Leadership Moment - River Blindness

Health care is inherently a complicated issue because it is not a pure economic decision. The social and moral implications are difficult to measure in dollars and cents, at least for the short term. I will be the first to admit that I am far from understanding the long term implications and costs of the various healthcare systems. The ongoing raging debate in the US Congress reminded me a case study I did sixteen years ago in a leadership class with Dr. Michael Useem at Wharton regarding to river blindness disease (Michael Useem, The leadership moment, Three Rivers Press, 1998).

River blindness is a disease caused by infection with a parasitic worm. Symptoms include severe itching, bumps under the skin, and blindness. It is the second most common cause of blindness due to infection. Most of the infected population are in Africa but also in other parts of the world as well. In some regions of Africa, villagers assume that becoming blind is a natural part of growing old.

The case was about how a scientist, Dr. William C. Campbell, in Merck’s New Jersey laboratory came up a potent drug for human parasites, which later was marketed as ivermectin, with virtually no side effect. However, the drug was needed only by people who could not afford it. In the end, Merck, led by its CEO, Dr. Roy Vagelos, made the decision to not only produce the drug but also distribute it free to any countries that request it. It was clear from the very beginning that there was no expectation it would ever make an economic return on the investment based on the standard financial measures. Nevertheless, Merck made the decision to proceed, with the support from World Health Organization and then Carter foundation. This was a leadership moment that eventually impacted the life of hundreds of millions of people around the world, the moment when a corporation had the audacity to make a social need more important than profits. As described in Dr. Useem’s book, among others, one of the paybacks realized by Merck is the ownership by which the behavior of other Pharmaceutical companies is judged. I assume it is part of the corporation brand equity which served the shareholders for the long term. 

Although the drug has not completely eradicated the disease from the world, blindness has decreased, transmission rates are being reduced, and there is hope that river blindness someday is but a memory. With the continued effort from Merck, Carter foundation, World Health Organization, and support from many other organizations, the drug was used to treat and control the disease to over 100 millions people worldwide.

According to World Health Organization, Guatemala became the fourth country in the world after Colombia (2013), Ecuador (2014), and Mexico (2015) to be verified free of the river blindness in July 2016 after successfully implementing elimination activities for decades.

For those of us who are following the development, Dr. William C. Campbell was the recipient of the 2015 Nobel Prize in Physiology or Medicine for the discovery of the avemectin family of compounds, the forerunner of ivermectin. 

Taking leadership and making the right decision in the business world is not always easy. What would you have done if you were in the position of Dr. Campbell and Dr. Vagelos?