Sharing Knowledge for Global Health

Health inequity can result from asymmetry in how we globalize knowledge or the technologies themselves. Consider two tales of globalization--one where the products cross the borders, but the consumer protections lag behind, and another where the expectations of life-saving products cross the borders, but the products themselves lag behind. The first is the story of tobacco, where trade globalizes these products across borders, but oftentimes, the public health protections from tobacco excise taxes to smoke-free spaces and places may lag behind. The second is the story of affordable access to essential medicines, from HIV/AIDS medicines to cancer drugs, where the expectations of treatment cross borders, but the availability of products lag behind.

When the forces of globalization are asymmetric, health inequities arise. From bench to bedside, there are various points for intervention. Making available research tools, key platform technologies, and published findings can allow investigators to explore solutions suited to resource-limited settings, not just high-income countries. Tiered access to the building blocks of knowledge or to the end products segments availability between markets that receive preferential treatment and those that do not. Pooling lowers the transaction costs of licensing intellectual property for the essential components required to work on a treatment. Pooling may be applied to the building blocks for a platform technology or, as the Medicines Patent Pool does, for the components of a combination drug treatment, such as for AIDS. Push and pull financing can also shape how affordable end products coming to market are. Describing these various approaches, the program has produced a commissioned paper for the Institute of Medicine’s report, “The U.S. Commitment to Global Health: Recommendations for the Public and Private Sectors” (2009) and a journal article for the Harvard International Law Journal (2012).