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Testing Drugs on India's Poor
Posted by
ScuttleMonkey
on Mon Dec 19, 2005 03:43 PM
from the pincushion-for-cash dept.
from the pincushion-for-cash dept.
theodp writes to tell us Wired is reporting that a lot of medical research firms are using India's poor as a hot test bed. From the article: "The sudden influx of drug companies to India resembles the gold rush frontier, according to Sean Philpott, managing editor of The American Journal of Bioethics. 'Not only are research costs low, but there is a skilled work force to conduct the trials'"
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News: The Myth of the New India 378 comments
theodp writes "An NYT op-ed on The Myth of the New India reports that only 1.3M Indians are participating in the so-called new economy of BPO, leaving 400M have-nots without a piece of the pie. Despite recent gains, nearly 380M Indians still live on less $1 a day, setting the stage for rural and urban conflict." From the article: "No labor-intensive manufacturing boom of the kind that powered the economic growth of almost every developed and developing country in the world has yet occurred in India. Unlike China, India still imports more than it exports. This means that as 70 million more people enter the work force in the next five years, most of them without the skills required for the new economy, unemployment and inequality could provoke even more social instability than they have already."
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Wait (Score:4, Funny)
Re:Wait (Score:3, Funny)
Re:Wait (Score:5, Funny)
Are you kidding? The unemployment rate for lab rats will skyrocket! How are the poor rats supposed to feed their kids? WON'T SOMEBODY THINK OF THE RAT CHILDREN?
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Re:Wait (Score:4, Insightful)
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Re:Wait (Score:5, Insightful)
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Re:Wait (Score:4, Informative)
What crap!
Not every poor person in India dies of starvation. Infact, starvation related deaths have gone down significantly.
And the drugs that are being tested have been approved for human testing by the Indian equivalent of the FDA. Yes, we have institutions that help protect our rights too. It isn't just in your country that people have rights, you know.
There's a reason why India is being targeted.
Yeah, and unfortunately you don't know about it.
India is being 'targeted' because the Indian population shows incredible genetic diversity unavailable anywhere else. This diversity means that with a few test cases, you can test your drugs on someone with a mediterranean genetic makeup, an australoid genetic makeup, a mongoloid genetic makeup etc. and various combinations of the above. It's not just about the money. Otherwise they would go to Chinese prisons.
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Re:Wait (Score:5, Interesting)
http://www.stopanimaltests.com/ [stopanimaltests.com]
If you want to be an animal rights activist, there is the legitimate organization called the ASPCA http://www.aspca.org/ [aspca.org]
They have been around for over 130 years.
PeTA is a bunch of wackjob veggie hippies that hates humans and are considered terrorists.
http://www.naiaonline.org/body/articles/archives/
http://www.activistcash.com/organization_overview
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Re:Wait (Score:5, Insightful)
Corporate pigs shipping work out to places that have NO health and safety laws... all in the name of short term shareholder profits. These bastards have NO ethics... how would they feel if they themselves were on the breadline with no job protection and the only work available being dirty, shit jobs exported from countries that should know better
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Re:Wait (Score:4, Interesting)
It's interesting to see that the same people who support the ecoterrorism by the Animal Liberation Front which has crippled our ability to test drugs on animals are now complaining about the ethical issues of testing drugs on people in India. If only we lived in one big socialistic world, people wouldn't get sick and need drugs, right?
It is obviously the corporations fault. Their love of profits make them test life-saving drugs on people instead of doing the decent thing and going out of business (giving their drugs to noone). If only they knew that their profits are what make people sick in the world.
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Re:Wait (Score:4, Insightful)
Yeah, you're right. Without question. But someone's gotta be the first to test a drug. The real problem here is that the drug companies are trying to act without the restrictions of the US. Were they operating under the same restrictions over there, then I really wouldn't have much of a problem here at all, since someone, somewhere, has to be the first.
The US/FDA COULD refuse to accept or deny the right to sale to any drug that is tested without adhering to the same restrictions/rules that they would have to in the US. Test subjects would still be cheaper, but at least there would be incentive for treating these people decently.
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Re:Wait (Score:4, Insightful)
However, when a corporation decides to "shop around" and find the cheapest solution to their problem, I don't see how that's not just a large-scale version of when I go on Froogle to find the cheapest place to get my new DVD burner.
This whole scenario plays into what economists call "factor price equalization". The idea goes something like this: Let's say you're in the business of manufacturing something (like a car engine or whatnot). You've got all of your manufacturing pieces in place except for one: you need ten thousand washers placed on ten thousand bolts. For doing this job, "Joe American" in Detroit wants $10/hr, plus medical, dental, and vision coverage... and 2 weeks per year paid vacation. Meanwhile, Shankar in India will do the same job for $4/day and requires none of the other benefits.
Now, if "Joe American" were able to put the washer on the bolt with an expertise, precision, and efficiency that was simply unmatched by Shankar, then there might be a reason to pay him the 20x as much. However, even if there was such a disparity in skill, it would also have to be worth it to you to have the washers put on the bolts with that extra skill.
Alas, in reality, there is no skill disparity when it comes to tasks as simple as this, so the American worker can offer no advantage to the employer to justify his high price. The "equalization" part of Factor-Price Equalization theory is the observation that, eventually, the prices (in wages and benefits) charged by Joe American and Shankar will equalize. Eventually, increasing competition for Indian labor will drive their price up, while Joe American will finally come to the realization that simply having been born in the USA doesn't make up for the fact that he never finished high-school and he'll face the fact that the value of his labor is much lower than what he was, up until now, able to get away with.
The lesson is clear: If you want to be well-compensated for your work, you need to be able to do something that... A) few other people can do (ie, low supply), and B) many people want/need done (ie, high demand). This lesson isn't new. It's just that we're now starting to see a decrease in people being able to get away with not heeding it.
Now, like I said at the outset, the fact that there exist such squalid conditions in India (and countless other parts of the world) might qualify as a travesty (and how is employing these people doing anything but working towards eliminating that?), but... as has been pointed out here numerous times... the hundreds of workers showing up every day don't consider themselves to be exploited. They call it opportunity.
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Re:Wait (Score:4, Informative)
Correct me if i'm wrong.
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Ethics (Score:5, Insightful)
I can't tell if he's being serious, but if he truly does have no moral qualms about that last statement, then he frightens me.
Re:Ethics (Score:4, Insightful)
The sad part is, it doesn't really matter. That's the way things are, when you're poor and sick you're willing to try nearly anything. Even experimental drugs. If for no other reason than you can't afford anything else.
We like to talk about how it sucks our jobs get outsourced to India (and rightfully so, in my eyes), but we have to realize that India is still an incredibly poor country.
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Re:Ethics (Score:3, Interesting)
There are certain upsides for the patients. Yes, they're risking their lives for the chance at health, but in return they are at least getting some medical care. If they're lucky some previously unknown ailment will disqualify them from the study, and get them into one which is more appropriate.
As a lab rat without health insurance, most of my medical care has been through such studies. I get the meds I need to keep on breathing, a
Pff.. (Score:4, Funny)
Damn you trained and abled Indian workforce!
Re:Pff.. (Score:5, Interesting)
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Re:Pff.. (Score:5, Funny)
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Re:Pff.. (Score:4, Insightful)
This need not even be a Bad Thing. The janitor in the school where I work participates in medical studies three or four times a year (as much as he is allowed to) and he makes more money than I do. He doesn't suffer a bit from it and if I had more spare time I would consider joining him. Clinical studies are not necessarily dangerous. Sometimes they just want to see if a medicine has side effects, makes you sleepy or so. I don't think they want to find out the mortality rate.
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outsourcing (Score:4, Funny)
Re:outsourcing (Score:3, Insightful)
No Surprise (Score:5, Insightful)
Re:No Surprise (Score:5, Informative)
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Re:No Surprise (Score:4, Insightful)
IT was not a fertility treatment... it was prescribed to reduce morning sickness...
NOT for me... my brother is one of the victims
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Generic versions of patented drugs (Score:5, Insightful)
WHy do they want to prevent that? What about in the U.S. where we have things like Walgreen's Wal-tussin to compete with Robitussin (same ingredients, cheaper cost for the consumer)? (same with Sudafed, etc.) Does this fall under the kind of thing WTO wants to stop?
Re:Generic versions of patented drugs (Score:5, Insightful)
Cynical answer: the difference is that the USA doesn't want Indian companies to hurt the sales of US-American companies. If it's two US-American companies fighting, the USA as a whole don't lose anything, but if it's foreign companies...
I think there's some truth in both answers.
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The Miracle of Birth: The Third World (Score:4, Funny)
The Miracle of Birth, Part 2: The Third World
Mom: Come on, now. Out you go. Now, uh, Dalip, Bhim, Harinder, Ajit, Indra, Mandeep, it is being past your bedtime.
Kids: Oh, mother!
Mom: Now, not to be arguing! Lakshmi, Sita, Gita, Surinder...
Dad: Wait! I have something to be telling whole family.
Mom: Oh, quick - please to be going and getting the others in, Pradeep.
Kids: What could it be being?
Dad: The call center is closed! There is to be no more work. We are now to live among the untouchable.
Kids: [whispering among themselves]
Dad: Come in my little loves, I am having no option but to be selling you all for scientific experiments.
(Dad goes on to blame the Anglican church for not standing up to the (bloody) Catholics (who are to be filling up the whole world with children they cannot afford to be bloody feeding) when it came to talking about contraception in the UN and WHO forums on overpopulation, and the whole family breaks out into song... You know the rest.)
There are Jews in the world, there are Buddhists,
Anglicans and Catholics, and then,
There are those that outsource to Mohammed, but
I've never been one of them...
"Skilled work force"? (Score:5, Funny)
Umm, so essentially their skill is they're sick and need drugs? Talk about a back handed compliment. Well, Rahim, you have just the skills we're looking for, Leprosy.
Re:"Skilled work force"? (Score:3, Informative)
One case where less regulation will help! (Score:4, Insightful)
I'll bet that India and the rest of the "developing" world will be the next scientific powers given their highly educated and motivated workforce, and the fact that they're a little less backward when it comes to science. Example: South Korea is taking on a cloning project while we're still fighting over teaching evolution in school, abortion and stem cell research.
Sometimes it makes me wish we'd let the South win the civil war. They could live in backward redneck-land and the rest of the country could get on with evolving the species.
And today's Unintentional Iron award goes to... (Score:5, Interesting)
Outstanding! One is rarely treated to such a display of irony: a sweeping, uninformed, all-inclusive condemnation of a huge swath of the country, contending that they, what... are losers because they make sweeping, uninformed judgements about things?
I don't suppose you've met any of the loony hardcore Catholics from New England? Or perhaps some Mormons from the upper-Rockies area? Or maybe some urban Baptists from, say, Philadelphia? Or perhaps some addled-brained Wiccan Nitwits from Seattle? Or maybe some Orthodox Jews from downtown NY,NY? There are people with retro-silly sensibilities all over this country, and always have been. New England is still infested with Puritans. No amount of MTV or porn spam seems to cure it.
On the other hand, I've met some of the most literate, gracious, science-informed, fundy-allergic, down-to-earth people in the world south of the Mason-Dixon Line. On balance, they're often considerably more rational and forward-thinking than some of the culture-rot-population I've met lurking in a lot of the northern cities. I'm just as tired of urbane, metrosexual pseudo-intellectuals who think that hydrogen is a new energy source being hidden by the government as you are of the hillbilly that thinks he's been abducted by aliens because he drank too much cough syrup.
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Down the slippery slope we go! (Score:4, Insightful)
Ethics matter; ethics help assure good science.
There's definitely an advantage to conducting your human trials in places where people aren't breathing down your neck.
Ever frakkin' wonder why the FDA dares to breath down peoples necks? Do you think that people should be informed of the risks of the test; the potential for long term harm. Do you want pharmaceutical companies to document the positive and the adverse reactions of medical testing?
Thank God we've found poor, uneducated people living in a country with a rampant caste system - where the poor are of even less spiritual value than the elite! Testing can proceed apace. And don't worry, the ends do justify the means.
Gee, the South Koreans can have cloning by having one of their lab assistants donate her eggs - amongst numerous other problems with that particular series of experiments.
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Okay (Score:3, Insightful)
Re:Okay (Score:4, Insightful)
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Straight from the movies ... (Score:5, Insightful)
WWII (Score:3, Interesting)
Re:WWII (Score:4, Insightful)
are a result of the many barbaric experiments done by Nazi scientists
on their prisoners back in WWII.
I think this is not exactly the case. More to the tune of "...a lot of the medical advancements we enjoyed in the 50s and 60s..."
So are the insights they gained from their immoral experiements bad enough that we shouldnt use it on moral grounds?
Back then, the origin of the studies was just conveniently forgotten. Unlike Dr. Mengele [wikipedia.org], his boss (Adolf Butenandt) managed to continue his career in post-war Germany - mainly by vigorously destroying every evidence of his deeds. Mengele fled to South America but his research was (in parts) considered the de-facto standard until the early sixties - he himself being a good scape-goat, too, taking most of the guilt of the rest of the staff with him.
The reason, the concentration-camps were so attractive to all kinds of bio-scientist at that time were really two-fold:
- total lack of regulations
- the possibility to generate an mind-staggering amount of samples in a very short time
(previous studies on twins, one of Dr. Mengele's favorite projects, had taken years and were taken on a much smaller sample)I must assume, it's the same in India today, again: lot's of samples, little paper-work. If corporations don't apply any ethics, things will run out of control, again. It may even run out of control with more regulation - after all, who can counter the killer-argument of "but it may cure xyz-cancer or AIDS".
In the current climate of "sacrifice some lives for many/some freedoms for the big-picture", it's only a small step.
Don't rely on the assumption that scientists will just do "the right thing" - more often than not, the prospect of being able to "advance science" will just open new abysses, which later generations will look down with disgust and horror.
cheers,
Rainer
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Outsourcing guinea pigs (Score:3, Interesting)
"Doctors are easier to recruit for trials because they don't have to go through the same ethics procedures as their Western colleagues," Ecks said. "And patients ask fewer questions about what is going on."
Hmm. There are obviously some ethical questions here, but I think that it is for the best. Cheaper trials means more research, and the tests are only conducted when it is almost certain to succeed. The US is much too stringent with medicine, because of lawsuits. People with shorter life expectancies don't care quite as much about the risks of testing drugs, and the sooner drugs are out there helping people, the better.
Cue comments about how this is the most evil thing ever, and that nothing is as valuable as a human life (which is why, instead of buying christmas presents, you will donate to third world countries' medicine.)
move along, nothing new here (Score:5, Interesting)
In fact, this is one of the biggest problems in our current medical knowledgebase. Many important drug and poison studies have been conducted in India due to its unique mix of being technologically advanced enough to manage a study, structured enough to organize them, and having a large body of people willing to join them.
The big downside is that India is not an ethnically diverse country. Thus, the results are not necessarily transferrable.
Back in the '50s and '60s, the PCB studies were performed in India. PCBs were found to be highly toxic. It wasn't until the '70s and '80s that followup studies identified the fact that PCBs are vastly (as in 100x type vastly) more toxic to people of Indian and Japanese descent than to people of Caucasion and African descent. If the studies had been done in South America, America, Canada, or Europe, we'd probably still be using PCBs all over the place.
It is critical for the further advancement of medicine that we move beyond our current statistical approach to medicine and studies and start defining which genetic and environmental factors are indications or contraindications for specific medicines. Many medicines kill some people and save others. Rather than tossing them aside, we must start learning to identify when they will kill and when they will save. That requires tests across diverse populations. India doesn't qualify.
blessing and curse (Score:5, Interesting)
In general, humans are pretty genetically uniform. But some crucial differences do pop up. Heck, think of testing something as benign as dairy products. Most of the world can't drink milk.
Fun bit o' trivia: a significant number of chemicals that cause cancer in rats, don't in mice. And visa versa. Makes you wonder how reliable those tests are extrapolated to humans!
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Animal rights activist sheer! (Score:4, Funny)
$$$ greater than Human life? (Score:4, Insightful)
"Third World lives are worth much less than the European lives. That is what colonialism was all about," said Srirupa Prasad, a visiting assistant professor of medical history and bioethics at the University of Wisconsin-Madison.
hits the nail on the head. unfortunatly.
examples like this are common in medicine (Score:4, Interesting)
Testing Drugs on America's Poor. Different? (Score:5, Insightful)
For years people right here in the US have been selling body fluids and enrolling in drug trials to make extra cash.
But there's a moral issue when it is done in some other country?
Can we quite patronizing the people? They're poor not retarded.
The perils of genetic variations (Score:5, Insightful)
Drug Patents (Score:4, Interesting)
This is a very interesting statement. One part of patent theory is that commercial organizations won't invest in developing new products unless they have a guarantee that someone else can't just copy their product and sell it. It will be interesting to see if abiding by drug patents promotes drug manufacturing and research to move to India, or if it means that they can't afford the patent costs and nobody can afford drugs there anymore.
Make the FDA a "Informational" only (Score:4, Interesting)
One could argue that the market could regulate these drugs. If a drug company release a drug that did serious damage to 20% of the people taking it, this information would spread quickly and soon most people would stop taking that drug. But I would argue it is far better to have to undergo the rigorous testing the FDA puts most of the drugs through before they're made public so the dangers are known before it's available to most people.
On the other hand, I think there is a lot to be said for making the FDA an "informational" body only. In other words, it would do the same testing it does now, and all drugs would have to be submitted before release just as they are now, but regardless of the outcome of that testing the drug companies could make that drug publicly available. Before taking a drug, or before a doctor prescribes a drug, this database would be consulted to see the dangers and see how effective it is. The patients and doctors could then make their own decision as to whether or not this drug is good or bad.
If I'm dying of cancer I should be able to try anything I damn well please... in fact, if I've got a bad cold I should be able to try anything I damn well please. If I'm stupid and try the pharmacological equivalent of rat poison, then so be it... but the government shouldn't be able to limit my options.
From bad to worse (Score:4, Funny)
Re:I'm Fine With It (Score:5, Insightful)
Some would say the difference between life as a dahlit and life as a dahlit after being paid for it is most certainly a form of force and coercion.
Besides, these people don't have much use in society or a future, especially in India's caste society. This is an excellent opportunity for them to contribute something to better mankind and benefit the rest of us. We should be applauding and congratulating them for their sacrifice. We shouldn't try to take this away from them.
So you agree- givent he caste system they don't have any real choice at all.
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Re:I'm Fine With It (Score:5, Insightful)
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