Formal procedures are being evolved to ensure that local AIDS organizations are consulted each time a clinical trail is about to be conduct in Africa. Special attention must be given to the free, informed and explicit consent required of all participants in clinical trials, as well as to the guarantees on which it rests Consent can only be ghiven as a result of an individual interview conducted in the language best undertsood by the patient. In December 1995, the ANRS disclosed plans for a clinical trial on neurosyphillis in HIV-infected persons to be conducted in Mozambique. A group of five French AIDS organizations, including Act Up-Paris, complained to the ethics in charge of the trial and demanded alterations which have since been carried out. More broadly speaking, all the rules usually observed in developed countries must be followed as well in developing countries.
Many problems surround that trial.
Medical care will be provided to patients enrolled in the trial according to guidelines laid out by the Senegalese Ministry of Health. The trouble is that those guidelines recommend the use of a number of basic drugs mentioned on an official list, which does not include any treatments for CMV and KS, to mention only two opportunistic diseases. This tends to suggest taht patients enrolled in the trial will not receive appropriate care should tehy need drugs that do not appear on the official list. On Top of that, it would no do to upset the balance maintainde by the Senegalese Ministry of Health. Up-Paris recently sent one of its members to Dakar, Senegal, to interview AIDS organizations and investigators on that topic.