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November 7, 2010

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Visionary medical scientist and corporate leader

IN the 1980s, around 120 million carriers of hepatitis B were reported every year in China and 10 percent of newborns acquired chronic hepatitis B from their mothers.

The disease was responsible for almost half a million deaths from liver cancer and end-stage cirrhosis each year before China's universal hepatitis vaccination program was implemented in 1992.

A visionary American scientists and corporate leader, Dr Roy Vagelos, was instrumental in the program that saved tens of thousands of lives. At the time he was chairman of MSD (Merck, Sharpe & Dohme, known as Merck in the United States and Canada).

After the Chinese government approached the pharmaceutical giant, Vagelos, then chairman of the board and CEO of Merck & Co Inc, and fellow board members decided to transfer its hepatitis B vaccine technology to China, for free.

An agreement was reached in 1989. Two plants using local scientists and engineers who had learned from and worked with MSD were built, one in Beijing in 1993 and one in Shenzhen in 1994. Together they now produce more than 20 million doses per year.

Back by that kind of supply, China's Ministry of Health integrated the hepatitis B vaccination into its nationwide EPI program in 2002.

Official research in 2006 shows that infant hepatitis B carriers have been reduced from 9.7 percent in 1992 to less than 1 percent in 2006. And the carriers in the total population dropped from 10 percent to 7.2 percent.

Working at Merck from 1975 to 1994 and was CEO for nine years, Vagelos built a distinguished career in which he made Merck one of America's most admired companies at the time. He has spoken worldwide about the corporate social responsibility of the world's big drug companies in combating major public health problems.

Now over 80 years of age, Vagelos is still passionate about public health and vividly remembers his company's commitment to China. He was recently in Shanghai as part of a trip to various Chinese cities where he met with medical researchers. He and Michel Vounatsos, President of MSD China, talked with Shanghai Daily.

Q: Thanks to the vaccination program, the number of hepatitis B carriers has been dramatically reduced. How do you view the results?

Vagelos: I think the Chinese have done a wonderful job. Back in the 1980s, about 500,000 Chinese were dying from the disease that we knew we could prevent. So we recognized the size of the problem. When we were approached, we agreed and decided technology transfer was the way. Those who were involved in the technology transfer considered it the most important thing in their career. In 2005, I met with some of the original engineers and scientists involved in the project in Beijing and they were very emotional about their achievements. They told me around 85 percent of Chinese infants were covered. Now the rate is higher, 93 to 94 percent. I don't think it could have been done more rapidly in the US.

Q: Does the vaccine only work in newborns?

Vagelos: No. There are also vaccines for adults, but there are no comparable figures since we only tracked infants. Comparing the research findings with a 1992 study, we see that at that time the HBsAg (hepatitis B surface antigen) rate was about 10 percent in children older than one year. Now the rate in the whole population has declined to 7.2 percent. That is because the infants are immunized.

Q: Why did you pick China for free technology transfer?

Vagelos: It is because they came to us. There were a great number of Chinese people infected by the virus at the time. That is a big target. If you want to do it, it is better to do it in some place where you can make a big impact and offer great help. It is a very good thing to do.

Q: Was it difficult to convince other members of your company to accept the free transfer?

Vagelos: No, there would be no profit to be gained in China, because they could not afford it. So either we did it, or it wouldn't happen. Not to have done it would have been a terrific disappointment to the Merck people involved in producing the vaccine. They were mostly high-minded people who wanted to work to make a difference, not just make a living. Knowing that we could prevent the disease but never did so would have been a terrible thing.

Q: President Vounatsos, does MSD still carry on the tradition of helping those in need gain access to vaccines?

Vounatsos: MSD is more committed than ever to ensuring that corporate responsibility is an integral part of the way we do business by improving access to medicines, vaccines and health care. We supports the Chinese governments in its efforts to prevent and treat HIV/AIDS with a US$30 million, five-year program, the most extensive one of its kind between the government and a foreign company in China. Besides, we have helped train community medical workers nationwide, as well as donating thousands of Merck Manuals.


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