Testing our drugs on the poor abroad

Exploitation and Developing Countries: The Ethics of Clinical Research

Volumn , Issue , 2008, Pages 105-141

  Pogge, Thomas ^a  

^a NONE

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EID: 84890724270     PISSN: None     EISSN: None     Source Type: Book    
DOI: None     Document Type: Chapter

References (29)

1. In a press release on July 18, 2002, Discovery Laboratories Inc. reported the mortality rate for untreated RDS to range from 35 to 50 percent. My figure of 140 deaths reflects the rough midpoint of this range: 43 percent. This press release is no longer available on the Internet.
2. This case is a hypothetical and thus does not purport to reflect accurately the conditions of poor fishermen working in the Bay of Bengal.
3. "So-called," because many of these countries are not developing at all. Assessed at purchasing power parity (PPP), real per capita income in Peru, for instance, is lower today than it was in 1981, and real per capita income in Bolivia is lower than it was in 1977. See UNDP, Human Development Report 2004, 332-33.
4. This claim is more fully elaborated in other work. See Thomas Pogge, "'Assisting' the Global Poor," in The Ethics of Assistance: Morality and the Distant Needy, ed. Deen K. Chatterjee (Cambridge: Cambridge University Press, 2004), 260-88
5. Pogge, "Reply to the Critics," Ethics and International Affairs 19 (2005): 55-84;
6. Pogge, "Severe Poverty as a Human Rights Violation," in Freedom from Poverty as a Human Right: Who Owes What to the Very Poor? ed. Thomas Pogge (Oxford: Oxford University Press, 2007), 11-54.
7. See, for example, "The Ethics Industry," Lancet 350 (1997): 897;
8. Marcia Angell, "The Ethics of Clinical Research in the Third World," New England Journal of Medicine 337 (1997): 847-49;
9. Peter Lurie and Sidney Wolfe, "Unethical Trials of Interventions to Reduce Perinatal Transmission of Human Immunodeficiency Virus in Developing Countries," New England Journal of Medicine 337 (1997): 853-56;
10. Joe A. Stephens et al., "The Body Hunters," six articles in the Washington Post, December 17-23, 2000;
11. Florencia Luna, "Is 'Best Proven' a Useless Criterion?" Bioethics 15 (2001): 273-88;
12. Paquita de Zulueta, "Randomized Placebo-Controlled Trials and HIV-Infected Pregnant Women in Developing Countries: Ethical Imperialism or Unethical Exploitation?" Bioethics 15 (2001): 289-311.
13. See, for example, David B. Resnick, "The Ethics of HIV Research in Developing Nations," Bioethics 12 (1998): 286-306;
14. Robert Levine, "The Need to Revise the Declaration of Helsinki," New England Journal of Medicine 341 (1999): 531-34.
15. For discussion, see also Carol Levine, "Placebos and HIV: Lessons Learned,"Hastings Center Report 28, no. 6 (1998): 43-48;
16. Troyen A. Brennan, "Proposed Revisions to the Declaration of Helsinki: Will They Weaken the Ethical Principles Underlying Human Research?" New England Journal of Medicine 341 (1999): 527-31.
17. Results of these and subsequent Phase III trials (www.drugs.com/NDA/surfaxin_040615.htm) suggest that Surfaxin can be highly effective against RDS.
18. See also Fernando Moya et al., "A Multicenter, Randomized, Masked, Comparison Trial of Lucinactant, Colfosceril Palmitate, and Beractant for the Prevention of Respiratory Distress Syndrome among Very Preterm Infants," Pediatrics 115 (2005): 1018-29;
19. Sunil Sinha et al., "A Multicenter, Randomized, Controlled Trial of Lucinactant versus Poractant Alfa among Very Premature Infants at High Risk for Respiratory Distress Syndrome," Pediatrics 115 (2005): 1030-38.
20. On this concept, see especially David Gauthier, Morals by Agreement (Oxford: Oxford University Press, 1986), chap. 4.
21. World Bank, World Development Report 2007 (New York: Oxford University Press, 2006), 289.
22. See www.fic.nih.gov/about/summary.html.
23. UNDP, Human Development Report 1998 (New York: Oxford University Press, 1998), 49.
24. See www.uis.unesco.org.
25. Panos Kanavos et al., "The Economic Impact of Pharmaceutical Parallel Trade in European Union Member States: A Stakeholder Analysis," LSE Working Paper, 2002, www.lse.ac.uk/collections/LSEHealthAndSocialCare/pdf/Workingpapers/Paper.pdf.
26. Patrice Trouiller et al., "Drugs for Neglected Diseases: A Failure of the Market and a Public Health Failure?" Tropical Medicine and International Health 6 (2001), 945-51;
27. Pierre Chirac and Els Toreelle, "Global Framework on Essential Health R&D," Lancet 367 (2006): 1560-61, also available at www.cptech.org/ip/health/who/59wha/lancet05132006.pdf.
28. The moral significance of our causal involvement in severe poverty abroad is extensively discussed in my works cited in note 11.
29. My estimate of what all affluent countries would need to contribute to implement the reform plan-$70 billion annually-is significantly less than what the United States alone is spending on its "humanitarian" intervention in Iraq.