ABSTRACT
Ethical concerns in using a lower dose of equine rabies immune globulin (eRIG) to irrigate wounds from dog bites to prevent rabies are discussed. A lower dose of eRIG was used because of a general shortage of eRIG and the high market cost in the Himachal Pradesh state of India. The cost and availability of drugs in low- and middle-income countries (LMIC) often necessitates testing a lower dose of a vaccine or treatment than that recommended by international organizations (eg WHO). It raises the issue that recommendations may be designed for higher income countries without taking into consideration issues of supply and cost. Secondly a case-control design to compare dosages or delivery systems is usually not an option so investigators must often use historical data for comparison or other study designs. The ethical issues in the testing of drugs and vaccines in LMIC must be continuously reviewed by the international community
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The Zika virus (ZIKV) epidemic is spreading: 67 countries are now reporting transmission, and over 2,000 cases of congenital Zika syndrome (CZS) have been confirmed. The heaviest burden has been borne by those living where poverty, poor infrastructure, and lack of access to health services are common and the penetration of Aedes aegypti is high. Because most cases are asymptomatic, the most dramatic signs of the disease appear through the CZS cases. In spite of the need for disaggregated epidemiological data to understand transmission patterns and evaluate interventions in vulnerable populations, there is no reliable count of ZIKV cases by sex and ethnicity (1).
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Released in August 2013 and starring Matt Damon and Jodie Foster, “Elysium” is a science fiction film that explores political and social issues, with a special focus on healthcare, class, and justice.
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he Xpert® MTB/RIF (hereafter Xpert) is a recent technology that has “demonstrated sensitive detection of tuberculosis (TB) and rifampicin resistance directly from untreated sputum in less than two hours” . Many are in favour of the widespread implementation of this technology in India. In a recent article in the IJME, Singh, Bhan and Upshur state that “India is ethically obliged to phase in the nationwide deployment of Xpert…as soon as reasonably possible” and “is ethically obliged to provide those diagnosed with first-line drug resistance universal access to second-line TB drugs” to treat multiple drug-resistant tuberculosis (MDR-TB) .
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A national conference on the evolving roles of ethics committees in India was held on May 31 and June 1, 2013.The conference was organised by the Apollo Hospitals Education and Research Forum, and supported by the Indian Council of Medical Research, Apollo Hospitals, Sanofi, and Quintiles.