Testing Drugs on Indias Poor – Is it Ethical?

Now this is an interesting moral issue indeed, having previously discussed morality briefly, with the issue of Universal Morality (does it exist?)[/url] lets have a look at this.

Wired[/url] is reporting that a lot of medical research firms are using India’s poor as a hot test bed.

From the article:

The sudden influx of drug companies to India resembles the gold rush frontier, according to Sean Philpott, managing editor of The American Journal of Bioethics.

‘Not only are research costs low, but there is a skilled work force to conduct the trials,’ he said. In the rush to reap profits, Philpott cautions that drug companies may not be sensitive to how poverty can undermine the spirit of informed consent. ‘Individuals who participate in Indian clinical trials usually won’t be educated. Offering $100 may be undue enticement; they may not even realize that they are being coerced,’ he said.

By 2010, total spending on outsourcing clinical trials to India could top $2 billion, according to Ashish Singh, vice president of Bain & Co., a consulting firm that reports on the health-care industry.

Regardless of where clinical trials are performed, the FDA requires the same evidence showing that a drug is safe and effective before it will approve any drug, according to a written comment from Ken Johnson, senior vice president of The Pharmaceutical Research and Manufacturers of America Foundation.

So is this legal, or ethical?

You can look at it from various perspectives..

Are the big companies exploiting the poor by moving to a country with a weaker economy and offering less incentive for testing?

Do these uneducated people really comprehend the risks they are taking during clinical trials?

I know in Europe it’s quite common for students to do drug testing and it pays a lot, according to the risk and duration. I never considered it though, I mean just because it works as intended on a rat, who knows what it’s going to do to me.

Nevertheless, even before the anti-generic rules were enacted, companies performing clinical trials in India saw their share of problems. In 2004, two India-based pharmaceutical companies, Shantha Biotech in Hyderabad and Biocon in Bangalore, came under scrutiny for conducting illegal clinical trials that led to eight deaths.

I would imagine the insurance costs for such trials in Europe are MUCH higher aswell, perhaps they don’t even bother insuring the atendees in India as their lives are worth less?

Third World lives are worth much less than the European lives. That is what colonialism was all about,” said Srirupa Prasad, a visiting assistant professor of medical history and bioethics at the University of Wisconsin-Madison.

This seems to be a fact.

Or are they just saving costs to develop better, safer and cheaper pharmaceuticals for the rest of the world?

Would you conduct in a clinical trial?

Is $100USD fair for you?

Source of quotes: Wired.com

Discussion on Slashdot

I thought this one was pretty funny.

So first they took away our call centers… Then they took away our IT jobs… Now they’re taking our priviledge to test dangerous drugs on the poor and destitute?

Damn you trained and abled Indian workforce!

It is a serious matter however..thoughts?

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6 Responses to Testing Drugs on Indias Poor – Is it Ethical?

  1. Dabido(Teflon) December 20, 2005 at 12:52 am #

    Are the big companies exploiting the poor by moving to a country with a weaker economy and offering less incentive for testing?

    Yes, they are. Most likely it is legal, but I doubt it is ethical.

    Do these uneducated people really comprehend the risks they are taking during clinical trials?

    I remember seeing a documentary on peopel in India being paid to get Vasectomies. They were getting paid US$15. You needed a large family before they would do it, btua lot of guys were getting it done for the money.
    Do I think they understand the risks for this? No. I think they understand they will have money for food.

    One of my old flatmates James was a Pharmacy Student at Sydney Uni, and he was doing clinical trials. he was supposed to be in a ‘Non-smokers’ demographic – but the blighter kept smoking. I thought that was unethical of him, as itcould have wrecked the resultant trial if he died of lung cancer and they decided not to use the drug as they thought it was causing it. He was doing it just for some extra cash … and really, isn’t that the problem. If one group won’t do something for cash, the corporate world find another group … and they dont’ care who get’s used and exploited along the way.
    Especially if they can get someone who will do it for peanuts and doesn’t understand the ramifications.

  2. lionel December 20, 2005 at 2:21 am #

    Is animal testing out of fashion?

  3. Kenny Lee December 20, 2005 at 6:30 am #

    the world is all about exploiting and being exploit. Never ending story.

  4. howsy December 20, 2005 at 7:04 am #

    It won’t be too long Malaysia will be next soon. I think it is even included in part of our National Biotech Policy-to allow drug companies to be set up here and conduct clinical trials!
    Btw, have you ever donated any bodily fluids (besides blood-you know what I mean…) before? It pays pretty well.

  5. Chris December 20, 2005 at 11:00 am #

    Well, the drugs will have to get tested on humans eventually – otherwise, who’s to say it’ll work.

    But I for one, feel that this is grossly unethical. The thing is, most drug companies make huge amounts of money anyway. This is greed.

    In this case, if you offer a poor Indian father a chance to test out a potentially harmful drug for US$100, it’s like giving him an entire year’s wages for popping a pill.

    If he’s in dire need of the money, he may very well do repeated tests with different drugs.

    Culturally, the problem with this scenario is that – if this man dies – he’s just going to accept it as fate, dying for the good of his family. That sort of thing.

    Just my 2.5 sen (inflation)

  6. formerlyfrombrunei December 20, 2005 at 10:07 pm #

    kinda like in that movie Constant Gardener eh, but set in Africa. they made it impossible for the poor to get essential meds unless they agree to be tested with drugs they dont need. what a world.