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MERCK CHAIRMAN REAFFIRMS PLEDGE TO DONATE MECTIZAN IN EFFORT TO REACH ALL WHO SUFFER FROM RIVER BLINDNESS

 MERCK CHAIRMAN REAFFIRMS PLEDGE TO DONATE MECTIZAN
 IN EFFORT TO REACH ALL WHO SUFFER FROM RIVER BLINDNESS
 Experts Meet This Week; Seek Ways to Reach More People
 -- Four million treated in first five years of donation;
 -- Onchocerciasis afflicts 17 million -- 90 million at risk;
 -- Millions suffer severe itching; disfiguring skin changes;
 -- A leading cause of blindness in the developing world
 UNITED NATIONS, Sept. 23 /PRNewswire/ -- After a day spent reviewing ways to vastly increase the use of a drug for treating the disfiguring and blinding tropical disease known as river blindness, public health experts were reassured by the chairman of Merck & Co. Inc. that the company would continue to donate MECTIZAN for as long as it is needed for treating the disease.
 "While it is heartening to see that our donation has reached nearly 4 million people in five years, much more needs to be done," said Dr. P. Roy Vagelos today at the United Nations in New York as he reaffirmed Merck's commitment to donating MECTIZAN without any charge for as long as it is needed to treat the disease, technically known as onchocerciasis. "We are committed to making MECTIZAN available without charge for as long as there are people suffering from river blindness who need this drug."
 Dr. Vagelos was joined by Dr. Hiroshi Nakajima, director general of the World Health Organization, and President Jimmy Carter, as well as physicians, scientists, and representatives of major voluntary organizations working in developing countries, in marking the first five years of the donation program.
 A committee of experts who review and approve applications for MECTIZAN to be used in community-wide treatment programs is based at the Carter Center, in Atlanta.
 The United Nations gathering followed an all-day symposium at the Macklowe Hotel in New York, where more than 100 experts reviewed the accomplishments and lessons of the first five years of mass treatment programs -- and looked for ways to further the use of MECTIZAN during the coming years.
 A Leading Cause of Blindness in the Developing World
 The World Health Organization lists onchocerciasis as one of the most important tropical diseases, and a leading cause of blindness in many Central and West African countries. According to WHO statistics, the disease afflicts some 17 million people and threatens 90 million; it is responsible for blindness in some 350,000 people, as well as severe visual loss in up to a million people.
 The impact on eyesight may be even greater: In 1990, Drs. Bruce Greene and Hugh Taylor, who conducted extensive field studies in Liberia, wrote in Science that onchocerciasis "causes blindness or visual loss in 1 to 2 million" and "more than half of the inhabitants of hyperendemic areas will become blind before death."
 The researchers wrote that onchocerciasis is "a major blinding disease that, until recently, has been essentially untreatable." Experts say that blindness in Africa generally results in a one-third reduction in life expectancy.
 Discovery of Important Medicines
 Dr. Vagelos said he felt fortunate to be chairman of a company that has discovered so many important medicines that it can undertake such a project. Among those discoveries was ivermectin, which was isolated from Japanese soil samples.
 "The active ingredient in MECTIZAN is ivermectin, which has been studied extensively and turned into a variety of very successful products, primarily for veterinary uses," Dr. Vagelos explained. "Recognizing the huge potential for treating human onchocerciasis, we proceeded with additional laboratory studies and a seven-year clinical research program in which we collaborated with the World Health Organization."
 The result was a formulation of ivermectin known as MECTIZAN, which was approved by French regulatory authorities shortly before Merck's announcement on Oct. 21, 1987, that the drug would be donated for treating onchocerciasis.
 MECTIZAN Widely Distributed in Five Years
 During the five years since Merck announced the donation, numerous non-governmental and private voluntary organizations have undertaken programs to distribute MECTIZAN. The Onchocerciasis Control Program, administered by the World Health Organization, has been a major factor in getting MECTIZAN to those at risk.
 Merck also makes MECTIZAN available directly to hospitals and other health care facilities for treatment of individual diagnosed cases through a program based in Paris and operated by Dr. Philippe Gaxotte, the Merck medical director responsible for the MECTIZAN Treatment Program.
 During the first five years, approximately 4 million people have been treated with MECTIZAN. Because many of these people have now received treatment for two, three or even four successive years, the total number of treatments given, including retreatments, now exceeds 7 million. The average dose of MECTIZAN is 1.5 tablets, which means that nearly 10 million tablets have been shipped thus far.
 The Impact of Community-Wide Treatment
 In the Liberian study, published in Science, Drs. Greene and Taylor showed that through community-wide treatment they were able to reduce the prevalence of infection in five-year-old children by 21 percent; and reduce the annual incidence of infection among children ages 7 through 12 by up to 45 percent (prevalence is the extent of existing disease; incidence is the rate at which new cases occur).
 More recently, in studies conducted in Guatemala, Dr. Eddie W. Cupp made similarly dramatic findings and wrote in Parasitology Today that "the use of ivermectin for control of (onchocerciasis) in Guatemala and southern Mexico is quite promising."
 Late last year, the Pan-American Health Organization and WHO approved a resolution to eliminate onchocerciasis as a public health problem in the Americas by the year 2002.
 How and Where Onchocerciasis is Spread
 Onchocerciasis, which is endemic in 34 countries, is transmitted through the bite of a blackfly. The name river blindness comes from the association of the disease with the fast-flowing rivers where the blackfly breeds -- and near which the victims usually live.
 Onchocerciasis is found primarily in large parts of Central and West Africa, and in more limited areas of Central and South America.
 In the African villages where it is most prevalent, onchocerciasis has blinded up to 15 percent of the population. For example, in three Ghanaian villages that were studied, 60 percent of people over age 55 were either completely or partly blind. The disease has forced entire communities to abandon fertile riverside lands and resettle in less fertile areas.
 Earlier Drugs Were Unsuitable for Mass Treatment Programs
 Before MECTIZAN was available, drug treatments for onchocerciasis included diethylcarbamazien (DEC) and suramin, both of which may have severe side-effects and in some cases may be associated with death in infected persons. Neither drug was suitable for mass treatment programs.
 In an 11-country area of West and Central Africa, the Onchocerciasis Control Program has used helicopters since 1974 to spray larvacides on breeding sites in order to control the blackfly that is responsible for transmission of onchocerciasis. The OCP now distributes MECTIZAN in addition to spraying rivers.
 -0- 9/23/92
 /CONTACT: Art Kaufman or Kimberly Verbonitz of Merck & Co. Inc., 908-594-6878/ CO: Merck & Co. Inc. ST: New Jersey, New York IN: HEA SU:


CK-LR -- NY035 -- 2613 09/23/92 11:41 EDT
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