Progress in many research areas is limited by funding constraints, so budgets must always be subjected to thorough scrutiny. However, we must be equally thorough in examining research costs regarding the anticipated benefits of that research. For example, if we apply this to Professor Potts' remarks about the high costs of clinical trials of microbicides,1 it is clear that he has presented only one side of the equation. Yes, costs are high. For a Phase III trial of a microbicide, we must budget about $3,000–5,000 annually per participant for follow-up, and there will be several thousand participants. So the trial may cost up to $20–40 million. But it's not a matter of "when expenses such as these are spelled out." They have been, and researchers agonize about ways to economize. If "costs can frame ethics," then the reverse is also true: a considerable proportion of the trials' costs flows...

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