A 30-year struggle to control
schistosomiasis has revealed
much about patents and profits
In 1964 Aklilu Lemma of Addis Ababa University traveled
to Adwa, Ethiopia, to study schistosomiasis. This
debilitating disease of the liver or bladder affects some 300
million people in Africa, Asia and Latin America. The
Schistosoma parasite multiplies within snails that infest rivers
and ponds; when humans use the water, the organism enters
their skin. At one brook, Lemma saw women washing
clothes with the sudsy extract from the local endod berry.
Downstream, the snails were dead.
Back in Addis Ababa, Lemma, who has a Ph.D. from
Johns Hopkins University, instituted a program to study
whether the endod berry could be safely used in controlling
Schistosoma-bearing snails. Although endod also kills
mosquito larvae and fish, he found that it is harmless to rats;
in humans, it is an emetic. "People grow it around their
houses," Lemma reports. "They have tested it for safety and
adopted it as a useful plant."
The subsequent saga of the berry attests to the difficulties
that developing countries experience in benefiting from their
own biodiversity. Each observer attributes endod's travails
to a different stumbling block, but one moral seems to be
clear: it takes a determined, politically savvy proponent to
ensure that the promise of a product is realized for its own
Lemma's results attracted scientists from the National
Research Development Corporation in London, who
offered to collaborate. "They took sackfuls of berries,"
Lemma relates, and he says he heard no more from them.
Returning to Adwa, he and his colleagues started a test to
see if endod could halt schistosomiasis. If the disease was
not transmitted for five years, they theorized, children
between one to six years of age should be free from it.
In 1970 Lemma left for a sabbatical at the Stanford
Research Institute (SRI), stopping in London to check on
his "collaborators." The tests had been so encouraging, he
was informed, that the scientists had patented rather than
published. Lemma did not appear on the patent, which was
for an extraction process for endod. At SRI, he worked
with Robert M. Parkhurst, who isolated the active
ingredient in endod, naming it "lemmatoxin." Along with
chemist Wilfred A. Skinner, the researchers obtained a
patent on a different method.
But Lemma convinced his colleagues that because endod
was "poor man's medicine for a poor man's disease," it was
unseemly to profit from it. Accordingly, SRI donated its
patent to a nonprofit foundation that Lemma hoped to
establish in Ethiopia. "I felt we should get the farmers to
grow it and use it locally," Lemma explains. He challenged
the British scientists to donate theirs as well. The affair
became diplomatically embarrassing; the scientists
In 1974 the results from Adwa came out: among 3,500
children between one and six years in age, the prevalence of
schistosomiasis had fallen from 50 to 7 percent. Yet to
become widely adopted, endod needed the blessing of the
World Health Organization. That was not forthcoming. Ken
E. Mott, who heads the WHO's schistosomiasis project,
says the problem was Lemma's patents: "It was uncertain
how endod should be developed, because somebody had a
personal [and financial] agenda in this."
The WHO instead recommended a chemical molluscicide
marketed by Bayer at $27,000 a ton in hard currency.
(Endod sells for about $1,000 a ton.) The WHO
questioned the safety of the berry, requiring that it pass tests
costing millions of dollars. But the WHO would not help
fund such tests, and in 1987 Mott advised the Italian
government not to provide research grants for endod.
The endod patents then belonged to the Ethiopian Science
Foundation, which was eventually subsumed by the
Ethiopian government. Lemma attributes the WHO's
animosity to a difficulty believing that good science can
emanate from developing nations. "The things done in Africa
did not hold any weight in the U.S. or Canada," Parkhurst
In 1976 Lemma joined the United Nations, serving on the
Science and Technology Commission. He convened two
endod conferences; funding started to trickle in from
foreign-aid agencies and private organizations. The
International Development Research Center (IDRC) in
Ottawa offered to conduct the toxicity tests required by the
WHO--provided the Ethiopian government renounced the
endod patents. The test results, published in 1990,
surprised no one. "It's as harmless as soap," states the
IDRC's Don de Savigny.
Along with a colleague, Lemma received the Right
Livelihood Award from the Swedish parliament in 1989 and
was finally able to establish the nonprofit Endod
Foundation. In 1990 the University of Toledo in Ohio
granted Lemma an honorary degree. After Lemma's
acceptance speech, his host, Harold Lee, asked if endod
might be effective against zebra mussels. These mussels
choke submerged pipes in the Great Lakes, racking up
billions of dollars in damage. Lemma demonstrated how to
apply the berries: the mussels died. In 1993 and 1994 the
university obtained patents on this use of endod, with
Lemma as an investigator. The university agreed to donate
10 percent of its earnings to the Endod Foundation.
Last year Lemma requested that the University of Toledo
donate the patents to the foundation, which would make
them freely available to African ventures. The university
responded with an offer to either sell the patents for
$125,000 or license them for a $50,000 fee, plus 2.5
percent royalties and $10,000 in legal expenses, reserving
the right to withdraw the license if net sales were less than
$10 million in five years. Such terms, Lemma says, are
impossible. "It is not university policy to give things away,"
Lee retorts. "Lemma can develop endod for another use
and get [his own] patent." But no one is benefiting from
these patents: lemmatoxin is too costly to synthesize, and no
African country will sell endod to the Toledo group.
Meanwhile work on schistosomiasis goes on. The IDRC is
conducting a field test to ensure that endod is efficacious in
checking the disease. The Agronomic Institute in Florence is
encouraging farmers to grow endod on wastelands. The
University of Oslo is working with Addis Ababa University
to check whether simply using endod as a soap can control
"Endod," Mott says, "has ended up not benefiting anybody
except a few personalities who have extended their careers
by presenting themselves as advocates for the Third
World." Diverse reasons are offered for endod's tortuous
history. Parkhurst opines that "bureaucracy is what killed it
more than anything," along with a distrust of Third World
science. De Savigny points out that endod is not an
expensive cure backed by the biomedical industry:
"Something you pick off a bush doesn't have that kind of
support." Lee charges that Lemma does not work hard
enough: "Why do you think I spent two years and got a
patent, and he spent 30 years and got nothing?" Lemma
counters that endod may yet end up benefiting rural
Africans: "That is my wish and my dream."
This is the first of a two-part series on the legal and ethical
issues that arise when patenting biodiversity.
by Madhusree Mukerjee