medical exploitation of India

Via Krish, a story in Wired about how India is now the big site for clinical trials and drug development. Costs there are low, and as the editor of the American Journal of Bioethics noted:

Individuals who participate in Indian clinical trials usually won’t be educated. Offering $100 may be undue enticement; they may not even realize that they are being coerced.

I heard a radio program on this a few months back and tried to get my mother riled up about it, but it’s really just another strand in the rich and varied tapestry of India’s exploitation by the West/North/what-have-you.

As with most issues surrounding technology development, it boils down to an issue of pragmatics versus ethics. Pharmaceutical companies in Europe and Asia can’t find people willing to do clinical trials of their drugs in the US, even with some generous incentives. After all, who wants a placebo? On the other hand, you can get lots of volunteers for just $100 a pop in India plus paying the doctor to administer the trial, and the FDA will approve your trial. You get your drug approved, patent it, and prevent anyone in India from actually being able to afford it.

It’s not a problem specific to India either — patients in Russia are exploited in similar ways. When access to quality healthcare is limited, desperation is the primary motivating factor. Is it ethical to give a placebo in these situations? Should there be restrictions on how these studies are marketed to the public? Bioethics is going out the window in our rush for progress and refusal to shoulder the risks ourselves.