Adriana Petryna extends the conversation about clinical research trials unto a more globalized context and analysis. Contract research organizations are increasingly present in Eastern European and Central American societies. In an effort to recruit extensive population samples for clinical trials, the people of these countries are utilized as a resource by which new drugs are tested and approved. Petryna expresses concern about the ethical implications of this off shoring process, and investigates why the issue must be addressed with reasonable sensitivity.
Apparently, the North American and Western European population, being so highly medicated, consequently produce drug-drug interactions that obscure the observation and identification of specific drug effectiveness. Test results on these populations are therefore less statistically significant, and human subject research is therefore extended to new locations. The populations in these countries typically experience poorly financed health care systems, and are therefore generally more eager to volunteer for clinical research trials. They also experience ‘treatment naivete’ insofar as these populations are considerably undiagnosed. Can it be certain though that results from treatment-naïve groups are applicable to treatment-saturated markets?
Petryna is also concerned about the influences these increased clinical research trials will have upon the developing health care of those countries. Furthermore, the legal institutions of these countries are also sometimes underdeveloped, and the trial volunteers are therefore often unprotected in the event of legal ambiguity and recourse. This cautiousness towards clinical trial research is emphasized by ‘the paradigm of expected failure,’ for this is the somewhat questionable way by which these trails are designed and executed. The increasingly global context of pharmaceutical research must be treated with sensitivity.