By Joseph Ali

Capacity development for low- and middle-income countries (LMIC) in research ethics is often viewed as  something  best done by enabling individuals to be successful in the field; providing students or trainees with  sufficient  knowledge and resources to study, teach, and practice research ethics at home.  Under a traditional  ‘trainee-focused’  model of capacity development, where educational activities occur by-and-large for individual  trainees, efforts are made to focus training on those issues that are perceived to be most relevant to the context from which trainees come.  Training can therefore be of very high caliber, well resourced, and tailored.


Of course, one might rightly argue that developed country perspectives on regulations, guidelines, lessons, cases, arguments, and values that form much of the content of research ethics education have been so often articulated that, for better or worse, they have become interwoven with discourses on bioethics in the developing world.  That is to say, even when one provides instruction in research ethics by using examples (or even instructors) from developing country contexts, one brings to the discussion certain developed-world notions, metaphysical outlooks, and epistemological methods that frame the pedagogical experience.


So, while research ethics capacity development, as a researcher-focused and trainee-focused discipline has its place, it also has its limitations. Most prominently, followers of such models of capacity development are often, to put it simply, ‘not sure what to do’ with home environments – which are shaped by languages, traditions, cultures and religions, as well as educational, social, economic, institutional and political realities.  This may be expressed as reluctance to take on certain capacity development challenges associated with working with LMIC institutions to help secure ‘homes’ for trainees so they can best utilize and adapt their newly acquired skills in research ethics.


While some noteworthy advancements in research ethics in low- and middle-income countries can likely be attributed to the training of highly motivated individuals, it is increasingly becoming clear that without adequate institutional, national, and regional structures in place to foster research ethics, the field will be slow to flourish in LMIC settings.  However, before making this claim one must first be able to describe what a properly functioning research ethics system should look like, in any given context.


In recognition of this challenge, and the increased need for institutions and nations to coordinate their research ethics policies, offerings and infrastructures with their human capital and demand, Adnan Hyder MD, MPH, PhD, proposes that more work needs to be done to understand how research ethics systems operate, how they learn and develop, how they impact individuals, and how they relate to other spheres and indicators of well-being.


Dr. Hyder’s recent talk, “Institutional Capacity Development for Research Ethics Systems in Developing Countries: A Missing Link?“ (video below) makes a case for why it is important to better appreciate the complex relationships that exist between social systems, health systems, and research ethics.


Video
: Dr. Adnan Hyder Speaks About Research and Research Ethics Systems


Related Publication:  Hyder AA, Dawson L, Bachani AG, Lavery JV. Moving from research ethics review to research ethics systems in low-income and middle-income countries. Lancet 2009;373:862–5.





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