Making A Difference For Mothers And Merck

By Rob Wright, Chief Editor, Life Science Leader
Follow Me On Twitter @RfwrightLSL

From The January 2016 Issue
How Merck Balances The Business Of Corporate Social Responsibility

In 2011, Merck undertook a big corporate social responsibility (CSR) initiative — Merck for Mothers. According to Priya Agrawal, the program’s executive director, the $500 million dollar 10-year program was driven from the senior-most Merck leadership. Ken Frazier, Merck’s chairman and CEO, began looking at the United Nation’s millennium development goals (MDG), and posing the question, ”What is the biggest challenge out there?” recalls Agrawal. “Indicators were all pointing to the opportunity to make a significant impact on maternal health — the UN’s MGD5: improve maternal health.” MGD5 has two primary targets: reduce by three quarters the maternal mortality ratio; and, achieve universal access to reproductive health.

To accelerate addressing MGD5 goals, Merck for Mothers conducted an intense listening and learning exercise with key stakeholders (i.e., communities, organization, and global health leaders). “What we heard was that this wasn’t an issue just in the developing world,” says Agrawal. “Even in the U.S. maternal mortality was an issue, actually on the rise, which was the opposite of countries like Afghanistan and Sierra Leone.”

But when deciding to tackle such a complex issue, besides listening, where does one start? “We first determined where applying resources would have the most impact,” she explains. “The two areas where we saw the highest ROI were access to family planning [contraception], which can reduce maternal mortality by 30 to 40 percent, and access to quality care around the time of childbirth.” As a company with extensive expertise in contraception and the hospital environment, these CSR opportunities were well aligned with Merck’s mission. The next step was to determine how best to allocate $500 million. Although the goal was to design, test, and then advocate for the scale up of systems to address these opportunities, Agrawal says not to forget the importance of measurement. One of the first things Merck for Mother’s did was to allocate 10 to 14 percent of the $500 million on evaluation. “When you develop a solution, you need data to demonstrate whether or not it works so key decision makers will have the confidence to want to invest in scaling it up,” she says.

At three years young, the Merck for Mothers program is now in 30 countries (e.g., India, Senegal, and the United States). In India the focus was on enabling affordable quality maternal health services wherever women seek care. Ninety percent of India’s population goes to private providers, of which, Agrawal estimates there being about 100 different types. Because of this high degree of market fragmentation, the focus for Merck was how to apply the company’s market segmentation expertise to the problem. “We worked on developing tools that would help the government segment providers into categories so they could be regulated toward the goal of delivering better quality of care,” she states. In Senegal the opportunity was access to family planning, to which Merck brought its supply chain proficiency.

Tackling the rising mortality rate in the U.S. was a little different. “Our analysis revealed that no one was really funding maternal health in the United States,” she shares. The problem first required Merck applying its communications skills to increase awareness of the issue. Another issue was data gap, the result of very few organizations bothering to conduct root cause analysis of maternal mortality events. Merck partnered with AMCHP [the Association of Maternal & Child Health Programs] to better understand why U.S. women were dying during pregnancy and childbirth. One successful outcome from this collaboration was the development of AMCHP’s Every Mother Initiative. Involving 12 states (i.e., Colorado, Delaware, Florida, Georgia, Illinois, Louisiana, Missouri, New York, North Carolina, Ohio, Oklahoma, and Utah), the program targeted strengthening their maternal mortality surveillance and review processes. Another U.S. issue was the lack of a “code blue” maternal mortality protocol. “If you have a heart attack, everyone knows exactly what to do,” Agrawal analogizes. “If you're dying of postpartum hemorrhage, even in the best hospitals treatment depends on which doctor you're seeing.” The solution was to help professional associations (i.e., The American Congress of Obstetricians and Gynecologists (ACOG), Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), and the California Maternal Quality Collaborative (CMQCC)) collaborate to define a standard safety bundle of care.

While the Merck for Mothers is a noncommercial initiative, it still provides benefits to Merck’s commercial operations. For example, because the core Merck for Mothers team consists of five people, the group relies on the expertise of Merck employees to successful execute. “When those people go back to their day jobs they have gained additional expertise that will prove beneficial as we continue to expand into new markets,” Agrawal concludes.

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