1.By being unable to include clean needles in the prevention package the trial failed to meet its ethical obligation to provide the best possible prevention standards and according to GPP all trial participants’s well being should be protected and their safety should be a priority.So failure to include clean needles is a high risk for contracting HIV/AIDS. This actions could results in the trial being suspended from conducting trials in the future.

2. research teams should identify and meet with the relevant stakeholders during protocol development and negotiate for better comprehensive treatment packages and the stakeholders should be given a chance to identify the methods of prevention that could be included in the package and all the methods should be discussed in order in order to ensure that they will adhere all the national policies and GPP guidelines