A research ethics scandal appears to be breaking in India in regards to research carried out with adolescents within a school without parental consent. (Hat tip to Nita)
While the school principal claimed that this was just part of routine practice this seems to be false, as it is part of a study being carried out by the Health Care and Research Association for Adolescents. Furthermore despite the innocuous sounding name a committee came to the conclusion that the privacy of the participants was violated, and worse still it was done for commercial purposes.
Apparently this research involved genital examinations and a number of probing personal questions, about for example, underwear size and menstrual periods. The researchers claim that they presumed the school had handled consent.
It will be interesting to see what measures the Indian government takes to deal with this.
Postscript while we would all like to think this sort of thing won't happen here (wherever here is) posts like this: Drug study on kids won't require consent should suggest that we should not relax too much.
Wednesday, August 01, 2007
India Research Ethics Scandal: Students made guinea pigs in sex study
Monday, July 30, 2007
Difficulties of predicting the effects of widescale interventions
An article in the Boston Globe details how an attempt to decrease AIDS in Botswana has backfired fatally.
In essence what has been promoted has been the usage of formula feeding as opposed to breast milk on public health grounds for mothers with HIV.
NKANGE, Botswana -- Doctors noticed two troubling things about the limp, sunken-eyed children who flooded pediatric wards across Botswana during the rainy season in early 2006: They were dying from diarrhea, a malady that is rarely fatal in Nkange. And few of their mothers were breast-feeding, a practice once all but universal. After the outbreak was over and at least 532 children had died -- 20 times the usual toll for diarrhea -- a team of US investigators solved the riddle.
A decadelong, global push to provide infant formula to mothers with the AIDS virus had backfired in Botswana, leaving children more vulnerable to other, more immediately lethal diseases, the US team found after investigating the outbreak at the request of Botswana's government.
The findings joined a growing body of research suggesting that supplying formula to mothers with HIV -- an effort led by global health groups such as UNICEF -- has cost at least as many lives as it has saved. The nutrition and antibodies that breast milk provide are so crucial to young children that they outweigh the small risk of transmitting HIV, which researchers calculate at about 1 percent per month of breast-feeding.
This is both tragic, and points out the difficulty of predicting the effects of wide scale interventions. The logic of the intervention seemed sensible, and in the developed world it probably makes sense, in the developing world the advice turns out to be deadly. What this seems to demonstrate is the necessity of rigorous testing and a good evidence base, before public health initiatives are undertaken. In particular the worry here, is after ten years of promotion how difficult will it be to roll back the advice, and what damage will this do to promotion of public health in the developing world on the advice of the developed world.
