It might at first seem plausible that a company would seek to cut costs by pushing a trial on deprived and ill-educated people who do not not ask questions of free medicine. But if selling in a Western market was the ultimate goal, this would be a stupid way to design a trial. Its aim would be to test safety and efficacy, which means limiting confounding factors that might offer alternative explanations for changes in a subject’s health. Testing on a population with high rates of HIV, malnutrition and other serious medical problems would make it very difficult to achieve useful results.
Nonetheless, Wired reports that there are serious ethical concerns over drug trials being run by Big Pharma in India:
Shantha Biotech failed to obtain proper consent from patients while testing a drug meant to treat heart attacks. Biocon tested a genetically modified form of insulin without the proper approval from the Drug Controller General of India or the Genetic Engineering Approval Committee.
In another incident, Sun Pharmaceuticals convinced doctors to prescribe Letrozole, a breast cancer drug, to more than 400 women as a fertility treatment in a covert clinical trial -- and used the results to promote the drug for the unapproved use.