All clinical studies are overseen by two very important governing bodies, the Food and Drug Administration (FDA) and an Institutional Review Board (IRB). While the FDA’s primary focus is both the safety and efficiency of research studies, the IRB’s sole purpose is to protect research subject rights. Additionally, all clinical research studies are overseen by a Principal Investigator - a medical doctor trained to conduct research studies properly, safely and ethically.

http://www.saresearch.com/clinical-research-studies.shtml

The industry has decided to go global due to the lack of investigators and study participants in North America and Europe. This trend will most certainly continue and a large portion of the trials are not overseen by the US FDA.

http://ctmagnifier.org/2010/M2010_3_04.aspx