Marseille 2007
| Abstract #446 - Anthropology of clinical research in resource-poor settings or emerging countries | ||||
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Session: 16.3: Methodology Matters (Parallel) on Monday @ 14.00-16.00 in 5 Chaired by Graham Hart, Dominique Costagliola Authors: Presenting Author: Mr Egrot Marc - Insitut de Recherche pour le Dveloppement, France |
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| Additional Authors: Mrs Desclaux Alice, Mr Taverne Bernard, Mrs Micollier Evelyne, | ||||
| Aim: A research program coordinated by IRDs UMR-145 and the CReCSS explores clinical research as an anthropological study object in West Africa and Asia using ethnographic surveys that address experiments in bio-medicine and traditional medicine. | ||||
| Method / Issue: Data collection was carried out using qualitative and comprehensive ethnographic methods (non-directed and semi-structured interviews, direct observation and press and document review). The surveys were carried out among people included in the protocols, actors in the study or members of society interfering with clinical research. | ||||
| Results / Comments: Conducting clinical studies in resource-poor settings or emerging countries has developed over the last twenty years, especially in the domain of AIDS. This increase in medical research sparks numerous questions and concerns, and often even polemics, where taking positions that are sometimes ideological can complicate the implementation and realization of research protocols. Nevertheless, numerous questions and controversies raise relevant issues (method, objective, ethics, politics, etc.) particularly when these studies address vulnerable populations. The issue of clinical studies in Southern countries raises specific and particular implications in the sector of traditional medicines, which is closely tied to the political will promoting local medicines and supported by the WHO since 1978 and by other numerous institutions. The proposed stakes are not only medical, but often economic (local resources, developing production, even exportation, etc.) or concern identity (indigenous medicine versus bio-medicine). Actors involved in the process of clinical research are numerous: researchers from the North and the South, clinicians and staffs of hospital services involved in the study, healers in the case of evaluation related to neo-traditional treatments, monitors for the clinical study, clinical research assistants, contract research organizations (CROs), patients, promoter, the ethics committee, follow-up committee and independent committee, industrial drug producers, etc. For all these actors, the perception, stakes and outcomes (scientific, medical, economic, political, ideological) as well as the social uses of clinical trials differ. In order to be understood, their logics for action and their practices must be considered, not in isolation, but in interaction with one another. Therefore, the proposed approach will concentrate on the complex entanglement of the logic of actors, within and also on the periphery of the research protocol. In effect, the anthropological perspective allows this study object to be situated in a more global contextsocial, cultural and politicalthus taking into account all the social actors that interfere in its progress and operation. Analysis of the perception, real-life consequences and impact of trials for patients who participate in them also holds importance, particularly because it allows ethical questions to be placed within the complexity of cultural contexts. | ||||
| Discussion: The present program will contribute to enriching reflection about clinical trials in Southern countries while producing new analyses. It will complete and strengthen the various enterprises aimed at an improved understanding of the stakes mobilized by the biomedical research developed in these countries. Examples of divergent viewpoints between actors in research, and/or the ethical dilemmas observed in the field will be discussed. | ||||
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