Onchocerciasis was first identified in 1893 and in 1926 was determined to be related to black flies. By the 1970's there was still no cure that could be used for a community-wide treatment. There were two drugs that were currently being used. They were diethylcarbamazine (DEC) and Suramin. They were effective in killing the parasite that causes Onchocerciasis. However, they had severe side effects. The drugs had even caused death in some patients. In 1974, the Onchocerciasis Control Program was created by the World Health Organization (WHO). The initial plan was to kill the flies by spraying larvicides at breeding sites. This was not very successful. The flies developed resistance to the sprays. In other areas, the flies would disappear and then reappear in the same area. (Donaldson 216)
In 1978, legislation was passed that would grant drug companies tax benefits and seven year exclusive marketing rights if they developed drugs for diseases affecting fewer than 200,000 Americans. However, no U.S. or international organization would created incentives for companies to develop cures for diseases, such as River Blindness, in Third World countries. No company wanted to take on this task alone, because of the high cost of research and bringing the drug into the market. It takes on average 12 years and $200 million to bring a new drug into the market. Since most of the people who would need these drugs were in Third World countries, and would not have the ability to pay even a small amount of the cost of the drugs. Therefore the drugs could not be priced high enough to recover the investment for the research. (Donaldson 216)
Merck spends large amounts of money on research because it knows that success in ten or twenty years depends on present investments. In 1974, Merck Sharpe & Dome Research Laboratories were researching 54 soil samples from Kitasasto Institute of Japan trying to discover naturally occurring antibiotics. One sample showed strong antiparasitic properties. The sample, No. 0S3153, was a soil sample from a golf course near Ito, Japan. The compound responsible for the antiparasitic properties was ivermectin. It was believed ivermectin would be effective in horses, cattle, and other animals. In 1978, the U.S. Department of Agriculture and foreign regulatory bodies approved the first ivermectin based animal drug, Ivomec. (Donaldson 219) In 1995, Ivomec accounted for $740 million in sales for Merck.
Further research was performed on the properties of ivermectin. In the late 1970's, Dr. William Campbell, a researcher for Merck, noticed that ivermectin was effective with horses in killing a gastrointestinal parasite, Onchocerca cervicalis. This parasite is similar to the parasite, Onchocerca volvulus, that causes Onchocerciasis. Dr. Cambell wondered if a version of ivermectin could be developed for humans. Dr. Roy Vagelos, head of the Merck research labs, knew Merck would have to spend millions of dollars to develop a form of ivermectin for humans and would have to conduct field trails in remote parts of the world. (Donaldson 219)
Dr. Vagelos faced many issues in his decision of whether to allow further research into a drug that could eliminate River Blindness.
