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More and more people, especially in poor countries, are asking what they stand to gain from taking part in clinical trials.

This is only fair, says Jon Cohen in this article, but he deplores the accompanying extreme distrust of drug companies, or 'pharmanoia', that he says is detracting attention from more legitimate concerns.

One ethical dilemma that has plagued HIV/AIDS trials is whether or not to give antiretroviral drugs to participants who become HIV positive during — but not because of — the trial.

Over the years, as the price of these drugs has dropped, trial organisers have become more willing to supply them to participants.

This, says Cohen, indicates that some of these research quandaries are more about cost, than issues of right or wrong.

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