To inform the public policy discourse related to access to medicines, vaccines and health care in the developing world, Merck is engaged in a number of high-level forums, for example:

• Merck has been actively involved in the design and development of The Medicines Transparency Alliance (MeTA), which was established by the U.K. Department for International Development in 2008. The alliance aims to build transparency and accountability around the selection, procurement, sale and distribution of essential medicines, and to tackle the excessive mark-ups, corruption and mismanagement that cause good quality medicines to be either too expensive or unavailable for hundreds of millions of people in developing countries. It aims to do this by working with all stakeholders — public, private and nongovernmental — to broker widespread disclosure of medicines pricing, quality and availability data in participating countries. Merck's subsidiary in the Philippines also has become actively involved in the pilot program, serving as the private sector representative and contributing to the pilot's design and implementation.  Through the pilot, seven pilot countries have assembled working groups that will seek to identify obstacles to transparency in pricing and availability of medicines, and devise plans to address them.
•  Merck was also an active member of the Global Fund Technical Working Group (TWG) on In-Kind Donations. Commissioned by the Global Fund, the working group was comprised of nominated representatives from all sectors including private, academic and nongovernmental, to examine the potential advantages and concerns associated with the Global Fund's acceptance of donations of in-kind goods. The TWG identified four priority issues - recipient sovereignty, donor participation, management cost and market impact — and  commissioned studies to evaluate these issues.
  
  Based on data gathered and in-depth analyses, the TWG recommended that: (1) the Global Fund should continue to consider opportunities for accepting service donations, but should also develop standards and policies to guide these decisions; (2) given the lack of information available for the category of non-health products, a policy recommendation should be deferred until necessary data is available; and (3) for health products including medicines, the Global Fund should not manage and/or facilitate donations of health products primarily due to the current lack of capacity within the Global Fund to manage a large scale donation program, recipients surveyed were not in favor of accepting donations of health products for a variety of reasons, and concerns over potential market impact. The TWG recommended revisiting donations of health products following adequate experience with the Global Fund's Voluntary Pooled Procurement mechanism.
  
  The TWG made it clear that these recommendations do not imply a priori characterization of product and service donations as positive or negative, but rather make a pragmatic judgment on the current viability of the Global Fund as an implementing vehicle for such donations. This recommendation was ultimately endorsed by the Global Fund Board.
  
• Initiated by Merck earlier this decade, the Partnership for Disease Control Initiatives (PDCI) is a coalition of pharmaceutical companies and nongovernmental organization partners engaged in specific disease control or elimination programs for neglected tropical diseases. The coalition seeks to identify opportunities to collaborate and, ultimately, to integrate treatment strategies and programs where feasible, while reducing undue burden on local governments and communities.  PDCI works closely with the World Health Organization (WHO), the U.S. Agency for International Development (USAID) and other interested parties.  
• Merck is a founding partner in the GAVI Alliance, a historic public/private partnership committed to improving the health of children by extending the reach and quality of immunization coverage in least developed countries. Merck represented the private sector on the GAVI board for several years through May 2008.
• Merck was a founder and is still an active member of the Partnership for Quality Medical Donations (PQMD), a coalition of pharmaceutical and medical supply manufacturers and nongovernmental organizations engaged in the delivery and administration of needed medicines, vaccines and medical supplies to the developing world and in response to disaster situations worldwide.  PQMD's mission is to improve the standards for and quality of donations globally through awareness raising, advocacy, education and sharing of best practices.  PQMD contributed to the final draft of the WHO Guidelines for Drug Donations and its members were the first U.S. signatories to the Guidelines.  More recently, PQMD has advocated for eliminating inappropriate taxes and tariffs on imported and donated medicines.
• Established in 1996, the NGDO Group for Onchocerciasis Control collaborates to improve and expand onchocerciasis treatment programs in conjunction with Merck's MECTIZAN Donation Program, focusing on distribution strategies, sharing of best practices, advocacy and communications, and logistical challenges.  Merck is a liaison member, offering guidance, management and business experience and ideas where needed.
• Merck serves as a board member on the Executive Group of the Global Alliance to Eliminate Lymphatic Filariasis (GAELF), which acts as an oversight committee for the GAELF, addressing partnership issues, treatment strategies and fundraising needs.