Friday, May 17, 2019

Francophone Africa: bioethics terra incognita?

My colleagues and I have written about this before: stimulating bioethics in Francophone African countries involves a number of significant hurdles. First, there is language. Bioethics is predominantly expressed in English: the journals are in English, the majority of degree programs in bioethics are conducted in English, as are the vast majority of books, conferences, scholarship opportunities and so on. Designing a bioethics course makes this crystal clear: what readings are you going to assign? The second hurdle is that French-language bioethics (mainly from France and Quebec) is generally not focused on the kinds of social/economic/political circumstances that researchers, clinicians and public health practitioners in Africa have to wrestle with. 'Developing world bioethics' has been getting more airplay over the last decade, but as far as Africa is concerned, the focus is predominantly on ex-British colonies.

It is not just in bioethics, apparently. At the moment I have been reading about the history of research during the colonial period in Africa. Africa as a Living Laboratory by Helen Tilley is a fascinating read about how scientific research in Africa mixed and mingled with the interest and exercise of colonial powers. I picked up a copy of Randal M. Packard's A History of Global Health, which starts with colonial health initiatives and runs right up to HIV and PEPFAR. Melissa Graboyes' The Experiment Must Continue: Medical Research and Ethics in East Africa is also an engaging and informative read. But here too the focus is almost exclusively on Anglophone Africa. So whereas you can get at least some sense from these books of what kinds of health research with humans was taking place in Africa long before research ethics committees and 'bioethics' came onto the scene, what was going on in Francophone Africa during this period seems to be much harder to discern. To me at least.

This is unfortunate if you want to discuss historical events and patterns that have shaped relationships between (say) researchers and the larger community. Why should anyone in Francophone Africa, wanting to study bioethics, have to care about what happened in the Tuskegee Syphilis study? Bioethics education in this part of the world should include the local history of experimentation, at least as far back as the colonial period. The search continues.

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