A review of The Body Hunters: Testing New Drugs on the World’s Poorest Patients by Sonia Shah. The New Press, 2006.
Experimenting on humans is not something we like to think about, but when clamoring for new drugs is paired with the single-minded profit-seeking of the companies that develop them, breaches in human rights inevitably occur.
In The Body Hunters: Testing New Drugs on the World’s Poorest Patients, investigative journalist Sonia Shah describes the practices of the “pharma monolith.” Before new drugs are snatched up by the “drug-marinated” West, they must first be screened for overly obvious negative effects. This is done on the bodies of the world’s poor.
In the last decade, pharmaceutical companies have quietly moved more than half of their clinical trials to developing countries. The advantages of testing in Africa, Asia, Latin America and Eastern Europe are numerous: the availability of sick people, the extent to which their illnesses tend to progress and the lack of ethical oversight. Lured by the promise of Western-style care, impoverished patients are more than willing to surrender themselves for experimentation. As one clinician gushes: “the best thing about Zambia is that they just cannot say no.”
But it is when patients could clearly benefit from a trial that such tests are the most ethically contentious. The placebo control, despite its unquestionable scientific merit, demands that one half of the patients enrolled in a study not be given any treatment. In a trial for a novel AIDS drug this means that doctors and scientists watch one half of their HIV-positive patients deteriorate despite the existence of proven antiretroviral treatments, a situation that would incite outrage and disgust in Europe and the United States. This double standard is typically dismissed with passive fatalism from researchers, federal regulators and pharmaceutical executives.
Shah does not attempt to mask the complexity of the issue. Patients and facilities do occasionally benefit from joining trials. And governments of developing countries actively advertise the bodies of their own populace as the best material for experimentation, hoping to lure millions of dollars of clinical trial money.
The abuse inherent in the current system of testing drugs in the developing world is made painfully clear and so is the need for deep, radical change in the way clinical trials are handled.