Abstract
In line with the policy objectives of the United Nations Sustainable Development Goals, this commentary seeks to examine the extent to which provisions of international health research guidance promote capacity building and equitable partnerships in global health research. Our evaluation finds that governance of collaborative research partnerships, and in particular capacity building, in resource-constrained settings is limited but has improved with the implementation guidance of the International Ethical Guidelines for Health-related Research Involving Humans by The Council for International Organizations of Medical Sciences (CIOMS) (2016). However, more clarity is needed in national legislation, industry and ethics guidelines, and regulatory provisions to address the structural inequities and power imbalances inherent in international health research partnerships. Most notably, ethical partnership governance is not supported by the principal industry ethics guidelines – the International Conference on Harmonization Technical Requirements for Registration of Pharmaceutical for Human Use (ICH) Good Clinical Practice (ICH-GCP). Given the strategic value of ICH-GCP guidelines in defining the role and responsibility of global health research partners, we conclude that such governance should stipulate the minimal requirements for creating an equitable environment of inclusion, mutual learning, transparency and accountability. Procedurally, this can be supported by i) shared research agenda setting with local leadership, ii) capacity assessments, and iii) construction of a memorandum of understanding (MoU). Moreover, the requirement of capacity building needs to be coordinated amongst partners to support good collaborative practice and deliver on the public health goals of the research enterprise; improving local conditions of health and reducing global health inequality. In this respect, and in order to develop consistency between sources of research governance, ICH-GCP should reference CIOMS ethical guidelines as the established standard for collaborative partnership. Moreover, greater commitment and support should be given to co-ordinate, strengthen and enforce local laws requiring equitable research partnerships and health system strengthening.
Highlights
Health research is vital for better population health, equity, and national development [1]
Capacity building is an ethical obligation premised on the principles of social justice and health equity; the principles respectively require the equitable distribution of risks and benefits in health research and equal access to the resources needed to improve and maintain positive health outcomes [7]
The need for autonomous and locally-led systems of health research has been better recognized with international policy campaigns, and in novel ethical research guidance
Summary
Health research is vital for better population health, equity, and national development [1]. Addressing the ethics of the partnership in a way that goes beyond traditional research ethics (sound science, participant safety and autonomy), the CIOMS guidelines identify a crucial point: the act of entering into partnership has accompanying ethical responsibilities This marks the need for collaborative research partnerships to contribute to sustainable capacity building activities that brings structured changes to local skills, knowledge, and systems. This is important because aiming to combat one specific health disease through collaborative research or even providing a oneoff research training amongst partners will not alone secure conditions of good health for a population; co-ordinated commitment towards institutional and national capacity building is required. This approach honours nation state sovereignty and promotes local health research capabilities
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