Ethics, equity, climate change, and infectious disease research: a scoping review

Abstract

Objectives This scoping review aimed to summarise ethical issues related to climate-sensitive infectious diseases identified in the scientific literature. Methods We conducted a scoping review of PubMed to assess the level of engagement by scientists in the ethical and broader equity issues intersecting with climate-sensitive infectious diseases. Articles were included if they covered at least two out of three subjects – infectious disease, climate change, and ethics; and were published in English since 1995. Results The majority of scientific work in this field has focused on the relationship between climate change and vector-borne diseases (e.g., malaria and dengue fever) or water-borne diseases (e.g., cholera). Many studies identify the role of climate change in exacerbating inequities caused by the convergence of social and environmental determinants of health and show that the world’s most vulnerable populations are disproportionately impacted. However, few studies included explicitly normative ethical analysis of these trends, and there was limited discussion of the ethical responsibilities arising in infectious disease research including in relationships between researchers and communities. Conclusions This review provides a foundation for renewed and ethically-informed research on climate-sensitive diseases in low-and middle-income countries. It also highlights critical knowledge gaps and reveals where more work is needed to understand and respond to the ethical implications of these relationships and thereby inform more ethically conscious infectious disease research.