Clinical trials of drugs and vaccines among the desperately poor in poor nations: ethical challenges and ethical solutions.

Clinical research has been expanding into poor nations in recent years. In doing research in such settings, the response to challenges arising due to the vulnerability and resultant potential exploitation of very poor subject populations is heightened awareness of the need for adequate local oversight and regulation. More regulation, however, often is difficult to implement and may not be practical. The provision of benefit at the conclusion of clinical trials in poor nations or for poor people is a better response to the moral challenge of exploitation.