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Drug trials in developing nations around the world are growing exponentially. They are cheap. Rules are more lax. Uganda is one of the leading places in the world where this trend is taking place. In one of the world's AIDS epicenters, in Gulu, northern Uganda, children are given a choice: be part of a drug trial involving risky treatment and at least get regular medications. Or rely on public health programs that often mean regularly missing required dosages of life-saving pharmaceuticals. The result is emblematic of a system where the ethics of drug trials face a grim reality. “The problem is that inadequate medical care creates a strong impetus for parents to agree to have their kids in research,” said Elizabeth Woeckner, president of Citizens for Responsible Care and Research, an organization that works to protect people who are the subjects of scientific research. “What should be voluntary is not quite so.” In the last five years, drug trials in Uganda have nearly doubled. There have been more than 100 trials in the last five years there. Drug companies such as Bristol Myers Squibb, Pfizer and Novartis, as well as American agencies, including the National Institutes of Health and the National Cancer Institute, work in places like Uganda because of the low cost and the number of patients who will sign up quickly for tests. At the same time, public funding for global health is diminishing. Despite safeguards, since the late 1990s a number of well-publicized cases have highlighted tests that appeared to violate ethical standards and regulations. While signing up for a trial is voluntary, that doesn't make the decision easier - especially for parents who must decide what is best for their children, and knowing that the alternative means. This in-depth investigation goes beyond the surface to show the tough choices that arise from even the best intentioned drug trials, the vast sums of money at stake, and the seismic shift that has happened in the past decade for how the world tests drugs on humans.