Table 6.

Answers to question 7. “What are “compelling and scientifically sound methodological reasons” as outlined in paragraph 32 of the Declaration of Helsinki for your institution which would justify the use of placebo?”

Compelling and scientifically sound methodological reasons	Country
Questionable effectiveness of standard treatment	Armenia, Canada, Cuba, Israel, Namibia
Assay sensitivity/ when placebo is the most rigorous test of efficacy	Germany, Ghana, USA, The EU
No current proven intervention exists	Namibia, Uganda, Zimbabwe
High placebo response rate	Canada, Chile, Cuba
None if effective treatment exists	Japan, United Arab Emirates, Zimbabwe
Standard treatment is too toxic	Ghana, Tanzania
Available treatment is too expensive	Botswana, Uganda
Non-responders	Israel, Tanzania
Add on	Ghana, Saudi Arabia
Size of placebo groups may be smaller than in active control studies	Saudi Arabia