Ethical challenges posed by human infection challenge studies in endemic settings

Human infection challenge studies (HCS) involve intentionally infecting research participants with pathogens, often with the ultimate aim of developing new interventions against infectious diseases. Despite ethical concerns about research involving vulnerable populations, there are both scientific and ethical reasons to consider conducting more HCS in low- and middle-income countries where neglected diseases are often endemic. HCS researchers can reduce the risks to participants (and the risks of transmission from participants to others) by controlling multiple factors (eg those related to the laboratory environment, participant selection, the pathogen, and the timing of treatment); but HCS nonetheless raise important ethical issues, some of which may be particularly pertinent to HCS in endemic settings. This article provides background on HCS in general, as well as recent HCS in low- and middle-income countries, and an overview of the ethical issues associated with HCS in endemic settings.

The importance of "throwing money at" the problem of global health.

More funding from wealthy countries is required to improve health care and the infectious disease situation in developing countries. Although progress has been made, funds for fighting AIDS, tuberculosis, and malaria remain inadequate. These treatable and preventable diseases together kill over 6 million people every year. Funds are needed to improve access to existing medicines as well as to increase research and development of drugs. The idea that "throwing money at the problem is not going to solve it" rightly holds that increased funding is not sufficient for solving the health care problems of developing countries. In order to work, funds must be spent wisely. This does not mean that increased funding is unnecessary.