Bad Blood: Medical Racism Didn't End With Tuskegee

When President Clinton offered the long-overdue apology for the hideous and racist Tuskegee experiment, the reaction across the land was what we usually see when old national sins are dredged up. Yes, we say, mistakes were made, (the passive voice eliminates the agent and spares us the guilt), but that was long, long ago and now we know better. Sure, the CIA drew up lists of Guatemalans to assassinate, but, hey, it was the Cold War and things got a little crazy there for awhile. That sort of thing could never happen now, we tell ourselves, conveniently ignoring the unwholesome fact the we are still supporting terrorists and terrorist states, from Peru to Haiti to Indonesia.So it is with Tuskegee: It was a terrible thing, we say, but not likely to happen again now that we've reached "the end of racism." In case you haven't heard the blather, racial harmony is the order of the day, or would be if the African-Americans would just pipe down. Plus, science is much more ethical now, we are told. As the Washington Post said, in reference to Tuskegee, "Such a study is unthinkable today. There are rigid ethical guidelines for medical research participants in human studies." (I think the Post meant to say that the guidelines were for researchers and not for participants.)Someone at the Post might want to go to Los Angeles and ask around concerning those "rigid ethical guidelines." In particular, the Post should ask the families of the black and Hispanic infants who were experimented on from 1989 to 1991. During those years the Centers for Disease Control (CDC) and Kaiser Permanente of California tested an experimental, high-potency version of a measles vaccine on 1,200 minority infants. The vaccine was a high-titer (or "high-concentration") of a standard Edmonston-Zagreb measles vaccine. The high-titer E.Z., with potencies up to 500 times the concentration of standard E.Z., was given to children as young as four months of age. Such high potencies were given in hopes of overcoming naturally occurring maternal anti-bodies that make the standard vaccine ineffective if administered in the first year of life. (The normal age for measles inoculation is 15 months.) Experiments using the high-titer E.Z. vaccine had previously been carried out in Mexico, Senegal, Haiti, Benin, Burundi, Zaire, Bangladesh, and Guinea-Bissau. Anybody see a pattern here? In Haiti -- where for years pharmaceutical companies have found a ready population of inexpensive human guinea pigs -- the experimenters (from Johns Hopkins University) relied on the U.S.-funded and -trained state terror apparatus to provide subjects. Women were coerced by the Haitian Centers for Development and Health, which has close ties to the paramilitary death squads that are keeping Haiti safe for North American investors. Those death squads are also, apparently, keeping that country safe for the North American medical establishment. In the Los Angeles study, researchers didn't do anything quite so heavy handed. But they did fail to inform parents that infants enrolled in the study might receive an experimental vaccine, one that was not approved for general use in the United States. Dr. David Satcher, director of the CDC, admitted as much in congressional testimony earlier this month. Satcher told the House Subcommittee on Human Resources that "the consent form was deficient in that the EZ measles vaccine was not identified as experimental, and parents were not given an adequate description of the foreseeable results...." This, Dr. Satcher might have pointed out, was in direct violation of the Nuremberg Code, which was drawn up in 1947 in response to the hideous Nazi experiments in the concentration camps. The first principle of that code is: "The voluntary consent of the human subject is absolutely essential." Dr. Satcher's admission that "the consent form was deficient" was disingenuous: It was a confession that hid a larger transgression. In April 1990 Dr. Michel Garenne, director of the high-titer Edmonston-Zagreb study in Senegal, informed the CDC that the high potency vaccine seemed to be causing increased mortality rates, but his warning was ignored. The vaccine, it turns out, suppresses the immune system for up to three years after immunization. During those three years the child faces increased risk of contracting - and dying from -- other infectious diseases. The mortality rate for the children immunized with the high-titer E.Z. vaccine was 20 percent higher than it was for children immunized with the standard-strength EZ vaccine. In one study the mortality rate was 80 percent higher. Girls seemed particularly susceptible to infection after inoculation. Dr. Garenne's data were confirmed in February of 1991, but the CDC continued the Los Angeles experiment until October of 1991 when Lancet published his findings. After he went public, the CDC could no longer ignore him. Infectious Disease Weekly summed up this dismal history in its July 29 1996 issue: " ...black and Hispanic babies were enrolled in the experiment before it was halted in 1991 after repeated warnings that babies were dying in greater numbers than expected up to three years after vaccination with the high dose measles vaccine." (Emphasis added.) The same article quotes Barbara Loe Fisher, president of the National Vaccine Information Center, who said, "The parents in inner-city L.A. were not told what it meant to subject their babies to a dose of measles vaccine many times stronger than a normal dose. They weren't told that the measles vaccine is not recommended for use in American babies under 15 months of age. They weren't told that measles vaccine can cause brain inflammation and death. Their human rights were violated - rights protected by the Nuremberg Code, the Declaration of Helsinki and U.S. federal laws created to protect human subjects in medical experiments." It doesn't take a great deal of imagination to picture the maelstrom that would have broken out had it been revealed that white babies were being experimented on in such a manner. And now comes news that as many as 1,000 non-white children are to be sacrificed - quite literally - in yet another study. The June issue of the Progressive reports that 12,000 HIV-infected pregnant woman in Africa, Asia and the Caribbean are being used as subjects in studies of AZT. These studies, sponsored by the CDC and the National Institutes of Health, are being conducted in hopes of finding inexpensive ways to prevent AIDS passing from mothers to babies at birth. This is a fine goal. But studies in the United States and in France have already reported striking evidence that AZT can reduce by up to a third transmission from mothers to infants. Still, the researchers plan to use some of those 12,000 women for "control subjects"; those women will be given placebos and thus effectively denied proven medical care. Denying proven treatment to human subjects for the sake of research is ethically indefensible. This is exactly what happened at Tuskegee. There, 399 men were denied treatment. Twenty-eight died of syphilis, 100 of related complications. Forty wives and 19 infants were infected. In the AZT tests, the death toll is likely to be higher. Dr. Sidney Wolfe, director of Public Citizen's Health Research Group told the Progressive , "as many as 1,002 newborn infants in Africa, Asia, and the Caribbean will die from unnecessary HIV infections...." And, as Dr. Wolfe's group pointed out in a letter to Donna Shalala, secretary of Health and Human Resources, these studies too are in violation of the Nuremberg Code. One of these studies is set to use women in the Dominican Republic as guinea pigs. The doctor planning that study, Dr. Neal Halsey of Johns Hopkins University (again!), has been defending the ethical lapses. Halsey said research guidelines "do not call for imposing all standards of care on developing countries. This is impractical and resented by developing country officials and practitioners." No word yet from the good doctor on how the folks in developing countries feel about being treated like laboratory animals. Presumably they don't resent that as much as they resent having decent "standards of care" imposed on them. Such lax ethical standards would not be tolerated in this country (unless the subjects were black or Hispanic, of course) which is why the experiments are taking place in nations where most people are poor and black. The persistence of this double standard suggests that "paranoia" among African-Americans in the wake of Tuskegee might better be interpreted as a healthy skepticism concerning the white man's intentions. None of these contemporary experiments can compare to the Nazi practices that gave rise to the Nuremberg Code, but the underlying ideology -- which claims that some people are racially inferior and therefore not deserving the full range of rights accorded human beings -- is uncomfortably close to Mengele's.