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Book and Media Reviews
November 1, 2006

Drugs, Developing World

Author Affiliations
 

Book and Media Reviews Section Editor: Harriet S. Meyer, MD, Contributing Editor, JAMA.

JAMA. 2006;296(17):2146-2151. doi:10.1001/jama.296.17.2149

Investigative journalist Sonia Shah has written a lucid, well-researched work on professional and governmental corruption and mismanagement associated with clinical trials conducted by the pharmaceutical industry in the developing world. It deserves the attention of leaders of the medical profession and policy analysts concerned about the human consequences of US health care costs rapidly approaching the point of unsustainability (25% of total gross domestic product).

The Body Hunters opens dramatically, with a group of physicians and scientists meeting in 2003 at a pharmaceutical industry–sponsored symposium, on a dull October day in a windowless, basement conference room in Washington, DC. The attendees' published presentations explore the commercial possibilities of conducting clinical trials among the world's impoverished ill. One common theme is that the destitute ill should welcome this access to expensive innovative medicines. Another theme asserts that phase 3 clinical trials for safety, quality, and efficacy have become a “vast canyon” draining drug company profits. Shah valuably highlights the adverse consequences when such an ideology drives changes in the governance of globally important drug safety organizations, such as the US Food and Drug Administration (FDA).

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