The Body Hunters: Testing new drugs on the world’s poorest patients By Sonia Shah, Pearson, Rs 450

A crisp forward by John Le Carré substantiates Sonia Shah’s contribution in unveiling the darker side of the world’s most profitable trade — that in medicines. Shah, who is a journalist by profession, gives a damming account of a new kind of imperialist politics, where health is used as a category of domination over the world’s poor.

We are all indebted to the interventions of modern medicine in our life. But successful drugs leave behind a trail of countless other failed drugs and constant experimentation upon humans. If the history of human experimentation tells us anything, it is that the poorest and the most powerless people are the most abused.

Western medicine has relied on human experimentation since ancient times. Greek physicians discovered the nervous system in 300 BC by dissecting the bodies of the criminals and the poor. Controlled clinical trial emerged in the United States of America in the Forties and it mostly used prisoners for its purposes. The Germans used the victims of concentration camps as guinea pigs for their medical analyses during World War II. By the Seventies, most drug companies collaborated with university hospitals and doctors to conduct trials. Over the course of the Eighties and the Nineties, the drug companies were competing among themselves to launch a large number of hitherto unused drugs in the market. A new breed of more aggressive drug-makers got tired of their laidback academic partners. Outfits like the contract research organizations came into being by the late Nineties.

CROs are private organizations that, for a fee, take a drug company’s blue prints for a clinical trial and promptly deliver the results. CROs capitalize on the millions of poor patients treated at small clinics by local physicians. Expectedly, their favourite destinations are the impoverished countries of eastern Europe, Latin America, Africa and Asia.

Illegal recruitment of a large number of doctors in general practice, instructions to hospitals to prescribe a particular brand of medicine, callousness of government bodies, ever-growing list of dangerously under-tested products that are forced upon the poor, reputed medical journals endorsing particular pharmaceutical products at the behest of the companies selling them — all these are part of the package. And all this is aimed at maximizing the profit of multi-national pharmaceutical companies. Trends in the industry suggest that life-style drugs are more in circulation than life-saving drugs. Increased production of drugs that are meant to lower cholesterol-levels or enhance sleep or correct erectile dysfunctions suggests that while the rich gets more and more ‘drug-marinated’, the poor becomes more ‘medicine-famished’, with risks of experimentation on the latter ever on the rise.

GlaxoSmithKline, Wyeth, Pfizer and other drug giants, by shifting clinical trials to ‘low-cost’ countries such as India or Zambia, save over $200 million a year. They get the licence to conduct tests in the global south that would cause scandals in the developed world. So the drug quinacrine burns the fallopian tubes of women and in Zambia, AIDS babies in clinical trials are administered placebos. The quest to develop lucrative new drugs leads to the transfer of research trials to the developing world where ethical compunctions are minimal and where poor patients abound. It is the same ‘not in my backyard’ attitude that sends toxic wastes and open-pit mining to Asia and Africa while Americans enjoy the use of disposable plastics and aluminium foil.

Shah’s courageous account cracks open many disturbing issues. Carefully annotated with case studies, this book will be of interest to all socially-aware people in general, and to students of the sociology of health in particular.