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Ethics of clinical research in the developing world


Many commentators believe that all clinical-trial participants must receive a level of care equivalent to the world's best. Using HIV/AIDS research as an example, we show how this 'Uniform Care Requirement' can undermine biomedical research aimed at improving global health, and then we point towards a more rational and balanced approach to ethical assessment.

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Figure 1: The global burden of HIV/AIDS.
Figure 2: March for treatment access.
Figure 3: Early versus delayed initiation of antiretroviral therapy.


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Correspondence to Jack Killen.

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General information about HIV/AIDS Centers for Disease Control and Prevention

Joint United Nations Programme on HIV/AIDS (UNAIDS)

National Institute of Allergy and Infectious Diseases

HIV/AIDS treatment Department of Health and Human Services and Henry J. Kaiser Family Foundation. Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents

Harvard Consensus Statement on Antiretroviral Treatment for AIDS in Poor Countries

Medical Management of HIV Infection by John G. Bartlett, M.D. and Joel E. Gallant, M.D., M.P.H.

Bioethics resources Council for International Organizations of Medical Sciences

National Institutes of Health: Bioethics Resources on the Web

National Reference Center for Bioethics Literature

World Medical Association

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Killen, J., Grady, C., Folkers, G. et al. Ethics of clinical research in the developing world. Nat Rev Immunol 2, 210–215 (2002).

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