Testing Drugs on India's Poor

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'"

Wait

[nizo (81281)]

So now we are outsourcing the jobs of lab animals [wikipedia.org] to India?? And I shudder to think what the "No Indian testing" [wikipedia.org] label will be in Europe (maybe a big hand patting a meditating guru on the head?)

Re:Wait

[advocate_one (662832)]

it's as big a scandal as the ships being dissassembled by hand on the beaches of India... and all the surplus PCs being shipped off to be stripped down by hand...

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

Re:Wait

[by Anonymous Coward]

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?

Re:Wait

[by Anonymous Coward]

Comment was a dig at PeTA. PeTA hates humans.
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/c a_arson_terrorist(8-7-03).htm/ [naiaonline.org]
http://www.activistcash.com/organization_overview. cfm/oid/21/ [activistcash.com]

Re:Wait

[MickLinux (579158)]

Except that though the choice may be semi-informed, it won't be free when the person has a choice between being killed by drugs or killed by starvation (along with their family). There's a reason why India is being targeted. I think I can do without those drugs. Even if not using them shortens my life.

Ethics

[Winckle (870180)]

"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."
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.

Pff..

[iSeal (854481)]

So first they took away our call centers... Then they took away our IT jobs... Now they're taking our priviledge to test dangerous drugs on the poor and destitute?

Damn you trained and abled Indian workforce!

Re:Pff..

[metternich (888601)]

In all seriousness though, it is the US poor who volunteer to praticipate in research studies here too. I have one friend who paid her way through college doing this.

Re:Pff..

[Surt (22457)]

I have a (male) friend who did that too. As a bonus he can code faster than anyone I know using his third arm.

outsourcing

[jimbolauski (882977)]

I guess India's poor cost less to test on the the US bunny rabbit, I for one can not believe companies would take away jobs from som many bunnies I can't even imagine how bunnies can take care of their large families.

No Surprise

[ben_white (639603)]

I find this quite disturbing. I, however, am not surprised. I have been in academic medicine for 15 years, and have seen the requirements for human research change to the point that many clinicians have just given up any hope of being able to practice and participate in meaningful clinical trials due to the exploding amount of red tape. Of course the red tape does serve a purpose; from the article:

In another incident, Sun Pharmaceuticals convinced doctors to prescribe Letrozole, a breast cancer drug, to more than 400 women as a fertility treatment in a covert clinical trial -- and used the results to promote the drug for the unapproved use.

This type of problem was not terribly uncommon in the past in the US (and I assume other industrialized nations), but is not common now, due to the oversight of clinical trials we have now.

Re:No Surprise

[ben_white (639603)]

Seems to me I remember a fertility treatment called thalidomide....and a bunch of babies born without arms and legs being the reason for that. Isn't it amazing how profit creates short memories?

Not a fertility treatment, but a treatment for morning sickness (see here [wikipedia.org]). And interestingly enough, never approved for distribution in the US (until 1998 for leprosy and myeloma).

Generic versions of patented drugs

[op12 (830015)]

FTA: "But in March, everything changed when India submitted to pressure from the World Trade Organization to stop the practice and implement rules that prohibit local companies from creating generic versions of patented drugs."

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

[slavemowgli (585321)]

Non-cynical answer: the difference is "patented". Robitussin's active ingredient was patented in the 1950s, so the patent has long since run out, and everyone's free to recreate it.

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.

The Miracle of Birth: The Third World

[Tackhead (54550)]

> Wired is reporting that a lot of medical research firms are using India's poor as a hot test bed.

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"?

[Hamster Lover (558288)]

Not only are research costs low, but there is a skilled work force to conduct the trials.

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.

One case where less regulation will help!

[ErichTheRed (39327)]

I'm not sure what kind of FDA-equivalent the Indian government has, but there's definitely an advantage to conducting your human trials in places where people aren't breathing down your neck.

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...

[ScentCone (795499)]

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.

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.

Straight from the movies ...

[cpn2000 (660758)]

The Constant Gardener [imdb.com] anyone?

move along, nothing new here

[RhettLivingston (544140)]

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

[jbeaupre (752124)]

Lack of diversity during certain phases is a good thing. It improves the signal to noise ratio in the statistics. It's why they use identical white mice. It's a bad move, when you extrapolate. Which is what someone did in your example. Luckily they erred on the safe side. Still, a good study should move from the narrow to the broad.

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!

Testing Drugs on America's Poor. Different?

[Kunta Kinte (323399)]

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

[G4from128k (686170)]

This sounds like a recipe for disaster. I, personally, would avoid drugs that had not been tested on people genetically similar to myself. People are not identical in their ability to absorb, metabolize, respond to, or excrete medications. A drug that works well in one population can easily fail to help (or have fatal side effects) in people in a different population.

Re:I'm Fine With It

[Marxist Hacker 42 (638312)]

They are getting paid for it, a nice enough sum that it's worth their health and life. They aren't being forced or coerced into it.

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.

Re:I'm Fine With It

[by Anonymous Coward]

If you have seen the film "Constant Gardener", you can see the problems associated with this practice. The main problem is lack of accountability. So what if a couple people die from these drug tests. They are poor, no one is going to miss them. No one will fight for them.