Public Health Ethics
Good Collaborative Practice - Perspectives from a Paediatric Malaria Vaccine Trial in Ghana And Tanzania.
Abstract: Collaboration in international health research has the potential to promote and sustain health worldwide and to reduce overall global health disparities. Successful international partnership enables health research to reach diverse populations, along with strengthening local health system capacity and providing access to novel health. Although collaborative research has generated new knowledge and advanced science in the past 30 years, questions have been raised as to what extent collaborative health research programmes have contributed to developing local systems and improving conditions of good health in low resource settings. The objective of this ethics project has been to explore what is good collaborative practice and; what are the roles and responsibilities of international research partnerships operating in low resource settings. This project is based on the review of current research governance documents, academic literature and; in conjunction with 52 semi-structured (N=52) key informant interviews presenting the experiences of stakeholders involved with a Phase III paediatric malaria vaccine trial: (vaccine candidate RTS, S) (NCT00866619) of GlaxoSmithKline (GSK, Vaccine Developer) and the Malaria Vaccine Initiative programme of PATH (Funder-Development Partner). The respondents included stakeholders from research centres in Ghana and Tanzania and wider partners involved with the conduct of the trial. The interview transcripts were evaluated with thematic coding.
The results are presented across four papers and address the governance of global health research; defining health research for development; ethics of delivering care in global health research and responsibilities of partnership at the end of a trial. Crucially, to be most effective in low resource settings collaborative programmes need to recognise research as a tool of public health. This requires equitable partnership structures targeted at improving local conditions of health and reducing global health disparities. International collaborative partnerships can support this goal by developing capacity (leadership, skills and infrastructure) that conducts context-sensitive research and; protects and promotes population health. Equally, research governance and regulatory frameworks need to endorse provisions of good collaborative practice that support and co-ordinate a network of robust research systems worldwide. Finally, the opinions and experiences of stakeholders in this project on international health research have shown that an unequivocal commitment to equity and unity is needed between partners to face the challenges of improving global population health.