Therapeutic Dose: Visions of the Past, and Future, at Merck

June 23, 2005
Can Merck summon up the kind of inspired thinking and leadership that took on river blindness?
“We try never to forget that medicine is for the people. It is not for the profits. The profits follow, and if we have remembered that, they have never failed to appear.” – George W. Merck, former chairman, Merck & Co.
One day in 1978, a senior researcher at Merck, Dr. William Campbell, had a moment of inspiration. A compound that had proven successful in treating microscopic worms in horses just might work on similar parasites in humans. The agent, which Merck called Ivermectin, had been discovered a few years earlier in a soil sample taken from a golf course in Japan. If modified, Campbell thought, it could destroy the parasite responsible for afflicting hundreds of thousands of people with the disease onchocerciasis, river blindness.He took his theory to Dr. Roy Vagelos, then head of Merck Research Labs and later chairman and CEO, who was intrigued. But it would cost millions to alter and manufacture the drug for human use, with no guarantee of success. Even if the drug proved effective in combating the terrible skin disfigurations and eventual loss of sight caused by the disease, there was no profit in it. Few of the victims of river blindness had clean drinking water, much less the money to pay for advanced medicines.As research head, Vagelos controlled the R&D purse strings. He could devote the necessary resources to continue pursuit of a river blindness cure. Or not.He did. The eventual result was the drug Mectizan, whose story is well documented. (Try for starters.) Merck made the decision to donate Mectizan for river blindness until it was no longer needed. While the disease is largely under control, it has not been eradicated. Today, Mectizan is provided to more than 40 million people in 34 countries each year. It is funded and distributed by a public/private partnership called the Mectizan Donation Program (, which has donated more than 300 million doses of the drug in the past 20 years. Merck recently contributed another $1 million to fight river blindness in the Sudan and other conflict-ravaged countries.Last month, Merck announced another public-private initiative, this one a cooperative HIV/AIDS prevention project with the government of China. This is a groundbreaking step on many fronts. Gaining the support of a government that has to now been reluctant to openly confront HIV/AIDS is an achievement in itself. Merck has committed $30 million toward the project over the next five years.When I was growing up, my dad — both a family physician and a habitual stock market investor — believed that shares of Merck should be a cornerstone of every portfolio. Few, including my dad, feel that way any more. “Expect falling sales for years to come, and don’t be tempted by the stock’s depressed price, which is down 64% since the start of 2001,” says Kiplinger’s Personal Finance magazine this month.Old George W. Merck and Dr. Vagelos might not have been the shrewdest of businessmen, but they at least kept the big picture in mind. There are still people at Merck with imagination and vision. We can only hope that new president and CEO Richard Clark is one of them.
Mohammad Back to Work

In this column in March, I profiled Mohammad, a veteran QA supervisor who had been unceremoniously downsized by his employer, a major pharmaceutical firm, as he neared retirement. There is good news to report: Mohammad has landed another position as a quality engineer for another drug company. He took a pay cut, but is content, he says.

—Paul Thomas
About the Author

Paul Thomas | Managing Editor