mid-pandemic, UAEM global released the ‘Equitable Access Technology Framework’ — a best-practice guidance document to rethink university policies on access to medicines and technology transfer. We’ve simultaneously been tracking the public funding going into COVID-19 research together with UAEM students across the globe and dancing around London in costume at the Free the Vaccine Carnival March in July.

‘Free the Vaccine’ March in London in July 2020 © Fiona Davey

Whilst we focus on changing policies and practices at British universities, our members also raise their voices in support of global access to medicines issues, such as the ongoing campaign in support of a Waiver for patents and monopolies on COVID-19 medical technologies for the duration of the pandemic, and WHO’s C-TAP. In such instances we turn to our older siblings again. As a member of the Missing Medicines Alliance, a UK coalition of advocacy organisations campaigning for equitable access to medicines, including MSF UK, we’ve been part of strategic advocacy on these issues nationally and internationally.

We’re grateful to our ‘older siblings’ for the work they have and continue to do. But we’re also keenly aware that tomorrow’s change makers are already emerging. Think Greta, Malala and other young people spearheading the many social and environmental movements that are springing up.

And it’s easy to see why — during our training sessions, when we explain the structure of the current medical innovation system to new-comers, we often get asked — “Why would you even design a world like that? That’s just stupid!”

While many accuse young people of naivety, we would argue that the opposite is true — young people are astute critics of the world around them, understanding but unconvinced by the old arguments. It’s not just fresh-faced criticism that young people can bring to the table, it’s imagining a better world for the future and trying to build it now.

Fortunately, we’ve got many more years ahead of us to try and build that world we want to see.

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*University research provides an essential contribution to the medical innovation system, with 1/3 of novel drugs originating in a university lab.

You can follow UAEM UK on Twitter : @uaemuk

This blog is a place to reflect on our experiences working for access to medicines. For the official MSF Access Campaign website please visit msfaccess.org.