Editorial: HIVResearch, Ethics, andtheDeveloping World

becomes. Here, thedebate hasfocused on whether thestandard ofcareintheUnited States-an expensive andcomplex regimen ofzidovudine-must beprovided toall HIVinfected pregnant womenwhojoin aresearch study inthedeveloping world. Different scientists andscholars inbioethics havedrawn theline differently interms ofwhatinterventions routinely available inthedeveloped worldmustbeprovided toresearch participants inthedeveloping world. Atanextreme, noonesuggests requiring thatthemost expensive andcomplex ofWestemtertiary care, forexample, renal dialysis orcoronary bypass, mustbeprovided inresearch conducted inthedeveloping world. Indeed, public debates about theHIVperinatal transmission trials havenotevenfocused onwhether thewomeninthetrials should beprovided HIVcombination therapy asthey would bein theWest8 orwhether theyshould evenhave thezidovudine continued postpartum. Inaddition todiscussing therecent debate conceming intemational HIVresearch, these articles also focus onwhether ornotrandomized, controlled trials mustbeconducted forresearchers toleamabout anintervention's efficacy. Thechoice ofastudy design isnot simply between ethically questionable perfect trials that produce complete knowledge versus