Sunday Times (Johannesburg) - October 2, 2005
Brendan Boyle

Among those who do research on the disease that kills more than two million Africans a year, some could be dodging ethical obligations that apply elsewhere in the world.

Though critical of the low foreign commitment to research in Africa, however, BMJ guest editors Jimmy Volmink and Lola Dare were particularly critical of African scientists working at the heart of the pandemic.

"The dearth of research done in Africa for Africa is untenable," they said in an editorial.

Volmink is Professor of Primary Health Care at the University of Cape Town's medical school. Dare is the chief executive of the Centre for Health Sciences in Nigeria.

"There can be no doubt that African research is moribund. Inequalities in health research contribute to inequalities in health," they added.

Many of the papers in the BMJ's Africa-theme edition reported promising findings on the treatment of non-Aids related health challenges, including a possibly cheap medication to prevent women from bleeding to death after giving birth.

One paper argued that African governments could save around a quarter of a million child lives every year by abandoning fee systems initially introduced at the behest of International Monetary Fund and World Bank advisers.

Fees caused poor families to wait too long before seeking help and sometimes stripped them of the means to rebuild their health after treatment.

In one paper co-authored by Volmink, scientists said only 77 research projects on the prevention or treatment of HIV/Aids had been completed in Africa since 1987, nearly all of them mounted and funded by foreign governments and pharmaceutical companies.

Though Africa is estimated to have more than 25 million people with HIV/Aids, none of the studies involved more than 40000 people.

"This may reflect a lack of economic ability, political will or research capacity to conduct intervention research in African countries," the authors said.

Volmink told the Sunday Times that African countries often did not benefit from research on the continent. Drugs arising out of the research often were too expensive for Africans or not available.

"In healthcare, it is absolutely critical that the questions that we answer in research are asked by Africans because they arise out of African experience and they reflect our priorities," he said.

Volmink said the research had also raised concerns about the ethical standards applied in Africa.

Only 39 of the 77 trials tracked were ethically approved by the host country and the home base of the researchers, where standards were likely to be higher.

"Ethical processes in Africa need to be beefed up considerably, otherwise people can get away with doing research in a host country that would never be ethically approved in their own countries.

"It is critical that the ethics should be approved by both sides - the host country and the country of the people who are coming in," he said.

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