Case Study: Collaboration

MECTIZAN Donation Program, Merck


In 1987, Merck announced that it would donate MECTIZAN, our breakthrough medicine for the treatment of onchocerciasis, to all who needed it, for as long as needed. More commonly known as “river blindness,” onchocerciasis can cause intense itching, disfiguring dermatitis, eye lesions and, eventually, blindness. The disease is one of the leading causes of preventable blindness worldwide.

MECTIZAN relieves the agonizing itching that accompanies the disease and halts progression toward blindness—two characteristics of the disease that dramatically affect the quality of life. MECTIZAN is well suited for distribution in remote areas by community health workers through mass distribution programs.

To facilitate the donation and delivery of MECTIZAN, and to eliminate river blindness, Merck established a multisectoral partnership involving the World Health Organization (WHO), the World Bank and UNICEF, as well as ministries of health, nongovernmental development organizations and local communities.

In 1998, Merck expanded the Merck MECTIZAN Donation Program to include the prevention of lymphatic filariasis (LF) in African countries where the disease coexists with river blindness. The disease is currently estimated to infect more than 120 million people, with more than 40 million incapacitated or disfigured with swelling of the limbs, breasts (lymphoedema) and genitals (hydrocele). Swollen limbs often develop dramatically thickened, hard, rough and fissured skin (elephantiasis).

Merck has made a long-term commitment to donate as much MECTIZAN as necessary to treat river blindness and to prevent lymphatic filariasis. The goal is to eliminate both lymphatic filariasis and onchocerciasis by 2020 and 2025, respectively.

Lessons Learned

Our experiences with the MECTIZAN Donation Program to-date have highlighted the critical importance of the following:

  • Appropriate assessment tools to easily identify target populations
  • A broad partnership with a common agenda and identified roles for all parties
  • An appropriate community base for treatment with local support
  • Streamlining the drug management process to reduce the burden on countries
  • The ability to adapt as needed to address new challenges and a continually changing environment

Results to Date

  • An estimated 40,000 cases of river blindness are prevented by the Merck MECTIZAN Donation Program annually
  • In the 19 countries of the African Program for Onchocerciasis Control (APOC), more than 8.2 million disability-adjusted life years have been saved between 1995 and 2010.
  • The impact of the MECTIZAN Donation Program extends beyond the immediate health benefits; estimates show that investments in river blindness control programs (e.g., MECTIZAN treatment and aerial spraying to control black fly populations) are helping people live not only healthier but also more productive lives
  • In 2013, Colombia received verification from the World Health Organization that river blindness was eliminated, becoming the first country to achieve that milestone. By 2016, it is expected that all six formerly affected countries in the Western Hemisphere (Brazil, Colombia, Ecuador, Guatemala, Mexico, Venezuela) will have achieved verification that river blindness has been eliminated.
  • In 2009, Togo became the first sub-Saharan African country to stop treatment for LF; continuing surveillance confirms that transmission of the disease was successfully interrupted. In addition, transmission has been interrupted in several endemic areas in Nigeria, Mali, Senegal, Sudan and Uganda.

While much has been achieved, there remain a number of additional challenges that Merck and our partners are actively addressing, including plans to change from a control- to an elimination-strategy for river blindness going forward. However, in accordance with the goals outlined in the WHO Roadmap for Neglected Tropical Diseases, we expect the elimination of lymphatic filariasis and river blindness by 2020 and 2025, respectively.

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