Most of Marcia Angell's review of The Constant Gardner recounts how drug companies really do use third world inhabitants as guinea pigs for pharmaceutical testing, which is all very horrifying, but this bit was far and away the most chilling: "Yet the [movie] is based on the premise that a pharmaceutical company would be so threatened by disclosures of its activities that it would have someone killed. That is what is fantasy. In fact, many of the practices that so horrified le Carré's heroine are fairly standard and generally well known and accepted. They seldom provoke outrage, let alone murder. A company like KDH would not kill someone like Tessa even if it were willing to do so; it wouldn't have to. Her concerns would have seemed isolated and futile, and the companies would hardly have taken notice of them."

Angell, meanwhile, gets at what's so noxious about testing pharmaceuticals in the third world—most of it is for drugs that will only be used in the developed world. Very few companies test new treatments for malaria, or sleeping sickness, or what have you; that's just not where the money is. Instead, they find willing patients abroad—who will happily sign up for drug trials in exchange for a few bucks and the promise of free care—to test experimental drugs for things like cholesterol reduction, with little to no oversight. (See also the Washington Post's six-part series from 2000, "The Body Hunters.") "In my view," says Angell, "research should not be done in the third world unless it concerns diseases that are virtually confined to those regions." Right, and that should happen right about the time we get an independent FDA. Luckily no one needs to track down and kill anyone who holds this view; it's already far on the fringe.