Journal international de bioethique et d'ethique des sciences最新文献

Since the 1990s, the pharmaceutical industry has been a major contributor to the economic growth of India. India is the world’s largest vaccines producer, and it attracts foreign direct investors who are relocating production capacities and research activities to develop new drugs in India. India, however, suffers from a lack of trust due to repeated scandals over clinical trials. Some of these scandals have led to economic sanctions, such as the withdrawal of hundreds of generic drugs from consumption in Europe in 2015. These measures followed irregularities detected in clinical trials carried out on volunteers. While India has taken steps to reform the bioethical institutions responsible for the control of clinical trials, we show in this contribution that loopholes persist. Two periods can be distinguished. The first period, between the early 2000s and 2013, gathers a significant growth in the number of clinical trials with a growth in bioethical scandals. It led the Indian government, under pressure from the civil society and the Supreme Court, to take action to curb clinical trials and to reform bioethical institutions. The second period, from 2013 to 2021, is characterised by an increase in the number of clinical trials in a context of strengthening the efficiency of bioethical institutions. We show that the increase in clinical trials is mainly due to the implementation of the TRIPs agreements on generic drugs. This development put another pressure on national vigilance authorities which remain undersized with respect to the magnitude of the Indian clinical trials market. It also highlights again the structural frailties of the Indian Federal System.

Agroecology has become a trendy word in political and media discourse and the subject of international debates, but its meaning remains unclear. This article defines this experimental science and explains its substance, and then goes on to examine how and to what extent agricultural law has allowed it to enter the political arena. It explains why agricultural Frenc Law and UE agricuktural Policy struggles to offer a secure and comprehensive framework for agroecology whereas this multi-disciplinary, complex and systematic science is looking to the future and aims to protect future generations.

Despite progress in the detection and treatment of the Human Immunodeficiency Virus (HIV), major challenges remain in developing countries due to insufficient resources and infrastructure. The number of people living with HIV who do not know their serostatus has fallen worldwide. However, a number of existing obstacles stand in the way of better results. The socio-cultural context in Africa hampers knowledge and understanding of the disease, leading to stigmatizing attitudes, reluctance to undergo screening and poor access to treatment.Inequalities also exist within the countries of the North, as in the case of the French West Indies, which benefit from a policy to combat HIV/AIDS, with results that fall short of those in mainland France. For this reason, we have chosen to compare the situation in the West Indies with that in Benin, in the context of African culture.Our analysis takes stock of the issues and prospects linked to the accessibility and use of screening care in sub-Saharan Africa and the French Departments of America (DFA).In both cases, fear of the disease, stigmatization, fear of a positive HIV test result and fear of disclosing the test result limit preventive and treatment actions for an effective fight against HIV.In sub-Saharan Africa, women are more likely to accept a screening test than men. Certain populations, including adolescents and homosexuals, are in a vulnerable position. The comparison reveals similar attitudes and suggests actions or recommendations in both countries that have produced results.Innovative strategies and specific programs must be implemented to turn the tide in the fight against the HIV epidemic.

As a part of personalized medicine, pharmacogenomics (PGx) allows practitioners to provide the right drug for a given patient, in accordance with the result of a genetic test. This practice raises many ethical issues that are discussed in the literature, sometimes within the larger context of personalized medicine. This article is based on a literature review that is original insofar as it is interdisciplinary and based on an approach that articulates individual and social rights. Here, we propose to reconsider some classic ethical issues, such as informed consent, incidental findings and data protection which are raised by genetic testing and also by PGx in the same or in a different way. We also analyse broader collective issues around racialization and health equality. Our purpose is to contribute in drawing links and parallels between individual rights and collective rights using a social approach. This analysis discusses these ethical issues in research and in clinical setting, understanding the treatment of the individual in his dual quality of patient and research participant.

Since the 60s, and particularly after various scandals in the 90s, national research ethics committees in Africa have established themselves as key players in the field of international clinical research. Notably based on the principle of double ethical review, their existence has historically been aimed at preventing a form of ethical dumping, a temptation that still exists today on the part of some research promoters. While the international framework of “soft” law has favored their emergence and legitimacy, a legal and regulatory framework of “hard” law is also necessary at local level for each national research ethics committee, to ensure its proper functioning and the optimal fulfillment of its missions. The aim of this article is to analyze the similarities and differences between three national ethics committees in Africa, specifically the CNERS of Guinea, the CNERS of Benin and the CNESVS of Côte d’Ivoire, in terms of status, missions, legal or regulatory ground and, more generally, autonomy. This analysis will enable us, on the one hand, to take account of common logistical difficulties and, on the other, to go beyond differences in legal status and missions to define what enables this type of committee to fully exercise its role(s). Finally, this article proposes to model the various elements that contribute to the autonomy and resilience of a national research ethics committee, around a notion proposed on this occasion: the “circles of autonomy”.