The exposure of a 64-year-old secret study conducted in Guatemala on human subjects by the US Public Health Service has created an international uproar, forcing the US government to issue a belated apology.
The criminal experiment was brought to light last May in a paper presented by Wellesley University professor Susan Reverby to a conference in Minnesota. The New York Times published an article based on the paper last Friday. It is to be formally published this January.
The 29-page paper provides details of a secret experiment on Guatemalan prisoners, soldiers and mental patients by doctors employed by the US Public Health Service (PHS). In all, some 696 individuals were infected with gonorrhea, chancroid and syphilis, without their consent or knowledge. The experiment was part of a study on the evolution of these diseases and on the effects of penicillin in preventing, rather than curing, the disease. That study was never published, although some of its results did appear in other scientific papers.
Of the 497 infected with syphilis, 332 were treated at least partially and 85 appear to have been fully treated. However, 71 died during the studies.
Though not infected with syphilis, also conscripted for the experiment were nearly 400 orphan children whose ages ranged between 6 and 16 years, who were used to perfect the blood-testing procedures.
Reverby, found out about this secret study while researching another infamous syphilis experiment involving 399 black sharecroppers in Tuskegee, Alabama. That study, which began in 1931 and ended in 1972, was also carried out by the PHS. The participants were never informed that they had the venereal disease, nor were they treated for it. Many of them infected their wives and had children born with congenital syphilis. The Tuskegee experiment appears to have involved black men who had already contracted syphilis.
Not so the Guatemalan experiment. In that case, the researchers systematically infected their victims, at first by providing them with prostitutes who had also been deliberately infected by the researchers. When that proved inefficient, they directly exposed them to the germs of the venereal disease through abrasions on their genitals, and on their skin, and through injection. Shortly after contracting the disease, the victims were treated with penicillin.
According to Reverby’s report, the appearance of penicillin and other antibiotics and their early effectiveness, worried some researchers that syphilis and other infectious diseases would be wiped out before they could be thoroughly studied. The Guatemalan experiment was an extension of a similar experiment in which so-called volunteers at a prison in Terre Haute, Indiana were infected with gonorrhea.
According to Reverby, Guatemala was chosen because it was a country where syphilis was less common than in the American South. The country was also virtually ruled by the United Fruit Company, and it had a Public Health Service that was willing to comply with the study in return for much needed medical supplies. Furthermore it was alleged that the venereal disease affected highland Mayan Indians in a less virulent ways than it affected other Guatemalans. Reverby suggests that such racial pretexts are common when experimenters intend to target some oppressed population. A similar racial pretext was used in the Tuskegee trials.
The Guatemalan experiment took place between 1946 and 1948, years that coincided with the famous “Doctors’ trial” at Nuremberg that indicted 23 German doctors for engaging in experiments on thousands of concentration camp inmates; most of the victims were Jews, Poles, Roma, and Russians. Sixteen doctors were found guilty, seven of whom were hung. As a result of the trial, an international code of medical ethics was developed, the Nuremberg Code, which demands that any experimentation on humans be done only with informed consent and be medically useful.
The significance of the Doctors’ Trial was not lost on some of the PHS researchers. Dr. Cutler’s boss, a PHS physician whose name was R.C. Arnold, is said to have been troubled by the experimentation on the mentally ill, due to the fact that they could not give consent that “some goody organization” could find out and “raise a lot of smoke”.
Later on, the US doctor who led the Guatemalan experiment, Dr. John Cutler, a veteran of the Terre Haute study, also participated in the Tuskegee experiment. Joining the PHS in this study were the National Institute of Health and the Pan American Health Organization, at the time virtually a branch of the PHS, writes Reverby. Cutler died, unrepentant, in 2003.
During these years, the US government was actively destabilizing the Guatemalan regime of President Juan José Arevalo, whom the Truman administration accused of communism. The Arevalo government had succeeded the brutal dictatorship of Jorge Ubico, who ruled Guatemala with an iron fist, with US backing, between 1931 and 1944. In 1954, the CIA overthrew Arevalo’s successor, Jacobo Arbenz, and installed a government, that, much like Ubico’s, proceeded to rule Guatemala with brutal methods in the service of the banana companies.
The New York Times’ publication of Reverby’s findings set off quick reactions by the State Department and White House.
In a joint statement, Secretary of State Hillary Clinton and Health and Human Services Secretary Kathleen Sebelius said: “We deeply regret that it happened and we apologize to all the individuals who were affected by such abhorrent research practices.” Both officials promised that they would initiate a thorough investigation on this matter. Obama also called Guatemalan President Álvaro Colom to apologize.
The Guatemalan syphilis trial, however, exposes a practice of shady drug and medical trials that continue to this day, underscoring the cynicism of the US government’s apology.
The regret expressed by Clinton and Sebelius notwithstanding, unethical human experimentation in the United States did not stop with the Guatemalan or Tuskegee trials. Since the 1950s, cities such as San Francisco, have been sprayed with bacteria; as have the rapid transit systems in New York and Chicago. Between 1950 and 1972 mentally disabled children were intentionally infected with hepatitis. In addition, people have been unknowingly exposed to radioactive iodine, plutonium and other radioactive elements.
The use of impoverished people in colonial and semi colonial nations for drug trials is on the rise. Pharmaceutical companies routinely turn to countries such as Nigeria and South Africa for drug trials that would be illegal in the US. Often these populations are left to their own devices at the end of the trial or if things go wrong.
According to a study conducted by the Tufts Center for Drug Development, in 1997 the US conducted 5 percent of clinical studies outside of the United States and Western Europe, but by 2007 the share had increased to 29 percent.
In 2008 in Argentina, for example, 12 children died after they were used in a study of a new flu drug by the GlaxoSmithKline pharmaceutical company that involved thousands of impoverished children across South and Central America. None of the trials took place in Europe or the United States, due to high cost and more stringent standards. According to media reports, parents of some of the children said that they either had no idea that they were part of a drug test, or that they had been coerced into participating.