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Merck And River Blindness

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Brian Rex

on 6 June 2014

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Transcript of Merck And River Blindness

Ethics in Management
Mr. Ralph Apuan
Team A

Merck And River Blindness
We will talk about:
Analyzing and evaluating alternatives.
How alternatives would change if you were working in a foreign country?
What effect does globalization have on the choice of preferred alternatives?
Decide on the most valid alternative and make recommendations.
We will talk about
The disease is caused by the parasitic worm Onchocerca volvulus and is transmitted to humans through the bites of black flies which are found in fast flowing rivers. People who frequent these rivers to fish, bathe, or collect water are at increased risk of infection. A person exposed to these areas can receive about 20-25 bites an hour by black flies. Onchocerciasis causes intense itching, disfiguring dermatitis, and eye lesions that result in blindness and severe skin rash.
River Blindness
In February 2000, the World Health Organization referred to the disease as a "scourge of humanity throughout recorded history," with approximately:

120 million people at risk of contracting river blindness;
18 million people infected with river blindness, 99% of them in Africa

One million people already visually impaired, blinded, and suffering from intense skin rashes with itching so intense it drives people to commit suicide.

Even those who escaped the disease still suffered its effects as farmland near rivers was abandoned, productivity suffered, and children had to give up school to look after stricken members of their families.

Disease Information and Statistics
AFRICA: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo,
Cote d'Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Ghana, Guinea,
Guinea Bissau, Liberia, Malawi, Mali, Nigeria, Senegal , Sierra Leone , South Sudan, Sudan, Tanzania,Togo
Uganda, Yemen
LATIN AMERICA: Brazil, Colombia, Ecuador, Guatemala, Mexico, Venezuela

Onchocerciasis endemic countries
1. World Health Organization. Onchocerciasis and its control, report of a WHO Expert Committee on Onchocerciasis Control. Geneva: World Health Organization; 1995. Technical Report Series No.: 852.

2. World Health Organization. Onchocerciasis Control Programme 1974-1994. Geneva: World Health Organization; 1995. Document No.: WHO/OCP/CTD/94.1.

3. Despommier DD, Gwadz RW, Hotez PJ, Knirsch CA. Parasitic Diseases. 4th ed. New York: Springer-Verlag; 2000. p. 138-142.

4. Thylefors B, Negrel A-D, Pararajasegaram R, Dadzie KY. Global data on blindness. Bulletin of the World Health Organization 1995;73(1): 115-121.

5. The Carter Center. The Crab & The Fly: River Blindness
Retrieved from: http://www.cartercenter.org/news/multimedia/HealthPrograms/river_blindness_crab_fly_2008.html

6. Centers for Disease Control and Prevention. Parasites - Onchocerciasis (also known as River Blindness).
Retrieved from: http://www.cdc.gov/parasites/onchocerciasis/
Any Questions?
What is River Blindness
Explanation of the people effected
Adult Onchocerca volvulus worms can live for fifteen years in the human body. The male and female worms entwine in nodules in the subcutaneous tissue of the skin. After mating, the female worm releases around 1000 microfilariae larvae a day into the surrounding tissue.

The goal in Uganda is to treat the people infected with medication and rid the region of the black flies with water treatment. Abate (larvicide) is the treatment to freshwater that kills the water stages of the black flies who live off of freshwater crabs. Without the crabs a black fly larvae will die.
We will talk about:
Merck as a company
Ethical issues
Dr. William Campbell
In 1979, Dr. William Campbell, a research scientist working for Merck and Company, discovered that one of the company’s animal drugs might eradicate the roundworm that causes river blindness. Campbell and his research team appealed to Merck’s Chairman
Dr. P. Roy Vagelos to receive funding so they could develop a human version of the drug.
Dr. William Campbell
Merck Company
The Merck management team quickly saw a number of issues:
Research and development of the drug would cost over $100 million, and the opportunities for profit were minimal because most victims were too poor to afford the drug

Distributing the drug would require significant investments into infrastructure and distribution channels

If the drug didn’t work properly, the negative publicity could hurt the reputation of Merck and reduce sales of the animal version of the drug.
After several meetings, Vagelos and his management team concluded the moral obligation of producing the drug outweighed the costs and slim chance of economic rewards. In late 1980, Vagelos approved a budget that provided the funding necessary to research and develop a human form of the drug.
Seven years later, Merck had a drug that could eliminate the parasite that caused river blindness and prevent new infections. A single pill only had to be taken once per year. As the company expected, neither the governments of nations affected by the disease nor the World Health Organization (WHO) purchased the phenomenal medication. Therefore, Merck elected to distribute the drug for free to afflicted and potential victims. With the help of the WHO, Merck financed an international committee responsible for developing the necessary infrastructure to deliver the drug to remote villages in Africa, Latin America, and the Middle East.
By 2004, the drug was provided for free, relieving 40 million individuals of intense suffering and blindness. Not only does Merck donate the necessary medication, but they also donate a substantial amount of money.
When asked why the company would invest heavily in a product that made no direct revenue, Dr. Vagelos responded "once the company realized it possessed a solution to devastating problem, the only ethical choice was to develop it."
Merck & Co. traces its origins to Jacob Friedrich Merck, who purchased a drug store in Darmstadt, Germany, in 1668, and also to Emanuel Merck, who took over the store several generations later in 1816. Emanuel and his successors gradually built up a chemical-pharmaceutical factory that produced raw materials for pharmaceutical and other preparations.

In 1891, George Merck emigrated to the United States and set up Merck & Co. in New York as the US arm of the family partnership, E. Merck (named for Emanuel Merck), which is now Merck KGaA. In keeping with a national wartime policy, Merck & Co. was confiscated in 1917 and re-established as an independent American company. Until the end of World War II, the company was led by George W. Merck. Merck & Co. hold the rights to the name in North America, while its former parent company retains the rights in the rest of the world.

"We try never to forget that medicine is for people. It is not for profit.
The profits will follow, and if we have remembered that, they have never failed to appear. The better we have remembered that, the larger they have been."
Merck & Co. Philosophy
Merck & Co.
The Merck Company is a perfect example of what a company should be. They thought about the customers rather then there stockholders. The idea of public before profit is a amazing idea that we as society have gone away from. Even when nobody wanted to help, the Merck & Co. came up with there own product, committee, and distributor to get this medicine to the people spending there own money and not charging the consumer.

This type of health care globalization is important because it is a team effort to help these developing countries out of medical crisis.

Ethical System
Duty Based
Moral Obligation
Commitment to the affected
•Do the right thing.
•Do it because it's the right thing to do.
Mectizan is the most common treatment
of River Blindness. Mectizan kills the immature worms which relieves itching, improves vision and prevents blindness. Killing the larvae also prevents transmission.

Mectizan was found to be very safe because:
needs no refrigeration
needs no needles
needs no highly trained people to distribute
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