My name is Michelle Julien, I am the author of a book (1) about the people testing our drugs - the invisible, those whom consumers ignore or whose existence they'd rather ignore.

I participated to about ten clinical trials in France and in the United Kingdom. In my book, I also included an investigation carried out in the USA. My first clinical trial dates back to 1995. I have therefore a 15-year watching experience of what is going on behind the scenes of drug development and on the attitude of media/general public towards the people participating to clinical trials. In a certain way, I am a voice that is never heard. Even worse, a voice that the media flout because it stirs our bad conscience up.

A clinical trial aims at obtaining a full market approval for the tested pharmaceutical product - an authorization which is granted by the national agency for drug regulation, like the FDA in the USA. In other words, its finality is not to make a drug safer (as most consumers believe), but to allow the laboratory to market its product at the chemist's (so that the consumer may buy it). Consumers' belief is based on a cynical and utilitarian conception of medical research: they take pleasure in believing that Others (animals and humans) must sacrifice themselves (or be sacrificed) in order to eliminate all “danger” from a pharmaceutical product. This pharmaceutical product is swallowed by consumers to compensate for their lack of will to suppress an addiction to smoking, to junk food, to a sedentary existence... so as to better maintain a lifestyle which is always more “at risk” for health. 'Drug side effects? This is for the others!', the consumer thinks. People have the same attitude towards their own drug consumption (and their vision of human testing) than smokers have with tobacco danger. Less than a daily smoker over four considers that the risk of cancer associated with their own tobacco addiction is high. Smokers make up a strategy to keep a distance from risks ('tobacco, that's dangerous... for the others', for example). Drug consumers have the same logic: the person in danger is the one testing drugs, never the consumer, who buys the same pharmaceutical product. Drug side effects (shall we remind that all drugs have side effects?) concern other people, never oneself.

Which vision do people - and through them, the media - have of human testing? The general public believes and the media present drug testers as beings who are ready for anything – meaning that they don't have any respect for their own life – to earn some money, whether the motivation is despair (unemployment, divorce, Third-World inhabitants) or, even better, that they are greedy for “easily” earned money. This is a very sordid and particularly sensationalist way to consider human testing, especially because clinical trials do not only come down to the first phase – namely the one concerning healthy subjects – which follows the preclinical phase (in vitro, animals) and precedes the phases of ill subjects (phases II and III).

With superiority and a good deal of contempt, media call these testers “professional guinea pigs”, or even, in a subtler way, “professional lab rats”. These two expressions are used in a recent article “Perils of the professional lab rat” by Alison Motluk, published in the magazine New Scientist (2). A choice of words proving how journalists love to dehumanize people taking part in clinical trials. This dehumanization is serious, because not only does it make abuses and test excesses on live and sensitive subjects (human and animal) more trivial, but it also influences consumers to distance themselves from those testing new drugs, by putting the human subjects in the same “inferior” rank as animals. 'They are not like us. They are only animals'.

'Motivated by the lure of money, would humans be testing - gripped by fear - a pharmaceutical product, with no consideration for their own life and health?', this is how the journalist Alison Motluk summarizes the issue, by taking a sick pleasure in exhibiting her guinea pig “witnesses”. A much more comfortable position than to become an “insider” by deciding to participate to a clinical trial to observe and to learn from the inside, instead of simply be happy to make telephone calls to “guinea pigs”, the buttock conveniently settled in the sofa! In the pharmaceutical world, there are “me too” copies, a very easy and lucrative replica of “blockbuster” drugs. In the journalistic microcosm, the same behavioral excess is adopted: repeating stories found in other more important newspapers. The Canadian Alison Motluk' article never evokes what is going on in her own country; however, her “investigation” symptomatically reuses the same data that her American colleague Carl Elliott mentioned in his article “Guinea-Pigging”, published in The New Yorker, on January 7, 2008. Easy shot. Sensational attention-catcher. To reproduce on a loop what has been read in other colleagues' articles (or on the Internet). The journalist selects the “right” witnesses, who will support her opinion. Without trying to understand, simply enjoying what complies with the mainstream idea. All articles about “professional lab rats” are copied from the same “model”, without ever hinting at the real problems and asking the right questions. Medical testing excesses should not be limited to the easy stigmatization of “the abuse of the too much money earned by these professional lab rats”.

First of all, most clinical trials always focus on the same illnesses: type II diabetes, high blood pressure, cardiovascular diseases; illnesses linked to our lifestyle. In a society characterized by passive consumption, it is always easier to continue to force-feed people with drugs without showing them the human (and animal) cost for their unhealthy lifestyle treatment/preservation. The selection criterion (set by laboratories) for phase I healthy subjects “candidates” is a paradox inventory. They are predominantly men, while in the United States, 80 % of drug consumers are women. They are young men, while the tested drugs concern chronic diseases due to old age. Most of them are Blacks and Latinos, who belong to the category which is most excluded by the American health system. This health system is based on an immoderate consumption of allopathic drugs, the highest global rate (3), but only for those who can afford them. And these well-offs, who are often the very same refusing a medical care system based on national solidarity, would consider it humiliating to be in the position of a “tester” candidate.

What kind of shock would be needed to make people stop considering drugs as a trivial consumption product? An “immersion” experience, similar to the BBC programme Blood, Sweat and Takeaways, about what is going on behind the scenes of industrial food? Must the privileged replace the underprivileged in clinical trials? Concerning more specifically healthy subjects, the bottom of the problem is first of all that they are healthy. Shouldn't alternatives to the use of “healthy” humans be mentioned, instead of showing them off like freaks, as the society does, without ever calling their use into question?

- This article was originally written in French. Many thanks to Tania Ricci for her translation


(1). Le Monde Ignoré des Testeurs de Médicaments[The Unknown World of Drug Testers] (Éditions du cygne, 2008)
(2). Alison Motluk , Perils of the professional lab rat, New Scientist, 28 juillet 2009 :  http://www.newscientist.com/article/mg20327181.500-perils-of-the-professional-lab-rat.html?full=true
(3). North America represents 48 % of global drug consumption, while France is at the first place in the European drug consumption chart.