20 May 2002 16:45 EST

by Bella Starling, BioMedNet News

Rather than relaxing standards, "we need to have tougher codes," charges the editor of a medical ethics journal in a BioMedNet News report today. He is responding to a working party of the Nuffield Council on Bioethics, which recently urged different standards for medical research in developing and developed nations.

But maintaining a universal bioethics standard worldwide, argues a member of that working party, would lead to "catastrophic" results in the Third World.

The new Nuffield Council report (entitled The ethics of research related to healthcare in developing countries) recommends, among other points, that participants in Third-World medical research should be offered the best treatment available from their national health-care systems, but not necessarily the best available anywhere (which is the standard adopted in many prior consensus reports on the subject, including the landmark Nuremberg Code of 1947). Its authors note that today only 10% of health-research funds are devoted to deadly ailments such as malaria, tuberculosis, and AIDS, which are prevalent in the nations where 90% of the world's population lives.

"Taken as a whole, we hope that these recommendations will allow research to be conducted so that it has the greatest chance of providing useful information, without risking exploitation of vulnerable people," says working group chairman Kenneth Calman, who is vice chancellor of the UK's University of Durham.

Other provisions recommend that developing countries set up their own research oversight bodies, include local expertise in planning medical research, and assure that researchers try to secure access for all participants afterwards to any treatment that has proved successful during a trial.

The report is "too strong on pious hopes," maintains Richard Nicholson, editor of the Bulletin of Medical Ethics, pointing out that even in the most affluent countries patients have died during clinical trials, despite strong systems for protection of human subjects in research.

But if developing countries are held to the same ethical standards as the rest of the world, vital research for their populations "simply wouldn't happen," argues Peter Smith, head of infectious diseases at London's School of Hygiene & Tropical Medicine.

According to the international medical aid group Medecins Sans Frontieres, of the 1,393 new chemical entities developed between 1975 and 1999, only 13 were medicines to treat tropical diseases.

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See also:
Protection urged for "vulnerable" participants
Bill O'Neill
BioMedNet News - 24 April 2002

International research ethics: progress, but not perfection
[Science and society]
John E. Jesus and Elizabeth S. Higgs
Trends in Molecular Medicine, 2002, 8:2:93-95

Health Research Ethics in Africa
[News]
D.E. Arnot, S. Jepsen and W. Kilama
Parasitology Today, 2000, 16:4:136-137

Ethical jurisdictions in biomedical research
[Science and society]
Joseph M. Mfutso-Bengu and Terrie E. Taylor
Trends in Parasitology, 2002, 18:5:231-234

Some ethical and design challenges of screening programs and screening tests
[Review article]
Matthew J. McQueen
Clinica Chimica Acta, 2002, 315:1-2:41-48
 

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