PARIS - Scientists gathered in the French Alps this weekend to discuss the complex problem of poisonous and ever-lasting cow pies.
The cause of the problem is believed to be a medicine called ivermectine, which is given to cows, sheep and horses before they go to summer pasture in the Alps. The medicine, which protects the animals from parasites, .has made their dung toxic and virtually indestructible.
Insects that feed on the droppings are dying, threatening the survival of birds and bats that eat the insects. A single cow pie - or cowpat - left by an animal treated with ivermectine is capable of killing up to 20,000 dung-eating insects a week.
"A cow produces about 12 cowpats a day," said Professor Jean Pierre Lumaret of the University of Montpellier. "If the dung does not decompose, it becomes like stone, which stops the grass from growing. In the Mediterranean area, we have seen cowpats (from treated animals) survive for four years or more."
The aim of this weekend's conference in Isere, southeast France, is to persuade farmers and veterinarians to use another kind of treatment.
ivermectin/Mectizan
An apparently highly significant statistical association between the use of ivermectin in the elderly, and increased risk of death. Barkwell R, Shields S. Deaths associated with ivermectin treatment of scabies. Lancet 1997; 349: 1144-1145.
source: http://www.dermatology.org/skintherapy/stl0302.html 2sep01
The discovery of Mectizan began with Dr. William Campbell, a veterinary researcher in Merck’s animal health division who retired in the 1980s. As early as the 1970s, Dr. Campbell already had a string of successes under his belt, including the discovery of the antiparasitic medicine thiabendazole. But he also had an intense interest in human parasitic diseases, which he explored whenever he had a break in his research. In the mid-1970s, Dr. Campbell’s interest, and Merck’s encouragement to pursue it, laid the groundwork for what would eventually become Mectizan.
In 1975, Merck researchers evaluated thousands of soil samples, including 54 from the Kitasato Institute of Japan, for possible agents of therapeutic value in animals. One soil sample, from a Japanese golf course, was surprisingly powerful against parasites.
Realizing the potential of the find, Merck quickly established an interdisciplinary research team headed by Dr. Campbell. The result: the discovery of the avermectins, a class of highly active antiparasitic agents. Ivermectin, which was later derived from the avermectins, proved to be extremely effective against parasites in many animals.
In 1978, Dr. Campbell tested ivermectin against gastrointestinal worms in horses. Results from treated and untreated horses showed that ivermectin was effective against the microscopic worms known as Onchocerca cervicalis, which, Dr. Campbell realized, were closely related to Onchocerca volvulus, the immature worms that caused river blindness in people. With this knowledge and with the encouragement of P. Roy Vagelos, M.D., then president of the Merck Research Laboratories and later Merck chairman and CEO, the company began seriously to consider the potential use of ivermectin in people.
As soon as data on the compound’s safety and effectiveness became convincing, Merck contacted the World Health Organization and, in 1982, the two organizations began a collaborative ivermectin research program in people. At this juncture, Dr. Campbell turned the project over to his Merck colleagues, Drs. Mohammed Aziz and Kenneth Brown, who worked to develop human health products for the company.
The Merck Mectizan Donation Program Becomes a Model for Treating Other Diseases in the Developing World
Although the struggle against river blindness is not yet over, health care workers are now examining The Merck Mectizan Donation Program for lessons they hope to apply to other health issues in the developing world.
Sir John Kerr, former ambassador to the United States for the United Kingdom and Northern Ireland, addressed this point in June 1997 during a ceremony at the World Bank: “Although it is a uniquely dreadful disease, there is nothing else unique about river blindness. The elimination of river blindness as a public health problem can be followed with other diseases, and the application of the principles that have been established so successfully in this program can be applied in other sectors of development.”
With the hope that others will benefit from the experiences of those involved in The Merck Mectizan Donation Program, it now seems clear that the program will continue to help those in need even after river blindness has been brought under control.
From the Manufacturing Plant to the Community: Supplying Mectizan to Millions Of People
Each Year Proved to Be No Easy Task —
Even for a Global Partnership
It soon became clear to Merck that giving away Mectizan would be one of its most difficult logistical and marketing challenges ever. In addition to the manufacturing and distribution process, the company, working with The Merck Mectizan Donation Program staff and local health workers, had to get the message out to those in need: there was now a very well-tolerated and effective medicine that would end the terrible itching and save them from going blind. The company also had to ensure that those treated continued to receive Mectizan each year for up to 12 years — the average life cycle of the worms.
Over time, as civil strife and natural disasters forced people to flee their homes into different regions and across borders, it became even more difficult to ensure the program’s success. It would take each participant to make the process work, starting with employees at Merck’s chemical manufacturing plant in Puerto Rico.
From Puerto Rico, Mectizan is sent in its bulk chemical form to a second Merck facility in Haarlem, the Netherlands, for tableting and bottling, and then to Riom, France, for final packaging. From Riom, Merck ships Mectizan to ministries of health and non-governmental development organization workers in countries where treatment programs for onchocerciasis have been established. Merck’s office of contributions oversees all logistical, shipping and customs issues. It also works closely with field workers and The Merck Mectizan Donation Program staff to ensure tablets arrive on time and in the quantities necessary.
The job of health workers in the field is often complicated by myriad challenges, ranging from land mines to flash floods, for which their medical training does little to prepare them. Irene Goepp, manager, Onchocerciasis Control Program, southern Sudan, explains, “If there are roads at all, they are often rough terrain and difficult to pass. The people involved in Mectizan distribution often have to go on foot in tall grass or they have to go on bicycles through swamps and over hills.”
Once in the villages, health workers from one of the many non-governmental development organizations (see chart on pg. 15) must communicate the value of Mectizan. Through informal presentations and grassroots communication, health workers stress that Mectizan is well tolerated and should be taken each year for up to 12 years. They also work to dispel any myths about the medicine.
Non-Governmental Development Organizations Affiliated with The Merck Mectizan Donation Program
ACROSS (Mercy Corps International)
Africare
AICF International Contre la Faim
Aktion Afrika Hilfe
Bahá’i International Community
Centre Medical Evangelique
Charitable Society for Health Improvement
Christian Medical Institute of Kasai
Christoffel-Blindenmission
Comitato Collaborazione Medico
Diocese of Makurdi
Diocese of Torit
Global 2000 River Blindness Program
HealthNet
Helen Keller International
Hospital Teule/Tanga Region
Interchurch Medical Assistance
International Eye Foundation
International Foundation for Education and Self-Help
International Medical Corps
International Rescue Committee
Lions Clubs International/Lion’s Sight First
MAP International
Médecines Sans Frontičres/Doctors Without Borders
Norwegian People’s Aid
Organisation pour la prévention de la Cécité
OXFAM
Pan American Health & Education Foundation
Sight Savers
U.S. Committee for UNICEF
World Vision International
source: http://www.merck.com/overview/philanthropy/mectizan/contents.htm 2sep01
source: http://www.fpnotebook.com/ID104.htm 2sep01
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