We’re Working to Stem the HIV/AIDS Epidemic
	•    Merck’s HIV/AIDS research program is among the largest and longest in our history. •    We have taken concrete steps to increase the affordability of our HIV medicines in the world’s poorest countries ravaged by HIV/AIDS. •    We are sharing our expertise and resources to increase access to education, prevention, care and treatment. Stemming the epidemic tide of HIV/AIDS is a challenge of a magnitude never before seen. The statistics are staggering. UNAIDS and the World Health Organization estimate that more than 40 million adults and children are living with HIV/AIDS. While global leaders and partners, both public and private, struggle to solve this global health care crisis, Merck is sharing its research and resources to increase access to education, prevention, care and treatment. The road has been and will be long, but encouraging progress is being made. Merck’s primary contribution to curbing the HIV/AIDS epidemic will continue to be doing what it does best: discovering and developing breakthrough medicines and seeking an effective vaccine to treat and prevent HIV infection. Merck Research Laboratories began its extensive research program focusing on HIV/AIDS nearly 16 years ago, and HIV/AIDS continues to be one of the largest and longest research efforts in the history of the Company. Our scientists invented significant antiretroviral medicines: Crixivan and Stocrin. In addition, we are entering early clinical trials with a new-mechanism agent called an HIV integrase inhibitor. We realize, however, that the best way to stem the tide of this epidemic is through prevention. That’s why our scientists continue to search for a vaccine. Today, after a number of disappointments, we have a vaccine candidate in early-stage clinical trials. In addition to doing what we traditionally do best, Merck is also committed to doing what we can to help broaden access to HIV education, prevention and treatment programs around the world. This is especially important in resource-constrained countries that remain at greatest risk as economic conditions, poor health care infrastructure, limited resources and cultural barriers continue to fuel the spread of the virus. It is clear that ensuring adequate access to HIV care and treatment in those countries most directly affected cannot be managed by one country or company alone, as U.N. Secretary-General Kofi Annan observed in his 1999 Diana, Princess of Wales Memorial lecture. The cooperative efforts of governments, HIV organizations, multilateral international organizations like UNAIDS and the World Health Organization (WHO), and companies are needed if efforts are to be scaleable and sustainable. To this end, in 1998, Merck forged one of the first public-private partnerships to learn more about the broader issues surrounding health and HIV in the developing world. The Enhancing Care Initiative (ECI) (www.eci.harvard.edu) is a multidisciplinary, multinational collaboration to enhance the care of men, women and children living with HIV/AIDS in Brazil, Senegal, the KwaZulu Natal province of South Africa and Thailand (later extended to include Puerto Rico). ECI provided concrete learning about effective responses to the epidemic in resource-constrained settings that paved the way for Merck to become a pioneer in comprehensive HIV education, care and prevention programs around the globe. Accelerating access to medicines by increasing affordability Multiple approaches are required to help the greatest number of people in need. In May 2000, Merck was a founding partner in the UN/Industry Accelerating Access Initiative (www.unaids.org/acc_access/) along with UNAIDS, the WHO, the World Bank, UNICEF, the UN Population Fund and four other research-based pharmaceutical companies. Participants are committed to working with governments, international organizations and others to find ways to broaden access while ensuring rational, affordable, safe and effective use of drugs for HIV/AIDS-related illnesses. By December 2001, more than 70 countries had indicated their interest in collaborating with UNAIDS on access to care and support, including 40 countries in Africa and 24 in Latin America. In March 2001, Merck took a further step to spur additional access to HIV medicines by significantly lowering prices for Crixivan and Stocrin in countries where lowered prices could contribute to greater availability. At the new price levels, Merck will make no profit on these medicines in the poorest countries and those hardest hit by the HIV epidemic.1 This new pricing policy makes discounted prices available to about 112 countries. To date, 50 countries have accepted our offer – and medicines are already being shipped and are reaching patients in 45 developing countries. Merck shares the sense of urgency felt by people who are battling the scourge of HIV/AIDS around the world. And progress is being made – in the delivery of more affordable medicines, in devising more effective prevention and education programs, and in the search for a safe and effective vaccine. While that search goes on, Merck and others in the health care industry will continue to do what they must: build partnerships that offer the best hope for progress. HIV is an indiscriminate killer, but we are not powerless to halt its global spread. A comprehensive approach to HIV in Botswana Lessons from other global and local initiatives (www.merck.com/pro/hiv/pdf/Global_Voices-812-hi_res.pdf) continue to spur innovative thinking at Merck. In July 2000, the Republic of Botswana, the Bill & Melinda Gates Foundation and Merck forged an innovative partnership to improve the overall state of HIV/AIDS care and treatment in Botswana, one of the countries hardest hit by the HIV/AIDS epidemic. In collaboration with the government of that country, and with an intensive commitment of resources, the African Comprehensive HIV/AIDS Partnership in Botswana will advance significantly HIV/AIDS prevention, health care access, patient management and treatment of HIV in Botswana, a country where about 40 percent of the adult population is HIV-positive. The Merck Company Foundation and the Bill & Melinda Gates Foundation are each contributing $50 million over five years to help Botswana fundamentally strengthen its primary health care system. Merck is also donating its HIV/AIDS medicines as part of this program, to be used as directed by the Republic of Botswana in accordance with national treatment guidelines. A Romanian success story In January 2002, the Romanian Ministry of Health and Family made a remarkable announcement: all HIV-positive patients in that country who need treatment now have access to antiretroviral therapy and other HIV/AIDS-related health care services. That is quite a change from 1997 when only 32 percent of patients were under treatment and, of those, only 1.5 percent were on triple-combination therapy. Now, more than 90 percent of those treated are on triple-combination therapy, reflecting international standards of quality HIV care. The government publicly thanked Merck for its part in making this success possible. Beginning in 1997, Merck and the National AIDS Committee had collaborated on treatment guidelines and other measures to help Romania strengthen its response to the HIV epidemic. The Company made a $1 million donation in 1999, which helped Romania establish Regional AIDS Centers that equipped physicians with cutting-edge equipment that allowed them both to monitor how patients respond to therapy and to tailor disease management to the best effect. In 2001, Merck also made its two antiretroviral medicines available to the government at not-for-profit prices. This action enabled Romania to greatly enlarge the number of patients included in a treatment program. Romania’s HIV/AIDS problem differs from that in many other countries of the world: most of those infected are children. More than 5,000 Romanian children and almost 2,000 adults are living with HIV. They now have new hope for the future, thanks in no small measure to the remarkable public-private partnership between Merck and Romania. Reaching those in need While we have invested considerable resources in helping the HIV/AIDS epidemic, Merck is also committed to helping solve other social and medical problems through our philanthropic outreach around the world. Below are just a few of the ways we help those in need. •    Merck Medical Outreach Program: Through the Merck Medical Outreach Program, the Company provides life-giving pharmaceuticals and vaccines for use in ongoing humanitarian programs in developing countries and in response to disaster and emergency situations worldwide. In 2001, Merck donated about $300 million in funds, medicines and other aid around the world. •    The Mectizan Donation Program: This program is the largest component of our product donation program. Mectizan is used to treat river blindness (also known as onchocerciasis), a debilitating disease that results in excruciating itching, severe skin disfigurement and, eventually, total and permanent blindness. In 2002, we are celebrating the 15th anniversary of the program, which is active in 32 of 35 endemic countries in Africa, Latin America and Yemen. To date, more than 650 million tablets of Mectizan have been donated to people at risk for river blindness, treating more than 25 million people a year. •    Expanding Access in the United States: Merck also recognizes that there are people in the United States who need the Company’s help to get our medicines. To help expand access to those without pharmaceutical insurance, Merck donates its products and services through the Merck Patient Assistance Program. Through this program, Merck provided medicine in 2001 to almost 350,000 patients in the United States. •    Merck’s Commitment to Healthy Aging: The Merck Company Foundation earmarks nearly $1 million in funds each year to encourage innovative studies and programs to improve elderly care. Our Company is committed to supporting a health care system that further improves the quality of life of the elderly and recently launched programs specifically dedicated to elder care worldwide. (See www.merck.com for more information.) •    Employee Giving: The Merck Employee Giving Campaign is an annual fundraising drive and an opportunity for Merck people to contribute to any 501c(3) health and human services organization. In 2001, Merck employees helped the Company reach a new record by contributing $8.7 million, an increase of 42 percent over the previous record-setting year. With The Merck Company Foundation dollar-for-dollar match, the campaign totaled $17.4 million.
	1 These prices apply to countries in the low category of the Human Development Index (HDI, published by the United Nations Development Program) or to medium HDI countries with an adult HIV prevalence of 1 percent or greater (as reported by UNAIDS). For countries in the medium HDI category with an adult HIV prevalence of less than 1 percent, Merck is offering prices of U.S.$1,029 per year for Crixivan and U.S.$920 per year for Stocrin. For high HDI countries, Merck will make its antiretroviral medicines available at competitive, market-based prices that take into account local purchasing power and competitive products.
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