>From the Nigerian Vanguard Daily (Lagos) at:
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.
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