When it comes to its global health giving, Merck predominantly focuses on HIV and hepatitis C. However, this corporate funder is also interested in reforming policies and delivery systems as they relate to chronic and infectious disease prevention and treatment in developing countries. One disease that has been plaguing some of the world’s least developed countries for decades is onchocerciasis, also known as river blindness.
Oncho is most widespread in parts of Africa, Latin America, and Yemen, and is one of the five most common neglected tropical diseases (NTDs). It's a horrible disease, and we've written before about efforts targeting River Blindness, most notably by the Carter Center, which has made some strides in this direction. Last year, the center received a $10 million grant from the Nigeria-based Sir Emeka Offor Foundation to fund its plans to eliminate river blindness in Nigeria by 2020.
That grant was a sign of the rising momentum around River Blindness, a disease that the WHO has called for its elimination in high burden countries in Africa by 2020 though its Roadmap on Neglected Tropical Diseases. Merck’s contribution to the END Fund—a $1 million partnership with the Mectizan Donation Program—aims to do just that. But not necessarily in the same manner as other like-minded organizations combating NTDs.
Instead of focusing on prevention and treatment activities such as mass drug administration and behavioral modification, the Merck/Mectizan partnership is moving to the next level of river blindness elimination: post-treatment surveillance.
Merck has worked for nearly 30 years to make the river blindness treatment drug ivermectin (which goes by the brand name Mectizan), available for free to those who have contracted the vector-borne disease. And it has no plans to discontinue this practice. But getting the rubber stamp of official elimination from the WHO involves more than dramatically decreasing river blindness infections.
Eligible participating countries must follow a policy framework that includes surveillance periods, verification processes and documentation before it can receive official elimination status. As one can imagine, this process involves a lot of red tape that poor countries may not have the resources or knowledge base to cut through. Not to mention that the costs associated with running mid- to long-term disease surveillance systems—which can last anywhere from 12 to 36 months—can be untenable for developing and least developed nations.
The END fund is hoping to alleviate some of that burden by helping countries prep for post-treatment surveillance periods required by the WHO before an application can be submitted for official elimination verification status.