Former Merck CEO discusses drugs developed by Merck

Former president and CEO of Merck & Co. Roy Vagelos discussed Merck’s role in combating major diseases, such as river blindness and Hepatitis B, in a chemistry colloquium held this Wednesday at Dartmouth.

Onchocerciasis, or river blindness, is a parasitic infection once prevalent throughout sub-Saharan Africa and South America. The disease is caused by a filarial worm, Onchocerca volvulus. It is transmitted through the bite of the black fly, a vector that breeds near rivers. In its larval or microfilarial stage, the worm lives under human skin and in the eyes causing extreme itching and eventually, blindness.

In 1981, researchers William Campbell and Mohammed Aziz at Merck showed that Ivermectin, an anti-helminthic used to treat cattle and pets for worms, could paralyze the worm responsible for river blindness. Field studies showed that one tablet of Ivermectin would be enough to treat the disease for a whole year. At the time, river blindness affected 18 million people worldwide and put 100 million at risk, many of whom could hardly afford the drug, Vagelos said.

Vagelos’ attempts at securing aid from the U.S. government and the World Health Organization (WHO) for the distribution of Ivermectin were unsuccessful. He decided instead, in 1987, that Merck would donate the drug to “all those who need it for as long as they needed.” With the help of WHO and the Carter Center, the program has reached nearly 80 million people. The disease has been nearly eradicated from South America. He added that other corporations have since followed Merck’s example in philanthropy.

Ivermectin was initially discovered from a Japanese microbe. Vagelos said that the mechanism behind Ivermectin’s high potency is its affinity for chloride channels. In nematodes, Ivermectin poisons these channels, allowing chloride ions to pour into the nervous system paralyzing the worms.

Vagelos went on to describe the development of the first recombinant vaccine, the Hepatitis B vaccine. By expressing the surface antigen of the Hepatitis B virus in yeast, researchers were able to develop a safe and effective vaccine. When the Chinese government found it too expensive to buy large amounts of the vaccine, Merck agreed to a technology transfer, training chemical engineers and helping set up factories.

“When a company is in a position to affect the lives of millions of people in the developed world,… it should use some of [the money generated] for the rest of the world,” Vagelo said.

He cited other positive benefits for Merck such as goodwill from stockholders and customers, and the ability to recruit top scientists and engineers. He also said that the countries that have been helped by Merck will eventually become customers.

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