Ethics and the difficulty of conducting clinical trials in developing countries

THE RACE TO DEVELOP A TREATMENT FOR HIV has never been so urgent as the virus has been rapidly decimating the developing world, while becoming less of a threat in more developed countries.' It is currently estimated that as many as sixteen thousand individuals are being infected with HIV every day and around ninety percent of these infections are occurring in developing countries.(2) As this race to develop a vaccine has progressed, it has raised controversial questions as to what standards should apply to any clinical trials performed in developing countries. In Part I of this paper, I discuss the how the current controversy involving clinical trials arose. In the latter sections I discuss how a more involved proactive approach by the WHO and UN/AIDS would be beneficial in removing the cloud of skepticism that seems to follow these clinical trials. Furthermore, a more defined system to establish post trial drug availability and stronger standards for informed consent would be valuable improvements to the current practices.