Applications

Please scroll down to download applications.

To obtain a hard copy of an application please contact the Mectizan Donation Program at mectizan@taskforce.org or +1 (404) 371-1460. See below for details on the application process.

Please note that applications can take as long as six months to process in some cases. Please submit applications well applications be submitted well in advance of planned mass treatment activities to allow processing and shipping time.

Eligible institutions applying for Mectizan for the first time will need to contact the Mectizan Donation Program prior to completing the Initial Application for Mectizan for Onchocerciasis Control

Eligible institutions applying for Mectizan from the second year onwards will need to submit the Re-Application for Mectizan for Onchocerciasis Control

Application Review Process for the treatment of onchocerciasis only

Once the application is submitted, it is reviewed by the MDP and the Mectizan Expert Committee (MEC). The applicant will be notified if there are any questions that need further elaboration or clarification. Upon approval, the MEC recommends to Merck to ship the appropriate number of tablets of Mectizan to the applicant institution.

The MEC evaluates the application based on the applicant’s ability to:

• Determine which populations should receive mass treatment with Mectizan based on epidemiologic data;
• Demonstrate the capability of providing the needed treatment in a medically responsible manner; 
• Determine the correct dose of Mectizan based on weight or height;
• Identify those ineligible for treatment because they are less than the prescribed weight or height, pregnant, breast-feeding within 1 week post-partum, seriously ill or have a history of hypersensitivity response to Mectizan;
• Develop and maintain an accurate record-keeping system to document persons being treated and program achievements; Identify any adverse drug experiences following Mectizan treatment and give appropriate medical care;
• Promptly document and report SAEs (see Appendix F for SAE reporting form - Onchocerciasis); Assure that the drug is used only for intended purposes; Maintain regular, periodic cycles of treatment in a sustainable manner.

Applications for Lymphatic Filariasis Elimination Programmes should originate from Ministries of Health who will ensure responsible use of these drugs in the National Programs by national staff and by organizations working in association with (or with the permission of) the national government.

Downloadable Applications for Mectizan and/or albendazole in Microsoft Word are available at the bottom of the page.

Instructions:

1. From your Internet Explorer browser, click on the appropriate application
2. Save the document on your computer system
3. Open the document in MS Word and complete the application
4. Save the document and send via email to: mectizan@taskforce.org