Global health equity in United Kingdom university research: a landscape of current policies and practices

Abstract

BackgroundUniversities are significant contributors to research and technologies in health; however, the health needs of the world’s poor are historically neglected in research. Medical discoveries are frequently licensed exclusively to one producer, allowing a monopoly and inequitable pricing. Similarly, research is often published in ways that make it inaccessible. Universities can adopt policies and practices to overcome neglect and ensure equitable access to research and its products.MethodsFor 25 United Kingdom universities, data on health research funding were extracted from the top five United Kingdom funders’ databases and coded as research on neglected diseases (NDs) and/or health in low- and lower-middle-income countries (hLLMIC). Data on intellectual property licensing policies and practices and open-access policies were obtained from publicly available sources and by direct contact with universities. Proportions of research articles published as open-access were extracted from PubMed and PubMed Central.ResultsAcross United Kingdom universities, the median proportion of 2011–2014 health research funds attributable to ND research was 2.6% and for hLLMIC it was 1.7%. Overall, 79% of all ND funding and 74% of hLLMIC funding were granted to the top four institutions within each category. Seven institutions had policies to ensure that technologies developed from their research are affordable globally. Mostly, universities licensed their inventions to third parties in a way that confers monopoly rights. Fifteen institutions had an institutional open-access publishing policy; three had an institutional open-access publishing fund. The proportion of health-related articles with full-text versions freely available online ranged from 58% to 100% across universities (2012–2013); 23% of articles also had a creative commons CC-BY license.ConclusionThere is wide variation in the amount of global health research undertaken by United Kingdom universities, with a large proportion of total research funding awarded to a few institutions. To meet a level of research commitment in line with the global burden of disease, most universities should seek to expand their research activity. Most universities do not license their intellectual property in a way that is likely to encourage access in resource-poor settings, and lack policies to do so. The majority of recent research publications are published open-access, but not as gold standard (CC-BY) open-access.Electronic supplementary materialThe online version of this article (doi:10.1186/s12961-016-0148-6) contains supplementary material, which is available to authorized users.

Global health research and education at medical faculties in Germany

“…This approach has been recommended by the World Health Organization's Consultative Expert Working Group and has demonstrated successes in Canada and the United States [9,34]. A study examining equitable licensing practices in the United Kingdom has found a similarly low rate of equitable licensing adoption [5]. Equitable licensing is nearly nonexistent at German medical faculties.…”

“…Recent studies assessing global health research at universities in the United States of America (USA), Canada, and the United Kingdom (UK) identified significant shortcomings in the equitable dissemination of research results [3][4][5]. In terms of the share of health research funding compared to corresponding global burden of disease, research on poverty-related and neglected diseases is underfinanced by a factor of five at universities in the UK [5]. Similar imbalance in the allocation of resources for neglected diseases research were found for North American research universities [6].…”

Structural violence and the biomedical innovation system: what responsibility do universities have in ensuring access to health technologies?

“…By engaging in inequitable technology transfer practices, such as the exclusive licensing of a novel health technology to a private company or a spin-off, universities enable the downstream formation of pricing monopolies that limit affordable access to health technologies. 1 2 The WHO defines health technologies as ‘the application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives’. 3 Worldwide nearly 2 billion people lack access to essential medicines and 100 million people are pushed into extreme poverty annually due to their inability to pay for their healthcare expenditures.…”

“…2 14 The dissemination of university research should be rooted in the concept of global health equity, which envisions a needs-based approach to health and well-being of humanity rather than one based on economic and social privileges. 1 To uphold these commitments to inclusive knowledge dissemination in the interest of the public, universities should ensure during the technology transfer process that the global community receives a return on investing into R&D. 1 6 15 Indeed, pharmaceutical companies often claim that the exclusivity of patents and pricing monopolies promote risk taking in early innovation, yet universities are often the source of important publicly funded research that underlies novel health technologies. 6 Universities therefore have the opportunity to prevent the creation of pricing monopolies and access barriers downstream, and a responsibility towards the global public who contributed to R&D funding to do so.…”

Building health research systems: WHO is generating global perspectives, and who’s celebrating national successes?

“…They described an 18-month process to develop a consultative research agenda and questions for health systems research in which a wide range of stakeholders participated and which produced a useful starting point. Gotham et al [31] examined the landscape of current policies and practices in relation to global health equity in United Kingdom universities’ research, and suggested various improvements.…”