Showing posts with label human subjects. Show all posts
Showing posts with label human subjects. Show all posts

Wednesday, May 13, 2009

Lessons Learned from PrEP Trial Cancellations

Between August 2004 and February 2005, the HIV prevention world was rocked by the suspension and cancellation of two pre-exposure prophylaxis (PrEP) trials in Cambodia and Cameroon. To the considerable surprise of researchers, advocates and donors, these HIV prevention trials became embroiled in escalating controversies and sparked protests by activists speaking on behalf of the communities where trial participants were being recruited. The activists not only raised questions about how the research was being conducted, but also challenged the fundamental ethics and underlying motives of the research.

Just this week, my colleagues at the Global Campaign for Microbicides released two in-depth case studies relating the events that led to these trial cancellations and extracting the lessons they provide for current and future research:


Acknowledging that no single version of the events constitutes the “real story”, the case studies are built from extensive interviews with researchers, policymakers and other government officials, donors, NGO staff, and advocates to reconstruct often incompatible accounts of what eventually led to government intervention that halted the research.
The case studies capture the political context and backdrop against which the controversies arose and the underlying and unaddressed conflicts that led to the costly collapse of two Phase 3 trials.

These reports are important and exciting reading for anyone interested in sound science, human rights, gender equality and communication across enormous cultural, social, and economic disparities. The HIV prevention field has made substantial progress since 2005 in forging mechanisms to be transparent and build trust between trial communities and researchers. Still, much remains to be done and the potential for conflict remains.

As the first PrEP trials move toward completion this year, these case studies offer a timely look at what we have learned and what pressing challenges remain unaddressed.

T
he two case studies are available on-line at http://www.global-campaign.org/.


UPDATE: Dr. Free-Ride over at the blog Adventures in Ethics and Science is going to be hosting a virtual journal club on these two case-studies. Join in the fun here.

Thursday, February 05, 2009

Nigerian Families' Claims Against Pfizer Over Drug Tests Reinstated

[Courtesy of Alicia Ouellette]

The United States Court of Appeals for the Second Circuit has handed down a case of major importance in research ethics and international law. The case is Rabi Abdullahi v. Pfizer. The plaintiffs are Nigerian children and their families who were subjected to medical experimentation in Nigeria by drug manufacturer Pfizer. Specifically, the children were among two hundred sick children in Nigeria given the experimental antibiotic Trovan as part of a protocol designed to test the efficacy of Trovan against that of a standard antibiotic treatment. The plaintiffs sought, and won, the right to sue Pfizer in federal court for damages caused by Pfizer's involuntary medical experimentation.

The decision is legally significant for its holding that nonconsensual experimentation on humans violates a legally enforceable norm of customary international law. No American court or treaty recognized such a norm before this case. Not surprisingly, the opinion is not unanimous. The dissent accuses the majority of creating "a new norm out of whole cloth [that] misconstrues – rather than vindicates – customary international law."

The opinion can be accessed at this link: http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA1LTQ4NjMtY3Zfb3BuLnBkZg==/05-4863-cv_opn.pdf#xml=http://www.ca2.uscourts.gov:8080/isysquery/irla125/10/hilite.

The opinion is long, and includes several technical legal issues. But the court's analysis of whether universally accepted and legally enforceable norms of international law prohibit medical experimentation on non-consenting human subjects (which begins in earnest at page 22 of the opinion) breaks new ground in American law. It is worth reading.

[Editor's Note: For articles that give you more background on the Nigeria vs Pfizer Trovan suits, here are links to few:

http://news.bbc.co.uk/2/hi/africa/6721771.stm

http://news.bbc.co.uk/2/hi/africa/1220032.stm

http://news.bbc.co.uk/2/hi/africa/6719141.stm

http://www.washingtonpost.com/wp-srv/world/documents/Clinical_Trial_Report.pdf

http://www.washingtonpost.com/wp-dyn/content/article/2006/05/06/AR2006050601338.html]