The United States has grappled for years about its ability to provide healthcare to its citizens, particularly its poorest citizens, and its ability to do so at an affordable cost to those citizens.
For all its faults, though, for the most part, when someone does receive healthcare, they know what's being done and what the treatment they get is supposed to do.
Then there's India.
Many Indians live in extreme poverty and are unable to pay for even the cheapest, most basic healthcare. In fact, some resort to selling their organs on the black market to people who often pay them less than the promised amount for the organs after they've been removed, because hey, you're recovering from major surgery now, what are you going to do about it? As such, if someone is to receive healthcare- and if you're in the 'untouchable' caste, you're headed to the back of the line- it is likely going to have to be free and specially provided in many cases. And in many cases, multinational pharmaceutical companies are willing to provide that healthcare.
Just not the healthcare that the people receiving it are told they're receiving. Since what appears to be 2005, people from the untouchable caste have been given vouchers to help pay for healthcare costs. Many of these people have been escorted to the front of the line and told the entire cost would be picked up. What they were not told- and what they could not read from the agreement because of rampant illiteracy and documents given to them in deliberately unfamiliar languages- was that they were not to be getting the treatment they were supposed to get. Instead, they have been used as unwitting guinea pigs to test out new drugs before they're placed on the market to sell to, oh, let's say you. Whatever happens to these patients, happens. And hundreds of times every year, what happens is that the new, untested drug ends up killing them, or giving them new health problems. The BBC article linked above tells of, among other stories, one healthy three-day-old baby that the family was told needed a polio vaccine, given forms to sign in English- a language they don't understand- then given one such untested drug, and promptly developed chronic bronchitis. The families are not compensated.
Today, India's supreme court has called on the pharmaceutical companies to end this practice and ordered that the Directorate of General Health Services, the position in charge of the trials, be stripped of authority. The overarching government agency, the Central Drugs Standard Control Organization, was found earlier this year to be colluding with the pharmaceutical companies to speed up approval of the drugs for Indian consumption; several of those drugs are not permitted to be sold in the United States, Canada, Australia or the European Union. They've ordered that future trials be placed under the authority of the Union Health Secretary, viewed as a more trustworthy position.
At least two Indian states, Bhopal and Madhya Pradesh, have banned drug trials outright due to the unreliability and lack of ethics; Bhopal is particularly sensitive to this as some of the victims were previously survivors of the Union Carbide gas leak in that state in 1984. Efforts are being made to bring the trials back to both, though if things don't improve, one wonders if more states will join them.