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Merck did field trials and gradually became convinced that were tens of millions of human beings who ought to be taking ivermectin regularly. The drug does not cure the infection; it does not even get rid of the fully grown O. volvulus worm. But it holds down the spread of the microfilariae well enough to prevent harm to the eye. One or two doses per year do the trick.

My initial reaction was: “Wow, nobody got a Nobel for ivermectin yet?”

In 1987 Merck satisfied French drug regulators, who are influential in the parts of Africa where river blindness is the worst scourge, that ivermectin was effective and safe. But there was no hope that African patients could cover Merck’s manufacturing costs, and international charitable partners were reluctant to help build a distribution bridge.

Merck is part of a corporate family tree that goes back to the 17th century. The U.S. incarnation of Merck has done some shady things in the not-so-distant past, and no drug company is what you’d call wildly popular. But Merckian culture assigns a high value to public goodwill, and its CEO Roy Vagelos, seemingly as much out of indignation and frustration as anything, made an extraordinary pledge. Ivermectin, he announced, would be made available free for the treatment of river blindness “wherever it is needed, for as long as it is needed.”

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“Free” is, almost 20 years later, still the price Merck charges the global poor for ivermectin. The company sends more than 100-million doses of the drug to Africa every year, and river blindness might be on the road to eradication. In Latin America, where onchocerciasis was a less pervasive problem to begin with, ivermectin has already helped reduce eye injuries resulting from the pest to zero. Emergent superpowers of do-gooding like the Carter Center and the Gates Foundation have joined in to support Merck’s perma-donation with logistical help.

This represents the substantial neutralization of an ancient human scourge. It has happened entirely within the last quarter-century. It is not talked about much outside of business schools (where Roy Vagelos is a popular case study) and NGO circles. And while the Nobel is very well deserved, it would be a shame if everyone overlooked this medication’s journey to the places it is needed.

National Post

ccosh@nationalpost.com

Twitter.com/colbycosh