Pfizer to donate $500m in drugs

The donation of Zithromax -- one of the largest ever by a drug company -- is part of a program aimed at eliminating trachoma by the year 2020. Pfizer plans to donate 135 million doses of Zithromax, whose patent expires in two years.

Trachoma, a plague since ancient times, is caused by the chlamydia parasite that thrives mainly in arid areas in some of the poorest parts of Africa, Asia, and Latin America, where clean water and sanitation are often scarce. The infection can result in turned-in eyelashes, which scratch and scar the cornea, leading to blindness.

It is passed person to person or by flies and has blinded an estimated 6 million people.

The introduction of Zithromax to fight trachoma in recent years raised hopes that the disease could be eliminated.

"In the past, we used an ointment, which has to be applied twice a day for six weeks. Imagine mothers trying to put the ointment in the eyes of kids every day, twice a day," said Jacob Kumaresan, president of the International Trachoma Initiative. "Zithromax truly changed everything. Now people get a single dose annually."

Paula Luff, director of Pfizer's international philanthropy program, said in an interview from New York that the results from nine countries over the past five years in fighting trachoma led to the decision to increase its donation of the drug dramatically. Pfizer had donated 8 million doses in the last five years.

Morocco produced some of the strongest data. Since 1997, the strategy to combat trachoma has reduced the prevalence of the disease by 90 percent among children under 10 years old. Morocco hopes to eliminate trachoma by the end of 2005.

"The programs showed remarkable results," Luff said. "There came to be an understanding that we needed to do something to bring this to scale quickly in order to meet the goal of trachoma elimination."

Kumaresan's organization has implemented a four-pronged approach to fighting trachoma called SAFE, which stands for surgery, antibiotics, face washing, and environmental change. Environmental change refers to improving access to clean water and improved sanitation.

"The drugs are critical, but they are not the entire program," he said. "If you do the social change -- improving hygiene, washing hands and faces -- then it will be a sustainable thing for people."

Trachoma has been found in 46 countries. Industrialized nations, including the United States, eliminated the disease by improving hygiene in the early 20th century.

Pfizer is one of several pharmaceutical companies that have in recent decades donated large quantities of drugs to fight diseases in poor countries. The most successful example has been Merck & Co. Inc.'s Mectizan donation program, in which the company found that an antibiotic used to fight parasites in farm animals was highly effective in preventing river blindness, or onchocerciasis, in humans. In October 1987, Merck said it would donate Mectizan for the treatment of river blindness for as long as was needed; the program continues.

Merck's donation not only has saved untold numbers of people from blindness, but still generates much favorable publicity for the company, a fact well noticed by other drug companies. Health experts often note that other drug companies are looking for the "next Mectizan."

Pfizer's Luff said her company closely studied the history and the mechanics of the Mectizan program. She said the company's motivation to make its donations wasn't to improve its image.

"When I first presented this opportunity to the Pfizer management team, they didn't ask me how many column inches this would generate, but rather how are we going to measure progress, how are we going to move the needle against a disease that's been around since the time of the pharaohs," she said. "Our philosophy is if you do good work, measure it, do it with the right partners, then attention will come from that."

John Donnelly can be reached at donnelly@globe.com.