Donor leverage and equitable access to essential medicines

Donor Leverage and Equitable Access to Essential Medicines

CHAN Chee Khoon
Universiti Sains Malaysia

In early 2007, the Indonesian government decided to withhold its bird flu virus samples from WHO’s collaborating centers pending a new global mechanism for virus sharing that had better terms for developing countries.  In breaking with the existing practice of freely sending flu virus samples to these laboratories, the health minister expressed dissatisfaction with a system which obliged WHO member states to share virus samples with WHO’s collaborating centers, but which lacked mechanisms for equitable sharing of benefits, most importantly affordable vaccines developed from these viral source materials by patent-seeking commercial entities.  The 60^th World Health Assembly (May 2007) subsequently resolved to establish an international stockpile of avian flu vaccines, and mandated WHO to formulate mechanisms and guidelines for equitable access to these vaccines.  Beyond the immediate concerns of timely and affordable access to pandemic flu vaccines, the Indonesian initiative has also raised the intriguing possibility of other analogous instances where study volunteers or donors of biological materials and personal information in clinical trials, laboratory-based studies or other research settings could exercise corresponding (donor) leverage to advance health equity.  In this paper, we describe a survey of clinical trial volunteers (and potential volunteers) to canvass their attitudes towards donation of biological materials and personal information under various hypothetical scenarios for benefit apportionment or disposition.  Related to this, we are also keen to explore trusteeship arrangements as repositories for retaining intellectual property (IP) in the public domain, IP arising from publicly-funded biomedical and health research and involving biological materials and personal information freely donated by individual study subjects or communities.