Is it safe to test vaccines on third world people?

Answer 1

Testing vaccines or medicines on third world people, in order to avoid possible risks of testing on US citizens would be unethical.

In a perfect world, yes, it is unethical to test any medication on groups of people who cannot either give informed consent, or are so desperate that they will consent regardless.

However, this leaves out the practical dimension. Withholding a possible cure or vaccine from a group solely based on their lack of education or lack of wealth is also condescending, and has the possible downside of allowing people to die unnecessarily.

The bottom line here is that to be safe and ethical, the drug companies should:

1. Make sure that preliminary testing is done to the same standards, regardless of whether the human trials are to be conducted in a developed or developing country.
2. Those being offered the vaccine are capable of following the directions required for the trial, so as to provide meaningful data about the drug's usefulness - that is, the recipient population needs to understand how to use the drug
3. All recipients are fully informed about the risks that the drug poses, AND are updated frequently as to the ongoing progress of the trial (including possibly having the trial stopped ahead of time if it proves dangerous).
4. No one should be forced against their will (either by their government, the drug company, or social convention) to participate in the test.

The main reason to test drugs in the Third World is cost: people in the developed world may be sufficiently confident in their ability to combat the disease that they refuse to take part in such a trial, and getting enough participants can be difficult. That is, people who chose to participate in a drug trial make a cost-benefit choice: are the possible beneficial aspects of the drug greater than the possible side-effects? This choice is based heavily on the individual's condition and social options. Frankly, those in the Third World generally have much less to lose, and thus, will accept more risk from such a trial.

The bad part of conducting trials in the Third World is that it is far easier for the trial to become corrupted - due to the significantly lower education level, and generally very high social instability, getting those in the trial to follow proper procedure can be extremely difficult in some cases. Also, due to the generally poorer health of those in the Third World, determining the exact effects of a drug on such a person can prove more difficult than with a developed country's test subject.