Kemri-Wellcome Trust Research Programme, Centre for Geographic Medicine, Nairobi Unit, P,O Box 43640, 00100, Nairobi, Kenya.
BMC Med Ethics. 2011 Oct 3;12:20. doi: 10.1186/1472-6939-12-20.
The concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research.The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya.
We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups.
Our study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research.
This study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in practice and distil lessons on how best to involve individuals and communities in promoting ethical conduct of global health research in resource poor settings.
在资源匮乏环境中,为增强全球健康研究的社会价值,利益共享的理念现已成为应对与个体、社区和东道国相关的道德问题的关键策略,当这些个体、社区和东道国参与国际合作健康研究时。利益共享框架对合作健康研究开展的影响,例如,体现在大量要求利益攸关方之间预先进行接触,以确定研究对东道国社区的社会价值的出版物和研究伦理准则中。虽然已经制定了国际指导方针,说明如何通过利益共享等策略来促进研究的社会价值,但这些理念和准则在多大程度上被参与全球健康研究(尤其是资源匮乏环境中的全球健康研究)的人员所吸收,情况尚不清楚。我们检查了肯尼亚与健康相关研究中的利益攸关方对这些意识的了解程度。
我们对肯尼亚更广泛的健康研究系统中的关键信息提供者进行了深入访谈,包括来自主流健康研究机构、网络和大学、教学医院、政策制定者、机构审查委员会、民间社会组织和社区代表群体的研究人员。
我们的研究表明,尽管人们对正义和研究的道德方面有一定的认识,但这种认识并没有以文献和全球健康研究伦理准则中使用的术语来表达。
这项研究表明,尽管从理论上讲,可以做出几种努力来解决资源匮乏环境中研究参与者及其社区关注的道德问题,但利益共享等权宜之计并不简单。我们建议需要更加关注在实践中实施伦理原则的过程,并汲取关于如何最好地让个人和社区参与促进资源匮乏环境中全球健康研究的伦理行为的经验教训。