Nearly 40% of all clinical trials are conducted outside of Western Europe and the United States. The development of trials has accelerated in poorer countries, where costs are lower and patients can find the chance to get free drugs, reliable access to doctors and maybe the hope of a cure, too good to pass up. A cheap and plentiful supply of patients for testing can mean that drugs reach the market quicker as well as at a lower cost to the drug companies. Criticism has been leveled at this practice though through it's use of paid middlemen and doctors to recruit patients, questions are also being asked about whether international standards are systematically applied in second and third world countries and if local ethics review committees really ask the same amount of questions as their US based counterparts.

Paolo Pellegrin went to Russia where clinical trials are being run by almost every major western pharmaceutical company to see the recruiting grounds and some of the recruited.