At Merck, we believe that by serving the public interest, our business interests also will be served. This core belief is the fundamental reason Merck is a leader in health policy issues worldwide. In the United States, we supported adding a critical prescription drug benefit to Medicare, the U.S. health insurance program that provides health care benefits for millions of seniors and persons with disabilities. The landmark Medicare reform bill that President Bush signed in December 2003 will allow seniors to choose their coverage from qualified, private health plans that rely on market competition, rather than government price controls, to improve quality, integrate care and manage costs. This new legislation not only benefits patients in need, but also Merck, which is well-positioned to compete because of our focus on providing real value in patient care.

Merck's support for Medicare reform is emblematic of our long-standing commitment to promoting access to essential medicines for those in need. For more than 50 years, we've been making our products available to low-income individuals and families in the United States through our Patient Assistance Program. This program is designed to provide prescription drugs to patients who do not have insurance or other coverage for prescription medicine. In 2003 alone, the program helped make Merck medicines available to more than 600,000 Americans in need.

The Patient Assistance Program offers Merck medicines entirely free-of-charge: there are no application fees, no co-payments and no age restrictions. Patients qualify if they have a maximum household income of $18,000 for individuals, $24,000 for couples or $35,000 for a family of four, and cannot afford to pay for the prescription medicine. Doctors can also request that exceptions be made for patients in special circumstances.

Patients can get information through www.merck.com or by calling 800-727-5400. They can also apply through their physician's office.

In keeping with our ongoing commitment to promoting access to essential medicines for people in need, we recently announced that we will provide our medicines free for low-income Medicare beneficiaries who exhaust their $600 transitional assistance allowance in Medicare-endorsed drug discount cards.

As a global health care company, Merck also recognizes the link between global health and economic health. Disease is not just a consequence of poverty; it is also a cause of poverty. And, conversely, improved global health is an essential driver of economic growth.

That is why we make our medicines, expertise and experience available in developing countries that are experiencing health crises such as HIV/AIDS. While developing new medicines and vaccines will always be Merck's greatest and most important contribution to global health, we remain committed to building partnerships that help to broaden access to medicines in resource-scarce areas, along with the capacity to deliver them.

One notable example: the joint effort initiated in 2000 by the government of Botswana, The Merck Company Foundation, Merck and the Bill & Melinda Gates Foundation in response to the crushing HIV/AIDS crisis in that country. The funding and support of this partnership have enabled government and community organizations in Botswana to develop large-scale, sustainable programs focused on prevention, treatment, care and support.

Three years into this innovative effort, the news from Botswana is encouraging. To date, the nationwide anti-retroviral treatment program has enrolled more than 18,000 patients and treated more than 11,000. These figures represent a significant proportion of the number of people in Botswana who have tested positive for HIV infection and are eligible for treatment.

More than 90 percent of individuals who have entered treatment are living healthier, more productive lives. Between 30 and 40 percent of these people would most likely have died without treatment.

We believe that the lessons learned from our work in Botswana serve as an example in the global fight against the HIV/AIDS pandemic, and demonstrate the value of Merck's leadership on health care policy issues around the world.