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Breakthroughs in the early 1990s in the treatment of AIDS in the U.S. and other developed countries is bleakly complemented by continued increases in the incidence of AIDS and persistently high mortality rates in poor countries, especially those in Africa. The high cost of treatment "cocktails" makes mass distribution of such drugs impracticalùbut does not preclude a search for less expensive, somewhat effective treatments. There is particular interest in any regimen that can prevent the transfer of the AIDS virus from mother to newborn. But when international research agenciesùincluding the National Institutes of Health (NIH) and the Centers for Disease Control (CDC) in the U.S.ùundertake trials of such treatment in Africa, a medical ethics watchdog group leads a high-profile protest. It is unethical, asserts Public Citizen, to test a treatment regimen of the drug AZT against a control group receiving a placebo when it is clear that some treatment with the drug is better than none. Designers of the experiments assert, however, that only a comparison with a placebo group can provide definitive results in the context of developing countries. This case, available in both a text and web version (www.ksg.harvard.edu/case/azt) frames the ethical issues involved in medical testing in developing nations; specifically it frames the conflict facing policymakers such as those in NIH and CDC who, having endorsed the AIDS trials in Africa, must weigh the objections raised by advocacy groups and a prestigious medical journal. The web version includes video interviews with key critics and decision-makers.