This article discusses the development of guidelines to ensure that researchers work in culturally appropriate and non-exploitative ways with indigenous Australian populations. Reflecting the concerns of some research populations in developing countries, the authors note that indigenous communties in north-east Victoria had had negative experiences with research projects because of the lack of community control, lack of local benefits, and interpretation of data in isolation from social context.

The resulting guidelines are based on the Australian National Health and Medical Research Council (NHMRC) Guidelines on Ethical Matters in Aboriginal and Torres Straight Islander Health Research and include input from researchers and community representatives.

Issues covered include appropriate consultation measures before research is done in populations that work and act collectively, topics that needed to be agreed between the community and researchers before the start of research, ongoing community involvement in the research and implementation of any outcomes, administration of local ethical review of research, supervision of inexperienced researchers, and data storage and retention.

US-based ethicist Christine Grady argues that clinical trials of vaccines, including against HIV, require special considerations when it comes to deciding upon an ethical framework. Most clinical trials, she says, are for therapeutic drugs, with narrowly focused outcomes aimed at benefiting the individual. Vaccine trials have broader goals, including that of benefiting the community at large, rather than simply the individual.

The commentary is clearly written and aimed at general readers with a basic understanding of the concept of vaccines, but not requiring a specialised knowledge of vaccines or immunology terms. It uses examples drawn from different types of vaccine research, including against malaria, rotavirus, and hepatitis virus infections. 

The article summarises specific issues involved in vaccine trials that are worth considering when deciding upon ethical guidelines, including the need to ensure that the design of a trial is appropriate not only for the scientific question being asked, but also for minimising risks and maximising benefits to the trial volunteers. These include the questions of whether or not a placebo arm should be included, and the nature of placebos, as well as the process of selection and randomisation of volunteers into different groups within the trial.

In this article, Solomon Benatar and Peter Singer suggest that too much reliance has been placed on the role of international guidelines in suggesting what is ethical, and note that such guidance always needs to be interpreted.

They argue that the term 'standard of care' has not been clearly defined, and that this has hindered international debate on this topic. Criticising the idea that the standard set by developed countries should be considered the norm, the authors propose a new conception of 'standard' of care that takes account of the social, economic and political context within which a clinical trial is conducted.

This article from the Gambia Government / Medical Research Council Joint Ethical Committee is an early response to the criticisms in the New England Journal of Medicine and The Lancet that placebo-controlled trials to prevent mother-to-child transmission of HIV were unethical.

The authors express concern that important research in developing countries would be threatened if research practice were changed in response to such criticisms. In particular, research that only compared new interventions with the best available therapy in developed countries would fail to provide information about interventions that are relevant and affordable for the local situation.

The authors note that there is sometimes a need to re-examine interventions that have proved effective in developed countries before it is possible to make an informed public health decision about introducing them in the developing world. They conclude that "stopping trials in Africa that are trying to help improve the health of poor people so that those in affluent countries can have peace of mind seems a tortured form of ethical logic".

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This 1997 editorial from The Lancet is one of three articles that kicked off the current debate about appropriate standards of care in clinical trials. Commenting on the other two articles (published the week before in the New England Journal of Medicine) it concludes that placebo-controlled trials of antiretroviral drugs used to prevent mother-to-child transmission of HIV violated a fundamental ethical principle of medical practice, namely that doctors should do no harm. The reason given is that women were harmed because they received no effective treatment to prevent transmission of HIV to their children.

The article dismisses the argument put forward by those justifying the trials: that if they had not been conducted none of the women would have received an effective treatment. Instead, it focuses on "the fact remains that some women were given a treatment that the physicians in charge knew was not the best possible intervention". The editorial goes on to explain the need for the ‘ethics industry’ that comments on such matters to be "rooted in clinical practice and not in armchair moral philosophy".

[This article is reproduced with permission from The Lancet.]

This article estimates the extent of migration, by level of education, from developing countries to the United States and other OECD countries. While it is clearly difficult to measure precisely the flow and levels of education of immigrants the authors summarise a study they conducted covering migration from 61 developing countries.

The study found that over half of those migrating to OECD countries headed to the United States, and that for most countries, people with a tertiary education have the highest migration rate. Assessing brain drain to other OECD countries is much more difficult, as the statistics available do not record the level of education. But they found — with various assumptions and exemptions — that the extent of the brain drain to OECD members is substantial, particularly from Iran, Korea and the Philippines.

The authors conclude that their results suggest that in several developing countries the outflow of highly educated individuals is a phenomenon that policy makers cannot ignore. But they say that more research, especially empirical studies, is needed to evaluate the impact of the brain drain on source economies and on worldwide welfare, as well as the reasons for such migration.

Foreign-born scientists and engineers contribute significantly to the brain power of the United States; in 1998 immigrants accounted for around 30 per cent of those conducting research and development. This article asks whether the concept of 'brain circulation' (as opposed to 'brain drain') is valid.

The article states that the large foreign component of US human intellectual capital is linked to the ability of the country's higher education sector to attract, support, and retain foreign science and engineering graduate students. And between 1988 and 1996, nearly two thirds of those receiving US doctorates planned to remain in the United States after completion of their studies (with particularly high "stay rates" for students from China and India).

The data discussed supports the notion of brain circulation for some countries (such as Taiwan and South Korea) and somewhat more brain drain for other countries (for example, China and India). In total, roughly half of all foreign doctoral recipients leave the United States immediately after completing their graduate education, and others leave after some years of teaching or industrial experience. The article concludes that more research is needed on the activities of foreign doctoral recipients who return to their home countries.

This article, which was prepared for the 1999 World Conference on Science, describes how use of the international diaspora provides a new and promising strategy for dealing with the brain drain issue in the context of a global knowledge society.

The authors describe various intellectual diaspora networks — which use their expatriate experts, scientists and engineers for development at home — and detail 'what makes a good network'. They say that the apparent success of such networks reinforces the notion that previous attempts to address the brain drain by preventing or regulating flows of skills were based on misplaced theoretical assumptions.

Various lessons and policy implications are offered, with the aim that these are used to guide the efficient use and development of science and technology diasporas.

In this article, Jean-Baptiste Meyer explains that although the 'brain drain' phenomenon is nothing new, a number of factors have recently contributed to an increasing awareness of the problem as well as attention to possible counter-measures. This is for two principal reasons: the size and nature of the phenomenon has changed, and so have its implications.

Although it can be considered in terms of the impacts of individual source and recipient countries, the skills exodus has become a global phenomenon. It is no longer an exclusively North/South phenomenon, as it now affects North/North and South/South relations. Additionally, the term 'migration' in this context is progressively being replaced by 'mobility', suggesting that permanent loss is gradually disappearing.

The author warns that this mobility should not be idealised, and that its down side is all too evident. At the same time one promising development, that of tapping into the 'diaspora', is offering a way to recover skills without requiring physical return of migrants.

This article is a highly readable account of the current situation regarding the flight of 'human capital' from Africa. It tracks the phenomenon over the past few decades, and outlines the various 'push and pull' factors at play. The author then describes a number of efforts to reverse the trend, such as the International Organisation for Migration's 'Migration for Development' programme.

"Unless serious steps are taken to develop critical institutions and human capacities," it says, "the recent positive developments in the economy will not be sustainable and will not make a significant dent on poverty." African governments must take more responsibility for the problem, rather than just becoming increasingly frustrated that its investment in human capital goes unrewarded.

This editorial article gives an overview of current perspectives on the brain drain in sub-Saharan Africa. The author reports on the resurgence of interest in the diaspora at the highest level, with the leaders of Nigeria, South Africa and the Ivory Coast intiating new projects aimed to tap into their citizens abroad.

Such initiatives aim to harness the potential represented by the diaspora in terms of the economic development of their home nations. This is partly through the creation of 'knowledge networks', but also through a growing awareness of members of the African diaspora who now see themselves as valuable elements of their home societies.

Despite these positive trends, the situation is deeper and more complex than might initially appear, not least because professionals are still reluctant to return to their native countries. The article suggests that it is necessary to "look beyond easy formulas to the real phenomena, in all their subtleties, which compose it".

As well as providing the full text of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement, the WTO website also offers:

• a basic introduction to the agreement
• a more detailed overview
• a list of frequently asked questions about TRIPS
• a factsheet on TRIPS and pharmaceuticals

This background paper describes the basic principles behind two strategies that could be used to bring down the price of drug therapies: parallel importing (bringing drugs from another country) and compulsory licensing (restricting the monopoly rights of existing patent holders to permit generic drug production).

Other means of lowering drug prices are also briefly discussed. The paper aims to provide people with sufficient information to participate fully in the debate surrounding international trade laws and access to essential drugs (especially HIV-related medications).

The report is also available in French and Spanish.

This paper — based on a talk McDonald (University of Sheffield, United Kingdom) gave at QUNO — considers the costs and benefits of the patent system. The paper gives examples showing that the costs would seem to be considerable and their distribution as uneven as that of the benefits.

Staring out with a 'conventional' view of patents, the author then considers the use of patents in practice. He warns that the patent system is ripe for abuse, and that such exploitation is deliberately hidden from those who bear its costs. The author concludes that the greatest cost to society is that the patent system is, in fact, 'anti-innovative'.

This is a readable and personal account of the rationale, history and shortcomings of the patent system.

This background briefing sets out in plain language the development aspects of intellectual property rules, from the UK government’s perspective. It describes the controversies surrounding intellectual property, lists the potential costs and benefits, outlines research into the 'appropriate level' of intellectual property rules, and discusses issues surrounding TRIPS (in particular access to medicines and biodiversity). The paper emphasises the need to maintain the flexibilities in the TRIPS Agreement, which the government believes allow all countries — including developing countries — to implement domestic intellectual property regimes that take account of their local circumstances.

This paper was presented by Anil K. Gupta, of the Honey Bee Network in India, at the Second WIPO International Conference on Electronic Commerce and Intellectual Property held in Geneva from 19-21 September 2001.

For a large number of communities and knowledge experts, says Gupta, globalisation has reduced the opportunities for expressing values. Their values no longer encourage them to conserve biodiversity and other resources and the knowledge systems associated with them. Furthermore, while these knowledge-rich, but economically poor, communities have provided leads for modern pharmaceutical and seed industries, they have hardly ever shared in the benefits.

The situation could be halted by introducing traditional knowledge digital libraries (TKDL), he says. Such a library system would explicitly acknowledge the providers, producers and reproducers of traditional knowledge, and would share the results of its documentation with them in the relevant local language. The IPR issues related to the TKDL are discussed extensively in this paper.

To carry forward the ideas presented in this paper, several policy and institutional changes will be necessary. One of the most difficult challenges in relation to TKDL is the extremely poor Internet infrastructure in most developing countries.

This paper discusses a number of policy issues surrounding the protection of traditional knowledge (TK) that may be relevant to future negotiations or a deeper treatment of this issue in various international fora.
The paper aims to:

• highlight various perspectives on the policy issues raised for developing countries and traditional and indigenous communities within them by the expansion of intellectual property rights (IPRs);
• outline some definitional problems and the rationale and objectives for protection, different strategies for the use of IPRs for such protection, and various modalities of a sui generis regime as well as alternatives to these;
• examine the possible functions of a regime on TK, its impact on the intended beneficiaries and key ethical, economic, environmental and social concerns;
• consider the possible contribution of overseas development assistance (ODA) in developing and implementing policies on the protection of TK.