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传染病和大流行中的公平数据共享。

Equitable data sharing in epidemics and pandemics.

机构信息

Queensland Bioethics Centre, Australian Catholic University, 1100 Nudgee Rd., Brisbane, Australia.

Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Australia.

出版信息

BMC Med Ethics. 2021 Oct 6;22(1):136. doi: 10.1186/s12910-021-00701-8.

Abstract

BACKGROUND

Rapid data sharing can maximize the utility of data. In epidemics and pandemics like Zika, Ebola, and COVID-19, the case for such practices seems especially urgent and warranted. Yet rapidly sharing data widely has previously generated significant concerns related to equity. The continued lack of understanding and guidance on equitable data sharing raises the following questions: Should data sharing in epidemics and pandemics primarily advance utility, or should it advance equity as well? If so, what norms comprise equitable data sharing in epidemics and pandemics? Do these norms address the equity-related concerns raised by researchers, data providers, and other stakeholders? What tensions must be balanced between equity and other values?

METHODS

To explore these questions, we undertook a systematic scoping review of the literature on data sharing in epidemics and pandemics and thematically analyzed identified literature for its discussion of ethical values, norms, concerns, and tensions, with a particular (but not exclusive) emphasis on equity. We wanted to both understand how equity in data sharing is being conceptualized and draw out other important values and norms for data sharing in epidemics and pandemics.

RESULTS

We found that values of utility, equity, solidarity, and reciprocity were described, and we report their associated norms, including researcher recognition; rapid, real-time sharing; capacity development; and fair benefits to data generators, data providers, and source countries. The value of utility and its associated norms were discussed substantially more than others. Tensions between utility norms (e.g., rapid, real-time sharing) and equity norms (e.g., researcher recognition, equitable access) were raised.

CONCLUSIONS

This study found support for equity being advanced by data sharing in epidemics and pandemics. However, norms for equitable data sharing in epidemics and pandemics require further development, particularly in relation to power sharing and participatory approaches prioritizing inclusion. Addressing structural inequities in the wider global health landscape is also needed to achieve equitable data sharing in epidemics and pandemics.

摘要

背景

快速的数据共享可以最大限度地提高数据的效用。在寨卡、埃博拉和 COVID-19 等传染病和大流行中,这种做法似乎尤为紧迫和必要。然而,之前广泛快速地共享数据引起了人们对公平性的极大关注。人们对公平的数据共享缺乏持续的理解和指导,提出了以下问题:传染病和大流行中的数据共享应该主要是为了推进效用,还是也应该推进公平?如果是这样,传染病和大流行中公平的数据共享应包含哪些规范?这些规范是否解决了研究人员、数据提供者和其他利益相关者提出的与公平相关的担忧?公平性与其他价值观之间必须平衡哪些紧张关系?

方法

为了探讨这些问题,我们对传染病和大流行中数据共享的文献进行了系统的范围界定审查,并对所确定的文献进行了主题分析,以探讨其对伦理价值观、规范、关注点和紧张关系的讨论,特别(但不限于)强调公平性。我们既希望了解如何在数据共享中体现公平性,也希望得出传染病和大流行中数据共享的其他重要价值观和规范。

结果

我们发现,效用、公平、团结和互惠等价值观得到了描述,并报告了与其相关的规范,包括研究人员的认可;快速、实时的共享;能力建设;以及向数据生成者、数据提供者和来源国公平分配利益。效用及其相关规范的讨论远远超过了其他价值观。还提出了效用规范(例如,快速、实时共享)和公平规范(例如,研究人员的认可、公平获取)之间的紧张关系。

结论

本研究支持在传染病和大流行中通过数据共享来推进公平性。然而,传染病和大流行中公平的数据共享规范需要进一步发展,特别是在权力共享和优先考虑包容的参与性方法方面。还需要解决更广泛的全球卫生领域的结构性不平等问题,以实现传染病和大流行中的公平数据共享。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a453/8495956/001ee286c22e/12910_2021_701_Fig1_HTML.jpg

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