Cheaper in India

India’s competitive advantage is supposed to be in the ability to perform a variety of services at a considerably lower cost than in the advanced economies. Outsourcing of various kinds has been a boon for India’s balance of payments, but few ask if there are any human costs to the outsourcing boom. Now the issue in one kind of outsourcing has exploded with reports of the death of 49 infants who were part of drug clinical trials at New Delhi’s All India Institute of Medical Sciences (AIIMS). It is far too early to draw a connection between the deaths and the clinical trials undertaken on behalf of two foreign companies. Over 2,100 infants were put through the clinical trials at AIIMS since 2006 and the babies who died were known to be suffering from very serious illnesses and included infants who were in the control group (i e, they had not been administered the test drugs). Yet, what this episode has done is to draw attention to a large and growing business where monitoring and safety mechanisms in the country are very poor.

Clinical trials for new drugs developed by pharmaceutical multinational giants are one of the less well known but highly lucrative activities that are increasingly being conducted in India. India’s disadvantages and advantages have morphed very well to present an attractive opportunity for the trials: its huge population guarantees a vast pool of people suffering from a variety of diseases – most of them “treatment naïve”. It also has an army of English speaking, welltrained medical and auxiliary staff. For a developing country it has a good number of private and public hospitals – and there is no specific legislation relating to biomedical ethics in place. This helps since it is not only expensive to test drugs in the west but the strict regulations and small populations make recruitment of subjects difficult.