Mectizan Donation Program (MDP) “for as long as needed”: A Template For Action

Photo credit: Mectizan Donation Program

Many industries have terms for ideas that sound good in theory but fail to deliver unless done right. In high-tech, for example, “shelfware” refers to software that is effectively useless because no one sees value in using it.

Public health practitioners have their own version of this concept. Dr. Walter Orenstein, who serves on The Task Force for Global Health’s board of directors and was the CDC director of the U.S. Immunization Program from 1988-2004, describes it like this: “Vaccines don’t save lives. Vaccinations save lives.”

In other words, a powerful health tool is only powerful when someone who needs it can get it and use it.

In 1987, the pharmaceutical company Merck & Co., Inc. (known as MSD outside the USA and Canada) saw an opportunity to do just this. And to help eliminate onchocerciasis, a parasitic infection caused by a worm that is transmitted by black flies that live near fast-flowing rivers. Most of those affected live in Africa, but the disease is also present in parts of Latin America and in Yemen. Infections can lead to unbearable itching and loss of sight; hence the disease’s common name, river blindness.

After more than a decade of testing its anti-parasitic medicine Mectizan for safety and efficacy, it made a bold decision: to donate the medicine — “as much as needed, for as long as needed.” Merck turned to The Task Force to provide the medical, technical and administrative oversight to deliver on Mectizan’s transformative potential.

The resulting partnership, the Mectizan Donation Program (MDP), has become a template for partnerships between pharmaceutical firms and philanthropic global health organizations. 

MDP will leave behind a legacy thanks to Merck’s introduction of ‘pharmaco-philanthropy’,” says Dr. Yao Sodahlon, director of the Mectizan Donation Program. “The program has raised the overall awareness of neglected tropical diseases.” 

Dr. Yao Sodahlon, Director of the Mectizan Donation Program. Photo credit: Mectizan Donation Program

How It Started

MDP’s operations are guided by the Mectizan Expert Committee, or MEC. Coordinated by The Task Force, MEC is an independent body composed of internationally recognized experts in public health, tropical diseases and social science. The committee provides scientific, medical and technical oversight to ensure that donations and administration of Mectizan conform to appropriate medical and public health practices. 

Mectizan Expert Committee and liaisons in November 1988. Pictured are: William Foege, Adetokunbo Lucas, Bruce Greene, Eric Ottesen, Michel Lariviere, Guillermo Zea-Flores, Kenneth Brown, Andrew Davis, Robert Kaiser, Bruce Dull, Stuart Kingma. Photo credit: Mectizan Donation Program

“We had this medicine and needed to get it to millions of people. No one had done that before and no one knew how,” said Joni Lawrence, MDP deputy director and a 25-year-employee at The Task Force. “[Task Force co-founder] Dr. Bill Foege had gotten the smallpox vaccine to millions of people in Africa and India and Merck wanted to tap into that knowledge, so they chose The Task Force.”

In the decade after its launch, the program steadily scaled up — delivering hundreds of thousands of treatments annually. The success of Mectizan distribution to communities that needed it created a framework for treating additional NTDs. The program then shifted into an expansion phase. In 1998, after the World Health Organization recommended the co-administration of Mectizan and a drug called albendazole to eliminate lymphatic filariasis (LF, commonly known as elephantiasis due to the swelling of limbs) in countries where the diseases are co-endemic, GlaxoSmithKline joined MDP by donating albendazole.

MDP has now delivered more than 13 billion Mectizan tablets for more than 5.5 billion treatments. Colombia, Ecuador, Guatemala and Mexico have eliminated river blindness, and Malawi, Togo and Yemen have eliminated LF. Several other African countries are making significant progress toward eliminating both diseases. Additionally, an estimated 46 million people no longer need treatment for river blindness and an estimated 265 million people no longer need treatment for LF. 

For those who do need it, the work continues. In 2022 alone, MDP reached people in 31 countries.

MDP Director Sodahlon says the program’s success has become a model for the pharmaceutical industry and nonprofits like The Task Force to tackle other diseases.

“Pfizer is donating Zithromax for trachoma and Johnson & Johnson donates mebendazole for soil-transmitted helminths,” he said. “Additionally, the core strategy developed to deliver Mectizan treatment, especially to rural communities, is now used for the delivery of other health interventions such as malaria prevention and Vitamin A supplementation.”

Deputy Director Lawrence notes that the program illustrates a core aspect of The Task Force’s approach: bringing together partners to tackle complex challenges.

“From our little spot in Decatur, Georgia, a full-time staff of four people run a program that treats 400 million a year and has become a model for other partners,” says Lawrence. “It’s a testament to The Task Force’s spirit of partnership and cooperation.”

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