AlexO'Meara.com » Uganda

In the U.S. do we only know how to give money?

Alex — Tue, 11 May 2010 20:24:49 +0000

I traveled to Uganda as part of my research for Chasing Medical Miracles. I had no idea what to expect when I got there. What I found was people who were kind, patient, strong, capable, intelligent and, more than anything else – and at the risk of sounding sing-songy – beautiful. They are also increasingly dying. That AIDS is devastating the country and all of Africa is not news. That U.S. funding for treatment and drug cocktails to extend life is slipping because of the economic crisis is news and, as this article in the today’s New York Times makes painfully clear, it is disturbing. It signals that in the United States our involvement in many causes is only financial, that it goes only so far as our check books. Is there more that we can donate than cash? Our expertise? Our presence to help those dying to help their families continue, to help prevent increased outbreaks? Are we only a nation of money givers or are we a nation of people who care so much that we will extend ourselves to the point of inconvenience to help others? The answer to that troubles me.

Dinavance Kamukama, 28, front right, with her cousins in Kampala, Uganda. She is on a waiting list for AIDS medication.

Pfizer’s Reputation

Alex — Tue, 27 Apr 2010 17:39:57 +0000

When I travelled to Uganda as part of my research into my book I wanted to stop into a clinic in Kampala that was run by Pfizer. I contacted their media office and we went around and around and was told I couldn’t visit the Infectious Disease Institute (IDI), which is on the grounds of Mulago Hospital. The reason was that only a limited number of trials were conducted there. Once in Kampala and interviewing officials I asked about the Pfizer clinic. One prominent doctor at Nsambya Hospital said IDI conducted a significant number of trials. A Ugandan health official said no trials were conducted at IDI. I was left wondering what was accurate: some trials, no trials, or lots of trials. What I was sure of was that Pfizer appeared to be a slippery operation when it came to trials . Recent articles have showed this to be true:

From the Wall Street Journal (subscription):

FDA Warns Pfizer On Clinical Study Of Antipsychotic Geodo

From Bloomberg/Business Week:

Pfizer’s Geodon Trial Had ‘Significant Violations’ (Update2)

The Courier Post:

Pfizer not fixing test problems, FDA says

Art from Uganda Trip

Alex — Sat, 10 Jan 2009 17:22:05 +0000

When I went to Uganda to do research on clinical trials for the book, of course I took pictures. They included the typical shots on safari of elephants, hippos, and birds. I took pics of warthogs kneeling right outside the door of my bungalow at the Mweya Lodge in Queen Elizabeth State Park. I also got great shots of the origin of the Nile river, the Rift Valley, and of majestic tea plantations. But I took most of my pictures in the capital city of Kampala, where I stayed at the Father Mazzoldi House, which is essentially a monastery, and where I was hosted by Father John Mary Mooka, who is working on his Ph.D. in bioethics. Kampala is a fascinating and beautiful city. It is home to almost two million people – swelling to almost four million people each workday. It’s also home to maybe ten traffic lights, tops. Despite the chaos and crowds, it all functions and flows beautifully each day thanks to a simple shared spirit of cooperation. I would go out in the city to run each day (saying to myself at least once, “I’m running in Africa!”) and be amazed at the gorgeous people, the grinding poverty, the ever-present efforts at personal entrepreneurship taking place on every corner (you can buy a cell phone as easy as sticking out your hand), and the constant buzz of motorbikes shuttling people dangerously but expertly in and out of traffic for a few shillings.

I took photos in hospitals, at AIDS clinics and in the countryside of doctors, patients, nurses, and of children and their parents enrolled in clinical trails. I took pictures anywhere I could put my arm out the window of a van and anytime I get the viewfinder to my face and click away. It was a fascinating trip made poetic through interviewing such strong, stoic, intense, and generous people. I posted some of the photos on Snapfish to share with friends (you can see them here) and since then a talented artist named Sarah Keane rendered a piece of art from one of the photos. I thought you might enjoy both the photos and Sarah’s artwork, which is featured for only a short time longer in a small group show in New York. They came about as a happy result of my research into clinical trials.

Global Trials Attracting Attention

Alex — Thu, 04 Dec 2008 05:50:04 +0000

Clinical trials in third world and other foreign countries are facing closer examination following several deaths, according to the Wall Street Journal. The article by Shirley S. Wang, Geeta Anand, and Jeanne Whalen, describes the unfortunate and wrenching death of an infant in India who was enrolled in a trial. The story says more scrutiny is being paid to overseas trials conducted by western drug companies in particular because those companies are running many more trials than before. They point out, as I did in a more in-depth examination of the globalization of clinical trials in Chasing Medical Miracles, that the cost of a trial in a developing country can cost half as much as running it in the United States.

In order for trial results to be valid for approving a drug, procedure, or device for sale in the U.S., the FDA stipulates that the overseas trial meets either the standards of the country where they are taking place or lives up to the Helsinki Declaration, whichever is more stringent. Many host countries, such as China, India, Russia, and others, have lax regulations. Frequently under-developed countries, find it’s in their interest to avoid imposing tough laws. The countries are so poor that they want to attract clinical trials because they provide people with medicine and other “treatment” that the government cannot provide.

When I went to Uganda to research my book I found that the government, universities, independent doctors, and the health ministry were working hard to impose tougher regulations to govern clinical trials. Other countries, however, didn’t even appear to be trying, as I discovered and wrote about in Chasing Medical Miracles:

One man, Ilian Ivanov, for instance, oversees the regulations governing clinical trials in Bulgaria. He is simultaneously the regulator and recruiter of companies to come and conduct trials in Bulgaria and he openly aspires to someday be employed by a pharmaceutical company, just like the man who occupied his post before him. Part of his $100 monthly paycheck goes toward a bottle of whiskey he keeps at the ready for visitors to his office. Ivanov insists he’s no pushover for allowing sponsors of clinical trials to cut corners. Two Bulgarian researchers felt his regulatory wrath once when he caught them conducting trials without government permission. He slapped them with a $10 fine.

To read the full Wall Street Journal article, click here. (A subscription is required but a free trial subscription is available.)