There is a "turf war for human subjects" as pharmaceutical clinical trials increased 16 times in low-income settings such as Africa, the Microbicides 2006 conference in Cape Town heard on Wednesday.
This is according to Professor Ames Dhai, head of Bioethics at the University of Witwatersrand Medical School.
Scientists are in a race, albeit tortoise slow, to see who can get the most effective microbicide, a gel that could prevent HIV transmission in women and that could raise billions of dollars for the first effective product and possibly even a Nobel prize for the winning researchers.
Close to 10 000 women are involved in microbicide trials, most of them in Africa, with often dangerous products being used, including lemon juice by Australian researchers on Nigerian women - which was found to be extremely damaging to the vagina.
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'Battle over who gets these patients' Dr Benoit Masse of the Statistical Centre of HIV and Aids Research and Prevention in Washington, USA, said an effective microbicide could be ready in as early as one year, or as late as five years.
He said true efficacy could be measured in trials involving 100 000 women, but this exceeded by ten times the number of women involved in trials globally.
Dhai of Wits Medical School raised questions about whether the patients' rights were always paramount. She observed that clinical trials tend to be focused in "geo-areas of political and economic instability with unequal social context".
This highly lucrative field for doctors and medical researchers see them, "battle over who gets these patients so they can say to the sponsor 'I can line up 500 patients tomorrow'."
Dhai said "international standards of ethics have starkly failed to deal with local contexts and experience shows ethical imperialism."
She emphasised that this not only failed to protect patients adequately but also saw northern countries display this ethical imperialism over doctors in resource poor, but information rich settings.
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