When it comes to international health research and inequality, the ethical focus is usually on the relationship between the (generally well-off) researchers and the (generally poor) participants. And rightly so. But there is another relationship which has received far less attention, even though the associated ethical problems have the same basic roots. There are, namely, vast differences in socio-economic status, political power and (oftentimes) skills among researchers from industrialized nations and researchers from in resource-poor ones. The big funders of health research -- and those that set the research agenda -- are located in Atlanta, Washington, Geneva or London, and researchers from developed nations are generally in far better positions to negotate and gain research support from them. They are also likely to have received education at well-equiped, prestigious universities, to have gained mentorship in regard to publishing in the better peer-reviewed journals, and hence to have much more impressive-looking CVs. No wonder researchers in developing countries sometimes feel they are bit players in someone else's game.
This degree of inequality can lead to tensions between researchers from abroad and local researchers in developing countries. The two live in strikingly different contexts, but they have to work closely together. To bring out the contrasts and the tensions these contrasts can raise, I have sometimes asked international researchers whether they share the global budget of their research projects with local scientists. Some do, some don't. Some don't like to disclose that they are making 400% more money than their partners. Some are embarrassed by how much of the budget goes to overhead for an institution which is already quite well off.
reports that last month a conference was held in Germany focusing on North-South research partnerships and equity. A framework was proposed
whose goal is to help ensure that developing country scientists have an equal role to those of developed countries in any collaborative research partnership. Capacity-building of individuals and institutions involved in health research in developing countries plays a prominent role within the framework. But then again, similar talk was aired at least a decade ago, and it is not clear how much progress has been made in the meantime. As long as the broader inequalities between countries in the 'North' and 'South' remain in place, and there is little serious commitment to combat them, the most well-meaning initiative to create equitable research partnerships faces very considerable challenges.
Labels: bioethics, developing world, Research ethics