Correspondence | Published:

Populations who test drugs should benefit from them

Nature volume 440, page 605 (30 March 2006) | Download Citation

Subjects

Sir

Paul Herrling, in his Commentary article “Experiments in social responsibility” (Nature 439, 267–268; 2006), describes pharmaceutical companies moving towards a more progressive approach to drug development and distribution in poor countries. But it is important to note that, even when research in developing nations leads to effective treatments, there is still the danger of local populations being exploited.

Recent clinical trials of a hepatitis E vaccine in Nepal are a case in point. Run by GlaxoSmithKline and the US government Armed Forces Research Institute of Medical Sciences, the trials showed an impressive on-treatment efficacy for the experimental vaccine (see M. P. Shrestha and R. N. Scott's report to the American Society for Tropical Medicine and Hygiene at http://www.astmh.org/meetings_new/ASTMH_05_FP2.pdf). But the methodology of the trial raises questions about the ethics of clinical-trial conduct among vulnerable populations. The research team had to drop original plans to test civilian volunteers in the city of Lalitpur, after local people objected to a lack of informed consent or participation in trial design (for details of these events, see J. Andrews Am. J. Bioethics 5, W1; 2005). Instead, they gave the experimental vaccine to soldiers in the Royal Nepalese Army, who are vulnerable as members of the armed forces and as some of the poorest people in a ‘least-developed’ country.

These ethical issues take on greater importance now that the hepatitis E vaccine may have public-health usefulness. Will the Nepalese community benefit? Or will the results be used only to develop a profitable vaccine for (mainly Western) travellers and US soldiers? We hope that GlaxoSmithKline and its collaborators make this vaccine accessible to the populations placed at risk by the trial, in line with the well-intentioned humanitarianism that Herrling describes.

Author information

Affiliations

  1. Yale University School of Medicine, 129 York Street, New Haven, Connecticut 06511, USA

    • Sanjay Basu
    • , Jason Andrews
    •  & Duncan Smith-Rohrberg

Authors

  1. Search for Sanjay Basu in:

  2. Search for Jason Andrews in:

  3. Search for Duncan Smith-Rohrberg in:

About this article

Publication history

Published

DOI

https://doi.org/10.1038/440605d

Comments

By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.

Newsletter Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing