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[ Merck Vaccine Network Press Release ]

Merck Launches Network
to Improve Immunization Programs in Africa

New Vaccine Services Training Program
Planned In Kenya And Mali

WHITEHOUSE STATION, N.J., Nov. 18, 2003 - Merck & Co., Inc. today launched the Merck Vaccine Network - Africa (MVN-A), an initiative designed to contribute to improving the immunization infrastructure in Africa. The multi-year program will fund the establishment of a network of vaccination training centers at academic institutions in Kenya and Mali to provide a sustainable source of skilled health care workers in those countries and across the region. Africa has the highest per capita burden of vaccine-preventable diseases in the world1, with only half of all children in sub-Saharan Africa getting basic life-saving vaccinations during their first year of life2.

“There is no single answer to the challenge of increasing access to vaccines in African countries and other developing nations. It will take multiple organizations, applying different approaches and solutions, to effectively address the problem," said Adel Mahmoud, M.D., Ph.D., president, Merck Vaccines. “The MVN-A program is one model that is aimed at supporting a vaccination delivery and management infrastructure in regions where there remains a shortage of basic health care."

As part of the MVN-A launch, The Merck Company Foundation has awarded grants to two academic collaborations that will work together to develop training programs in Africa. The collaboration in Kenya is between the Indiana University School of Medicine in Indianapolis and Moi University Faculty of Health Sciences in Eldoret, Kenya.

The collaboration in Mali is between the Center for Vaccine Development at the University of Maryland School of Medicine in Baltimore and the Center for Vaccine Development - Mali at the Centre National d’Appui à la Lutte contre la Maladie in Bamako, Mali. Each collaboration is supported with funding from The Merck Company Foundation of a maximum of US $200,000 per grant year, for up to four years.

MVN-A Program

The MVN-A program supports Merck’s commitment to the Global Alliance for Vaccines & Immunizations (GAVI), a public-private partnership focused on increasing children’s access to vaccines in poor countries. Each collaboration will use training curricula based on educational materials developed by the World Health Organization (WHO) and partners of GAVI. Over the next few months, the faculty of the academic institutions will assemble program staff, identify and recruit eligible trainees and finalize the curriculum. The first group of trainees is expected to enroll in the Fall of 2004.

A key strength of the MVN-A program is the long-standing collaborations already in place between the academic partners. Indiana University and Moi University have been working together since 1990 to develop healthcare leaders in both the United States and Africa by bringing medical students, residents and faculty to Kenya to teach, participate in patient care, and conduct research activities.

“Working within the framework of the relationship that already exists between Indiana University and Moi University, we expect to be able to build on and expand our medical education programs to healthcare workers in Kenya," said Dr. Edward A. Liechty, professor of pediatrics at the Indiana University School of Medicine, and co- investigator for the program in Kenya.

“By training immunization program managers through the MVN-A program, we hope to enhance Kenya’s ability to vaccinate and increase immunization coverage in Kenya. In the long term, the training will help reduce infant morbidity and mortality,“ said Dr. Fabian Esamai, professor of pediatrics, Moi University Faculty of Health Sciences, Kenya, and the co-investigator of the program.

“By educating healthcare workers in Mali and addressing logistical problems, it will be possible to effectively vaccinate more children, and ultimately, that will prevent illness and save lives," said Dr. Karen Kotloff, professor of pediatrics at the Center for Vaccine Development at the University of Maryland School of Medicine and principal investigator for the training program.

“The MVN-A program contributes to enhancing vaccination capacity in Mali by providing a substantial source of skilled healthcare providers. We are pleased to be part of an effort to expand our ongoing research collaboration," said Dr. Samba Sow, coordinator, Center for Vaccine Development - Mali and co-investigator of the program.

Prevalence of Vaccine-Preventable Diseases Highest in Africa

MVN-A is the fourth program launched by Merck in Africa. The program reflects the company’s commitment to improving access to medicines in the developing world through disease education, training and services initiatives.

Merck is focusing its efforts on Africa because the continent bears the highest per capita burden of vaccine-preventable diseases and has the highest concentration of GAVI-eligible3 nations in the world. Fifty percent of children in sub-Saharan Africa do not receive basic vaccinations during their first year of life, according to the WHO, UNICEF and the World Bank in a study released in November 20024. The report points out that vaccination rates in sub-Saharan Africa fell dramatically in the 1990’s while many areas of the world saw vaccination rates increase substantially5.

Other Merck initiatives addressing health issues in Africa include the 16-year-old Merck Mectizan® Donation Program, the UN/Industry Accelerating Access Initiative and the African Comprehensive HIV/AIDS Partnership (ACHAP) in Botswana. ACHAP is a partnership with the Government of Botswana, the Bill & Melinda Gates Foundation, Merck and The Merck Company Foundation.

About Merck

Merck & Co., Inc. located in Whitehouse Station, N.J., U.S.A., also known as Merck, Sharp & Dohme (MSD) in countries outside the U.S., is a global research-driven pharmaceutical products company. Merck discovers, develops, manufactures and markets a broad range of innovative products to improve human and animal health, directly and through its joint ventures.

Forward Looking Statement

This press release contains “forward-looking statements" as that term is defined in the Private Securities Litigation Reform Act of 1995. No forward-looking statement can be guaranteed and actual results may differ materially from those projected. Merck undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise. Forward-looking statements in this press release should be evaluated together with the many uncertainties that affect the Company’s businesses, particularly those mentioned in the cautionary statements in Item 1 of our Forum 10-K for the year ended Dec. 31, 2002, and in our periodic reports on Form 10-Q and Form 8-K (if any) which we incorporate by reference.

1 UNICEF. The State of the World’s Children 2001 Report. Table 3: Health, pg. 5.
2 World Health Organization, 2002 State of the World’s Vaccines and Immunizations Report. November 2002, pg. ix.
3 UNICEF. The State of the World’s Children 2001 Report. Table 3: Health, pg. 5.
4 World Health Organization, 2002 State of the World’s Vaccines and Immunizations Report. November 2002, pg. ix.
5 World Health Organization, 2002 State of the World’s Vaccines and Immunizations Report. November 2002, pg. x.

Contact Merck

Media:

Chris Loder
(908) 423-3786

Joyce Buford
(215) 652-4984

Investor:

Mark Stejbach
(908) 423-5185

Background documents

Grantee backgrounder

Vaccines and Immunizations - The Growing Need

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