Ethics in collaborative global health research networks

Despite enormous global inequalities in health, only a small proportion of medical research has addressed problems primarily affecting the world’s poorest people. To address this, reports by the Ad Hoc Committee on Health Research (1996) and International Conference on Health Research for Development together established a consensus on five core recommendations for the action needed to move towards a more equitable distribution of research resources. These called for action to: correct the 10/90 gap in research funding and set priorities; build up the capacity of health research systems in developing countries; create international research networks and public–private partnerships; increase funding for health research by developing countries; and create health research forums to monitor progress in health research. These recommendations together with the United Nations’ Millennium Development Goals led to a number of important developments. The Global Forum for Health Research 10/90 Report on Health Research 2003–2004 found that the landscape of medical research funding changed significantly between 1990 and 2003 and reported that there were now ‘many more actors engaged in funding or conducting health research relevant to the needs of developing countries’, estimating that global expenditure on research had ‘more than quadrupled’. The report noted that much of this new research took the form of emerging international research networks. Among others, the report identified the following: The Roll Back Malaria Partnership; the Global Alliance for TB Drug Development and HIV/AIDS. Such collaborations bring together diverse, distributed but interdependent groups of ‘actors’ in formations which may be temporary and partial, or long-term, substantial and interdependent. These include researchers, institutions such as universities and research institutes in both developed and developing countries, funders, research ethics committees, national ethics advisory bodies, health professionals and local community advisory boards. These developments continue and both the scale of the research being carried out on global health, and the shift towards more collaborative, networked approaches to global health research have been further encouraged by initiatives such as the Grand Challenges in Global Health Scheme (http://www.grandchallenges.org/).