India has become “a nation of guinea pigs”, claims Wired journalist Jennifer Kahn. Legislation was passed last year which allows drug companies to test their products without providing assurances that they were proven to be safe in the country where they were developed. Like China and Brazil, India has adopted drug trial outsourcing as “a fast route to economic and scientific growth”. The consulting firm McKinsey estimates that the market in India will be US$1.5 billion by the year 2010.

The problem with this, Kahn suggests is that the drugs probably deliver no benefits to poor Indian patients. Nonetheless many doctors find the financial rewards — either for themselves or for their hospital — for recruiting participants hard to resist. Furthermore, many of the patients are extremely naive. “When I try to explain that a drug is experimental, that it might not work, the understanding is not there,” says one doctor. “One woman said to me, ‘What do you mean, the drug might not work? All drugs work!'”

In his Business Ethics Blog, Chris McDonald, of Saint Mary’s University in Halifax, Canada, comments that although clinical trials in underdeveloped countries do raise serious ethical concerns, the aim of a clinical trial is never to benefit the patient, but rather to assess the effectiveness of a possible therapy.

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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