http://allafrica.com/stories/200101100249.html
Other related Nigerian press articles: http://allafrica.com/stories/200101080236.html http://allafrica.com/stories/200101030031.html http://allafrica.com/stories/200101060019.html http://allafrica.com/stories/200101040115.html http://allafrica.com/stories/200101030216.html http://allafrica.com/stories/200012210143.html
If someone has access to the original Washington Post article from December 17 could it please be posted here?
Johannes
The Guinea Pigs Of Kano
OPINION January 10, 2001
Mideno Bayagbon Lagos
No, this article is not about the Igboman who was flogged 80 times by some zealots for consuming alcohol in the ancient city of Kano. True, he was a Guinea Pig of sorts for the newly introduced Islamic code. But no, this is not about whether sharia is for Moslems alone or not.
It is about Pfizer, and it is about a drug called Trovan; it is about the 1996 Cerebral Spinal Meningitis, commonly known as CSM, out break; yes, it is about the Washington Post newspaper and its disclosure that more than 200 Nigerians were used as Guinea Pigs in an experiment to determine the potency or otherwise of the drug.
The American paper claims that Pfizer, the international pharmaceutical giant, in collaboration with its Nigerian offices used Trovan in a clinical trial on victims of the Kano epidemic of 1996 without observing the proper ethical medical steps. It says Trovan which was not then approved by the United States department for Drugs and Food Administration, was surreptitiously administered on 200 patients, 11 of whom died, while others are living with one form of deformity or the other.
In the dust this has raised locally, Pfizer has come out to deny this claim. It says, contrary to the Washington Post claim, that the NAFDAC, the federal ministry of health under Ihechukwu Madubuike, the Kano ministry of health, the Maiduguri University Teaching Hospital, and the Nigerian Medical Association, Kano chapter, were all involved. It claims further that its gesture was purely on a humanitarian ground. Of course this is coating a lie in a glossy, believable colour.
In all the claims and counter claims, certain things have become obvious. First, Pfizer international which had experimented Trovan, an antibiotic, on various diseases in the developed world wanted an ideal situation to experiment it on CSM patients so as to be able to determine its efficacy. Since there was never going to be the likelihood of a CSM epidemic in the developed world, it was therefore a welcome relief when the Kano epidemic occurred. CSM can only occur in the under developed part of the world, where living conditions are subhuman, crowded and generally unhygienic.
The Kano epidemic therefore presented a very rare opportunity for the company to use humans for its clinical test, to determine if Trovan can be effective too in the treatment and cure of CS M. That is why it got NAFDAC with a backing letter from the federal ministry of health to write to the United States department for Drugs and Food Administration, USDFA, to authorise the importation of the drug into Nigeria. The then finance minister, Chief Anthony Ani, was also got to authorise an import duty waiver for the drug and the equipment imported for the experimentation. The drugs and equipment were worth N18 million.
For the experiment proper, Nigerian doctors were involved, and it was they who administered the drug on 90 CSM patients out of which five died. And for a proper comparative clinical study, Pfizer also administered another drug, Ceftriasone on 97 others. Six more died in this group. Until the Washington Post article, nothing was said about those who survived but at a cost of one deformity or the other.
Nobody too has spoken about another drug, Chloramphenicol Succinate, banned in all the developed countries of the world, but which was authorised for use on some of the patients, this time not by Pfizer. This drug, it is being alleged records close to a 30 per cent fatality; it is not approved by NAFDAC. The simple questions which the commission already set up by the Kano state government must also try to unravel should be: who authorised its use, who imported it, which Nigerian doctors administered the drug, and what was the level of fatality recorded? Why was there no follow-up monitoring of the surviving patients?
In all these, Dr Idris Mohammed, who headed the epidemic team during the treatment should be of immense help. For example, why did he, after initially cooperating with the Pfizer team, turn around to complain that NAFDAC or the federal health ministry did not approve of the drug; was his complaint that patients consent were not sort true?
The Trovan controversy has also led to a current revelation, that the drug which was experimented on 7000 people worldwide, has now been discovered to have toxic effect on the liver. Indeed, in the USA alone, about 100 deaths have been recorded on account of this. This is why the USDFA has limited its use to only five cases, in hospitalised patients.
What the Trovan controversy has further shown is the ease with which, at the right inducement, NAFDAC and our doctors, especially those one in the teaching hospitals that the Indian pharmaceutical firms use in bringing in all sorts of drugs, can be used so cheaply.
In the blame and guilt sharing, our doctors, the regulating authorities are most to blame. Pfizer which did not put all the cards on the table, surely has a large chunk. We were just their guinea pigs. This is especially so given that because of the cost of Trovan, even WHO does not approve its use for Africa and third world nations in areas where it is believed to be effective.
What truly aches my heart is the fact that Nigerians can be so cruel to themselves.