For as Long as Necessary: Examining 30 years of MSD's Focus on Achieving Elimination of Onchocerciasis and Lymphatic Filariasis.

Established by MSD, also known as Merck & Co., Inc., Kenilworth, NJ USA in 1987, the Mectizan Donation Program (MDP) is the longest running disease-specific program of its kind. Initially aimed at control of onchocerciasis (river blindness), the company expanded its commitment through the MDP in 1998 to include lymphatic filariasis (LF). Both diseases are now candidates for elimination and the company is engaged in several global partnerships to help advance towards that goal. To support the steadily growing demand from country-led disease elimination programs, the company has put in place several administrative and operational improvements. In addition, the company is involved 'beyond the pill', including making financial and management contributions to partners such as the END Fund and the Expanded Special Project to Eliminate NTDs (ESPEN) to support the technical needs of elimination programs. While the time-bound elimination targets are challenging, clear progress is being made for both onchocerciasis and LF, with several national and subnational areas in Latin America and Africa having stopped transmission of one or both diseases. The company's donation of Mectizan and contributions of financial, management and technical resources reflect the company's long-standing commitment to pursue inventive ways to expand and enhance access to medicine. Continued support from MSD and other partners will enable countries to advance towards their elimination targets for LF and onchocerciasis.

Evaluating the health impact of a public-private partnership: to reduce rotavirus disease in Nicaragua.

The purpose of this article is to describe the RotaTeq(®) Nicaragua Partnership and the evaluation of the public health impact of the vaccine conducted by the partners, including the creation of a rotavirus surveillance program and a vaccine effectiveness assessment. The three main objectives of the partnership were to demonstrate that a new rotavirus vaccine could (1) be introduced rapidly in a developing country, (2) be successfully integrated into the existing vaccine delivery infrastructure, and (3) have a significant and measurable public health impact at the end of the 3-y program. The vaccine impact assessment required collaboration among partners with different areas of expertise, including the Nicaraguan Ministry of Health, Merck, local hospitals, government health clinics, laboratories, and a Technical Advisory Group. Through the partnership, RotaTeq(®) became available in a GAVI-eligible developing country, Nicaragua, in the same year it was approved in the United States. Vaccine coverage rapidly reached over > 90% of eligible Nicaraguan children. The impact assessment evaluated over 10,000 subjects and leveraged and enhanced the existing diarrheal surveillance infrastructure, ultimately providing the scientific community with some of the first real-world rotavirus vaccine effectiveness data from a developing country. The successful public-private partnership (PPP) was internationally recognized as a model for the rapid adoption of a new vaccine in a developing world setting. The model could be adapted to benefit other PPPs interested in demonstrating the impact of their own programs.