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When Experiments Travel

When Experiments Travel: Clinical Trials and the Global Search for Human Subjects

Copyright Date: 2009
Pages: 270
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  • Book Info
    When Experiments Travel
    Book Description:

    The phenomenal growth of global pharmaceutical sales and the quest for innovation are driving an unprecedented search for human test subjects, particularly in middle- and low-income countries. Our hope for medical progress increasingly depends on the willingness of the world's poor to participate in clinical drug trials. While these experiments often provide those in need with vital and previously unattainable medical resources, the outsourcing and offshoring of trials also create new problems. In this groundbreaking book, anthropologist Adriana Petryna takes us deep into the clinical trials industry as it brings together players separated by vast economic and cultural differences. Moving between corporate and scientific offices in the United States and research and public health sites in Poland and Brazil,When Experiments Traveldocuments the complex ways that commercial medical science, with all its benefits and risks, is being integrated into local health systems and emerging drug markets.

    Providing a unique perspective on globalized clinical trials,When Experiments Travelraises central questions: Are such trials exploitative or are they social goods? How are experiments controlled and how is drug safety ensured? And do these experiments help or harm public health in the countries where they are conducted? Empirically rich and theoretically innovative, the book shows that neither the language of coercion nor that of rational choice fully captures the range of situations and value systems at work in medical experiments today.When Experiments Travelchallenges conventional understandings of the ethics and politics of transnational science and changes the way we think about global medicine and the new infrastructures of our lives.

    eISBN: 978-1-4008-3082-4
    Subjects: Anthropology, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
    (pp. ix-xii)
    (pp. 1-9)

    If I drive two miles down the road that takes me to the supermarkets and retail shops of the midwestern town where I grew up, I will pass the local branch of Across-the-Globe-Research (AGR). A freestanding office space, newly built, with a redbrick exterior and white casement windows, the building is surrounded by a parking lot. The AGR facility looks like a standard suburban medical practice, but it is not quite that. It is an investigative research site that conducts clinical trials for the pharmaceutical industry. Clinical trials are studies designed to systematically evaluate new drugs or new ways of...

    (pp. 10-46)

    In the view of Dr. Lee, a company scientist who coordinates clinical trials in Eastern Europe, public distrust of the clinical trials process is rampant in the United States and in Western Europe, and “it is becoming a major barrier to our work.” For him, the growth of clinical research offshore expresses a straightforward yet unsettling value system: “If a doctor or nurse asked you if you were willing to put a family member in a clinical trial, and if it was not a life-or-death issue, would you do it? The answer would most likely be no. The fact is...

    (pp. 47-88)

    Across-the-Globe-Research (AGR) is located in one of several ethnically and economically diverse sections of a midwestern county. “Diversity is important for us,” Evan said in a conversation in his office in 2005. The middle-aged business manager told me that there are about forty thousand clinical research sites in the country, “but only about twenty thousand are heavily involved. These sites can capture only a small percentage of the overall American population.” Evan’s task, in part, was to find volunteers more representative of the broader population, providing data on demographic subgroups that can enhance the drug approval process.² AGR is well...

    (pp. 89-138)

    “Unfortunately, and really quite embarrassingly, we don’t know how many trials are being carried out worldwide today,” Dr. Ida Sim, associate director for medical informatics at the University of California, San Francisco, told me. It was March 2006 and I was at UCSF giving a talk on offshore clinical research. Dr. Sim approached me after the talk and told me that she was coordinating a World Health Organization (WHO) effort to create a global databank of clinical trials (the International Clinical Trials Registry Platform, ICTRP). She and her colleagues were advocating for a comprehensive metaregister of trials and their outcomes....

    (pp. 139-185)

    So far, I have been chronicling the offshoring of clinical trials and inquiring into the new experimental environments that are emerging internationally. The pharmaceutical industry has disaggregated core processes of drug development (such as clinical research) and rebuilt them in new locations, where it obtains access to skilled professionals and lower-cost infrastructures. Sitting in an elegant Warsaw office in 2005, a medical director of a multinational drug firm stressed the nonlocal character of clinical research: “We get the protocols from the research and development department in U.S. headquarters. We have no locally designed study.” This American-trained Polish physician managed teams...

    (pp. 186-200)

    Clinical research is essential to pharmaceutical globalization, but it also presents many challenges. In this book, I have explored the organizational cultures that make offshore clinical trials possible, the interests they serve, and the ethical and legal precepts that govern them. I have also probed, particularly in the pharmaceutical frontiers of Eastern Europe and Latin America, the context-specific calculations by which particular biological resources are sought and experimental groups configured. I charted the ways the private-sector research enterprise becomes a worldwide network, drawing from and thriving in public health institutions, and how governance and medical care occur in global but...

    (pp. 201-204)
  11. NOTES
    (pp. 205-224)
    (pp. 225-248)
  13. INDEX
    (pp. 249-258)