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ABSTRACT
A unique public/private partnership situated around a pharmaceutical, Merck's Mectizan® donation program stands out as an example of corporate philanthropy in the history of the pharmaceutical industry and provides insight into future public/private partnerships in public health. This paper considers the issues Merck faced in the decision to donate Mectizan (ivermectin) and in the subsequent development of the Mectizan donation program, delineating the moral and financial debates that arose within the company. Coming after almost 15 years of donation, this assessment of the program's strengths and shortcomings suggests how the pharmaceutical industry can better serve as a viable partner in improving international health.
IN 1978, PARASITOLOGIST WILLIAM CAMPBELL approached Roy Vagelos, head of the Merck Research Laboratories, with exciting information: ivermectin, the drug he was developing to treat parasitic infections in livestock, might also be effective in treating onchocerciasis, a human parasitic infection causing blindness in millions of people in sub-Sahara Africa, Latin America, and Yemen. If the veterinary drug could be found effective for human use, it could dramatically improve the lives of people in tropical countries at risk for onchocerciasis, a disease with no available cure.
Campbell and Vagelos knew that the millions of people who needed the drug were much too poor to pay for it, and that no conceivable market existed for the human use of the drug. Faced with this apparent conflict between humanitarian and corporate responsibilities, Merck nonetheless decided to test the drug for human use. On October 21, 1987, upon demonstration of ivermectin's dramatic efficacy against onchocerciasis, Merck announced that the company would give the drug, brand name Mectizan®, away for free to anyone who needed it for as long as it was needed. Merck's decision gave birth to a drug-donation program that has become one of the foremost examples of a public/private partnership in international health, treating more than 25 million people annually and donating more than 525 million ivermectin tablets in little over a decade.
While other public/private collaborations existed in the pharmaceutical industry before the Mectizan donation program, these collaborations were initiated by public sector institutions and involved corporate sponsorships. In contrast, the Mectizan donation program developed out of Merck's decision to develop a drug without a market, donate the drug, and assemble...