BRENDA COLATRELLA, an executive of the multinational pharmaceutical giant Merck & Co., remembers being stunned at a meeting back in 1996 by a proposal made by a colleague at the World Health Organization (WHO). Since 1987, Merck and the WHO had been partners in an innovative program to eliminate onchocerciasis, a leading cause of blindness in the developing world. Merck’s donations of its breakthrough drug Mectizan, with the WHO’s technical support, had already saved millions of Africa’s poor...

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