The first comprehensive examination of the ethical, social and cultural (ESC) challenges faced by major science programs in developing countries has identified a complex assortment of issues with the potential to slow critical global health research if left unaddressed.
The findings are published in this week’s PLoS Medicine.
The challenges range from problems such as government corruption to questions surrounding community and public engagement, cultural acceptability, and gender.
Professor Peter Singer (Senior Scientist, McLaughlin-Rotman Centre for Global Health, University of Toronto) and colleagues conducted 70 interviews with academics, government officials, and NGO and private sector experts from developing countries. The study team pinpointed 13 ESC issues of concern for major science programs, including:
- community engagement—developing world experts stressed the need for researchers to create opportunities to listen to and understand the concerns and interests of the communities in which they work
- cultural acceptability— the experts identified several examples of technologies now in development that could face cultural barriers, including intravaginal and aerosolized vaccines and nutritionally enhanced foods that look different from traditional varieties
- gender—in many developing countries, according to the experts interviewed, culturally-ingrained discrimination limits women’s opportunities to make contributions in science and health and advocate for their needs
- affordability—many new technologies will need to be donated or heavily subsidized to reach those in need, many of them living on less than a dollar a day
- corruption and poor governance—some developing world experts said that with the power to approve new technologies resting solely with governments and little transparency in those approval processes, political considerations often trump public health care.
“Concurrent with the rapid growth of scientific research in developing countries, there are more reports of projects that face challenges related to ethical, cultural and social concerns,” said Professor Singer. “Our goal was to anticipate issues that could be faced by such programs and try to prevent them as this important work moves forward.”
The McLaughlin-Rotman Centre team has supplemented its ESC investigation with three separate reports, also published in PLoS Medicine. The first discusses the team’s work as an ESC Advisory Service to the Grand Challenges in Global Health (GCGH) Initiative (http://www.gcgh.org/channels/gcgh), funded by the Bill and Melinda Gates Foundation, which offered 44 grants totaling $450 million for a broad range of innovative research projects involving scientists in 33 countries. The second and third papers focus on engaging communities and civil society organizations (CSOs) in biomedical research in developing countries.
“This is the first time ethical, social, and cultural counsel has been engaged on a large scale to provide advice in a systematic way on these issues in a developing world context,” says study co-author Dr. Jerome Singh of Centre for the AIDS Program of Research (CAPRISA) in Durban, South Africa, and a co-leader of the GCGH ESC advisory service.
Citation: Berndtson K, Daid T, Tracy CS, Bhan A, Cohen ERM, et al. (2007) Grand Challenges in Global Health: Ethical, social, and cultural issues based on key informant perspectives. PLoS Med 4(9): e268.
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Citation: Singer PA, Taylor AD, Daar AS, Upshur REG, Singh JA, et al. (2007) Grand Challenges in Global Health: The Ethical, Social and Cultural Program. PLoS Med 4(9): e265.
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Citation: Tindana PO, Singh JA, Tracy CS, Upshur REG, Daar AS, et al. (2007) Grand Challenges in Global Health: Community engagement in research in developing countries. PLoS Med 4(9): e273.
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Citation: Bhan A, Singh JA, Upshur REG, Singer PA, Daar AS (2007) Grand Challenges in Global Health: Engaging civil society organizations in biomedical research in developing countries. PLoS Med 4(9): e272.
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