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12. BIOETHICS AND INTERNATIONAL BIO-MEDICAL RESEARCH FROM THE POINT OF VIEW AND PERSPECTIVE OF AFRICAN CULTURE AND PHILOSOPHY
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~ 154 ~ CHAPTER TWELVE BIOETHICS AND INTERNATIONAL BIO-MEDICAL RESEARCH FROM THE POINT OF VIEW AND PERSPECTIVE OF AFRICAN CULTURE AND PHILOSOPHY [A French version of this paper, under the title „Bioethique et recherche biomedicale internationale sous l’angle de la philosophie et de la culture africaine”, is published in Ethique de la recherche et des soins dans les pays en developpement, edited by Francois and Emmanuel Hirsch, Paris: Vuibert, 2005, pp. 55-75] ABSTRACT One area in which the process of globalization has had an indisputable impact, for good or ill, is in the domain of bio-medicine. In recent years, there has been a great increase in the number of biomedical research studies in the developing world, especially in Africa. These researches are mostly carried out by researchers from the industrialized developed world, in some cases in collaboration with local scientists and researchers, but in all cases with funding from the developed industrialized world. Biomedical research in the industrialized world is very well regulated by a framework of institutional, national and international guidelines, backed in most cases by appropriate legislation and a generally enabling environment. In the developing world, however, such regulatory frameworks are largely inexistent. This situation raises grave dangers of unethical research, particularly so as extant international ethical guidelines, formulated in and by the industrialized developed world, from the viewpoint and perspective of the industrialized developed world, do not, in many respects, adequately address the interests and concerns of the developing world in an appropriate manner. In this paper, I attempt highlighting some of these problems and concerns, from the background, viewpoint and perspective of African culture and philosophies, as well as hinting in passing on how, in my view, the situation might begin to be redressed or at least addressed and ameliorated. ~ 155 ~ BIOETHICS AND INTERNATIONAL BIO-MEDICAL RESEARCH FROM THE POINT OF VIEW AND PERSPECTIVE OF AFRICAN CULTURE AND PHILOSOPHY INTRODUCTION The 10/90 gap (Global Forum 2001-2002) in all its ramifications is responsible for the present situation of the African continent vis-à-vis biomedical research. That situation is one in which the continent seems to present the most compelling conditions for externally driven biomedical research. These conditions include poverty, a heavy external debt burden, ignorance or lack of awareness, a heavy burden of all types of diseases and medical conditions, absence of any constraining regulatory frameworks, hopelessness and desperation, etc. So attractive have these conditions been to market/profit driven medical research that there seems to be a second scramble for Africa, comparable to that which led to the partition of Africa by European imperial powers in 1884. Other motivating factors for developed world’s medical research in the developing world are altruistic philanthropy and the desire to bridge the 10/90 gap as a matter of global rational self-interest. For these reasons, there has been an explosion in the number of biomedical research studies in Africa as well as in the other socalled developing regions of the world, particularly in the past two decades. Some of such studies have been accompanied by abuses and malpractices reminiscent of those which, within the Western industrialized world had led to the elaboration of regulatory texts for biomedical research, such as the Nuremberg Code, Declaration of Helsinki, International Ethical Guidelines for Biomedical Research Involving Human Subjects, The Belmont Report, etc. To cite only a single illustrative case, a clinical trial designed to text a drug called trovafloxacine alias Trovan, was recklessly carried out by a big Western pharmaceutical company on children in Northern Nigeria in 2001, during a meningitis epidemic, and resulted in the death of eleven of the children while a further two hundred became blind, deaf or lame. The case is briefly reported, amongst other similar cases, in Developing World Bioethics (Vol.1, No. 2, November 2002, p. 92) and discussed in some detail in a forthcoming article by Ruth Macklin (Macklin 2003). The whole situation has been greatly compounded by the HIV/AIDS pandemic which can be said to have chosen sub-Saharan [44.210.78.150] Project MUSE (2024-03-29 10:08 GMT) ~ 156 ~ Africa as its headquarters and against which a cure and/or vaccine is an extremely urgent necessity. Africa is thus caught in a situation where avoiding bio-medical research (whether internally or externally driven) is not an option in addressing the possible dangers of abuse or malpractices that may accompany such research. The only option is squarely to face the dangers posed by intensified bio-medical...