• Question: I would like to know whether you think that clinical trials in developing countries are exploitative?

    Asked by surridget to Anne, Carolyn, Joe, Mariana, Nick on 20 Mar 2010 in Categories: .
    • Photo: Joseph Devlin

      Joseph Devlin answered on 20 Mar 2010:

      Hi surridget,

      I think they often are exploitative, but they don’t have to be. My brother-in-law is a malaria expert who works in Indonesia doing field trials and their stuff is a great example. The aim is to develop a treatment for malaria (rather than a vaccine which he tells me will never work) and they are doing a major clinical trial.

      The difference between his work and some others is that his is funded by the Wellcome Trust rather than a drug company which means there are very different motivations. The WT isn’t trying to make money from this — in fact they are spending money in hopes of helping to eradicate the disease. A drug company, in contrast, typically have invested tons in a particular drug so they have a vested interested in showing that it is successful. If it is, they then need to recoup their investments by selling their drugs at a profit — normally, this prices them beyond the reach of the people in the third world who cannot afford them (i.e. AIDs drugs are a good example). So the third world takes all the risk of the trials and then ends up not benefiting if the results are good.

      As I say, not all trials are like that but the economics of drug trials can directly conflict with these ethical issues.

    • Photo: Carolyn McGettigan

      Carolyn McGettigan answered on 21 Mar 2010:

      I’m sorry, I don’t know about clinical trials in other countries. Participation in clinical trials for a drug should be voluntary, and the participants should be fully informed of the risks involved. In the UK, there are drug companies that offer very large sums of money to healthy volunteers, and you might think that someone needing money would be unfairly exploited by that. By the same token, a very ill person might wish to agree to be a trial case for a new drug or therapy if no other treatment has worked. In all of these cases, it is crucial that the researchers or clinicians administering the trial act responsibly, and that the volunteer/patient has access to sufficient information to make a balanced decision.

    • Photo: Nick Bradshaw

      Nick Bradshaw answered on 21 Mar 2010:

      I must confess I don’t know a lot about them. I know that in this country (and most other Western countries) there are very tight ehtical rules which must be followed if you conduct clinical trials. In fact the rules are so tight it is very hard to get them going, but it at least means that they are as safe and fair to the perticipants as possible.

      I think that if I heard that someone was performing a clinical trial outside of their own country without any obvious reason then I would be quite suspisious.

    • Photo: Mariana Vargas

      Mariana Vargas answered on 22 Mar 2010:

      Hello there, although I think this is a great question, I don’t know enough about this area to provide a detailed answer. As clinical trials are approved by the local health authorities in the country the are carried out, there is some variation on the ethical standards. This issue is very important, because by putting pressure on companies and countries who organise the trials (regardless of where they are carried out) we can make sure that they do not allow exploitation.

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