Alenichev Arsenii, Nguyen Vinh-Kim
Department of Anthropology, University of Amsterdam, Amsterdam, Netherlands.
ISGlobal, Barcelona, Spain.
Glob Bioeth. 2019 Jan 17;30(1):1-18. doi: 10.1080/11287462.2019.1566973. eCollection 2019.
The provision of gifts and payments for healthy volunteer subjects remains an important topic in global health research ethics. This paper provides empirical insights into theoretical debates by documenting participants' perspectives on an Ebola vaccine trial in West Africa. This trial provided hundreds of Africans with regular payments, food packages and certificates for participation. The researchers conducting the trials considered these socioeconomic provisions to be gifts in accordance with contemporary ethical standards and principles. Trial participants viewed them differently, however, approaching trial participation as a means for training and employment in what was from their perspective a new job market: the post-Ebola expansion of research and health care systems. This paper analyses participation in contemporary research by viewing the context-specific histories of trial participants through the lens of prior interventions, specifically participatory reintegration programmes conducted in Anglophone West Africa to overcome civil war crises. In particular, we argue that participation in the Ebola vaccine trial was inadvertently shaped by the design and outcomes of past reintegration programmes. Our results highlight the need to investigate existing socioeconomic landscapes which surround and indeed permeate clinical research as a prerequisite for understanding the participatory motives of vulnerable participants in West Africa and elsewhere.
为健康的志愿者受试者提供礼物和报酬仍是全球健康研究伦理中的一个重要话题。本文通过记录参与者对西非一项埃博拉疫苗试验的看法，为理论辩论提供了实证见解。该试验为数百名非洲人提供了定期报酬、食品包和参与证书。进行试验的研究人员认为，按照当代伦理标准和原则，这些社会经济方面的给予属于礼物。然而，试验参与者却有不同看法，他们将参与试验视为在他们看来一个新的就业市场——埃博拉疫情后研究和医疗系统扩张——中接受培训和就业的一种途径。本文通过从先前干预措施，特别是在西非英语国家开展的旨在克服内战危机的参与式重返社会项目的角度，审视试验参与者特定背景下的经历，来分析当代研究中的参与情况。我们特别指出，参与埃博拉疫苗试验在不经意间受到了过去重返社会项目的设计和结果的影响。我们的研究结果凸显了调查围绕并渗透到临床研究中的现有社会经济状况的必要性，这是理解西非及其他地区弱势参与者参与动机的前提条件。
