Donating Human Samples: Who Benefits? Cases from Iceland, Kenya and Indonesia - Benefit Sharing - page 111

undue inducement is not always easily resolved (see Chap. 2 ). Indeed a senior
Kenyan ethicist has commented:
Most people think that our commercial sex workers have been exploited. They have been
used and in the end there was no benefit from that. Society may benefit from the alleged
resistance. … we can say the whole world will benefit, but is that enough to these ladies
who have been attending the clinic since 1985? 32

The discussion about undue inducement will be revisited in Chap. 8 .

5.3.5.3 Export of Samples

The final concern is the use of samples abroad. In common with many developing
countries, Kenya does not have the capacity for scientific analysis of many of the

Table 5.3 Tim e Line and Details of Sex Worker Case
Date Details

1984 Cohort of female sex workers established in Nairobi to study STDs

1985 Majengo sex workers' clinic established in Pumwani Division, Nairobi, with com-

prehensive STD care and prevention services

1985 First-generation HIV testing kit used to test samples from the sex workers. Many

test positive for HIV, changing the focus of the research programme

1988-1993 Natural history study of HIV initiated, and efforts to enrol sex workers into the

cohort scaled up. Approximately 5% of sex workers enrolled in the study
repeatedly test negative for HIV infection, despite their high-risk behaviour

1993 Announcement of natural resistance to HIV in some of these women raises hopes

of a vaccine

1996 Results from study officially published in peer-reviewed journal. The scientific

world searches for an HIV vaccine

1998 International collaboration begins between Universities of Oxford, Nairobi and

Manitoba towards an HIV vaccine based on the immunological protection
mechanisms found in these sex workers

1996-2000 Ongoing studies reveal late seroconversion in some of the women who had been

classified as HIV-1 resistant. This catalyses further research

2001 Vaccine trials start and proceed through Phase I and II clinical trials

2004 Vaccine trials abandoned, as the vaccine offered insufficient protection against HIV

infection (Follow-up studies of 850 women in Majengo are being conducted as
part of the ongoing collaborative project by researchers from the Universities of
Nairobi and Manitoba.)

2005 Free antiretrovirals (ARVs) become part of Majengo sex workers' clinic compre-

hensive standard of care and prevention services

2005-2010 All HIV-infected sex workers enrolled in the Majengo sex workers' clinic who

qualify for ARV are initiated on therapy. Reduction in both morbidity and mor-
tality noted. Studies continue on single nucleotide polymorphisms to explain
HIV resistance among sex workers

32 See Footnote 29.