Medical experimentation in Africa
Encyclopedia
African countries have been sites for clinical trials by large pharmaceutical companies. There have been reports of unethical experimentation and unethical clinical trials in Africa and improper informed consent methods. The African Charter on Human and Peoples' Rights on the Rights of Women in Africa seeks to prohibit all experiments on women without their informed consent during clinical trials. Human rights activists are asking for more accountability in reference to informed patient consent in Medical experimentation in Africa.
and Helsinki Declaration both offer protection to subjects in clinical trials and medical experimentation.
: "experimental medicine or no medicine at all".
, Chad
and Burkina Faso
because many people avoid vaccinations. They believe that the vaccines are contaminated with H.I.V. or sterilization agents.
Several science journals, including Nature
, suggested that in one case against Bulgaria
where Libyan
children were infected through the re-use of incompletely cleaned medical instruments, there were accusations of iatrogenic, or healer-transmitted infections. Studies showed that the infections may have been due to needles not washed properly prior to the Bulgarian nurses arrival to Libya. This means that the acts may have been accidental. But given the history of Western medicine trials in Africa that are consciously done, there was heightened mistrust that it was not intentional. Programs for researchers doing research in Africa are being encourage to understand the clinical trial histories to improve informed consent process.
South Africa’s apartheid army forced white lesbian and gay soldiers to undergo ’sex-change’ operations.It was part of a secret program to purge homosexuality in the army. This was supported by psychological treatment by army psychologists. Many had to undergo to chemical castration, electric shock, and other unethical medical experiments if they could not be 'cured' with drugs. An estimated 900 forced ’sexual reassignment’ operations may have been performed between 1971 and 1989 at military hospitals. Many of these experiments were conducted at the Military Hospital at Voortrekkerhoogte. Many of the victims were young, 16 to 24-year-old white males drafted into the apartheid army although a few women did have to undergo experimentation.
Dr. Aubrey Levin is now Clinical Professor in the Department of Psychiatry (Forensic Division) at the University of Calgary
’s Medical School and a member at the College of Physicians and Surgeons of Alberta
.
was conducted by Wouter Basson
, a former head of South Africa’s chemical and biological weapons unit under apartheid in South Africa. He was charged with killing hundreds of blacks in South Africa and Namibia via injected poisons. He was never convicted in South African courts, even though his lieutenants testified," in detail and with consistency" about the medical crimes they conducted against blacks.
Once approved, the drug was then used as a population control measures in the 1970s. There was coercion of women to accept Depovera on white-run commercial farms.Population
control interests motivated many of the family planning programs. This led to its eventual ban in Zimbabwe.
(Namibia
) by Dr. Eugen Fischer
. His experimentation was largely done on mixed-race offspring in order to provide justification to ban mixed-race marriages. He joined the Nazi party thereafter where he did similar experiments in the Jewish concentration camps. Late stage studies were later continued by Doctor Hams Harmsen, founder of the German branch of International Planned Parenthood Federation (IPPF) whose name is also associated with the compulsory sterilisation in Nazi Germany.
trials conducted on HIV-positive African subjects by U.S. physicians and the University of Zimbabwe
were not performed with proper informed consent. The United States began testing AZT treatments in Africa in 1994, through projects funded by Centers for Disease Control (CDC) and the National Institutes of Health
(NIH). It included testing of over 17,000 women for a medication that prevents mother to child transmission of HIV/AIDS. The subjects did not fully understand the testing methods, the effectiveness, the possible dangers, or the nature of a placebo
in testing situations. They were also told about the trials under duress. Half of these women received a placebo that has no effect which means transmission was likely and a result an estimated 1000 babies contracted HIV/AIDS when a proven life-saving regimen already existed. The CDC ended the short course testing in 1998 after they announced they had enough information from Thailand
trials.
' highlighted the dynamics of conduct in clinical trials in Africa in the slum areas. This was based on a real-life case in Kano, Nigeria. New York Times best seller Harriet A Washington's book Medical Apartheid
, provides a historical account of experimentation on African Americans, but also includes the links to African experimentation.
African Charter on Human and Peoples
The provision of article 4(2)(h) of the Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa seeks to prohibit all medical and scientific experiments on women without their prior informed consent.Nuremberg Code and Helsinki Declaration
The Nuremberg CodeNuremberg Code
The Nuremberg Code is a set of research ethics principles for human experimentation set as a result of the Subsequent Nuremberg Trials at the end of the Second World War.-Background:...
and Helsinki Declaration both offer protection to subjects in clinical trials and medical experimentation.
National codes of Ethics
Many African nations lack any legislative protections for subjects of medical research. In most cases this is because nations cannot afford such research without subsidies from multinational pharmaceutical corporations. To court these pharmaceutical corporations, African nations minimize regulation on the conduct of medical research so that many legal battles do not arise.Poverty and experimentation
People living in the rural areas and slum area are more vulnerable to experimentation since they are largely illiterate and may not understand the effects of the experimentation. They are also forced with making Hobson's choiceHobson's choice
A Hobson's choice is a free choice in which only one option is offered. As a person may refuse to take that option, the choice is therefore between taking the option or not; "take it or leave it". The phrase is said to originate with Thomas Hobson , a livery stable owner in Cambridge, England...
: "experimental medicine or no medicine at all".
Iatrophobia in Africa
Medical experimentation has been occurring in Africa for a long time in some cases it has led to iatrophobia particularly on new drug clinical trials. Due to medical experimentation in the past, there is a fear and mistrust in some countries and areas in Africa of medical experimentation. For example, polio has been on the rise in NigeriaNigeria
Nigeria , officially the Federal Republic of Nigeria, is a federal constitutional republic comprising 36 states and its Federal Capital Territory, Abuja. The country is located in West Africa and shares land borders with the Republic of Benin in the west, Chad and Cameroon in the east, and Niger in...
, Chad
Chad
Chad , officially known as the Republic of Chad, is a landlocked country in Central Africa. It is bordered by Libya to the north, Sudan to the east, the Central African Republic to the south, Cameroon and Nigeria to the southwest, and Niger to the west...
and Burkina Faso
Burkina Faso
Burkina Faso – also known by its short-form name Burkina – is a landlocked country in west Africa. It is surrounded by six countries: Mali to the north, Niger to the east, Benin to the southeast, Togo and Ghana to the south, and Côte d'Ivoire to the southwest.Its size is with an estimated...
because many people avoid vaccinations. They believe that the vaccines are contaminated with H.I.V. or sterilization agents.
Several science journals, including Nature
Nature (journal)
Nature, first published on 4 November 1869, is ranked the world's most cited interdisciplinary scientific journal by the Science Edition of the 2010 Journal Citation Reports...
, suggested that in one case against Bulgaria
Bulgaria
Bulgaria , officially the Republic of Bulgaria , is a parliamentary democracy within a unitary constitutional republic in Southeast Europe. The country borders Romania to the north, Serbia and Macedonia to the west, Greece and Turkey to the south, as well as the Black Sea to the east...
where Libyan
Libyan
A Libyan is a person or thing of, from, or related to Libya in North Africa.The term Libyan may also refer to:* A person from Libya, or of Libyan descent. For information about the Libyan people, see Demographics of Libya and Culture of Libya. For specific persons, see List of Libyans.* Libyan...
children were infected through the re-use of incompletely cleaned medical instruments, there were accusations of iatrogenic, or healer-transmitted infections. Studies showed that the infections may have been due to needles not washed properly prior to the Bulgarian nurses arrival to Libya. This means that the acts may have been accidental. But given the history of Western medicine trials in Africa that are consciously done, there was heightened mistrust that it was not intentional. Programs for researchers doing research in Africa are being encourage to understand the clinical trial histories to improve informed consent process.
The Aversion Project in South Africa (1970s-1980s)
In a project headed by Dr. Aubrey LevinAubrey Levin
Aubrey Levin is a prominent professor of clinical psychiatry at the University of Calgary.Levin was fist licensed as a psychiatrist in South Africa in 1969...
South Africa’s apartheid army forced white lesbian and gay soldiers to undergo ’sex-change’ operations.It was part of a secret program to purge homosexuality in the army. This was supported by psychological treatment by army psychologists. Many had to undergo to chemical castration, electric shock, and other unethical medical experiments if they could not be 'cured' with drugs. An estimated 900 forced ’sexual reassignment’ operations may have been performed between 1971 and 1989 at military hospitals. Many of these experiments were conducted at the Military Hospital at Voortrekkerhoogte. Many of the victims were young, 16 to 24-year-old white males drafted into the apartheid army although a few women did have to undergo experimentation.
Dr. Aubrey Levin is now Clinical Professor in the Department of Psychiatry (Forensic Division) at the University of Calgary
University of Calgary
The University of Calgary is a public research university located in Calgary, Alberta, Canada. Founded in 1966 the U of C is composed of 14 faculties and more than 85 research institutes and centres.More than 25,000 undergraduate and 5,500 graduate students are currently...
’s Medical School and a member at the College of Physicians and Surgeons of Alberta
College of Physicians and Surgeons of Alberta
The College of Physicians & Surgeons of Alberta is a medical regulator in the Canadian province of Alberta. Its stated purpose is to "register physicians and issue medical practice permits, develop and administer standards of practice and conduct, and investigate and resolve physician-related...
.
Project Coast in South Africa (1979-1987)
South Africa's Project CoastProject Coast
Project Coast was a top-secret chemical and biological weapons program instituted by the South African government during the apartheid era. Project Coast was the successor to a limited post-war CBW program which mainly produced the lethal agents CX powder and mustard gas; as well as non-lethal...
was conducted by Wouter Basson
Wouter Basson
Wouter Basson is a South African cardiologist and former head of the country's secret chemical and biological warfare project, Project Coast, during the apartheid era. Nicknamed "Dr...
, a former head of South Africa’s chemical and biological weapons unit under apartheid in South Africa. He was charged with killing hundreds of blacks in South Africa and Namibia via injected poisons. He was never convicted in South African courts, even though his lieutenants testified," in detail and with consistency" about the medical crimes they conducted against blacks.
Depo-Provera in Zimbabwe
Depo-Provera for example, was clinically tested on Zimbawean women.Once approved, the drug was then used as a population control measures in the 1970s. There was coercion of women to accept Depovera on white-run commercial farms.Population
control interests motivated many of the family planning programs. This led to its eventual ban in Zimbabwe.
Sterilisation experiments in Namibia
In the case for sterlisation experiments were initially conducted on Herero women in German-occupied South West AfricaSouth West Africa
South-West Africa was the name that was used for the modern day Republic of Namibia during the earlier eras when the territory was controlled by the German Empire and later by South Africa....
(Namibia
Namibia
Namibia, officially the Republic of Namibia , is a country in southern Africa whose western border is the Atlantic Ocean. It shares land borders with Angola and Zambia to the north, Botswana to the east and South Africa to the south and east. It gained independence from South Africa on 21 March...
) by Dr. Eugen Fischer
Eugen Fischer
Eugen Fischer was a German professor of medicine, anthropology and eugenics. He was director of the Kaiser Wilhelm Institute of Anthropology, Human Heredity, and Eugenics between 1927 and 1942...
. His experimentation was largely done on mixed-race offspring in order to provide justification to ban mixed-race marriages. He joined the Nazi party thereafter where he did similar experiments in the Jewish concentration camps. Late stage studies were later continued by Doctor Hams Harmsen, founder of the German branch of International Planned Parenthood Federation (IPPF) whose name is also associated with the compulsory sterilisation in Nazi Germany.
Meningitis testing in Kano, Nigeria
The Pfizer drug, Trovan was used in a clinical trial in Nigeria. By the time the trial ended, 200 children were disabled and 11 were dead. This led to a lawsuit from the Nigerian government over informed consent in Kano, Nigeria. Pfizer countered that it met all the necessary regulations. This has led to mistrust of medical vaccines in Nigeria, particularly in Kano, where they refuse to participate in many trials now.HIV/AIDS Short-Course AZT Testing in Zimbabwe (1994-1998)
AZTZidovudine
Zidovudine or azidothymidine is a nucleoside analog reverse-transcriptase inhibitor , a type of antiretroviral drug used for the treatment of HIV/AIDS. It is an analog of thymidine....
trials conducted on HIV-positive African subjects by U.S. physicians and the University of Zimbabwe
University of Zimbabwe
The University of Zimbabwe in Harare, is the oldest and largest university in Zimbabwe. It was founded through a special relationship with the University of London and it opened its doors to its first students in 1952. The university has ten faculties offering a wide variety of degree programmes...
were not performed with proper informed consent. The United States began testing AZT treatments in Africa in 1994, through projects funded by Centers for Disease Control (CDC) and the National Institutes of Health
National Institutes of Health
The National Institutes of Health are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research. Its science and engineering counterpart is the National Science Foundation...
(NIH). It included testing of over 17,000 women for a medication that prevents mother to child transmission of HIV/AIDS. The subjects did not fully understand the testing methods, the effectiveness, the possible dangers, or the nature of a placebo
Placebo
A placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...
in testing situations. They were also told about the trials under duress. Half of these women received a placebo that has no effect which means transmission was likely and a result an estimated 1000 babies contracted HIV/AIDS when a proven life-saving regimen already existed. The CDC ended the short course testing in 1998 after they announced they had enough information from Thailand
Thailand
Thailand , officially the Kingdom of Thailand , formerly known as Siam , is a country located at the centre of the Indochina peninsula and Southeast Asia. It is bordered to the north by Burma and Laos, to the east by Laos and Cambodia, to the south by the Gulf of Thailand and Malaysia, and to the...
trials.
Pop culture references
The movie 'The Constant GardenerThe Constant Gardener
The Constant Gardener is a 2001 novel by John le Carré. It tells the story of Justin Quayle, a British diplomat whose activist wife is murdered...
' highlighted the dynamics of conduct in clinical trials in Africa in the slum areas. This was based on a real-life case in Kano, Nigeria. New York Times best seller Harriet A Washington's book Medical Apartheid
Medical Apartheid
Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present is a 2007 book by Harriet A. Washington. It is a history of medical experimentation on African Americans...
, provides a historical account of experimentation on African Americans, but also includes the links to African experimentation.
Perception
Popular fears of medical misbehavior has led to political manipulation of cases. In Libya, a case was manufactured by the Gaddafi government to blame an outbreak of HIV among young children on a group of Bulgarian nurses. After the Libyan Revolution of 2011, officials revealed they know the case had been manufactured.See also
- Human experimentation in North Korea
- Japanese human experimentation
- Nazi human experimentationNazi human experimentationNazi human experimentation was a series of medical experiments on large numbers of prisoners by the Nazi German regime in its concentration camps mainly in the early 1940s, during World War II and the Holocaust. Prisoners were coerced into participating: they did not willingly volunteer and there...
- Unethical human experimentation in the United States