Merck & Company, Inc.: Having the Vision to Succeed
by Stephanie Weiss and David Bollier
An Expensive Care for a Poor Market
In 1978, Dr. P. Roy Vagelos, then head of the Merck research labs, received a provocative memorandum from a senior researcher in parasitology, Dr. William C. Campbell. Dr. Campbell had made an intriguing observation while working with ivennectin, a new antiparasitic compound under investigation for use in animals.
Campbell thought that ivennectin might be the answer to a disease called river blindness that plagued millions in the Third World. But to find out if Campbell's hypothesis had merit, Merck would have to spend millions of dollars to develop the right formulation for human use and to conduct the field trials in the most remote parts of the world. Even if these efforts produced an effective and safe drug, virtually none of those afflicted with river blindness could afford to buy it. Vagelos, originally a university researcher but by then a Merck executive, had to decide whether to invest in research for a drug that, even if successful, might never pay for itself.
River blindness, formally known as onchocerciasis, was a disease labeled by the World Health Organization (WHO) as a public health and socioeconomic problem of considerable magnitude in over 35 developing countries throughout the Third World. Some 85 million people in thousands of tiny settlements throughout Africa and parts of the Middle East and Latin America were thought to be at risk. The cause: a parasitic worm carried by a tiny black fly that bred along fast-moving rivers. When the flies bit humans — a single person could be bitten thousands of times a day — the larvae of a parasitic worm, Onchocerca volvulus, entered the body.
These worms grew to more than two feet in length, causing grotesque but relatively innocuous nodules in the skin. The real harm began when the adult worms reproduced,...