Research in poor countries: the Guatemalan trials

The news (1) about the patently unethical trials carried out in Guatemala by researchers from the United States underscores the continuing necessity to regulate human research, inspire public trust, and strengthen existing protections for research participants in all countries, rich and poor. This is important given the increased vulnerability in resource-challenged settings of poor countries. Although several decades have passed since the trials were undertaken, they, along with other notorious trials such as the Nazi doctors’ trials and the Tuskegee Syphilis trial, remind us that scientific research, while beneficial, requires strong ethical safeguards. Many people in poor countries will see this trial as one more instance of exploitation of citizens of a poor country by researchers from a rich country.

Poor countries must be encouraged to build and maintain robust research ethics systems for the protection of persons who participate in research in those countries, and rich countries must ensure compliance with ethical requirements when they fund research in poor countries or when their researchers conduct research in poor countries. Rich countries must also continue to support efforts to bolster research ethics in developing countries. Such efforts have included those emanating from the Fogarty International Centre of the National Institutes of Health in the United States and the European Developing Countries Clinical Trials Partnerships.