Roy Vagelos | 09-06-24

Yes, John. My time at Merck started in 1975, where I was head of the Merck Research Laboratories, so the head of research for 10 years. And then the next 10 years, '85 to '94, through '94, I was CEO and chairman. During that period, the Merck research group came up with a number of very important drugs that are important to all people of the world. Those include, of course, the discovery of the statin for control of blood cholesterol, and that was, of course, a drug that revolutionized the treatment of heart disease based on cholesterol levels. And I'm sure some large numbers of patients, probably over age 65, there are probably 90% of people take a statin, and that was due to the discoveries at Merck. But in addition to drugs for common diseases like heart disease, there was also drugs for high blood pressure, infectious diseases, antibiotics, and other things that were important everywhere in the world. But on occasion, they came up with drugs or vaccines that were not popular and not very much represented in large populations of the world that can afford to buy them. And two examples: one is the discovery of a drug that could control river blindness. And river blindness is a disease that occurs in largely sub-Saharan Africa, but also in parts of Asia and Latin America. The drug is called Mectizan, and that was discovered by Bill Campbell and his team at Merck Research about 1975. And we discovered that it was a dynamite drug for killing parasites in all kinds of farm animals. Farm animals have their growth blocked by picking up parasitic worms from the soil, and taking a drug that would kill those parasites.

Well, let me tell you about that. The drug was first used to kill animal parasites and help them gain weight faster, and so it went on the market about 1978 or '79. And then in 1981, they discovered that the drug also worked to kill this parasite that causes river blindness. River blindness is caused by Onchocerca volvulus, which is the worm which is spread by the bite of a black fly. And the black flies live along rivers, and therefore it's called river blindness because the worm that's carried by these flies was injected into a human. They become tiny little microfilariae that cause enormous itching, and they also travel through all the skin, and people are going crazy with itching. But they go into the eyes and cause blindness. And the blindness is very prevalent. So there are over 100 million people who are at risk for losing their vision. And so we had a drug that was able to control that and kill all the parasites when dosing once per year, once or twice per year. And so we had this dynamite, magical-like drug that would kill these parasites and was very safe in humans. In 1987, the drug was shown to be safe and effective in large clinical studies in Africa. And then we had a drug that was available but could not be afforded by any of the people who needed it. These people were dirt poor and also dying of starvation. And so we approached the governments of Africa and other places, as well as the US government, to see whether the governments could get behind this drug, buy it for the people. And the answer was that it was not in their budget; they couldn't do it. And so when faced with that, Merck made the decision in 1987 and announced that they would contribute the drug free to anyone in the world for as long as it was required to make sure they did not become blind. And that started in 1987. And each year since then, of course, I retired at the end of 1994, so the next CEO made the decision again. And right up to the present, each year the company has contributed more Mectizan to prevent river blindness, but also lymphatic filariasis, another parasitic infection which causes elephantiasis. So between those two diseases, Mectizan is given away, contributed at the level of—let's see, last year was 300 million people were treated free by Merck.

That's right, that's right, John. We did. And that is, we discovered another product which was a vaccine that was developed in the United States, a recombinant vaccine which was approved in the US for use in children, vaccinate children, as was approved in 1986. And the vaccine prevented an infection by a virus, Hepatitis B virus, which gets into the liver and causes it to fail in some people. The prevalence of that virus in the US was about one half of 1%, but the virus goes on in the liver causing chronic liver disease and also liver cancer.

No, the number is not big enough. I'll tell you what it was. We developed this vaccine, a recombinant vaccine, the first in the world, and put it on the market in the US. The Chinese came and they explained to us, the Chinese government did, they explained that the prevalence, that is the presence of that virus in their population, was 9%. 9% of people were carrying in their liver a virus that causes chronic liver disease and liver cancer. It was the number two cause of death in China after number one, which was cigarette smoking. And so it was very important to them. And they had no money. So we wanted to do something for them, and we finally landed on the idea of training Chinese scientists and engineers to make the vaccine. They came and spent months in the Merck facilities to learn how to make the vaccine, which they did. In 1994, they started manufacturing the vaccine in China. That was a Merck vaccine, no royalty, no cost to them. Merck made not a penny of profit. But they did this, and the infection rate in China was 9% at the start. When they were fully vaccinated, it dropped to less than one half of 1%.

Well, my inner feelings are those of a doctor. You know, I was an MD from Columbia who practiced for a short time, but then did research and ended up in drug discovery. And the numbers of patients that our drugs saved lives or improved health, there's many, many hundreds of millions. And that's what I love about my profession and love about my career, and try to convince young people to follow suit and to both practice medicine and get into drug discovery if they're interested, because it's a wonderful way to live.

Yes, Regeneron was a startup when I started. I retired from Merck at the end of 1994, and the beginning of 1995, I joined the board of Regeneron, a startup that was having some difficulties. And I had the idea of helping them by being chairman of their board for a couple of years. As it turned out, that help was extended because I was made chairman for 28 years. And the company has done quite well.

Well, what we're doing with Columbia is helping to train new young doctors who are really smart and are interested in health-related careers of all sorts. So some of them will become practitioners, primary care doctors, many will become specialists, and some of them will go into research. And we want all our students to understand what the science is so they can help their patients maximally. And they do a wonderful job. So we support scholarships. We support the students who have financial needs can come to Columbia Medical School, and they will have all expenses paid if they have financial need—tuition, living expenses, everything. So our students graduate from medical school with no debt at all. And so this is a wonderful thing for them. And my wife and I love to do that kind of thing. But we also contribute to undergraduate students at the University of Pennsylvania and at partner colleges. And these are our three areas of targeting to help students, mostly in the science side.

John, I look forward to having you attend our meeting in the board of advisers because you've been very helpful to the medical school and to Columbia, which is now Vagelos College of Physicians and Surgeons. So thanks a lot for giving me an opportunity to tell you some of the things that happen at Merck. I look forward to it, and have a great weekend.