Overview of research in developing countries: priorities and challenges.
Int Conf AIDS 1996 Jul 7-12; 11:214 (abstract no. Th.A.260) Greenberg AE; Projet RETRO-CI, Abidjan, Cote d'Ivoire. Fax: 225-24-29-69.
To be effective, HIV/AIDS researchers in developing countries must strive to define relevant research priorities and must successfully confront a series of logistic and ethical challenges. After more than a decade of critical work describing the magnitude of the HIV/AIDS epidemic in the developing world, it is imperative that scientists conduct interventional research that is focused on the prevention of HIV infection and on the prophylaxis and treatment of HIV disease. High priority must be accorded to prevention research that targets modes of transmission that are common in developing countries; these include the prevention of heterosexual transmission through condom promotion, education of adolescents and commercial sex workers, and vaginal microbicides; of transfusion-related transmission through rapid, effective and low-cost serologic screening; and of mother-to-child transmission through vaginal disinfection and short-course antiviral therapy. Research on the diagnosis, prevention and treatment of HIV disease must focus on those opportunistic illnesses that are common in developing countries, such as tuberculosis and bacterial infections. There are multiple logistic challenges to conducting research in developing countries, including the adequate financing of scientific studies; the development of mutually beneficial partnerships between developing and developed nations; access to and maintenance of adequate laboratory and data management facilities; and the training of personnel in research methods. Ethical issues that are central to conducting research in developing countries include the obtaining of culturally appropriate and meaningfully informed consent; the development and maintenance of local ethical review committees; and the assurance of "distributive justice", that interventions such as drugs or vaccines that are tested in developing countries will be made available to the citizens of those nations should they be shown to be safe and effective.Finally, for research to result in lasting and effective prevention programs, interventions to be evaluated must be carefully selected. Interventions must be assessed judiciously and found to be economically sustainable, culturally acceptable and technologically appropriate in the developing countries where they will be evaluated and implemented.
Keywords: AEGIS, Developing Countries, HIV Infections, Acquired Immunodeficiency Syndrome, Heterosexuality, Condoms, Developed Countries, Research, Antiviral Agents, Research Design, Adolescence, Child, Human, Female, ICA11
