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Smith EM, Rakestraw C, Farroni JS. Scientific priorities and relational dynamics during the COVID-19 pandemic: A qualitative study. Account Res 2024; 31:356-376. [PMID: 36168913 PMCID: PMC10076447 DOI: 10.1080/08989621.2022.2130058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
To rapidly respond to the COVID-19 public health crisis, researchers have been called upon to prioritize pandemic research, while simultaneously modifying their existing research to maintain the safety of all stakeholders. This study aims to explore the experiences of health science researchers in their scientific practices, research priorities, and professional relational dynamics due to COVID-19. Specifically, we interviewed 31 researchers from diverse fields at the University of Texas Medical Branch. Participants worked on COVID-19, non-COVID-19 related research, or both. We integrated inductive and deductive coding using a thematic coding method. The following four themes were explored: 1) impact of research, 2) research priorities, 3) professional relationships and 4) contextual influences on science. Participants were drawn to COVID-19 work for a diversity of reasons including social need, scientific interest, professional duty, and increased access to funding opportunities. While collaborations have increased for COVID-19 researchers, interpersonal relationships have been challenging for participants. Additionally, political, familial, and personal stresses due to the pandemic have taken a toll on researchers in very different and often inequitable ways. To ensure team cohesion, there is a need to develop research practices, policies and systems that value empathy, flexibility, and interdependence.
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Affiliation(s)
- Elise M Smith
- Department of Bioethics and Health Humanities, School of Public and Population Health, Institute for Translational Sciences, University of Texas Medical Branch, Galveston, Texas
| | - Corisa Rakestraw
- Department of Bioethics and Health Humanities, School of Public and Population Health, University of Texas Medical Branch, Galveston, Texas
| | - Jeffrey S Farroni
- Department of Bioethics and Health Humanities, School of Public and Population Health, Institute for Translational Sciences, University of Texas Medical Branch, Galveston, Texas
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2
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Saylor KW, Joffe S. Enhancing social value considerations in prioritising publicly funded biomedical research: the vital role of peer review. JOURNAL OF MEDICAL ETHICS 2024; 50:253-257. [PMID: 37225413 DOI: 10.1136/jme-2022-108883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
The main goal of publicly funded biomedical research is to generate social value through the creation and application of knowledge that can improve the well-being of current and future people. Prioritising research with the greatest potential social value is crucial for good stewardship of limited public resources and ensuring ethical involvement of research participants. At the National Institutes of Health (NIH), peer reviewers hold the expertise and responsibility for social value assessment and resulting prioritisation at the project level. However, previous research has shown that peer reviewers place more emphasis on a study's methods ('Approach') than on its potential social value (best approximated by the criterion of 'Significance'). Lower weighting of Significance may be due to reviewers' views on the relative importance of social value, their belief that social value is evaluated at other stages of the research priority-setting process or the lack of guidance on how to approach the challenging task of assessing expected social value. The NIH is currently revising its review criteria and how these criteria contribute to overall scores. To elevate the role of social value in priority setting, the agency should support empirical research on how peer reviewers approach the assessment of social value, provide more specific guidance for reviewing social value and experiment with alternative reviewer assignment strategies. These recommendations would help ensure that funding priorities align with the NIH's mission and the obligation of taxpayer-funded research to contribute to the public good.
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Affiliation(s)
- Katherine W Saylor
- Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Steven Joffe
- Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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3
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Vervoort D, Fenton KN. Cardiac Surgery in Variable-Resource Contexts: Overly Ambitious or Long Overdue? Ann Thorac Surg 2023; 116:445-449. [PMID: 36965754 DOI: 10.1016/j.athoracsur.2023.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/05/2023] [Accepted: 03/11/2023] [Indexed: 03/27/2023]
Affiliation(s)
- Dominique Vervoort
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada.
| | - Kathleen N Fenton
- Division of Cardiovascular Sciences, Advanced Technologies and Surgery Branch, National Heart, Lung and Blood Institute, Bethesda, Maryland; Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland; William Novick Global Cardiac Alliance, Memphis, Tennessee
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4
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McCoy MS. Who Is Responsible for Promoting Equity in Rare Disease Research? THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2023; 23:83-85. [PMID: 37339309 DOI: 10.1080/15265161.2023.2207512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
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5
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Pierson L, Verguet S. When should global health actors prioritise more uncertain interventions? Lancet Glob Health 2023; 11:e615-e622. [PMID: 36925181 PMCID: PMC10060118 DOI: 10.1016/s2214-109x(23)00055-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/22/2023] [Accepted: 01/27/2023] [Indexed: 03/15/2023]
Abstract
Global health actors use economic evaluations, including cost-effectiveness analyses, to estimate the effect of different interventions they might fund. However, producing reliable cost-effectiveness estimates is difficult, meaning organisations must often choose between funding interventions for which reliable predictions of efficacy exist and those for which they do not. In practice, many organisations appear to be risk-averse, favouring more certain interventions simply because they are more certain. We argue that this practice is not justifiable. Prioritising projects backed by greater evidence might often produce greater health benefits. However, a general tendency to prefer more certain interventions will cause global health actors to overlook opportunities to help less well-studied populations, support promising but complex interventions, address the upstream causes of illness, and conduct the most important impact evaluations. We argue that global health actors should instead adopt nuanced attitudes towards uncertainty and be willing to fund highly uncertain interventions in some cases. We further describe the considerations they should take into account in rendering these judgements.
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Affiliation(s)
- Leah Pierson
- Harvard/MIT MD-PhD Program, Harvard Medical School, Harvard University, Boston, MA, USA; Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
| | - Stéphane Verguet
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
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Bakhshipour A, Rafaiee R. Upper and Lower Gastrointestinal Bleeding: A Retrospective Study on 10 Years Experiences in Southeastern Iran. Middle East J Dig Dis 2023; 15:116-120. [PMID: 37546509 PMCID: PMC10404084 DOI: 10.34172/mejdd.2023.329] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/18/2023] [Indexed: 08/08/2023] Open
Abstract
Background: Gastrointestinal bleeding (GIB) is an emergency medical situation that is very common, although often benign but can cause considerable morbidity and mortality and health care costs. The aim of this study was to analyze the endoscopic evaluation of upper GIB (UGIB) and lower GIB (LGIB) in Sistan and Balouchestan, southeast Iran. Methods: Data from patients with GIB in a referral university-affiliated hospital in Zahedan, Southeastern Iran during a 10-year period, were obtained. A total of 21884 reports of adult patients' endoscopy and colonoscopy from 2011 to 2020 who were admitted to Ali-Ibn-Abitaleb hospital were studied of which 5862 reports were related to GIB. Incomplete files were excluded. Information on age, sex, and endoscopic diagnosis of the 5053 reports was analyzed and compared using chi-square statistical test. Results: There were 3310 men (65.6%) and 1743 women (34.4%) with a mean (±SD) of age 48.4 (±19.83) years. 3079 patients had UGIB (60.8%) and 1974 patients had LGIB (39.2%). Peptic ulcer (72.8% duodenal ulcer and 27.2% gastric ulcer) was seen as the main reason for UGIB (29.7%) and hemorrhoids were the main reason for LGIB (44.2%). Mallory-Weiss syndrome was significantly common in the age<40 years old, and the incidence rate of malignancy was significantly higher in those aged>40 years old than in the younger age group (P<0.001). Conclusion: Peptic ulcer was the most common etiological factor and it was more common in men than in women. Gastroesophageal varices were the second most common cause of UGIB. Hemorrhoids and anal fissures were observed as the most common colonoscopic findings of LGIB. The prevalences of UGIB and LGIB are more common in men than women and increase with age. It is important for physicians to constantly update their information about the spectrum of diseases in their region and their changing over time to provide accurate diagnosis and management timely.
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Affiliation(s)
- Alireza Bakhshipour
- Professor, Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Raheleh Rafaiee
- Assistant Professor, Department of Neuroscience, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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MacKay D, Cohn E. Public Policy Experiments without Equipoise: When Is Randomization Fair? Ethics Hum Res 2023; 45:15-28. [PMID: 36691691 DOI: 10.1002/eahr.500153] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Government agencies and nonprofit organizations have increasingly turned to randomized controlled trials (RCTs) to evaluate public policy interventions. Random assignment is widely understood to be fair when there is equipoise; however, some scholars and practitioners argue that random assignment is also permissible when an intervention is reasonably expected to be superior to other trial arms. For example, some argue that random assignment to such an intervention is fair when the intervention is scarce, for it is sometimes fair to use a lottery to allocate scarce goods. We investigate the permissibility of randomization in public policy RCTs when there is no equipoise, identifying two sets of conditions under which it is fair to allocate access to a superior intervention via random assignment. We also reject oft-made claims that alternative study designs, including stepped-wedge designs and uneven randomization, offer fair ways to allocate beneficial interventions.
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Affiliation(s)
- Douglas MacKay
- Associate professor in the Department of Public Policy at the University of North Carolina at Chapel Hill
| | - Emma Cohn
- Undergraduate student majoring in public policy and global studies at the University of North Carolina at Chapel Hill
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Pierson L, Millum J. Health Research Priority Setting: Do Grant Review Processes Reflect Ethical Principles? Glob Public Health 2022; 17:1186-1199. [PMID: 33938386 DOI: 10.1080/17441692.2021.1922731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
Most public and non-profit organisations that fund health research provide the majority of their funding in the form of grants. The calls for grant applications are often untargeted, such that a wide variety of applications may compete for the same funding. The grant review process therefore plays a critical role in determining how limited research resources are allocated. Despite this, little attention has been paid to whether grant review criteria align with widely endorsed ethical criteria for allocating health research resources. Here, we analyse the criteria and processes that ten of the largest public and non-profit research funders use to choose between competing grant applications. Our data suggest that research funders rarely instruct reviewers to consider disease burden or to prioritise research for sicker or more disadvantaged populations, and typically only include scientists in the review processes. This is liable to undermine efforts to link research funding to health needs.
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Affiliation(s)
- Leah Pierson
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Joseph Millum
- Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, MD, USA
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
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Ewuoso C, Berkman B, Wonkam A, de Vries J. Should institutions fund the feedback of individual findings in genomic research? JOURNAL OF MEDICAL ETHICS 2022:medethics-2021-107992. [PMID: 35710317 DOI: 10.1136/medethics-2021-107992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
The article argues the thesis that institutions have a prima facie obligation to fund the feedback of individual findings in genomic research conducted on the African continent by drawing arguments from an underexplored Afro-communitarian view of distributive justice and rights of researchers to be aided. Whilst some studies have explored how institutions have a duty to support return as a form of ancillary care or additional foreseeable service in research by mostly appealing to dominant principles and theories in the Global North, this mostly normative study explores this question by appealing to underexplored African philosophy. This is a new way of thinking about institutional responsibility to fund feedback and responds to the call to decolonise health research in Africa. Further studies are required to study how this prima facie obligation will interact with social contexts and an institution's extant relationships to find an actual duty. The research community should also work out procedures, policies and governance structures to facilitate feedback. In our opinion, though the impacts of feeding back can inform how institutions think about their actual duty, these do not obliterate the binding duty to fund feedback.
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Affiliation(s)
- Cornelius Ewuoso
- Steve Biko Centre for Bioethics, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
| | - Benjamin Berkman
- Department of Bioethics, National Institutes of Health, Bethesda, Maryland, USA
| | - Ambroise Wonkam
- Division of Human Genetics, University of Cape Town, Cape Town, South Africa
- McKusick-Nathans Institute and Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jantina de Vries
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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Adegnika OS, Honkpehedji YJ, Mougeni Lotola F, Agnandji ST, Adegnika AA, Lell B, Sicuri E. Funding patterns for biomedical research and infectious diseases burden in Gabon. BMC Public Health 2021; 21:2155. [PMID: 34819025 PMCID: PMC8611934 DOI: 10.1186/s12889-021-12201-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 11/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Biomedical research plays an important role in improving health. There seems to exist a negative correlation between the amount of biomedical research funding and disease burden from all Sub-Saharan African countries. In this study, we describe funding patterns for biomedical research, explore the correlation between funding and burden of diseases, and quantify inequalities in funds distribution across diseases in Gabon over the period 2005–2015. Methods Data on medical research funds from 2005 to 2015 were retrieved through a structured questionnaire distributed to Gabonese biomedical research institutions and by consulting online databases. Data on the burden of diseases were gathered from the World Health Organization and the Institute for Health Metrics and Evaluation. We used Kendall rank correlation coefficient to explore the correlation between cumulative funds over time and the burden of disease. The inequality distribution of funding across diseases was assessed through Gini coefficient and Lorenz curve. Results Biomedical research funding was characterized by a remarkable growth from 2005 to 2010 and a decline from 2010 to 2014. Funds were mostly from external sources and from partnerships. There was inequality in research funds allocation across diseases and malaria was far the most funded disease. There was a significant negative correlation between cumulative funding and the burden of HIV, tuberculosis, and of Helminthiasis (from 2006 to 2010) suggesting that research may be contributing to the management of such diseases. A positive, although not significant, correlation was found between cumulative funds and malaria burden. Conclusions The negative correlation between HIV and tuberculosis cumulative funding and burden suggests that research may be contributing to the management of such diseases but further research is needed to assess the causal direction of such as relationship. As the burden of non-communicable diseases is increasing, more research funds should be focused on those. While research partnerships have been and will remain fundamental, Gabon should increase the amount of national funds to overcome periods of reduced research funding flows from abroad. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12201-w.
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Affiliation(s)
| | | | | | - Selidji Todagbe Agnandji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.,Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Ayola Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.,Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.,Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands.,German Center for Infection Research (DZIF), African partner institution, CERMEL, Lambaréné, Gabon.,German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.,Department of Medicine I, Division of Infectious Diseases and Tropical Medicines, Medical University of Vienna, Vienna, Austria
| | - Elisa Sicuri
- ISGlobal, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.,Health Economics Group, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
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Pierson L, Gibert S, Berkman B, Danis M, Millum J. Allocation of scarce biospecimens for use in research. JOURNAL OF MEDICAL ETHICS 2021; 47:740-743. [PMID: 32220871 DOI: 10.1136/medethics-2019-105766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/23/2020] [Accepted: 02/24/2020] [Indexed: 06/10/2023]
Abstract
Hundreds of millions of rare biospecimens are stored in laboratories and biobanks around the world. Often, the researchers who possess these specimens do not plan to use them, while other researchers limit the scope of their work because they cannot acquire biospecimens that meet their needs. This situation raises an important and underexplored question: how should scientists allocate biospecimens that they do not intend to use? We argue that allocators should aim to maximise the social value of the research enterprise when allocating scarce biospecimens. We provide an ethical framework for assessing the social value of proposed research projects and describe how the framework could be implemented.
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Affiliation(s)
- Leah Pierson
- MD-PhD Program, Harvard Medical School, Boston, Massachusetts, USA
| | - Sophia Gibert
- PhD Program in Philosophy, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Benjamin Berkman
- Department of Bioethics, National Institutes of Health, Bethesda, Maryland, USA
| | - Marion Danis
- Department of Bioethics, National Institutes of Health, Bethesda, Maryland, USA
| | - Joseph Millum
- Clinical Center Department of Bioethics/Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
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Faure MC, Munung NS, Ntusi NAB, Pratt B, de Vries J. Considering equity in global health collaborations: A qualitative study on experiences of equity. PLoS One 2021; 16:e0258286. [PMID: 34618864 PMCID: PMC8496851 DOI: 10.1371/journal.pone.0258286] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/24/2021] [Indexed: 12/19/2022] Open
Abstract
International collaborations have become the standard model for global health research and often include researchers and institutions from high income countries (HICs) and low- and middle-income countries (LMICs). While such collaborations are important for generating new knowledge that will help address global health inequities, there is evidence to suggest that current forms of collaboration may reproduce unequal power relations. Therefore, we conducted a qualitative study with scientists, researchers and those involved in research management, working in international health collaborations. Interviews were conducted between October 2019 and March 2020. We conducted 13 interviews with 15 participants. From our findings, we derive three major themes. First, our results reflect characteristics of equitable, collaborative research relationships. Here we find both relational features, specifically trust and belonging, and structural features, including clear contractual agreements, capacity building, inclusive divisions of labour, and the involvement of local communities. Second, we discuss obstacles to develop equitable collaborations. These include exclusionary labour practices, donor-driven research agendas, overall research culture, lack of accountability and finally, the inadequate financing of indirect costs for LMIC institutions. Third, we discuss the responsibilities for promoting science equity of funders, LMIC researchers, LMIC institutions, and LMIC governments. While other empirical studies have suggested similar features of equity, our findings extend these features to include local communities as collaborators in research projects and not only as beneficiaries. We also suggest the importance of funders paying for indirect costs, without which the capacity of LMIC institutions will continually erode. And finally, our study shows the responsibilities of LMIC actors in developing equitable collaborations, which have largely been absent from the literature.
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Affiliation(s)
- Marlyn C. Faure
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- * E-mail:
| | - Nchangwi S. Munung
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Ntobeko A. B. Ntusi
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Bridget Pratt
- Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Jantina de Vries
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Faure MC, Munung NS, Ntusi NAB, Pratt B, de Vries J. Mapping experiences and perspectives of equity in international health collaborations: a scoping review. Int J Equity Health 2021; 20:28. [PMID: 33422065 PMCID: PMC7796532 DOI: 10.1186/s12939-020-01350-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/09/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Whilst global health research often involves international collaborations, achieving or promoting equity within collaborations remains a key challenge, despite established conceptual approaches and the development of frameworks and guidelines to promote equity. There have also been several empirical studies documenting researchers' experiences of inequity and views on what is required to advance equity in global health collaborations. While these empirical studies provide critical insights, there has been no attempt to systematically synthetize what constitutes equity and how it can be achieved. To address this gap, we conducted a scoping review of qualitative studies, opinion and editorial pieces about what equity is and how it can be promoted in international collaborations. METHODS We conducted a scoping review to explore domains of equity in international health collaborations. This review included qualitative studies and opinion pieces or editorial pieces on equity in international health collaborations. We mapped the data and identified common themes using a thematic analysis approach. RESULTS This initial search retrieved a total of 7611 papers after removing duplicates. A total of 11 papers were included in this review, 10 empirical studies and 1 editorial piece. We conducted our search between October - November 2019. We identified 10 key domains which are important for promoting equity in international collaborations: funding; capacity building; authorship; sample ownership and export; trust; research agreement; acknowledging inequality; recognition and communication. DISCUSSION Our findings suggest that for international collaborations to be considered more equitable, it must at least consider the 10 domains we highlighted. The 10 domains map onto five key aspects of social justice theory, namely avoiding unequal power relations like subordination, group recognition and affirmation, promoting the well-being of all, inclusion in decision-making and ensuring self-development.
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Affiliation(s)
- Marlyn C. Faure
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Nchangwi S. Munung
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Ntobeko A. B. Ntusi
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Bridget Pratt
- Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Jantina de Vries
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Pratt B. Inclusion of Marginalized Groups and Communities in Global Health Research Priority-Setting. J Empir Res Hum Res Ethics 2020; 14:169-181. [PMID: 30866721 DOI: 10.1177/1556264619833858] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Community engagement is gaining prominence in global health research. But community members, especially those from groups and communities that are considered disadvantaged and marginalized, rarely have a say in the agendas and priorities of the research projects that aim to help them. This article explores how to achieve their inclusion in priority-setting for global health research projects. A total of 29 in-depth interviews and one focus group were undertaken with researchers, research ethicists, community engagement practitioners, and community-based organization staff. Thematic analysis identified two core dimensions of inclusion-representation and voice-and what is necessary to realize them with marginalized groups and communities in global health research priority-setting. A set of ethical considerations is proposed to assist researchers and their partners design more inclusive priority-setting processes.
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Abstract
Although the principle of fair subject selection is a widely recognized requirement of ethical clinical research, it often yields conflicting imperatives, thus raising major ethical dilemmas regarding participant selection. In this paper, we diagnose the source of this problem, arguing that the principle of fair subject selection is best understood as a bundle of four distinct sub-principles, each with normative force and each yielding distinct imperatives: (1) fair inclusion; (2) fair burden sharing; (3) fair opportunity; and (4) fair distribution of third-party risks. We first map out these distinct sub-principles, and then identify the ways in which they yield conflicting imperatives for the design of inclusion and exclusion criteria, and the recruitment of participants. We then offer guidance for how decision makers should navigate these conflicting imperatives to ensure that participants are selected fairly.
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Resnik DB. Practical Problems Related to Health Research Funding Decisions. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:21-22. [PMID: 30976205 PMCID: PMC6452879 DOI: 10.1080/15265161.2018.1523494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- David B Resnik
- National Institute of Environmental Health Sciences, National Institutes of Health
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Afolabi MOS, Sodeke SO. Public Health Disaster-Related Research: A Solidaristic Ethical Prism for Understanding Funders' Duties. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:37-39. [PMID: 30475178 DOI: 10.1080/15265161.2018.1523500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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MacKay D. Health Research Priority Setting: A Duty to Maximize Social Value? THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:25-26. [PMID: 30475188 DOI: 10.1080/15265161.2018.1523504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Garba I, Barraza L, Hall-Lipsy E. Acquired Duties for Ethical Research With American Indian/Alaska Native Populations: An Application of Pierson and Millum's Framework. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:40-42. [PMID: 30475179 DOI: 10.1080/15265161.2018.1523501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Dresser R. Conceptual, Structural, and Practical Challenges to Ethical Allocation of Research Funds. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:23-24. [PMID: 30475180 DOI: 10.1080/15265161.2018.1523502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Pratt B, Hyder AA. Priority Setting Is More Than Resource Allocation: Reflecting on the Content of Funders' Duties and Their Implications for Current Practice. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:27-30. [PMID: 30475187 DOI: 10.1080/15265161.2018.1523503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Bierer BE, Strauss DH, White SA, Zarin DA. Universal Funder Responsibilities That Advance Social Value. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:30-32. [PMID: 30475185 DOI: 10.1080/15265161.2018.1523498] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Barbara E Bierer
- a Multi-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard (MRCT Center), Harvard Medical School
| | | | | | - Deborah A Zarin
- d Multi-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard (MRCT Center) Center
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Hurst DJ. Is There a Business Case for Constitutive Duties of For-Profit Research Funders? THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:35-37. [PMID: 30475181 DOI: 10.1080/15265161.2018.1523495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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