In 2015, Dr. William Campbell was awarded the Nobel Prize in Medicine for his work in discovering ivermectins while employed with Merck & Co. in the 1970s.

The drug prevents onchocerciasis, called river blindness. In 1987, the World Health Organization (WHO) estimated that 18 million people in more than thirty countries in the Middle East, West and Central Africa, and Central and South America were infected with the river blindness disease.

The disease is spread by black flies that breed in fast-flowing rivers. A bite from one of these flies can transmit a worm that lives within the human body and can grow to over half a meter in length. The worm produces millions of larvae that can cause itching, skin nodules, eye lesions, and, in extreme cases, blindness. Through Dr. Campbell’s work, Merck developed Mectizan, an easily administered wonder drug that required only one annual dose with very minor side effects. The drug would not restore the sight of a blind person, but it would prevent others from becoming blind because the drug kills the worm’s larvae and prevents additional larvae from being produced.

However, Merck had a problem. The people who needed the drug often lived in remote areas of poor countries that were plagued with political and civil unrest.

These countries did not have drug distribution systems, nor did they have health care infrastructures. There were importation laws, and the citizens and nations that needed Mectizan could not afford North American–developed drugs.

On October 21, 1987, Merck announced that it would distribute Mectizan for free and for as long as necessary. Dr. Roy Vagelos, CEO and chairman of Merck, said that the company would make the drug “available without charge because those who need it the most could not afford it.”1 The company formed the Merck Mectizan Donation program, a private–private partnership. It collaborated with WHO, the World Bank, UNICEF, and various public and private stakeholders as well as local and village health care workers to coordinate the distribution of the drug. By 2015, the company had donated more than 2 billion treatments to an estimated 98 million people in thirty-one countries. Because of its success, the program was expanded to address lymphatic filariasis, known as elephantiasis.

Why would a for-profit pharmaceutical company donate a drug for free? Merck said that this was consistent with the company’s

“medicine is for the people” philosophy.

In 1950, George W. Merck said, “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. How can we bring the best medicine to each and every person? We cannot rest until the way has been found with our help to bring our finest achievements to everyone.”2 When asked, in 2015, about the free distribution of Mectizan, Dr. Campbell said,

“I think it was done because it was the right thing to do, and I think the employees

[at Merck] applauded it, because they thought it was the right thing to do.”3

Questions:-

1. Pharmaceutical companies have to spend millions of dollars and years of research to find just one successful drug. Merck spent time and money developing and then distributing Mectizan for free. Is it possible for Merck to justify, to its shareholders, making a sizable investment in a product and incurring ongoing costs in the distribution of that product when the product generates no revenue for the company?
2. Did Merck have an ethical obligation to develop and distribute Mectizan for free?
3. Do you think that Roy Vagelos, Merck’s CEO and chairman, demonstrated ethical leadership? What value did it have/create?
4. Based on the river blindness example, how would you describe the organizational culture of Merck in the 1980s?