Placing Equity at the Core of Global Health Research: Time for an Expanded Ethical Framework?

Abstract

It is generally accepted that the fundamental goal of global health research is to improve health and achieve equity in health for all people. Global health research has made valuable and important contributions toward achieving this, through clinical progress resulting from scientific discovery as well as enhancements in local research capacity and academic development. However, notable challenges remain. There are difficulties with the research itself, including obtaining authentic informed consent, effective safety monitoring, and overly cumbersome, often inapplicable regulations. Significant ethical tensions are also present, such as harmonizing research priorities with local health needs, addressing disparities in academic recognition between local and international researchers, and clarifying the ethical responsibilities of researchers after the completion of a study. We propose a revised ethical framework for global health research that calls for a renewed focus on equity. We put forward key elements of this framework and provide some examples of how these can be put into practice.