"The Body Hunters:
testing new drugs on the world's poorest patients"
by Sonia Shah
The New Press | November 2006 | ISBN 1565849124
Extract from "The Body Hunters"
Most Americans' lives are so intertwined with the ministrations of Western medicines from childbirth to daily aspirin that belief in its healing prowess is nearly an article of faith. But this isn't so in most of the rest of the world. About 80 percent of people living in developing countries-together comprising 64 percent of the total world population-rely on traditional healers, not Western biomedicine, according to University of California pharmacologist Mannfred Hollinger. And in parts of the world where Western medicine's foothold is flimsy at best, shoddy clinical trials can fuel a corrosive mistrust that undermines allopathic medicine more generally, with potentially devastating results.
Nowhere has this phenomenon been more apparent than in South Africa, where periodic controversies over flimsy subject protections in clinical trials ignited a volatile mix of racial resentments and mistrust accumulated over nearly fifty years of apartheid.
Between 1948 and 1994 the white minority in South Africa, descendants of Dutch, German, and French immigrants, doled out rights and privileges according to a schizoid system of racial apartness, "apartheid" in Afrikaans, the Dutch-like language they originated. When AIDS first emerged in the mid-1980s white conservatives in the country rejoiced openly. "If AIDS stops black population growth," one said, "it would be like Father Christmas."
Apartheid had already started a slow genocide among black Africans in the country. Between 1960 and 1983 South African police had forcibly relocated over three million nonwhite South Africans from their homes into racially segregated "townships" and "homelands," isolating them from the rest of society. While the government devoted 97 percent of its health care budget to hightech specialized care, culminating in a revolutionary heart transplant in Cape Town's Groote Schur Hospital in 1967, blacks were suffering forty-eight times more typhoid fever than whites and their children were dying from easily preventable diseases such as measles. In the townships tens of thousands of people might share a single water spigot. Conditions such as kwashiorkor, a severe form of malnutrition, raged, but the health department failed to take even minimal control measures. Black patients died waiting for ambulances to pick them up, while those reserved for whites idled nearby; those who survived the wait sometimes perished outside empty white hospitals that refused to let them enter.
Notwithstanding notable exceptions, the mostly white South African medical establishment complied with apartheid's strictures. Some medical researchers openly studied the supposed inferiority of blacks and new bacteria that might selectively injure or kill them. The South African Medical and Dental Council extolled the physician's right to "decide to whom he or she wanted to render a service in non-emergency situations." Doctors worked for the security police, witnessing whippings and other torture, and signed off on fraudulent reports that those who succumbed were victims of accidents or suicides.
When the apartheid regime finally fell to the African National Congress (ANC) in 1994, the problem of AIDS remained off the official agenda. ANC loyalists suspected that racist Western researchers had exaggerated the problem. Back in the 1980s NIH researchers had in fact circulated grossly inflated reports of HIV infections in African countries - Robert Gallo had reported that two-thirds of schoolchildren in Uganda were infected; National Cancer Institute researcher Robert Biggar, that between a quarter and one-half of the Kenyan population hosted the virus - based entirely on faulty assays. Hasty conclusions about HIV originating in Haiti had crippled that impoverished nation's tourism industry.
When Kenyan leader Daniel arap Moi condemned AIDS as nothing more than some "new form of hate campaign" against African economies, many ANC supporters agreed. "It seemed far-fetched that a disease would conveniently kill fags, prostitutes, drug users and blacks," recalls one South African ANC loyalist. "It was a Reaganite wet dream!"
The comforting illusion that AIDS was an overhyped nonproblem wouldn't remain intact for long. By the mid-1990s the virus's rampage on the continent had become all too clear. But the Western AIDS establishment once again appeared unhinged from African realities. Many now proclaimed that Africans were too backward for combination antiretroviral therapy, suggesting a vicious indifference to the plight of impoverished Africans.
© 2006 by Sonia Shah. This excerpt from The Body Hunters by Sonia Shah was published with the permission of The New Press.
About the author: Sonia Shah is an independent journalist and the author of Crude: The Story of Oil. Her articles have appeared in Salon, Playboy and The Nation, among other publications. She lives in Boston, Massachusetts. Her website is here.