FDA abandons the Declaration of Helsinki: The effect on the ethical aspects of clinical trial conduct in South Africa and other developing countries

L J Burgess, D Pretorius


Four years ago, the US Food and Drug Administration (FDA) ceased compliance with the Declaration of Helsinki (DoH) (2000 revision and all subsequent revisions) for conduct of clinical trials outside its borders. It instead ruled that compliance with the Good Clinical Practices (GCP) of the International Conference of Harmonization (ICH) is sufficient. However, the GCP-ICH guidelines do not address certain ethical requirements stipulated in the DoH, such as the use of placebos v. standard therapy, post-trial access to treatment and other benefits for participants; public disclosure of trial design; publication of trial results; and the disclosure of conflicts of interest.
The FDA’s adoption of less morally stringent guidelines could encourage pharmaceutical companies to take ethical short cuts. It could also have practical consequences for trial ethics in developing countries, especially where research ethics committees may not be promoting high standards of protection for participants in clinical trials, due to lack of financial and human resources.
Pharmaceutical companies may also pressurise research ethics committees to relax guidelines and legislation, in order to facilitate future clinical trials in developing and emerging countries that lack the resources to conduct their own clinical research on epidemics such as HIV/AIDS, which have devastating effects on their populations.

Authors' affiliations

L J Burgess, Tread Research CC/Cardiology Unit, Department of Internal Medicine, Tygerberg Hospital and Stellenbosch University, Cape Town, South Africa

D Pretorius, Andurihl Medical Writing CC

Full Text



Regulatory guidelines, Research ethics, Participant safety

Cite this article

South African Journal of Bioethics and Law 2012;5(2):87-90. DOI:10.7196/SAJBL.222

Article History

Date submitted: 2012-05-28
Date published: 2012-11-23

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