Mungo Soggot
Two eminent editorial board members of an influential United States medical journal which slated South African Aids drug trials on pregnant women have resigned in protest at the articles.
The New England Journal of Medicine said the trials – which give some of the women an Aids drug called AZT and others a placebo – violated established medical ethics.
The New York Times news service reported that the two editorial board members who quit – Dr David Ho, a virologist, and Dr Catherine Wilfert, a paediatrician – were the journal’s chief advisers on Aids.
Neither was consulted when the journal published the controversial editorial, which linked the trials to the infamous Tuskegee experiment in which black Americans with untreated syphilis were denied penicillin after it became available.
The magazine criticised the trials – which are also being conducted in 14 other developing countries – for denying some of their volunteers access to treatment which had become standard procedure in the US. Some local doctors involved in the trials were incensed at the criticism, as were the patients themselves. The doctors argued the criticism was culturally insensitive and that the US treatment – which is extremely expensive – could be ineffective among breastfeeding populations.
Dr Glenda Gray, who works on one of the trials at Soweto’s Chris Hani Baragwanath Hospital, said this week that the board members’ decisions were “appropriate”. Gray said the articles had not been balanced and had “far-reaching implications”.
She said that a US Aids drug trial due to start in South Africa next year had been cancelled after the articles appeared. The trials will be conducted in Brazil, Thailand and Argentina.
Gray told the Mail & Guardian earlier this month that the patients know they stand a one-in-four chance of being given a placebo. A string of Southern African doctors have written to the Department of Health and Human Services in Washington, to give their support to the trials. “Studies to test new therapies in Africa must take into consideration the local cultural, economic and social conditions,” they wrote,
The articles have sparked fierce debate in the US. The Chicago Tribune wrote in an editorial this week that the trials in developing countries “are merely doing what grim circumstance requires, sacrificing ethical punctilio in favour of seeking results that could conceivably save hundreds of thousands of lives in Third World countries”.