By Hauke Goos
Before they test a drug on children, pharmaceutical companies have to acquire the parents' consent, even in the developing world. They have to explain to the parents that this is a drug in the test phase, and that its safety and effectiveness have not yet been established. The parents must be made aware that there are alternative medicines available that have already been tried and tested. And they have to know that they have the right to exit the study at any time.
They heard on the radio about the white doctors offering help, says Zaharadeen's mother. What did the white doctors tell her? "Nothing," she says. "They wrote down Zaharadeen's name, and then they gave him a pill. Then we went home."
Right from the beginning, Zaharadeen suffered from symptoms of paralysis. The muscles in his legs felt hot, he said. Even today, the pain is sometimes so intense that he has to lie on a mattress for weeks on end.
Just one street down lives Safiya Sani Isa, whose son did not survive the test.
Pfizer is the world's biggest pharmaceutical company with a market value of €200 billion.
"No," she says. "We thought they came to help our children. We didn’t know that we had a choice between them and Doctors Without Borders."
For a long time, Pfizer refused to comment on the allegations. In 2001, company employees assured a Nigerian committee of inquiry that the test "was totally devoid of any commercial undertone."
Over the past few years, Pfizer has become a household name worldwide thanks to its potency drug Viagra. Boosted by the amazing success story of this and other products, within just three years the company's market value soared from €45 billion to over €200 billion. It was not the time to answer awkward questions.
But now, with this trial about to open, Pfizer has changed its strategy. The Americans want to regain control of the situation.
All contact with the company's headquarters in New York is organized by a woman who only goes by her first name: Sharon. She asks what the caller wants, who he has met in Nigeria, and who he is going to meet. Two days later, Dr. Jack Watters from the New York headquarters calls back. He is the Vice President for International External Medical Affairs, responsible for "corporate responsibility" and "human rights."
Watters has a British accent and a pleasant voice. He promises that he will do his best to answer every question.
Of course, says Watters, the parents gave their consent, but orally. He says that an authorized nurse then signed the release form in their name.
And the side effects? The risks for bones, joints and liver, especially for children?
None of this was known at the time, says Watters. "We didn't find out about the side effects until Trovan came out on the market, two years after the clinical test."
Watters has been with Pfizer since 1994, so he should know better. He should be aware that the side effects of the drug group that Trovan belongs to were documented no later than 1992. What's more, the Pfizer employees wrote in their own test protocol in 1996 that there was a significantly higher rate of joint problems among the children who were treated with Trovan. Fifteen percent of the test patients complained of pain, noted the Pfizer researchers, three times the rate for the reference drug.
And patient 0069? The girl who was subjected to further experiments, although her condition had worsened? What was her cause of death?
Watters said that he was not familiar with the details of this particular case, sorry.
Even following specific questions submitted to the company, Pfizer refused to comment on individual cases.
Recently, Irukera met in London with lawyers from the opposing party. Afterwards, he had the feeling that they had little idea what the trial was about. "I asked them questions, and every answer that they gave to my questions made the next answer even more difficult for them," says Irukera.
Now he is waiting at the airport in Abuja. It is late in the afternoon, and he has missed one flight and the next one has been postponed due to a storm over Lagos. But Irukera is totally calm, almost elated. Everything is going according to plan.
"Pfizer treated the Nigerians in Kano as if the life of a black child was worth less than the life of a white child," says Irukera. When he moved to Chicago, he admired the US for its self-confidence, for its greatness. But the more he found out about the Trovan test, the smaller the country became in his eyes. "Suddenly the Americans realize that they are dealing with blacks in Nigeria who are intelligent -- niggers with brains," he says, and laughs.
"Why don't you do these kinds of tests on children from Manhattan?" he asked Pfizer officials.
Surviving the 'Humanitarian Gesture'
Pfizer denies all the allegations. The company says that it is totally unclear whether the children died because of the tests or the after-effects of the disease. It appears that the corporation would rather make an out-of-court settlement. It would probably amount to a legal sensation if a Nigerian court were to rule that an American company had to pay billions of dollars in compensation.
Perhaps all of this is a question of power, not law, and no lawyer can change that, no document and no victim who happened to survive.
Mohammed Mustapha's son Anas Mohammed lives in a mud hut in the heart of the Kano slums. He is 16 years old; the house has no electricity or running water. Anas shares this humble abode with his 12 brothers.
Anas Mohammed is A. M., Pfizer's patient 0001.
Eleven years ago, his father and mother carried him to the hospital. He was five years old and weighed only 25 pounds. Now father and son are sitting on a bench in the shade. There is not a cloud in the sky and it is scorching hot outside.
Mohammed Mustapha, at the time did the doctors at the hospital explain anything to you?
"No."
Did anyone explain anything?
"No."
Did you have to sign anything?
"No."
Did you know that the doctors were not from Doctors Without Borders but from Pfizer, a pharmaceuticals company?
"No," says Mohammed Mustapha, and gives an unsure smile.
He pushes aside a straw curtain and rummages around in a box behind his bed. He is looking for the folder where he has kept Anas' medical documents all these years. Then he reappears with a white binder in his hand; he has saved every official document that he has ever received.
He still has stiff knees, says Anas, his son. For a long time, he received treatment for the condition, and things have improved with time. He survived the "humanitarian gesture," but he will never be healthy again. When he walks relatively long distances, the pain immediately returns.
Anas goes into his bedroom and after a few minutes returns with a pink plastic syringe in his hand. At the top of the syringe is a wheel, and when the plunger is pushed in, the wheel is supposed to spin and make sparks.
The wheel broke a long time ago, but Anas has kept the toy; it is the only one he has. He says that the people from Pfizer gave it to him after the final examination, as a reward.
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