Most importantly, a placebo controlled RCT would be unethical for a disease with high mortality rates.
You would run a randomized controlled trial with treatment control (not placebo controlled) when we have an effective treatment. These are about as good as it is assumed placebo effects figure the same in all tested treatment groups.
Well that seems unreasonable? Double-blind just gives better comparability of results with lower N. Statistics wouldn't object to, say, giving all Italian patients the treatment and most Chinese patients not. You'd just end up with a more complex model and wider uncertainty, but if the medicine worked on a noticeable scale, you'd pick it up eventually.
You need to do a double-blind test to confirm results.