Ethical Issues in International Relations & Funding

Medical and scientific research is essential for improving global health, health equity, and economic development. With the widening of the globalization process, these researches are now cross- national and cross-cultural.
Foreign-funded research in developing countries may sometimes be altruistic in nature, but largely it is guided by the economic interests and academic pursuits that may or may not reflect the interests of the host country.
In this regard, various ethical considerations arise, such as:

• Ethical Issues in clinical trials: Lack of informed consent from local people, unequal distribution of risks and benefits, lack of technology and knowledge transfer and exploitation of vulnerable populations are significantly visible.
• The potential vulnerability of the local teams: Local research teams and Ethics Review Committees might find it difficult to challenge the study design or the proposed research methodologies from an ethical perspective, especially if financial investments are expected to improve the local research infrastructure.
• Non-universal nature of ethical standards: The regulations, standards of care, consent procedures, and cultural expectations differ among countries. Thus, ensuring the same ethical standards across jurisdictions becomes a difficult task for regulators.
• Difficulty in monitoring research projects: Due to meagre resources and infrastructure constraints, it may be difficult for developing countries to effectively monitor research projects.
• Responsiveness to the local needs and benefit sharing: Medical research projects do not necessarily meet the needs of the local people whereas the risks associated with such medical research fall on them and benefit sharing is seldom equitable.
• Data protection: Research study data collection, handling, processing, storage, and protection should be done in accordance with the local legislation that not only ensures data integrity but also ensures privacy.
• Absence of a robust Ethical Review Mechanism: Currently, the ethics review mechanism is not present in all countries. An effective system for the ethical review of research, which includes the establishment and maintenance of research ethics committees, independent of government and sponsors, is lacking and needs to be developed.
• Non-Adherence to ethics guidelines: At most times, global search ethics guidelines such as the Helsinki Declaration, the Council for International Organizations of Medical Sciences Guidelines, and the Guidance on Good Clinical Practice are not adhered to while conducting medical research.

Thus, measures are required to ensure that ethical medical research is promoted, which is also beneficial to the local country. An ethical framework based on principles of duty to alleviate suffering, to show respect for human beings, to be sensitive to cultural differences, and to not exploit the vulnerable, can go a long way in benefiting all the stakeholders of foreign-funded medical research in developing countries.