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Science
Friday > Archives
> 1997
> September
> September 26, 1997
Bioethics:
The ethics of medical research in developing countries.
HIV transmission between mother and child has always been a major concern. In 1996, it was found that treatment with a course of high-dose AZT during certain times of pregnancy (a method known as the ACTG 076 protocol) reduced transmission of HIV dramatically. The ACTG 076 protocols, along with behavioral changes, such as stopping HIV-infected mothers from breastfeeding their babies, have helped lower the rate of mother-child transmission during birth from one instance in four births to under one in ten births in the U.S.
But in many developing countries, the situation is much worse. In countries like Uganda and Malawi, forty percent of pregnant women are thought to be infected with HIV. Low availability of AZT, which can cost around $1000 for a full-strength treatment during pregnancy, and the common nature of breastfeeding in these countries have kept the transmission rate from mother to child tragically high. U.S. government funded researchers working with the National Institutes of Health and the Centers for Disease Control and Prevention are trying to develop new, less expensive treatment regimens that might help to control the spread of HIV in these countries. The methods that they are using to test these treatments, however, are coming under fire. The studies, run in developing countries ranging from the Ivory Coast to Thailand, provide some pregnant women with reduced-strength treatments of AZT and others with placebo medications.
Some people feel that such practices bring the medical community back to the same low level as the infamous Tuskegee Syphillis Study, in which treatment was withheld from syphillis-infected African-American men in order to follow the development of the disease. Other scientists, however, claim that accurate placebo-controlled experiments are the only way to quickly, effectively prove the usefulness of the new methods, and point out that without these studies, almost no women in these developing countries would ever likely be able to recieve AZT.
In this hour of Science Friday, join host Ira Flatow for a look why these studies are done, and what alternatives are available.
Plus... a chat with the co-founder of NetDay, a "high-tech barnraising" effort to connect K-12 schools to the Internet. For information about helping with the project, contact NetDay's website.
Guests:
Norman Fost
Professor of Pediatrics
Director, Program in Medical Ethics
University of Wisconsin
Madison, WI
Peter Lurie
Research Associate
Public Citizen's Health Research Group
Visiting Research Scientist
University of Michigan
Ann Arbor, MI
Hoosen Coodavia
Professor and Chair
Department of Pediatrics and Child Health
University of Natal
Durban, South Africa
Michael Kaufman
Co-Founder, NetDay
San Francisco, CA
Books/Articles Discussed:
Related Links:
Dr. Lurie's
article protesting the trials, from the New England Journal of Medicine
The New
England Journal of Medicine's editorial about the clinical reseach in
developing countries
The Joint U.N. Programme on HIV/AIDS
The World Health Organization
The AMA's Global AIDS Link
The National Bioethics Advisory Committee
Bioethics for Beginners
NIH "Women and AIDS" factsheet
Info on the ACTG 076 protocol from the CDC
More ACTG 076 info, this time from NIH
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