What are the cultural barriers in these settings to introducing an intra-vaginal vaccine to stop the spread of sexually transmitted disease?
These and other ethical, social and cultural questions will be identified and addressed by a team of experts from the University of Toronto engaged to help guide the work of a major global health initiative supported by the Bill & Melinda Gates Foundation, the Foundation for the National Institutes of Health, the Wellcome Trust, and the Canadian Institutes of Health Research.
Under a five-year, US $10-million grant, the U of T team will collaborate with other experts in developing countries to identify and devise ways to address potential ethical, social and cultural (ESC) issues raised in the course of conducting projects under the Grand Challenges in Global Health initiative.
Launched in 2003, the Grand Challenges initiative is a major effort to achieve scientific breakthroughs against diseases that kill millions of people each year in the world's poorest countries. The ultimate goal of the initiative is to create "deliverable technologies" - health tools that are not only effective, but also inexpensive to produce, easy to distribute, and simple to use in developing countries. In 2005, the initiative announced grants totaling more than $436 million to support 43 groundbreaking research projects.
"The inequities in global health are arguably the greatest ethical challenge of our time. Our key goal in this project is to focus on the ethical, social, and cultural factors that influence whether a new technology is adopted by communities in need. Just as the Grand Challenges initiative aims to apply enormous energy and resources to solve key scientific challenges in global health, we aim to find innovative and constructive approaches to the ethical, social and cultural issues," says Peter Singer, MD, Director of U of T's Joint Centre for Bioethics (JCB), Professor of Medicine at U of T and University Health Network, and co-principal investigator with Prof. Jim Lavery, PhD, of the St. Michael's Hospital Centre for Research on Inner City Health, the U of T Department of Public Health Sciences and the JCB.
In the short term, the group - along with bioethics professors Abdallah Daar (Director of Ethics and Policy, McLaughlin Centre for Molecular Medicine), Jerome Singh (visiting professor in Public Health Sciences from the University of KwaZulu-Natal) and Ross Upshur (Family and Community Medicine) - will help facilitate achievement of current Grand Challenges project goals, such as creating new vaccines, controlling insects that transmit agents of disease and improving nutrition to promote health.
"One key aspect of this grant is that we are working with colleagues in the developing world to identify ethical, social and cultural issues in their regions and communities that could affect the development and adoption of new health solutions," Dr. Lavery says. "In this regard, our experience at St. Michael's Hospital with engaging our patient communities should make a useful contribution."
Adds Dr. Singer, "We believe it is very appropriate that this major grant is targeted to challenges in the developing world where 5 billion of the world's inhabitants live, where threats to human security are so severe and where the opportunities for improving health are so great."
Professor John Challis, Vice-President (research) and Associate Provost, lauded the grant as a major achievement not just for the university, but for the country. "We are very excited to be linked to the Grand Challenges in Global Health," Challis says. "I believe this initiative could revolutionize the way the international scientific community works to solve global health problems. What is particularly gratifying is that Canada is playing such a pivotal role in the ethical component."