Therapeutic research in low-income countries: Studying trial communities

Abstract

Social scientists undertaking studies in developing countries focus on ‘trial communities’: networks of funders, institutions, researchers, clinical staff, fieldworkers, and study participants. Whereas bioethicists consider universal ethical requirements, social scientists examine ethical practices in light of concerns and interests of parties involved in medical research. In conditions of poverty, high morbidity and weak public health services, subjects are heavily induced by the prospect of high quality care that researchers seem to offer. Studies of health research undertaken by well-established institutions in Africa show that parents eagerly have their children ‘join’ such projects. They assess benefits and risks less in research terms and more through overall trust in care provided previously by such institutions in the community. Bioethics should go beyond concern with protecting individual subjects from research risks and should view clinical care and research functions as indistinguishable for many who seek sustained support for the children’s health.