Hopkins' global health grade: good, but not good enough

Remember the last time you got a B in a class? Maybe a B was OK, a hard-earned accomplishment in a difficult, GPA-sinking course. Or perhaps a B just wasn't good enough — a subpar finish that left you mentally shaking a fist at other classmates.

The grades are in for the Johns Hopkins University.

Universities Allied for Essential Medicines (UAEM), an international student-run health advocacy group, recently released the first-ever University Global Health Impact Report Card. The report card ranked the top 54 North American research universities on their overall contributions to global health.

Hopkins received a B, ranking third overall behind Case Western Reserve University and the University of British Columbia.

Co-released with Doctors Without Borders and endorsed by global health luminary Dr. Paul Farmer, the report card evaluated universities in three categories: innovation, looking at the amount of research activity in areas with the most global impact; access, covering efforts to promote affordable global access to university-led discoveries; and empowerment, which assessed the strength of global health training opportunities at each university.

Not surprisingly, Hopkins broke the curve on empowerment, with top scores given for the university's world-class global health training programs. Hopkins also earned points for its institutional commitments to access-oriented technology transfer practices. These commitments, laid out in a list of 10 recommendations endorsed by Hopkins President Ronald Daniels last November, affirm that global social good, rather than licensing revenues or corporate profits, should be the primary goal of Hopkins-led research.

These recommendations also support the use of so-called humanitarian licensing provisions, which give the university greater power to promote global access to Hopkins discoveries during licensing negotiations. The new licensing provisions afford flexibility in selecting biotech partners that are well suited to deliver university discoveries to the world's most impoverished populations. If one company can't deliver a new drug or medical technology at affordable, globally accessible prices, the university can partner with another company to get the job done.

Hopkins administrators, and especially the Office of Technology Transfer, deserve enormous credit for their work on these policies. These are major accomplishments that reflect Hopkins' role as a global health leader and that represent important steps forward for the university.

But there are still clear opportunities for improvement. First, Hopkins should put serious, sustained effort behind its new commitments to global access licensing, with regular, transparent reporting on how well its biotech partners are sharing our research with the world. Second, Hopkins should endorse stronger, more specific support for generic production of essential medicines, a strategy that has already helped millions of patients in sub-Saharan Africa access affordable, life-saving HIV medications. Such support is especially important in countries with strong generic drug manufacturers, especially India — now known as the "pharmacy for the developing world" for its ability to deliver high-quality, affordable medicines to low-income countries.

In Paul Farmer's endorsement for the University Global Health Impact Report Card, he encouraged students to "call on their institutions to enact meaningful policies that improve the chances that lifesaving medicines reach those who need them most."

Are Hopkins students willing to settle for a B? Most are not. The university shouldn't either.

Brooks Puchner (brooks.puchner@jhmi.edu) and Tyler Brown are students at the Johns Hopkins School of Medicine. Contributing to this article are Roger Samuels, also a student at the School of Medicine; Ali Greenberg, a rising senior in Hopkins' Public Health Studies Department; and Mike Rogers, a 2011 alumnus of Hopkins' Krieger School of Arts and Sciences. The University Global Health Impact Report Card is available at globalhealthgrades.org.

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