Improving Access to Vaccines and Immunization in the Developing World

Despite Merck's efforts to develop and implement effective philanthropic and business strategies to help remove barriers to access, challenges remain due to the complex and multi-faceted nature of the problem. Improving access requires more than simply making our vaccines available at fair and affordable prices.

We believe that truly to address—and, ultimately, solve—the issue of access in developing and middle income markets, the international community must pool its resources and expertise to strengthen health care infrastructure, ensure adequate financing for health, and help to build local health care capacity through training and support. For this reason, a key element of Merck's access strategy is promoting and participating in public/private partnerships (PPPs) with governments, nongovernmental organizations(NGOs), multilateral organizations, community-based organizations and other corporations to address specific health and development challenges beyond those which Merck has immediate and direct control. For more information, please click here.

Merck, as part of the pharmaceutical industry, was a partner in the GAVI Alliance from the start. Formed in 1999, GAVI is a public/private partnership committed to saving children's lives and protecting people's health by increasing access to immunization in poor countries.

Merck Vaccine Network – Africa (MVN-A): As part of our commitment to the GAVI Alliance, Merck initiated the Merck Vaccine Network – Africa (MVN-A), a multi-year philanthropic initiative to help increase the capacity of national immunization programs in Africa by supporting academic partnerships in the development of sustainable immunization training programs. With funding from The Merck Company Foundation, MVN-A launched in 2003 with the establishment of training programs in Kenya and Mali that provide mid- to high-level immunization program managers with hands-on training in vaccine management and immunization services. Supplemental funding granted by The Merck Company Foundation in 2007 provided for the establishment of two new MVN-A training programs in Uganda and Zambia, as well as the expansion of MVN-A training activities in both Kenya and Mali. Over 510 immunization managers in these four countries have completed MVN-A training and returned to their medical facilities to share their expertise and knowledge with colleagues. For more information, please click here.

Charitable Vaccine Donation Programs

Merck does not believe that charitable vaccine donation programs are a sustainable solution to the global access challenge. However, we recognize that millions of patients need vaccines now.

Cervical Cancer: In 2007, Merck announced at the Clinton Global Initiative a major vaccine access initiative to help address the problem of HPV infection to lowest-income countries. Through the GARDASIL Access Program Merck pledged to donate at least three million doses of GARDASIL^® [Human Papillomavirus Quadrivalent (types 6, 11, 16, 18) Vaccine, Recombinant] over five years to support cervical cancer vaccination in lowest-income countries. The GARDASIL Access Program is managed by Axios Healthcare Development (AHD), a U.S. non-profit organization. In 2008, the Advisory Board of the GARDASIL Access Program recommended, and AHD later approved, eight organizations and institutions as the first recipients of GARDASIL through this humanitarian donation program. The first shipments of donated GARDASIL took place in the first quarter of 2009. The program will draw upon learnings and experiences of participants, thereby contributing to the public knowledge base around HPV vaccine access in lowest-income countries.For more information, please click here.

Vaccine Demonstration Projects

Demonstration projects add to the evidence base supporting new vaccine introduction in resource-poor countries and help to inform access decisions by health care officials and policy makers.

Cervical Cancer: Merck is partnering with PATH to conduct demonstration projects of GARDASIL in Peru, Vietnam and India to support the acceleration of the availability of cervical cancer vaccines in the most impoverished nations. Approximately 35,000 adolescent girls are participating in the demonstration projects, which are designed to generate evidence for the public-sector introduction of HPV vaccines in low-resource settings, inform global advocacy efforts, and provide analyses that together help to accelerate access to the protective effects of HPV vaccines. PATH, in collaboration with Merck, started the projects in April 2007 and expects them to conclude by 2011.

Rotavirus: Merck is conducting demonstration projects with ROTATEQ to gather evidence of the public health benefit of implementing a full rotavirus vaccination program. In 2006, Merck and the Ministry of Health in Nicaragua announced an initiative at the Clinton Global Initiative through which all eligible infants born in Nicaragua in a three-year period would receive free doses of Merck's rotavirus vaccine. Merck is also providing technical assistance for the duration of the program. As of April 2009, Merck provided nearly one million free doses of ROTATEQ® (rotavirus vaccine, live, oral pentavalent) to Nicaragua. Starting in March 2007, an estimated 27,720 doses of ROTATEQ are being administered every month; by April 2009, more than 750,000 doses had been administered through the national immunization program and the country had achieved rates of rotavirus vaccination that are among the highest in the world. The Ministry of Health reports that approximately 81 percent of eligible infants in Nicaragua were vaccinated with ROTATEQ in 2008.

Merck launched ROTATEQ in a unique public/private partnership with the government of Nicaragua in September 2006, marking the first time a new vaccine has been introduced in the developed and developing world in the same year. Merck is demonstrating the public health impact of a full rotavirus vaccination program and adding to the evidence base supporting the efforts of the global public health community to accelerate the introduction of routine rotavirus vaccines in resource-poor countries. For more information, please click here.

In addition to helping protect infants and young children from rotavirus, Merck and the Nicaraguan Ministry of Health are working to strengthen Nicaragua’s national rotavirus disease surveillance network and assess the public health benefit resulting from the early adoption and use of a rotavirus vaccine.

This program adds to the evidence base supporting introduction of routine rotavirus vaccination in resource-poor countries, and is helping to inform access decisions in other countries. Already, two and a half years since the launch of this unique demonstration project, a number of countries have expressed interest in introducing rotavirus vaccines.

Public Policy

Merck advocates for improving access to vaccines and immunizations in a number of ways.

Through stakeholder engagement, by participating in and formally responding to reports of formal collaborations and task forces focused on vaccines and immunization, including those sponsored by the GAVI Alliance, the World Health Organization, the Pan American Health Organization and trade groups such as The Pharmaceutical Research and Manufacturers of America (PhRMA) and International Federation of Pharmaceutical Manufacturers & Associations (IFPMA).
We have also engaged in small group discussions with individual stakeholders, as well as larger events such as the Infectious Diseases Summit, where, in 2008, Merck Chairman Richard T. Clark called for more collaboration to address some of the major global health challenges.

The content on this page was last modified on September 15, 2009.

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