When it comes to grades, many of us would be heartbroken if we were awarded a C+. It looks like Duke may be heartbroken, as well.
Last week, Universities Allied for Essential Medicines, an international non-profit student group, released the first-ever Global Health Impact Report Card. The project was endorsed by Doctors Without Borders and Paul Farmer, a Duke professor, alumni and trustee.
Duke received a C+.
Drawing on both self-reported and public data, the report card evaluates the 49 top-funded U.S. and five top-funded Canadian research universities using 14 metrics to assess universities’ impact on global health on the basis of innovation, access and empowerment. Specifically, the report card addresses a university’s commitment to neglected disease research, to adopting socially responsible policies that expand access to their biomedical discoveries worldwide and to fostering academic opportunities in global health. Each school is scored on all three measures with a sub-score and a calculated cumulative grade.
As a core member of the team that developed the metrics, I was very curious about what grade Duke would receive. After all, global health is not only the newest addition to the long list of majors that Trinity College offers, but also a subject many Duke students are committed to through the Duke Global Health Institute or programs such as Duke Engage. Duke as an institution has shown a commitment to global health, but how far reaching is its impact on global health and how does that commitment manifest itself?
With an overall grade of C+, Duke is ranked seventh behind the University of British Columbia, Harvard University and Johns Hopkins University, but ahead of 47 other schools. Most of us would not be pleased with a C+, and the grade may come as a surprise to many people since we have always been proud of Duke’s reputation in medical research and civic services. Duke received a B- in the categories of student empowerment and technology access and a C+ in innovation. The ranking, however, does not capture the entire story.
The report card acknowledges Duke’s significant contribution to innovation in global health, especially for neglected diseases, which account for nearly 10 percent of the global burden of disease. Almost 8 percent of the University’s National Institute of Health budget is devoted to neglected diseases, which is relatively high compared to other universities. Duke was also credited for providing a plethora of academic opportunities in global health, as well as coursework focusing on the role of intellectual property on access to medical innovations.
On the other hand, Duke did not score well on critical components of the accessibility metric. Although Duke publicly committed to promoting greater access to its medical discoveries in developing countries by signing the statement of equitable dissemination of medical technologies in 2009, there is little transparency or knowledge shared by Duke about whether they have followed through with this commitment. Duke’s Office of Licensing and Ventures is reluctant to release the figures about the global accessibility of Duke-developed technologies or reply to the surveys used for the report card. The global access principle is also difficult to find in the OLV policy or on its website.
With a significant number of pharmaceuticals and medical devices developed on this campus, Duke has the responsibility and ability to ensure there is global access to its technologies and discoveries. It is possible to achieve this by compelling firms licensing Duke’s technologies to remove the financial barriers that greatly diminish access to Duke’s biomedical discoveries, especially in low- and middle-income countries. Emory University, ranked above Duke in the report card, has drafted a Technology Transfer for Global Access Guiding Principles document, which can be readily found on the website of the Emory Technology Transfer Office. Transparency about technology licensing would be a good first step to improve Duke’s grade and ensure Duke technologies can actually get to the hands of those who are in need.
Duke has committed to “help those who suffer, cure diseases and promote health,” as stated in the Mission Statement of Duke University. Duke demonstrates a potential to not only be a leader in global health but also the leader in global health by virtue of its dedication to global health. Nonetheless, the report card is a wake-up call for Duke University and its students to realize that other than innovation itself, expanding access to these innovations is equally important to really change the status quo.
Trent Chiang is a Trinity senior. This column is the 12th installment in a semester-long series of weekly columns written by dPS members addressing the importance of social action, as told through personal narratives. You can follow dPS on Twitter @dukePS.