Drug Testing in Nigeria Case

Pfizer should not undergo drug testing of Trovan in Nigeria because:
1) the motives and ethics of the testing are questionable and 2) neither Nigeria, Kano Hospital nor Pfizer are prepared for the implementation of tests. If the testing of Trovan is done hastily and sloppily, a public relations disaster and lawsuits could ensue, and Pfizer could lose a potentially lucrative pharmaceutical.
Pfizer deals in the business of lives, and when your business is centered on the most precious commodity in existence, there must be strict, unerring focus on morality and ethics. Claims that Pfizer is testing Trovan for the benefit of world health and to aid the suffering children in Nigeria are false; Pfizer’s motivation is money. During Trovan’s development, constant references are made to raising company share prices, saving money by testing in Nigeria, and the possibility that millions of dollars are being lost each day. To top it off, Pfizer is racing against an expiring patent that threatens to undercut its pharmaceutical prices by 90%. One pharmaceutical executive stated, “The quicker we can complete clinical trials, the more money for our companies.” Nowhere is it mentioned than Pfizer has a humanitarian agenda, or that it even cares for suffering victims.
I am not chastising Pfizer’s motivation in pharmaceutical production; I am only recognizing the company’s chief priority. Trovan has potential to become a hugely profitable antibiotic, and those in power at Pfizer are under tremendous pressure to gain FDA approval. However, executives cannot allow the desire to release Trovan quickly cause them to undertake sloppy testing procedures. Nigeria, although tempting due to cost and timing, is a poor place for Trovan to be tested for moral, organizational, and branding reasons.
The principle moral dilemma in Kano is that Pfizer is working with children in an extremely poor, vulnerable, and illiterate population. It may be difficult to adhere to the GCP standards of informing children’s parents that their children “are part of a study of an unknown drug”, that there are “alternative treatments” (such as ceftriaxone) and that “their participation is voluntary.” The GCP’s ethical guidelines would be especially difficult to adhere to considering the limited amount of time doctors have to undergo testing. There is a large risk that doctors on tight deadlines will rush through and neglect ethical checklists.
Another moral issue is that conditions within the hospital are unsterile, making the clinical tests less credible. Pfizer may also need to displace patients from acceptable rooms into rooms with blood and fecal matter on the walls in Kano Hospital to make room for test subjects. Ethically, the hospital environment is not conducive to conducting an acceptable testing. It is possible that the standards are so poor that the FDA would not even accept the test.
People of Nigeria are often defined by statistics: only 29% of children are immunized and 8% of children do not reach the age of five. Buying into these statistics is an attempt to dissociate from Nigerians in the hope that it will rationalize testing on children in places like Kano Hospital. However, the fact remains: no matter how poor of a situation they are in, a Nigerian is a human test subject just as much as an American is. Pfizer executives cannot allow corporate greed to cause them to forget this fact and circumvent moral behavior.
If the massive potential for unethical behavior exacerbated by immense deadline pressures does not serve as deterrence from testing, the lack of organization in Kano Hospital should. The hospital Pfizer hopes to work in is “the worst hospital in the world” and the company has six weeks to implement a test that normally takes a year to plan. Nigeria itself is in complete disarray as religious wars and corrupt dictators ruin the country. Putting together a legitimate Institutional Review Board appears impossible, which serves as another reason to believe that the FDA will not accept the test if it is implemented. Pfizer has put billions of dollars into the careful development of Trovan; it seems absurd to now rush into a volatile, chaotic situation in the drug’s final development stages.
Finally, there is no guarantee that Trovan will be effective seeing as it has never been tested on children. If Trovan is administered unethically or has dangerous side effects, the fallout against Pfizer for harming Nigerian children will be fantastic. Pfizer’s brand image is based on trust; it is crucial that people have faith in the brand that creates the pharmaceuticals they put in their bodies. Along with the loss in trust that comes with treating Nigerian children unethically, consumers could lose trust in Pfizer solely due to the company’s decision to test drugs in Nigeria. Nigeria’s international reputation is very poor, which could take away the credibility of even successful drug tests done in the country.
In terms of ethics, the situation is filled with “what if’s” and risks. In terms of profit, the public relations disasters and lawsuits that would come about if Nigerian children were injured or killed due to unethical treatment or a faulty drug would be devastating.
Under immense pressure and facing profit losses, executives often make rash decisions that result in disaster, such as drilling that leads to oils spills or unnecessary entries into war. Pfizer executives have become so obsessed with producing Trovan as soon as possible that their ethical standards and rational decision-making skills are clouded. Those in charge have to step back for a moment and realize that Nigeria is in no way the proper environment for drug testing and that there are an astronomical number of risks involved in using Trovan on children in Kano Hospital. Levelheadedness and patience must be maintained to prevent a public relations disaster that could result in sales losses and lawsuits. If testing Trovan overseas in Nigeria is the ultimate goal, Pfizer should deliberately prepare for the next meningitis outbreak, which is known to come around during massive population movements during holy seasons.