Session 7 Reading Reflection

In When Experiments Travel, Petryna discusses the globalization of clinical trials and the effects, both positive and negative, that this change can have on the populations where the trials are moving to. Some of the reasons clinical trials are being moved outside of the US include lack of interested and qualifying participants, lack of research coordinators, lack of funding and the strict regulations in place in the US restricting and overseeing the clinical trial process. These companies argue that moving their clinical trials out of the US not only benefits themselves but it also benefits the countries that they now hold their trials in because people in these areas will now have access to free healthcare that they wouldn't have been able to receive otherwise. However the ethics of outsourcing clinical trials is questionable exactly because these areas have less regulations, which is one of the benefits that pharmaceutical companies enjoy when they take clinical trials outside of the US. Without regulations or committees overseeing the ethics of research, the true effects of the research on the patients is unclear and not always beneficial to them as the pharmaceutical companies like to say.
It is easy to claim that by merely bringing the medical advancements and making them accessible to people is already a good deed on the local population's behalf, however it is also important to look at how the medical advancements and technologies are used in the local populations culture and how it influences their community. For example in studies researching the efficacy of antiretroviral therapy in different countries in Africa, while they provided life changing medicine for people the antriretrovirals were also meant to be eaten with food in order to decrease the side effects. In order to deal with the lack of adequate nutrition, participants in the study were given nutritional supplements. However this can cause tension within families because when one family member is given a bag of nutritional supplements how could they not be expected to share it with their parents, siblings, or children? Some patients who were interviewed admitted to starving themselves in order to give the supplement to their children, however they also suffered worse side effects from the antiretroviral therapy because of this choice. This is only one example of how bringing a medical advancement to a foreign country and providing it to participants in a clinical trial is much more complexing than merely prescribing them the medication. There are many cultural and social circumstances that must be considered in relation to how the medications might change things either for better or for worse. Overall I feel that while pharmaceutical companies might give the impression that globalizing clinical trials is an easier and cheaper path than going through the regulatory process in the US, ultimately providing the same standard of care that might be provided in a US clinical trial can be much more complex because of different cultural, social, and religious contexts.