Good Enough To Use For Research, But Not Good Enough To Benefit from the Results of that Research: Are the Clinical HIV Vaccine Trials in Africa Unjust?

The epidemic of the Human Immunodeficiency Virus (HIV) infection in Sub-Saharan Africa, the region most affected by the HIV pandemic and where HIV is the leading cause of death, is reaching insurmountable proportions. In fact, out of the 36.1 million HIV infections worldwide, 25.3 million, seventy percent, are in Sub-Saharan Africa. Additionally, of the more than 15,000 people who are infected with HIV every day, ninety-five percent of the cases are in populations that live in developing countries such as those located in Sub-Saharan Africa. Due to the significant number of Africans infected with HIV, many researchers and ethicists have focused their attention on granting Africa fair opportunity to have access to clinical HIV vaccine trials. But fair opportunity to participate in clinical HIV vaccine trials does not guarantee that Africans will benefit from the research because of the very nature of clinical trials. This Article explores the ethical principle of Justice and its application to clinical trials in developing countries through the lens of the current HIV vaccine trials in Sub-Saharan Africa. Part II examines the history of the Justice principle as it pertains to clinical trials and answers the question of who should be included in the “society” that benefits from the results of the research. The benefits of the Justice principle, fair access to the results of clinical trials, is compared to the benefits of fair opportunity to clinical trials in Part III, which reviews the problems with past clinical HIV drug trials conducted in Sub-Saharan Africa. Part IV briefly surveys the current HIV vaccine trials underway in Africa, discusses some of the failures of researchers to apply the principle of Justice, and suggests a possible mechanism to ensure that future clinical trials conducted in Africa provide a benefit to a “society” that includes Africans