a1087: Aids Vaccine Trials in Haiti (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: Fonda's <fonphoto@snip.net>


I received the following article from a friend who translates scientific journals for a clip service.  He is credited following the article.  According to him,
> "Jeune Afrique" is the name of the magazine. It's published in France
>and as the name suggests, it focuses on current events in Africa and the
>African diaspora. It's sort of like a "Time" magazine for those interested
>in what's going on in Africa.

  ‹Dave Fonda



Vaccine Trials in Haiti: Are the Test Subjects Willing or Forced Volunteers?

By Juliette Bastin,  ìJeune Afriqueî No. 2131, November 13-19, 2001

Can vaccine trials be practiced on a poor, largely illiterate population, which is then faced with concepts it doesnít understand?  In Cite Soleil, a slum of Port-au-Prince, Haiti, forty people are participating in a test trial for vaccines against AIDS, one French (Aventis), the other American (Vaxgen).  The question of test trials on humans is a thorny one, especially in phase II, in which immune reactions and tolerance are closely watched.  The HIVNET 026 campaign, launched on March 27, 2001, was denounced in May by the Union of Haitian Physicians (UMHA).

The HIVNET 026 test is being carried out under the aegis of the National Institutes of Health (NIH), which provides management and financing and appoints the medical team chosen to carry out the project. In Haiti, the Haitian Group for the Study of Kaposiís Sarcoma and Infectious Diseases (GHESKIO) was given this responsibility.  The groupís leader, Jean William Pape, a graduate of Cornell Medical College in New York, is a recognized authority in his country. UMHA has reproached him for using as guinea pigs a population ìlargely illiterate and poor, who are not in a position to fully understand the particulars of the trial.î

Can educational seminars and the Community Consultative Council (CAB), whose responsibility it is to disseminate information to the people, do the job of transmitting essential concepts to people whose medical knowledge is non-existent?  It seems as if there are two kinds of campaigns according to whether the ìvolunteersî are from developed or developing countries.  These trials, organized in Europe or the United States, are rigorously laid out by legislation which, among other things, requires a clear understanding among volunteers who are chosen from a no-risk population, after medical and psychological tests. A long-term medical follow-up with access to care and a substantial remuneration are also required.  American law stipulates, moreover, that ìno pressure may be exerted, the volunteer must be fully consenting and informed and must have access to the best possible care during and after the trial.î

The fact that these stipulations are not respected in developing countries allows low-cost vaccine campaigns.  The selection of persons without means and motivated by the appeal of meager benefits seems to indicate that the code of ethics has not crossed the borders. Nevertheless, Ethicist Udo Schuklenk quotes the Helsinki declaration, which stipulates that ìin medical research on human beings, the interests of science and society must never prevail over the well-being of the subject.î  This is not at all the case in Port-au-Prince.  On the brochure offered to the volunteers, it is not clearly indicated whether they will be cared for in case of contamination.  There is only one directive: take care not to become infected with HIV during the course of the trial.

The question had already been raised in early 2000 following the publication of a book by the British author Edward Hooper, according to whom the AIDS epidemic had its origin in vaccine trials carried out in Central Africa in the 1950s on unknowing populations.  UMHA fears that history is repeating itself as these trial vaccines were developed using a genetically modified virus.  It doesnít appear to present any risk except for rendering the volunteers ìartificiallyî sero-positive, according to the Third World Network, an association which specializes in biotechnology.  One of its biochemists explains that ìit is very dangerous to modify and inoculate these viruses because they are very unstable organisms whose penchant for eventual mutation is unknown.î  But in an extremely poor country with no real system of prevention and which already has the highest rate of infection in the Caribbean, what difference does it make if forty more people test positive?

-Translated by Rodney Chonka












Respect;

      Dave Fonda

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