Shah et al.'s article was of great interest to me because of my experience of having lived and worked as a physician caring for patients with HIV/AIDS in a developing country. Shah et al. examined whether the National Institutes of Health's (NIH's) guidance was being implemented in NIH-funded antiretroviral treatment trials conducted in developing countries from July 2005 to June 2007. They reported that 70% of the 18 studies they reviewed "had specific mechanisms for posttrial medication access, but none guaranteed long term sponsor funding after the trials." The NIH requires that researchers make adequate plans for participants of antiretroviral research trials in developing countries to be given the option of continuing medication following the study's completion. I appreciate the authors' work in estimating the degree of compliance with NIH guidance based on their review of study protocols, but the research would have been even more informative and adaptive had they also surveyed the experiences of local participants of these research trials.
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