How much is your life worth?
Should your ‘worth’ in dollar terms be based to your ethnicity, religion, socioeconomic status or country of residence?
Would you, as a healthy individual, be willing to be exposed to SARS-CoV2 for a vaccine trial to protect all of mankind?
Ask a clinician about Clara cells, Reiter’s Syndrome or Wegener’s Granulomatosis and odds are, you will hear a near emetic response about lung physiology, inflammatory arthritis and necrotizing granulomatous inflammation with pauci-immune vasculitis, respectively.
Tongue twisting medical jargon aside, all three are ‘Third Reich eponyms’ with an infamous history. Max Clara’s Leipzig Centre was where all the prisoners executed in Dresden were dropped off for the ‘German Anatomist’. Wegener was an ardent member of the ‘Sturmabteilung’ (Brownshirts of the early Nazi movement). Last but not in the faintest sense least, Hans Conrad Julius Reiter, who probably tops them all, with his fatal experimental typhus vaccine study at Buchenwald.
The Nazi’s killed thousands in the name of medical science but, aside from understanding the effects of high altitude and hypothermia, the work of Mengele and others didn’t add anything substantial to clinical medicine. It did, however, bring about the institution of the Nuremberg Code and the Helsinki Declaration.
Sadly, the holocaust is hardly the the only example of ‘Guinea Pigging’ in Medicine.
Syphilis: The history of Syphilis is one as excruciating and morbid as the disease itself. The Guatemala Syphilis Study was an example of collaboration on a despicable scale. The then Guatemalan president cooperated with the US Government and deliberately infected over 5000 soldiers, prostitutes, prisoners, and psychiatric patients with syphilis and other sexually transmitted diseases. This was done in an attempt to track their untreated natural progression and test different therapeutic agents. The morbid experiment resulted in at least 30 documented deaths.
The Tuskegee Study in 1932 by the U.S. Public Health Service sought to track the natural progression of untreated syphilis in 600 poor, illiterate, male sharecroppers in Alabama. They were told they were receiving free healthcare, meals, and burial insurance but didn’t receive any penicillin. The study continued until 1972! Besides the study subjects, their wives contracted the disease, and many children were born with congenital syphilis. The US administration publicly apologised for both experiments.
Gynaecology: J. Marion Sims is widely acknowledged as the founder of modern surgical gynaecology for his pioneering efforts in the surgical closure of the vesicovaginal fistulas (which remain a major health issue in developing countries). He performed surgeries without anaesthesia on enslaved women, including 30 times in one woman with a particularly ‘difficult’ recurrent fistula. He too has gone down in medical folklore through the Sims’ speculum, Sims’ position, and Sims’ catheter.
The Rest…: The list hardly ends there but it would make this blog overtly morbid to include the experiments by the Japanese in WWII, those in Stalin’s Gulags, Statesville Penitentiary’s experiments with Malaria, Vanderbilt’s experiments with radioactive substances in pregnant women, Project 4.1 to study radioactive exposure in the Pacific Islands and other horrors.
The “cost” of clinical trials: In 2008, the Center for Research on Multinational Corporations released a document highlighting the detrimental effects of unethical clinical trials from the 1990’s and throughout the 2000’s in the developing world. It included clinical trials in Uganda with the anti-transmission drug Nevirapine where women experienced thousands of serious adverse effects resulting in the deaths of 14 women, which, surprise surprise, were unreported. Between 2005 and 2012, 2,644 deaths linked to unethical clinical trials occurred in India alone. A more recent report in 2019 claimed that since 2005, more than 5,000 people enrolled in clinical trials have lost their lives as a direct result of the study itself. In most developing countries ‘free’ medication/medical care and remunerations are still more profitable than many employment opportunities. The underprivileged bear the brunt of science. Sound familiar?
The Virus does not discriminate but we do.
During a televised discussion talking about a COVID19 vaccine trial using the Tuberculosis vaccine (BCG) in Europe and Australia, Jean-Paul Mira, head of intensive care at a hospital in Paris, said: “If I can be provocative, shouldn’t we be doing this study in Africa, where there are no masks, no treatments, no resuscitation?”
The comments have also fuelled existing fears in Africa that African people will be used as guinea pigs for a new coronavirus vaccine. Coronavirus centres have been targeted in African countries – most recently, a facility that was under construction in Abidjan in Ivory Coast was attacked. This is similar to the aggression since during the Ebola outbreaks in West and Central Africa when health workers were attacked on the suspicion that they were bringing the disease to their communities, rather than offering crucial medical care. Fear leads to suspicion and then the aggression. The vicious cycle continues.
The next time you read wishful news articles about a SARS-CoV2 vaccine, think not of Edward Jenner but the naive 8-year boy he experimented on. The ‘Father of Vaccination’ injected the son of his gardener with cow pox. That boy might be the reason that millions of vaccine preventable diseases have been kept at bay but none of us would want to be that boy.
So before you complain on Facebook that they should work doubly hard to develop a vaccine for this cataclysmic virus, ask yourself, “Will be willing to take the risk to be a modern day James Phipps?”