Getting medicines to people who need them in developing countries is a top goal of public health experts worldwide, many of whom note that people are dying all the time of diseases for which treatments exist. Universities, whose scientists' research is crucial to many of those drugs and which enjoy a share of royalties on some of those drugs, are finding themselves drawn into a debate that has as much to do with the economics of the pharmaceutical industry as anything that takes place in a laboratory.

At issue are negotiations being encouraged by the World Health Organization on a new treaty on international patent rights. While there is no final document to accept or reject, among the ideas being proposed are several that would seek to loosen patent protection on drugs used to treat some diseases, and provisions that would embrace the idea of international contests -- with large cash prizes -- taking the place of international intellectual property rights to encourage drug companies to work on such research.

The Association of University Technology Managers has urged its members to lobby the WHO for caution on these ideas, warning that many of them may be unrealistic or counterproductive. "Prize systems, a medical R&D treaty, and compulsory patent pools are being advocated as alternatives to patents and IP protections," said a memo sent from the association to its members. "These solutions could pose a challenge to our current and very successful system of innovation and tech transfer."

James Love, director of Knowledge Ecology International, published on The Huffington Post a sharp critique of the university technology managers' stance, framing the issue starkly as: "University patent managers versus developing countries."

Love wrote that he could understand why the pharmaceutical industry might oppose the WHO talks, but asked "why would the university technology managers side with big pharma in the WHO debates? Do they really think the current system is working well in developing countries?" Specifically, he praised the contest idea -- briefly pushed in the failed presidential campaign of John Edwards. The contest idea is a response to those who say that without strong patent protections, pharmaceutical companies lack the incentive to work on drugs to be used in developing nations. In theory, contests with large payouts might be an alternative to strong patent protections.

Jon Soderstrom, president of AUTM and managing director of the Office of Cooperative Research at Yale University, said that he and others in the association wanted to promote better access to drugs in developing nations, and that concerns about the WHO discussions were a matter of tactics, not goals. For Soderstrom, the debate is one he has seen at Yale, which has won praise from some and criticism from others for the way it has tried to make potential anti-HIV drugs available in developing nations.

Soderstrom said that the Huffington Post column was "a gross misrepresentation" of AUTM's position. "We are not trying to create new barriers or hurdles."

The contest idea is fine to try, Soderstrom said, but not by taking apart the intellectual property system. He said that he was skeptical that contests could be lucrative enough to attract drug companies. He noted that many drugs fail only after extensive and expensive testing, so they companies need to hold rights on some of the successful drugs they develop.

Many universities, he said, are willing to back reforms that deal with drugs that would primarily be used in developing nations, for diseases that primarily are present there. But he noted that many diseases are not unique to any one part of the world. If universities and governments want investments in cancer drugs, he said, "we can't create disincentives for investment."

AUTM is trying to point out the potential for unintended consequences, not to quash the discussions, Soderstrom said. "We just have to be very careful about what we are proposing."