As the HIV epidemic continues to spread, clinical and prevention trials are needed in developing nations to learn how best to alleviate suffering. Such international trials, however, raise ethical concerns because of great disparities in wealth, power, and medical infrastructure, and a history of exploitation.
In this article, Bernard Lo of the University of California and Ronald Bayer of the Joseph P Mailman School of Public Health, New York, argue that partnerships between developed and developing countries — involving researchers, government agencies and community leaders — are essential to working out ethical problems that arise in particular trials.
Researchers often want to focus on the technical aspects of clinical trials, but conducting research in developing countries presents important ethical obligations, they argue. The authors hope that establishing partnerships will ensure procedural fairness and promote the ethical conduct of clinical trials in a world characterised by grave inequities.
Reference: BMJ 2003; 327: 337-339