Les recherches cliniques Nord/Sud : des recherches équitables ?

The goal of this article is to review the principal regulations, scandals and questions raised by North/South clinical research in the light of 2 fundamental principles of research ethics: Autonomy and Justice. The debate on the standards of care to apply when clinical studies are exported from North to South currently rages. The 30th paragraph of the 2000 Helsinki Declaration is the object of numerous amendment proposals. It stipulates that “at the conclusion of the study, every patient entered into the study should be assured of access to the best proven prophylactic, diagnostic and therapeutic methods identified by the study”. In response to the debate, the World Medical Association (WMA) added an explanatory footnote in 2004, explaining that post trial arrangements must be made for study participants to have access to procedures as beneficial as the study or to other appropriate care. For some, this affected the sense of justice and equity this paragraph had before. Many are trying to think of a good way to organize more fair North/South clinical researches. One of the Fair-trade model principles is to seek equity by paying producers fair prices that have been determined through dialogue and participation of regional or local communities. Can Fair-Trade provide ideas to apply to North/South clinical researches?