The Ethics of Ethics Reviews in Global Health Research: Case Studies Applying a New Paradigm

With increasing calls for global health research there is growing concern regarding the ethical challenges encountered by researchers from high-income countries (HICs) working in low or middle-income countries (LMICs). There is a dearth of literature on how to address these challenges in practice. In this article, we conduct a critical analysis of three case studies of research conducted in LMICs.We apply emerging ethical guidelines and principles specific to global health research and offer practical strategies that researchers ought to consider. We present case studies in which Canadian health professional students conducted a health promotion project in a community in Honduras; a research capacity-building program in South Africa, in which Canadian students also worked alongside LMIC partners; and a community-university partnered research capacity-building program in which Ecuadorean graduate students, some working alongside Canadian students, conducted community-based health research projects in Ecuadorean communities.We examine each case, identifying ethical issues that emerged and how new ethical paradigms being promoted could be concretely applied.We conclude that research ethics boards should focus not only on protecting individual integrity and human dignity in health studies but also on beneficence and non-maleficence at the community level, explicitly considering social justice issues and local capacity-building imperatives.We conclude that researchers from HICs interested in global health research must work with LMIC partners to implement collaborative processes for assuring ethical research that respects local knowledge, cultural factors, the social determination of health, community participation and partnership, and making social accountability a paramount concern.

The Ethics of Ethics Reviews in Global Health Research: Case Studies Applying a New Paradigm

With increasing calls for global health research there is growing concern regarding the ethical challenges encountered by researchers from high-income countries (HICs) working in low or middle-income countries (LMICs). There is a dearth of literature on how to address these challenges in practice. In this article, we conduct a critical analysis of three case studies of research conducted in LMICs.We apply emerging ethical guidelines and principles specific to global health research and offer practical strategies that researchers ought to consider. We present case studies in which Canadian health professional students conducted a health promotion project in a community in Honduras; a research capacity-building program in South Africa, in which Canadian students also worked alongside LMIC partners; and a community-university partnered research capacity-building program in which Ecuadorean graduate students, some working alongside Canadian students, conducted community-based health research projects in Ecuadorean communities.We examine each case, identifying ethical issues that emerged and how new ethical paradigms being promoted could be concretely applied.We conclude that research ethics boards should focus not only on protecting individual integrity and human dignity in health studies but also on beneficence and non-maleficence at the community level, explicitly considering social justice issues and local capacity-building imperatives.We conclude that researchers from HICs interested in global health research must work with LMIC partners to implement collaborative processes for assuring ethical research that respects local knowledge, cultural factors, the social determination of health, community participation and partnership, and making social accountability a paramount concern.

Changes in the global sulfate burden due to perturbations in global CO2 concentrations

A large ensemble of general circulation model (GCM) integrations coupled to a fully interactive sulfur cycle scheme were run on the climateprediction.net platform to investigate the uncertainty in the climate response to sulfate aerosol and carbon dioxide (CO2) forcing. The sulfate burden within the model (and the atmosphere) depends on the balance between formation processes and deposition (wet and dry). The wet removal processes for sulfate aerosol are much faster than dry removal and so any changes in atmospheric circulation, cloud cover, and precipitation will feed back on the sulfate burden. When CO2 is doubled in the Hadley Centre Slab Ocean Model (HadSM3), global mean precipitation increased by 5%; however, the global mean sulfate burden increased by 10%. Despite the global mean increase in precipitation, there were large areas of the model showing decreases in precipitation (and cloud cover) in the Northern Hemisphere during June–August, which reduced wet deposition and allowed the sulfate burden to increase. Further experiments were also undertaken with and without doubling CO2 while including a future anthropogenic sulfur emissions scenario. Doubling CO2 further enhanced the increases in sulfate burden associated with increased anthropogenic sulfur emissions as observed in the doubled CO2-only experiment. The implications are that the climate response to doubling CO2 can influence the amount of sulfate within the atmosphere and, despite increases in global mean precipitation, may act to increase it.