The ethics of global clinical trials

C linical research by academic institutions and pharmaceutical companies has followed the general trend of globalization and has moved inexorably towards lowand middle-income countries (LMIC). This trend has raised various concerns, including whether the research being conducted is of value to public health in these countries or whether economically disadvantaged populations are being exploited for the benefit of patients in rich countries. Nevertheless, clinical trials and the research and health care that accompany them can directly benefit patients, in particular those who would otherwise have no or only little access to health care services. It is therefore a matter of striking a fine-tuned balance between the economic and research interests of pharmaceutical companies and academia and the needs of patients in LMIC to make sure that all sides benefit. ...................................................... “. . . clinical research also helps to build research and health care capacity and can improve local infrastructure and boost the economy” ......................................................