Merck Annual Report 2000

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The need for health care infrastructure
In many cases, simply donating medicines and vaccines is not enough. We also provide funds and advice drawn from experience to help many nations build the infrastructures required to fight disease. Our most urgent efforts focus upon HIV/AIDS – with good reason. New figures from UNAIDS, the United Nations’ agency devoted to battling this pandemic, reveal that the disease infects 36 million people, adding 5 million new cases this year alone. HIV/AIDS has killed 21 million people in the last two decades. While the spread of this scourge is slowing in North America and Western Europe, it is ravaging Africa and continues to spread in Eastern Europe, Russia, Latin America and Asia.

Botswana – Leading the fight against HIV/AIDS: Merck’s latest international attack on AIDS is the Botswana Comprehensive HIV/AIDS Partnership. This venture advances the treatment, care and prevention of the disease in the Republic of Botswana, where nearly one in three adults is HIV-positive. The Partnership includes The Bill & Melinda Gates Foundation, the Republic of Botswana and Merck. Botswana is just one nation in which Merck works with public and private partners to enhance the care of adults and children living with HIV/AIDS.
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    Merck has been striving to help the afflicted in those countries for some years.
    But our biggest efforts are in sub-Saharan Africa, where more than 25 million people are infected with HIV – 70 percent of the global total. Responding to calls from the United Nations and other institutions concerned with global health, we played a leading role in launching comprehensive public/private sector projects that we hope will serve as models for future prevention and care of this deadly disease.
    In May, Merck linked up with the world’s leading health and development agencies, including UNAIDS, the World Health Organization and the World Bank, along with four other pharmaceutical companies, to accelerate access to HIV/AIDS care and treatment in developing countries. The “Accelerating Access Initiative” represents an historic partnership among public and private sector organizations to begin to tackle HIV/AIDS in the developing world in a sustainable way. Senegal, Uganda and Rwanda have already reached agreement on obtaining more affordable access to HIV/AIDS medicines, and discussions are underway with more than 30 other developing countries.

Vaccines – Giving the gift of life to children: These Honduran schoolchildren (right) may never suffer from measles, mumps and rubella thanks to a Merck donation of more than 1 million doses of M-M-R II. We recognize that the availability of safe and effective vaccines is one important step along the road to access. That’s why we pledged a $100-million (5 million doses) donation of Recombivax HB, our vaccine for the prevention of hepatitis B, to support the Global Alliance for Vaccines and Immunizations (GAVI).
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UNAIDS figures show that no nation is more heavily stricken with HIV/AIDS than Botswana, with the disease reaching epidemic proportions. In collaboration with the Republic of Botswana, Merck and The Bill & Melinda Gates Foundation launched the Botswana Comprehensive HIV/AIDS Partnership. This initiative is designed to demonstrate the feasibility of a comprehensive, targeted approach to improving the entire spectrum of HIV prevention and care in one of the African countries hardest hit by the epidemic.
The Bill and Melinda Gates Foundation will dedicate $50 million over five years to help Botswana fundamentally strengthen its primary health care system. Merck and The Merck Company Foundation will also contribute $50 million for HIV/AIDS prevention and care programs as well as staff support. In addition, Merck will provide antiretroviral medicines at no charge for the treatment programs the government of Botswana decides to implement. Two other multinational companies, Boehringer-Ingelheim and Unilever, bring their medical, communications and distribution expertise to the project. Other partners are expected to join as the project develops.

Latest automation propels packaging: Bernard Basmaison, production technician, monitors a new, automated sterile filling line in Mirabel, France. Two employees can operate this high-speed line designed by Merck manufacturing engineers to fill and package thousands of vials of ophthalmic product every hour.
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    Merck believes that such targeted and comprehensive interventions will lead to long-term, maintainable health care solutions that will improve the care of people living with HIV in resource-constrained countries. Such an approach requires partnerships where we can supply management and pharmaceutical expertise to meet the priorities identified by local authorities. That is why we are collaborating with the Harvard AIDS Institute, The World Health Organization, The World Bank and several United Nations’ agencies, including UNAIDS, to accelerate access to HIV/AIDS solutions in much of the developing world. We strongly believe that such public/private partnerships are the best way to unite political commitment and the requisite skills, funding, and the products needed to meet the daunting challenge of HIV/AIDS.

    Medicine for all the people
    George Merck’s challenge to deliver our medicines to all who need them is interwoven throughout all of Merck’s initiatives to expand access. We will continue this effort as long as needs remain unmet. We will do so because it is the right thing to do for humanity and because it is the right thing for the Company and all its stakeholders. That is the standard George Merck set for us.

Merck Manufacturing:
Creativity combined with productivity
    Merck’s Strategy for Growth, senior management’s road map for strong corporate growth, has spawned the biggest construction boom in the history of Merck. The steady flow of successful new medicines to our ever-expanding global market creates a need for new laboratories and manufacturing facilities. Add in the new opportunities created by acquisitions, licensing and scientific breakthroughs, and we are building rapidly.
    As a result, the Merck Manufacturing Division now manages building and expansion projects unparalleled in the history of Merck. Five years ago our capital budget was $1 billion. In 2000, it was $3 billion. Projects range from a state-of-the-art manufacturing facility in Singapore that is about to open, to new laboratories at the Merck Frosst site in Montreal.
    Not surprisingly, construction of this magnitude calls for engineering expertise that maximizes efficiency and economy while providing for maximum flexibility, reliability and simplicity – the essential attributes of Merck’s Manufacturing Division. To this end, we have developed a series of business processes unique to the industry. One of these is the development of standard manufacturing modules that allow us to quickly introduce new products. For example, Merck will be using this approach in new pharmaceutical facilities, incorporating a high-speed, highly efficient granulation module Merck engineers had originally designed and installed in our Pavia, Italy, plant.
    The end result is that when Merck introduces a new product, formulation or package, the Company doesn’t have to redesign all over again. This reduces costs, shortens the time it takes to get new products to market and helps maintain our commitment to the highest quality.
    Flexibility, simplicity and reliability are hallmarks of the Merck Manufacturing Division global strategy. Adhering to that strategy has enabled the Merck Manufacturing Division to achieve productivity improvements that have contributed significantly to Merck’s success and profitability.

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