AIDS research in the developing world has raised ethical questions pertaining to the clinical testing of new therapies and potential vaccines. For example, controversy erupted over 1997 clinical trials that tested a shorter course of AZT therapy in HIV-infected pregnant women in developing countries. Earlier studies had shown that administering AZT to pregnant women for up to six months prior to birth could cut mother-to-child transmission of HIV by up to two-thirds. The treatment’s $800 cost, however, made it too expensive for patients in developing nations.
The controversial 1997 clinical trials, which were conducted in Thailand and other regions in Asia and Africa, tested a shorter course of AZT treatment, costing only $50. Some pregnant women received AZT, while others received a placebo—a medically inactive substance often used in drug trials to help scientists determine the effectiveness of the drug under study. Ultimately the shorter course of AZT treatment proved to be successful and is now standard practice in a growing number of developing nations. However, at the time of the trials, critics charged that using a placebo on HIV-infected pregnant women—when AZT had already been shown to prevent mother-to-child transmission—was unethical and needlessly placed babies at fatal risk (Hiv Testing, AIDS Testing, Hiv Vaccine, Aids Vaccine, Aids Research). Defenders of the studies countered that a placebo was necessary to accurately gauge the effectiveness of the AZT short-course treatment. Some critics speculated whether such a trial, while apparently acceptable in the developing nations of Asia and Africa, would ever have been viewed as ethical, or even permissible, in a developed nation like the United States.
Similar ethical questions surround the testing of AIDS vaccines in developing nations. Vaccines typically use weakened or killed HIV to spark antibody production. In some vaccines, these weakened or killed viruses have the potential to cause infection and disease. Critics questioned whether it is ethical to place all the risk on test subjects in developing regions such as sub-Saharan Africa, where a person infected by a vaccine would have little or no access to medical care. At the same time, with AIDS causing up to 5,500 deaths a day in Africa, others feel that developing nations must pursue any medical avenue for stemming the epidemic and protecting people from the virus