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This week the BMJ carries a debate on whether drug companies conducting clinical trials on patients infected with HIV in South Africa should continue to supply the drugs after the trial ends to the subjects who show benefit and who cannot afford to buy them (p 887).[1] Dr Peter King of Roche Products concedes chat subjects in clinical trials in Britain may be treated differently from chose in Africa and South America (p 890). This inequality of treatment prompts ocher questions. Should research be conducted in a country where the people are unlikely to benefit from the findings because most of the population is too poor to buy effective treatment? Are poor people in developing countries being exploited in research for the benefit of patients in the developed world where subject recruitment to a randomised trial would be difficult?
The marketing policies of multinational drug companies proves that they do not treat developed and developing countries equally. The Medical Lobby for Appropriate Marketing, an international lobby group based in Australia, repeatedly criticises companies which market in developing countries drugs that …