Based on their experience in participating in human challenge studies — technically called the Controlled Human Infection Studies (CHIS) — (where participants are deliberately infected with disease-causing pathogens) and responses from 117 potential participants, the authors of an August 2023 paper have argued that $20,000 for a six-month hepatitis C virus challenge study in the U.S. is “reasonable”.
Among the many contentious ethical issues that riddle the human challenge studies, disproportionate payment amounting to inducements for participation tops the list. The ICMR’s Bioethics Unit, which introduced a consensus policy statement on CHIS, says that payment should take into account the loss of wages and incidental expenses, and the time spent and efforts made while participating in CHIS. But it has made altruism central to participation. “The researcher must evaluate the true nature of altruistic motives to participate and select only altruistic participants that meet the selection criteria of the study,” the policy statement says.
Jake D Eberts, Communications Director at 1Day Sooner and a participant in the Shigella and Zika virus CHIS studies and one of the authors of the August 2023 paper disagrees with ICMR’s policy statement that centres altruistic motives to participate in a CHIS study. “If someone joins a CHIS for the money, as long as they understand the risks, I don’t think that’s inherently bad.” Jake was paid $7,350 for the Shigella CHIS study and less than $5,000 for the Zika study. 1Day Sooner serves as an independent monitor in CHIS so participants can reach out with their concerns and complaints. Dr. Anna Durbin, Professor of International Health at the Johns Hopkins Bloomberg School of Public Health and the principal investigator of the Zika CHIS study says that the payment is based on the time of each visit, the number of specimens collected, and what other studies in the area are paying; she had earlier undertaken dengue human challenge studies.
