Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA.
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA.
Int J Environ Res Public Health. 2023 Jun 23;20(13):6210. doi: 10.3390/ijerph20136210.
Best practices in global health training prioritize leadership and engagement from investigators from low- and middle-income countries (LMICs), along with conscientious community consultation and research that benefits local participants and autochthonous communities. However, well into the 20th century, international research and clinical care remain rife with paternalism, extractive practices, and racist ideation, with race presumed to explain vulnerability or protection from various diseases, despite scientific evidence for far more precise mechanisms for infectious disease. We highlight experiences in global research on health and illness among indigenous populations in LMICs, seeking to clarify what is both scientifically essential and ethically desirable in research with human subjects; we apply a critical view towards race and racism as historically distorting elements that must be acknowledged and overcome.
全球卫生培训的最佳实践优先考虑来自低收入和中等收入国家(LMICs)的研究人员的领导力和参与度,以及认真的社区咨询和对当地参与者和本土社区有益的研究。然而,直到 20 世纪,国际研究和临床护理仍然充斥着家长式作风、掠夺性做法和种族主义思想,尽管有科学证据表明传染病有更精确的机制,但仍假定种族可以解释各种疾病的脆弱性或保护。我们强调在 LMIC 中对土著人群的全球健康和疾病研究的经验,试图澄清在人类研究中既具有科学必要性又具有伦理可取性的内容;我们对种族和种族主义持批判态度,认为它们是必须承认和克服的历史扭曲因素。