(Accessed 20 March 2011)
The Challenge of Discharging Research Ethics Duties in Resource-Constrained Settings Jerome Amir Singh Perspective, published 15 Mar 2011
Linked Research Article
Jones-López EC, Ayakaka I, Levin J, Reilly N, Mumbowa F, et al. (2011)
Effectiveness of the Standard WHO Recommended Retreatment Regimen (Category II) for Tuberculosis in Kampala, Uganda: A Prospective Cohort Study. PLoS Med 8: e427. doi:10.1371/journal.pmed.1000427
Prospective evaluation of the effectiveness of the WHO-recommended standardized retreatment regimen for tuberculosis by Edward Jones-López and colleagues reveals an unacceptable proportion of unsuccessful outcomes.
The paper by Jones-López et al. in this week’s PLoS Medicine  (hereinafter “the Uganda study”) illustrates the challenge of conducting research in resource-constrained settings. At the time the study was proposed and initiated, the prevalence of multidrug resistant tuberculosis (MDR-TB) in Uganda was unknown. Further, second-line therapy for MDR-TB, available in other settings, was not available in the country. The Uganda study accordingly highlights at least two classic ethical conundrums: (1) should research be conducted in a setting if the existing standard of care for the health issue under investigation is “no treatment,” despite efficacious treatment existing elsewhere? and (2) should investigators introduce