It was not long since we heard of the largest documented outbreak of HIV within a hospital in history in 1998. Well over 400 children were infected with HIV at the El-Fatih Children’s Hospital in Benghazi, Libya. Irrespective of the controversial circumstances encircling the poor hygiene in the premise and the judicial aspect, we witnessed the lack of responsibility and the conspiracy theory involved to let the defendants free.
There are lots of other reported negligence and worrying medical ethics in the past as well. The most known might be the Tuskegee syphilis study.
“399 African-American men with latent syphilis and 201 men without disease were enrolled in the study based on the results of a 1930 venereal diseases control projects survey. The rural setting of Tuskegee – a deprived socioeconomic status, high rates of illiteracy and especially a paucity of medical care – were exploited by the investigators of the syphilis study who led the poor sharecroppers to believe they were being treated for “bad blood,” a euphemism for syphilis.”
The most vociferous criticism of the Tuskegee Study emanated from the fact that the poor black men in Alabama who already had syphilis were not provided with the adequate information needed to willingly consent to participating. The subjects were not consulted about the research project, its consequences to them and the alternatives available to them. The programme didn’t give them adequate treatment even after penicillin became available.
The recent revelation reported by the Washington Post covers shocking past medical experiments that conflict with the ethical norm of the profession. Isn’t it really pathetic to witness another horrific medical story revealed after former President Clinton had officially apologised for the inhumane acts during Tuskegee syphilis study? Such acts really conflict with the core principle of medical ethics – Non-maleficence (avoiding harm)! Who should we believe then if the most trusted social sects have immersed their hand in such nauseating activity?
One of these stories covers introducing people with disease in a very strange clinical trial.
“In federally funded studies in the 1940s, noted researcher Dr. W. Paul Havens Jr. exposed men to hepatitis in a series of experiments, including one using patients from mental institutions in Middletown and Norwich, Conn. Havens, a World Health Organization expert on viral diseases, was one of the first scientists to differentiate types of hepatitis and their causes. In another related 1946-48 study, American scientists infected prisoners and patients in a mental hospital in Guatemala with syphilis, apparently to test whether penicillin could prevent some sexually transmitted disease. The study came up with no useful information and was hidden for decades.”
This practice reveals how unethical past medical practices have been. According to current practice, drugs are normally tested first in laboratory and then on humans in clinical trials. The drug would be tested on healthy volunteers first to make sure it does not have any harmful side-effects when the body is working normally. But to introduce the disease into people considered ‘vulnerable’ for sake of medical research is devastating. Various similar past scenarios are exposed in this report.
There were also two international studies in the last two decades that sparked outrage regarding medical practice in the third world.
“U.S.-funded doctors failed to give the AIDS drug AZT to all the HIV-infected pregnant women in a study in Uganda even though it would have protected their newborns. U.S. health officials argued the study would answer questions about AZT’s use in the developing world. The other study, by Pfizer Inc., gave an antibiotic named Trovan to children with meningitis in Nigeria, although there were doubts about its effectiveness for that disease. Critics blamed the experiment for the deaths of 11 children and the disabling of scores of others. Pfizer settled a lawsuit with Nigerian officials for $75 million but admitted no wrongdoing.”
The Uganda case is similar to Tuskegee. It seems to me that the Big Pharma have moved testing to Africa where they deliberately infect small children with HIV or in the name of an alternative untried ‘new wonder drug’ in order to see its efficacy. Some might argue that if first line drugs are too expensive to be easily accessible, what is the problem with providing trial drugs to people who could not afford the more effective drug, for instance, in developing nations?
Big drug companies are conducting clinical trials in Africa with no consideration for ethics, the health of patients or the relevance of the drugs to the needs and the pathology of the continent. What happened with Pfizer during an epidemic without permission from either the government or the test subjects is really annoying as not taking responsibility is unethical and profit-biased approach that do fail to consider the consequences as manifested in controversies surrounding some of its drugs in the past. The developing world is now a place where pharmaceutical companies ignore ethical considerations and the health of patients. Without the informed consent of their subjects, who receive only the most basic information and usually inadequate therapeutic supervision, they conduct clinical trials with limited benefits to specific patients or the local population as a whole. Alongside Africa, India and Eastern Europe are also used as testing grounds for new medicines because costs are so much lower there than in the West and the rules regarding patient consent are so much more lenient.
It is time that we should fight for access to essential medicines and make accountable those responsible for unethical medical practices throughout the world!