OPINION
8 Obiter Dicta
Commodified Flesh? No. Commodified People
The Social Injustices of Clinical Drug Trials in the Global South
simmy sahdra › contributor
C
a pi ta l i sm: a wor d that describes a
society where an alarming number of
things can be bought and sold. Land, air,
resources, people’s thoughts and ideas—all
are liable for exploitation and depletion in service
of an expanding market. The human body has also
become a site of market expansion and profit generation. Countries such as China and India are known
for their large and striking “resource pool” of labour
which commodifies and dehumanizes people. India
has become an especially attractive site for large
pharmaceutical companies to carry out drug trials
at a low economic and high social cost, resulting
in death, uninformed consent, and disablement for
trial participants.
Clinical drug
trials are targeting participants
who are associated with social
differences—the
intersection of race, caste, class, gender, sexuality, and ability constructions—which render them
vulnerable to exploitation. In India, the media has
focused on people of lower castes and classes who
are targeted by doctors and major pharmaceutical companies. However, few scholars have delved
deeper into the issue of how to understand how
people associated with social differences are being
targeted to participate in drug trials in India. Such
groups are more inclined to accept greater risks at a
lower price because of their associations with social
differences and lower hierarchal positions in society.
Major pharmaceutical companies such as
Theravance Inc., Wyeth Research (now part of
Pfizer), Sanofi-Synthelabo (now Sanofi-Aventis),
AstraZeneca, Schering, and GlaxoSmithKline
choose to outsource their drug trials to countries of
the Global South, like India, because of decreased
costs and increased opportunities to exploit citizens
of those countries. Pharmaceutical companies recognize their power over Indian people associated
with social differences, but also, and more importantly, the power of their foreign direct investments
over the Indian government. This power imbalance
serves the interests of corporations, where profit
reigns supreme. As a result, few, if any, social repercussions are addressed.
However, corporations are only
part of the problem; many medical professionals
are given substantial monetary
incentives to recruit their own patients into trials.
Subsequently, this process creates a large conflict
of interest threatening the well-being of patients,
who commonly enter drug trials with uninformed
consent. As previously alluded to, the government
is also a major contributor to the persistence of this
social injustice. The Indian government has not
been inclined to impose and enforce stricter regulations or limitations on pharmaceutical companies
because of the economic benefits associated with
creating an attractive environment for foreign direct
“This power imbalance serves
the interests of corporations,
where profit reigns supreme.”
t humbs down
Knife attack on US amabassador Mark Lippert
praised by North Korean state media.
ê Rajesh Nadia has carved a small niche for himself as a recruiter in the international drug-testing industry.
Photo credit: investigations.nbcnews.com
ê A grieving widow holds a photo of his wife who had
been part of a clinical trial in Khandwa, India.
Photo credit: washingtonpost.com
investments. Like doctors and pharmaceutical companies, governments are not immune to capitalist
influences, which privilege profit over social cost.
The literature and media involving the drug
trials in India has been limited to describing negative repercussions of the targeting certain of class/
caste constructs and the shocking results of death.
For example, the BBC produced a documentary outlining the immense consent issues plaguing these
trials. In the reporting, it was found that doctors
were lowering the bar for consent to drug trials to
merely fingerprints. People were dying with no idea
of their involvement in drug trials, as consent was
commonly communicated in a language they did not
understand. While these facts are important to consider, a wider scope of information must be reported
and analyzed. The possible intersection of other
social differences such as ability, gender, and sexuality are not being addressed in reports such as the
BBC documentary. Furthermore, reporting deaths
is an effective method of grasping public awareness,
but the issue of disability should figure much more
prominently than it has. The disability of a primary
breadwinner as a result of drug trial participation,
for example, has a different, yet just as profound
impact on a family and deserves the same level of
awareness. This aspect of the soci