Our on-the-ground investigation found that Guinea-Bissau’s institutional instability and severe resource constraints raise significant concerns about whether ANY complex clinical trial can be ethically overseen without extraordinary safeguards.

The ENTIRE yearly public health budget is <$500k USD.

Major conflicts of interest on the GB ethics board:

1st source: “a mafia” & alleged members paid “one way or another by Bandim.”

2nd former deputy minister of health: “a fan club… a friend’s club.”

3rd: ppl “inside the committee” were employed by Bandim & ethics sign-off occurred despite COIs.

Our investigation repeatedly encountered a central structural problem: Guinea-Bissau’s health infrastructure appears deeply dependent on Bandim, complicating the independence of oversight.

INASA sources asserted that Bandim “is the government,” and INASA refused to provide document access.

A second source said the government was “too dependent” on Bandim describing reliance on Bandim-linked processes for civil registration and vital statistics & that “all the evidence in intervention projects… malaria, TB… all of it comes from Bandim.”

One person cited significant ethical concerns including concerns about whether consent procedures ensured true understanding of risks because he creole word for HepB is febri amarelu which translates to “yellow fever” and is indistinguishable from the disease, yellow fever.

A former health deputy said there is one coroner in the country, currently out of Guinea-Bissau due to health conditions that cannot be treated locally, meaning “no one can determine a cause of death" and there were four health ministers in the past year, underscoring institutional volatility.

After presenting this investigation to Congress, Bernie Sanders and Alexandria Ocasio-Cortez's offices inquired with the Guinea-Bissau government to confirm our findings. The study was cancelled with in 24 hours of our meeting, by the GB authorities.

So, why are we sharing this now?

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