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A healer’s first rule is ‘do no harm,’ right? Not necessarily. Growing numbers of drug researchers are heading for little-regulated Third World countries to test their wares, and the dubious ethics of some recent such trials has ignited a hot debate among doctors and scientists. The issue will be high on the agenda as the World Medical Association meets this week, reports the GUARDIAN (UK).

In one test in China, people were deliberately infected with malaria to see if it reduced the level of HIV infection. Hundreds of infants unlucky enough to be born into the control group of a study in Africa were allowed to become infected with HIV when the condition might have been prevented.

Defenders of these tests say the more stringent guidelines used in the US and other developed countries, which require the control group to be given some form of treatment, would be meaningless in poor countries. In, say, Uganda, they argue, the only alternative to the test drug is no drug, so that’s what the tests should use. “It is all well and good to create something in Uganda that simulates London or New York [by giving various treatments to all the groups in a trial], but what you get out of that is data that is no good anywhere other than London or New York,” says Robert Levine, a professor at Yale University School of Medicine.

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