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The World Medical Association Declaration of Helsinki states that every clinical trial participant should be assured of treatment after the end of the trial, but honouring this commitment in developing countries is difficult.

Jintanat Ananworanich and colleagues from the HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT) describe the HIV-NAT drug fund, which provides patients enrolled in HIV-NAT trials with post-trial financial assistance. Based on their ability to pay, applicants are asked to pay at least US$35 per month, while the fund pays at most US$120 per month. In 2003, 20 per cent of post-trial patients received aid from the drug fund, and over half paid the minimum amount.

The governments of developing countries must provide long-term drug supplies, say Ananworanich and colleagues. Drug funds, they say, are a temporary solution but must be made a priority for all institutions that run clinical trials.

Reference: The Lancet 364, 101 (2004)

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