In and outside his territories and dominions ... and with his far off neighbors, Priyadarsi has arranged for the medical treatment of man and beast. He has caused herbs, roots and fruits to be imported, wells to be dug and trees to be planted on the roadside for the enjoyment of men and animals.
--Edits of Asoka, third century BC, inscribed on a rock in Girnar, Gujarat, India
On occasion, an ethical consensus may be reached only to unravel as the question of "who pays" becomes a reality. This is precisely the issue facing the sponsors of HIV vaccine clinical trials in developing countries concerning the treatment of vaccine breakthroughs--individuals who become infected after immunization because the vaccine failed to protect them.
Prior to the advent of potent antiretroviral therapy (ART), HIV vaccine trials offered an opportunity to study both the efficacy of an HIV vaccine...