Walking Test Tubes

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Just as automakers and apparel manufacturers have fled the stringent labor and environmental laws of developed countries to set up shop in the developing world, pharmaceutical companies have streamed across borders in pursuit of warm bodies for the testing of new experimental drugs.

Drug giant GlaxoSmithKline has predicted that by next year more than half of its trials will be conducted overseas, a mark already hit by some of its competitors. In 2004 the U.S. Food and Drug Administration (FDA) estimated that drug companies angling for government approval of their products were launching more than 1,600 new foreign trials every year.

The most popular destinations are the broken, impoverished countries of Eastern Europe and Latin America. In Latin America, says Pfizer's Julio Camps, 'you can have fast recruitment . . . at a very reasonable cost.' Populations of patients no longer available in rich countries-those willing to swallow placebos and those who have never been treated for their illnesses-abound.

Pfizer's trial of the osteoporosis drug lasofoxifene, for example, required experimental subjects to be 'treatment-naive,' that is, never treated for the condition. Argentina was 'the number one recruiting site,' Camps said, calling the country's ability to provide willing guinea pigs 'amazing.'

Unlike human subjects in the United States and Western Europe, who frequently drop out of sometimes unpleasant clinical trials, Latin America's 'patient retention rates are nearly 10 percent better' than elsewhere in the world, according to the clinical-research trade publisher CenterWatch. And they do it for free: It seems that the provision of medicine, even experimental medicine, is sufficient.

The industry's new experimental bodies from poor countries rarely enjoy the benefits of the research they participate in. Sometimes the new drugs are unlicensed in their countries or priced out of reach. More often, however, the drugs are irrelevant to the health priorities of their communities to begin with. Overall, 90 percent of the global medical research budget takes aim at illnesses that cause just 10 percent of the world's diseases.

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