Placebo Studies in Third World Countries
The AIDS pandemic is at its worst in sub-Saharan Africa. In 1998 alone, 4 million of the 5.8 million new cases of HIV-infection were from sub-Saharan Africa (Debate 2002). Expensive drug combination treatments in developed nations cost approximately $15,000/year, whereas per capita expenditures on health care in sub-Saharan nations range from $5.00 to $10.00/year (Debate 2002). Making matters worse, 40 percent of pregnant women are estimated to be HIV-positive with a 1 in 4 or 5 chance of delivering an HIV-positive baby (Debate 2002). For infants who escape infection, there is a 14 percent chance of becoming infected via breastfeeding (Debate 2002).
While these numbers are tragic and sobering, other issues threaten to make them worse. Clinics in the region are unable to stock adequate supplies of basic medicines, let alone the complex and costly drugs used to combat HIV. Few are able to provide screening for HIV or the counseling necessary for those who do test positive. Adding to these woes, sub-Saharan nations lack the clinical infrastructure to administer and monitor the complex treatment for HIV, and few women seek prenatal care at the point in their pregnancies where treatment would be most effective.
Exacerbating these HIV issues in sub-Saharan Africa are a host of economic, environmental, cultural and biological factors. Despite the risk of HIV transmission, African health officials continue to promote breastfeeding due to the cost of formula, a lack of clean water supplies, and the risk of stigmatization by others as an HIV-infected mother (Debate 2002). Further, African women typically suffer from anemia, malaria, genital infections and vitamin deficiencies – all of which complicate HIV treatments currently available.
The standard of care in sub-Saharan African nations is obviously much lower than in developed countries. Nevertheless, the magnitude of the dis...