India must enforce strict rules on clinical trials
19-May-2014
Nalinakanthi V

INDIA : This year, on International Clinical Trials day, India has a reason to 
feel satisfied with the progress made in regulating the use of humans to test 
drugs. In August last year, the Supreme Court had batted for patient safety, 
coming down hard on the clinical research industry. But this is just the 
beginning. A vibrant environment needs to be created wherein adequate 
safeguards are available for trial patients while promoting novel research.
Though instances of unethical conduct of clinical trials in India dated back to 
2005, the issue came under spotlight only in June 2011, after the Economic 
Offence Wing of Madhya Pradesh submitted its enquiry report. The report brought 
to light some gruesome facts about the conduct of trials in the state. 
Thousands of individuals, mostly children, were subjected to drugs and vaccines 
trials between 2006 and 2010, violating guidelines.
Even the mentally ill were not spared. Many such patients were subjected to 
trials for various drugs including the ones used to treat premature 
ejaculation. This was driven by perverse, profiteering motive pursued by a few 
clinical research organisations (CROs) that amassed millions of dollars at the 
expense of innocent patients. "The entire research community has been blamed 
for the mistakes of isolated people," says Suneela Thatte, President of Indian 
Society of Clinical Research (ISCR).
A welcome ruling
After series of unsuccessful debates in various forums including the Vidhan 
Sabha, a writ petition was filed in the Supreme Court in January 2012 by the 
NGO Swasthya Adhikar Manch and others. In October 2013, the court ordered 
halting of all the 157 clinical trials approved between January and August 
2013. It sought a detailed report from the apex and technical committees, 
assessing the risk versus benefit for patients, before allowing trials in these 
157 drugs. The court also expressed concern over the non-existence of a strong 
framework to ensure safety of these patients.
This is a very positive move. Some changes have since been effected to the 
existing regulations such as mandating a video recording of the patient 
consent, registration of ethical committees and formulation of compensation for 
trial subjects who suffer adverse reaction, to name a few. But this will not 
suffice. Ensuring effective implementation of the set regulations is the most 
critical aspect.
Ensuring strict adherence to regulations will not only ensure protection of 
patients' right but will also benefit the CROs who have been doing legitimate 
business. "We have always wanted robust regulatory framework governing clinical 
trials in India," agrees Thatte.
The SC order is conducive to patients, but it has also made the clinical trial 
industry aware of its responsibilities towards patients. Today, on the occasion 
of International clinical trials day, the industry body ISCR plans to 
distribute a special patient handbook, which will serve as a guide for those 
who intend to participate in clinical trials. It is also conducting patient 
awareness programmes.
Safety and innovation
The industry's efforts now seem to be directed towards re-building the 
confidence among the patient community, while also sending the signal to the 
government that they are willing to adopt the best practises in clinical trials.
As a developing country, India needs to encourage investment in innovative 
research. Hence, it is important to strike a balance between safety of trial 
subjects and the country's healthcare needs, without compromising one for the 
other. "Patient is a very important stakeholder. Unless they come out and 
participate in trials, no innovative medicine will be available to patients" 
adds Thatte.

http://www.thehindubusinessline.com/opinion/putting-patients-first/article6026059.ece


                                                                                
  

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