35-kilometer distance. During the clinical trial, she'd been given all her antiretroviral drugs, and her transportation costs had been covered by the research funds. All of these ended once the trial was completed, leaving Celine with no choices. She was unable to tell me the names of the drugs she'd received during the trial, or even what the trial had been about. Yet what puzzled me most was Celine had given her informed consent(同意) to be a part of this trial, yet she clearly did not understand the implications of being a participant or what would happen to her once the trial had been completed.
I do not stand here today to suggest in any way that conducting HIV clinical trials in developing countries are bad. On the contrary, they are extremely useful tools, and are much needed to address the burden of disease in developing countries. However, without an effective system for reviewing the ethical suitability of them, these clinical trials may be of great problem.
In order for a clinical trial to produce valid and widely applicable results, they need to be conducted with large numbers of study participants and preferably on a population with a high rate of new HIV infections. Sub-Saharan Africa largely fits this description, with 22 million people living with HIV, an estimated 70 percent of the 30 million people who are infected worldwide. Also, research within the continent is a lot easier to conduct due to widespread poverty and inadequate health care systems. A clinical trial that is considered to be potentially beneficial to the population is more likely to be authorized, and in the absence of good health care systems, almost any offer of medical assistance is accepted as better than nothing.
The high occurrence of HIV drives researchers t