**6. Conclusions**

The need for new and better treatment options for medical research continues unabated. As long as that need persists, medical trials are likely to continue. Many medical researches are driven by economic or academic interests that may or may not reflect the needs of the host country.

The pharmaceutical industry is not a charitable business but it is a profitable one. There are many reasons that attract these companies, researchers, and sponsors to conduct their research in a developing country.

Many moral lessons have been learnt from the history of medical research. Regrettably, 50 years after the Nuremberg trials and the Nuremberg Code, unethical medical research on humans continues.

Protecting patients involved in research from harm or abuse and preserving their rights is essential to ethical research. Human rights, health development, and medical research ethics can be gathered together when standards are followed with minimizing bias and conflict of interests. Informed consent and confidentiality are important for both sociological study and clinical research keeping both human and patient rights.

Human and animal rights should be preserved in all categories of medical research. Quality of research in the medical field will be reflected on the quality of health care and welfare of the community whether it is performed in developing or developed countries. The 3 R's: Replacement, Reduction, and Refinement have to be followed. International guidelines provided by WHO, DH, CIOMS, WMA, UNESCO, and Nuremberg Code need to be ascertained in research whether performed in developed or developing countries. Most, but not all developing countries, have ethical review committees in the form of research institutes or other scientific panels. However, the reality is that these panels need to be independent and able to review clinical trials without prejudice.

We do not want a scientifically neat study if it is ethically flawed, we need to redouble our commitment to the highest ethical standards, no matter where the research is conducted, and sponsoring agencies need to enforce those standards.

The Tanta experience can be taken as a role model in developing countries to initiate guidelines to standardize the ethics of medical research at national and regional levels.
