The thalidomide tragedy

Until the mid-1950s, many scientists generally assumed the placenta was an impenetrable barrier. Thus drugs taken by pregnant women could not pass through the placental barrier to damage the fetus in the womb. Although some researchers and drug developers already had an idea that this was not the case, it was demonstrated dramatically in a terrible tragedy.

The drug thalidomide was developed in the 1950s by the West German pharmaceutical company Chemie Grünenthal GmbH. It was initially developed as a sedative but was also used to treat many other conditions, including colds, flu, leprosy, insomnia, and morning sickness in pregnant women. Researchers deemed the drug harmless for human use, despite not having done extensive testing, and it was licensed in 1956 for over-the-counter sale in Germany. Within just a few years, thalidomide was sold in around 47 countries.

Clinical evidence that the use of the drug led to nerve damage meant that it was refused a license by the Food and Drug Administration for sale in the US.

By 1961, doctors had begun to notice a large uptick in the number of babies born with severe birth defects to women who had taken thalidomide while pregnant. That year, Australian doctor William McBride published a letter in The Lancet connecting thalidomide to the birth defects. The drug was withdrawn by Chemie Grünenthal later that year. However, it had been traded under many different names and remained in many medicine cabinets for some time.

Researchers later discovered that the impact on development only occurred if the drug was taken between 20 and 37 days after conception. The incident led to almost universal requirements to test drugs for their effects on fetal development before being approved. Of course, this was too late for the nearly 100,000 babies worldwide who were affected. While most of these died shortly before or shortly after birth, around 10,000 survived with severe birth defects.

Guatemala syphilis experiments

While the thalidomide tragedy was caused by inadequate testing and a lack of regulatory procedures, other tragedies have been caused more deliberately. One of these took place in 1946 in Guatemala.

At this time, with WWII in full swing, the contraction of sexually transmitted diseases by soldiers who frequented prostitutes was a significant problem for the military. Although penicillin had recently been discovered as an effective treatment, it was unclear whether this would work in all cases, and supplies of the drug were limited. As a result, U.S. medical researchers were tasked with testing other treatments, such as orvus-mapharsen, which could be applied as a foaming wash following exposure.

Government officials and researchers, led by the United States Public Health Service scientist John C. Cutler, deliberately infected more than 1300 Guatemalan soldiers, prisoners, sex workers, and psychiatric patients with syphilis, gonorrhea, and chancroid, in most cases without notifying the infected.

These people then passed the diseases on to others unknowingly, and tests were conducted on around 5,100 subjects to refine diagnostic techniques. About 820 subjects received some form of treatment, including more than 650 of those who were deliberately exposed. However, many more received no treatment.

According to a research published in the American Journal of Public Health, the experiments were often not conducted in sterile settings. According to documents published by the Presidential Commission for the Study of Bioethical Issues, in September 2011, many of the people involved either did not give their consent or actively objected to being used for the experiments and were infected against their will.

The total death toll has been revealed as 83 of the 5,500 subjects, although the Presidential Commission couldn't verify whether the deaths were caused directly or indirectly by the infections, BBC reported.

This was not the first time that the U.S. government had experimented on people without their knowledge.

In 1997, President Bill Clinton issued a formal apology for the "Tuskegee Study of Untreated Syphilis in the Negro Male", a 40-year-long experiment involving hundreds of unsuspecting black men. The study, conducted by the U.S. Public Health Service at the Tuskegee Institute (now Tuskegee University), lasted from 1932 to 1972.

The purpose of the study was to determine the effect of untreated syphilis in black men. The 600 men in the study were never told that they had syphilis. Most of whom had never received medical care, the men were told that they were being offered free medical care. They were then tested for syphilis and given periodic checkups to measure the progress of the disease - but were never told they were infected, and no treatment was ever offered. Instead, even as some suffered advanced effects such as blindness and insanity, they continued to be told they suffered from "bad blood," and treatment continued to be withheld.

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https://interestingengineering.com/three-public-health-scandals