ABSTRACT

One of the great challenges in medical research is to conduct clinical trials in developing countries that will lead to therapies that benefit the citizens of these countries. Features of many developing countries — poverty, endemic diseases, and a low level of investment in health care systems — affect both the ease of performing trials and the selection of trials that can benefit the, populations of the countries. Trials that make use of impoverished populations to test drugs for use solely in developed countries violate our most basic understanding of ethical behavior. Trials that apply scientific knowledge to interventions that can be used to benefit such populations are appropriate but present their own ethical challenges. How do we balance the ethical premises on which our work is based with the calls for public health partnerships from our colleagues in developing countries?