The case of ivermectin: lessons and implications for improving access to care and treatment in developing countries.

On October 21, 1987, Merck & Co., Inc., announced plans to donate Mectizan (ivermectin), a new medicine designed to combat onchocerciasis (Ôriver blindnessÕ), for as long as it might be needed. Merck took this action, working in col laboration with international experts in parasitology, the World Health Organization, and other agencies to reach those affected by the illness. This unusual decision came twelve years after the discovery of ivermectin by Merck scientists and nearly seven years after human clinical trials in Dakar, Senegal. Merck chairman, Raymond V Gilmartin,hassincereaffirmed the companyÕs commitment to donate Ôas much Mectizan as necessary, for as long as necessary, to treat river blindness and to help bring the disease under control as a public health problemÕ. Through the continuing collaboration of an international, multi-sectoral coalition including the WHO, the World Bank, UNICEF, the Mectizan Expert Committee, dozens of Ministries of Health, the international donor community, more than thirty non-governmental development organizations, and local community health workers, there is hope that onchocerciasis can be eliminated as a major public health problem and socioeconomic development constraint within the next decade. The Merck Mectizan Donation Program (MDP) is now the largest ongoing donation program of its kind. There are active treatment programs in 33 of 35 countries in sub-Saharan Africa, Latin America, and Yemen in the Middle East, where onchocerciasis is endemic. To date, more than half a billion Mectizan tablets have been donated and shipped since the inception of the Program. An estimated 25 million individuals are treated annually, with the 200 millionth treatment scheduled to take place this year.