Bad Medicine for Children's Rights

Summary: Child victims of a controversial drug trial in Nigeria face an uphill battle in seeking compensation from pharmaceutical giant Pfizer.

This summer, pharmaceutical giant Pfizer began making payments to families of Nigerian children who died of meningitis following a controversial drug trial marred by allegations of lack of consent, inadequate documentation and medical malpractice. Although Pfizer continues to deny wrong-doing, the payments are being made in line with a $75 million out-of-court settlement in 2009 reached by the company and the government of Kano state, where the drug trial took place.

Awarding compensation should mark the beginning of the end of legal trouble over the trial for Pfizer, which in February announced a global settlement with all plaintiffs in all related cases, including claims brought in the United States by victims' families. The payments are administered by the Healthcare/Meningitis Trust Fund, originally established and funded with $35 million in response to a 2007 suit brought by the government of Kano state, where the drug trial took place.

While the Fund is ostensibly managed by an independent board of trustees, compensation has been slow to arrive. In response, the umbrella body representing 192 victims of the drug trial has now threatened to sue Pfizer for breaching the out-of-court settlement by deliberately holding out on the payment of compensation.

“The inordinate delay is in breach of our clients’ fundamental rights to the determination of their civil rights and obligations within a reasonable time,” argued Etigwe Ewa, lawyer for the Trovan Victims' Forum. Ewa's claims also highlight the lack of transparency in the methods for verifying the identity of alleged participants in the trial, and other advocates have complained about the DNA testing requirement to qualify for compensation. Because many victims do not understand what DNA testing is and fear any further medical interaction with the drug company, some have opted to abandon their claims.

This is not the only recent controversy that Pfizer has faced in relation to the drug trial; cables released by WikiLeaks late last year allege that the company hired investigators to unearth evidence of corruption against the Nigerian federal attorney general in order to persuade him to drop legal action over the trial. Details of the withdrawal of two cases filed against the company – one criminal and one civil – remain heavily guarded, which has provoked public suspicion in the country.

Sadly, Pfizer's decision to conduct clinical trials on children abroad does not stand alone. Even when these trials do not result in death or permanent disability, the issue of testing drugs on children is fraught with ethical concerns, especially in countries in which the medicine in question will likely never reach the shelves. Nonetheless, drug companies continue to outsource trials to less developed countries where expenses are low and doctors and patients are more easily convinced or, worse yet, pressured to participate.

For instance, a mother in Poland quickly saw her initial excitement about her son's enrolment in a study on a new drug for attention deficit hyperactivity disorder fade when, after five weeks had passed with significant improvement, the drug was withdrawn. She now not only worries about her son's future treatment, but questions her decision to volunteer him for the trial in the first place: "I can't believe I signed my son up for this trial without really understanding what I was agreeing to. I was blind. I realize now that people taking part in clinical trials should have the right to ask questions and be spoken to like human beings, not just guinea pigs," she said.

Read more about the globalisation of pharmaceutical testing here.

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