African AIDS: Whose Research Rules?

Michelle Barry a clinical researcher from Yale had to abandon a study she had planned which would have examined HIV infection rates in pregnant Tanzanian women. She had to do this because the government of Tanzanian told her she could not tell the women why she was taking blood or tell the women the result of the test. This conflicted directly with the regulation imposed on her study by Yale. Yale insisted on informed consent and insisted on telling the women the results. This is just 1 example of a growing problem in the research community. Africa is viewed by many AIDS researchers as the ideal place to conduct their activities because of the high incidence and transmission rates. More than 5 million people are infected and in some Central African cities the rate is 20-40% of adults. However the continent has its own cultural opinions about things like informed consent and other ethical aspects of medicine. There are also a great many ethical considerations for western researchers to consider. Is it ethical to test new vaccines and treatments on population that can not afford to purchase any effective treatments that are developed? Most researchers feel that this is a problem. Is it ethical to do research on the populations of the developing nations when the benefits will be mostly in developed nations? Some researchers have done what is called safari research in which they fly into a local village and collect information and blood samples. Then they fly home and determine their results and never report them to the local village. This makes local officials feel exploited. There is a general opinion in the research community that this practice is unethical. There are approximately 600 AIDs related studies being conducted in Africa currently. Of these approximately half involve researchers from outside of Africa. The problem of coercion must be considered. If people are offered cash for their participation in a study is this not placing unfair pressure on them?