Clinical trials for new pharmaceutical drugs are a sensitive business. Companies are under pressure to come up with new treatments for cancer, Aids, MS – the list is almost endless. But tests can be expensive. If they go wrong, companies are liable for compensation. No surprise, then, that in a globalised economy this business – like many others – is being outsourced to countries such as India where costs are far lower.
In a country of 1.2 billion people, where more than half the population lives in chronic poverty according to a recent UN report, the supply of people willing to take part in tests for very modest fees is inexhaustible. Compensation payouts are a fraction of what they would be in the West. Moreover, legislation on testing in India is lax.
As we report today, more than 1,700 Indians have died from 2007 to the end of last year while taking part in drugs tests sponsored by Western pharmaceutical companies. Many may have died from natural causes, but the fact that we don't know how many highlights a lack of openness and transparency in the way these companies operate. It is not clear that the testing companies have investigated the causes of these deaths while the evidence is strong that many people embarked on trials without having much idea of the risks involved. In some cases it is not clear they even gave consent.
Among the cases we report is one concerning tribal girls who were volunteered for immunisation tests on the say-so of the warden of the hostel in which they lived. Several later died. A further cause of concern is the way the large Western drugs companies farm out tests to other firms. There may be good reasons for this but it is bound to raise suspicions that these companies are trying to evade responsibility for when things go wrong.
Doubtless many people in India are grateful for the fees they have earned from tests. But if the big Western companies don't want to attract opprobrium, they should follow their own rules of conduct more clearly and allow greater outside oversight. They should also be legally present in the countries where tests take place, ensuring greater accountability. Lowering costs in the search for cheaper cures is one thing. Abusing people's poverty is another.
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* Without consent: how drugs companies exploit Indian 'guinea pigs'
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