Special Session with Mr. Raymond V. Gilmartin, Chairman, President, and Chief Executive Officer of Merck & Co., Inc.
At the beginning of the second day of the 31st Mectizan Expert Committee/Albendazole Coordination (MEC/AC) meeting in October 2003, the participants had the pleasure of a visit by Mr. Raymond V. Gilmartin, Chairman, President and Chief Executive Officer of Merck & Co., Inc.
The session began with a presentation by Dr. Björn Thylefors, Director of the Mectizan Donation Program, describing the successes and challenges of using Mectizan for the control of onchocerciasis as a public health problem in Africa, possible elimination of transmission of onchocerciasis in Latin America, and the elimination of lymphatic filariasis (LF) in countries where onchocerciasis and LF co-exist.
Mectizan Donation Program
Onchocerciasis
Achievements of the program:
- Good public health control of onchocerciasis in many countries with elimination of transmission possible in the Americas
- Effective Mectizan delivery through community participation
- Impact evaluations are ongoing
Challenges for the program:
- Reaching the ultimate treatment goal worldwide of 70-90 million Mectizan treatments per year
- Defining the endpoint of treatment with Mectizan: how long do we treat?
- Treating in areas of low endemicity (<20% onchocercal nodule prevalence)
- Sustaining national onchocerciasis control program
Research issues:
- What is the optimal frequency of Mectizan treatment needed to obtain the greatest impact? Is the goal control as a public health problem or elimination of transmission?
- Serious Adverse Experiences associated with Loa loa
- Monitoring Mectizan's continuing effectiveness
- Integration of Mectizan delivery into the primary health care system
Global control of onchocerciasis:
- Expansion of treatment coverage for complete control as a public health problem in Africa and Yemen should be continued
- Focus on elimination of transmission in the Americas
- Continue with operational research to maintain effective treatment programs
Lymphatic Filariasis
Achievements of the program:
- National elimination programs using Mectizan and albendazole have been established in 7 African countries plus Yemen; since 2000, a cumulative total of 43 million treatments using these two drugs have been approved.
Strategic issues:
- Achieving effective mass drug administration in both rural and urban areas
- Integration and sustainability of national elimination programs
- Mobilization of necessary resources
The Future:
- By 2010, it is hoped that LF elimination programs using Mectizan and albendazole will be underway in 28 African countries plus Yemen with a total at-risk population of greater than 400 million people
Research issues:
- Improvement of diagnostic tools for mapping of LF
- Integration of LF disability management
- Treatment strategy in L. loa endemic areas
- Sustainability of community-based support
Following Dr. Thylefors' presentation, program partners gave brief comments regarding their activities and expressed their gratitude for Merck's donation of Mectizan. The following are excerpts from the presentations and comments made during this special session.
