Ethical implication of clinical trials

Respond to this discussion post. Please do not rewrite the exact same thing as an answer;

The article for discussion this week, The Ethical Implications of Clinical Trials in Low and Middle Income Countries was especially interesting to me as I have a great interest in biomedical ethics. As discussed in this article some of the issues related to these types of studies are: if individuals participate in the studies, what standard of care looks like. In many of these less advantaged (or wealthy) countries, the standard of care looks very different then it does in the US or other wealthier nations. This presents ethical concerns when performing studies that would be carried out very differently in higher income countries. For obvious reasons, the concerns include the lack of access for study participants to treatments they may not otherwise have the opportunity to receive. From an ethical perspective, I would agree that failing to give participants access to a world standard of care is an ethical lapse on the part of the researchers. Another issue brought up in this article is the access/cost to or of the treatment after the study is completed. In many cases individuals in these low and middle income countries may have contributed greatly to the advancement of the study, but they (and or others in their communities) are unable to access the new treatment after the study is completed due to the cost of the drug. As argued by the author, these individuals have already paid a debt for these treatments and should be able to have some sort of benefit from their willingness to participate.

I find this article especially interesting considering the ongoing COVID-19 pandemic. As stated in the article countries in Africa, who have participated in other vaccine trials, and who have a relatively ‘low’ hurdle for entry were not included in the COVID-19 trials. Although variants have changed the trajectory of the disease, I do wonder if including these countries in the first place (through trials) and also providing the right supply of vaccines to them would help combat this from a more global perspective and given us a leg-up in terms of overcoming the pandemic from a public health perspective.