Apr 04

Transgenic mosquitoes vs. Zika trials

Positive article about transgenic mosquitoes and Zika virus

Apr 04

Ethics questions Zika trials

Ethics- Zika virus vaccine human challenge study


Apr 04

Equity in global health research in the new millennium: trends in first-authorship for randomized controlled trials among low- and middle-income country researchers 1990-2013

[PAHO/WHO Equity, Health and Human Development – Lista Equidad]


Equity in global health research in the new millennium: trends in first-authorship for randomized controlled trials among low- and middle-income country researchers 1990-2013

Margaret Kelaher, Lye Ng, Kieran Knight, Arie Rahadi


International Journal of Epidemiology

Published online: February 2017

Abstract / Resumen:

Background: Developing the research capacity of low- and middle-income countries (LMICs) has been shown to be one of the key ways that international health programmes and health research can create sustained benefit in these countries. The aim of this study was to examine trends in first-authorship for researchers from LMIC institutions (LMIC first-authors) over the period 1990-2013.

Methods: This study systematically reviewed research articles about randomized controlled trials (RCTs) in HIV/AIDS, malaria and tuberculosis (TB) conducted in LMICs from 1990 to 2013, and identified the institutional affiliations of the authors. Key variables extracted from the articles included author affiliation, funding source, disease, intervention type, region and year of publication. Poisson regression was used to explore the impact of these key variables on LMIC first-authorship over time.

Results: A total of 1593 articles were identified, of which 49.8% had LMIC first-authors. From 1990 to 2000 a total of 222 trials were published, and from 2001 to 2013 a total of 1371 trials were published, with a steady year-on-year increase over the period particularly evident in trials conducted in Africa. Whereas the absolute total number of LMIC first-authors has increased, as a proportion of all authors it declined. The relative rate increase in first-authorships post 2000 was 11.8-fold for non-LMIC first-authors and 2.8-fold for LMIC authors. LMIC first-authorship increased over time for research funded from LMIC; but LMIC first-authorship declined over time for research funded from high income countries (HIC).

Conclusions: The absolute increase in the number of trials in HIV/AIDS, malaria and tuberculosis in Africa has led to a modest increase in LMIC first-authors, and a much larger increase in non-LMIC authors. The findings suggest that more inclusive policies by international funders are important in shifting research control to LMICs and improving research equity in the future.


Keywords / Palabras clave:

Research; Low- and Middle-Income Countries; Global Health; Equity


How to access this paper / Como acceder a este artículo: click here.

* The author/source alone is responsible for the views expressed in this article/publication or information resource, and they do not necessarily represent the positions, decisions or policies of the Pan American Health Organization. = El autor/fuente es el único responsable por las opiniones expresadas en este artículo/publicación o recurso de información y no necesariamente representan las posiciones, decisiones o políticas de la Organización Panamericana de la Salud.



Visit the Portal/Blog of the PAHO/WHO Equity List & Knowledge network :http://equity.bvsalud.org

Visite el Sítio/Blog de la Lista de Equidad y Red de Conocimiento:
: http://equity.bvsalud.org/es

For additional information and to send contributions, please contact Mrs. Eliane P. Santos, Advisor, Library and Information Networks – KBR/ PAHO, Regional Office of the World Health Organization – pereirae@paho.org

Pan American Health Organization, Regional Office of the World Health Organization for the Americas

Office of the Assistant Director

Area of Knowledge Management, Bioethics and Research (KBR)

If you want to subscribe or unsubscribe from Equidad (PAHO/WHO Equity list & Knowledge network)please click here

Si desea registrarse o salir de la lista Equidad (PAHO/WHO Equity list & Knowledge network)por favor haga click aqui


Apr 04

Ethics and mHealth Survey

You are invited to complete an online survey as part of a research project being conducted by mobile health (mHealth) and ethics researchers at Johns Hopkins University.  The survey link is provided below and also here.

Mobile phone technology is increasingly being used in low- and middle-income countries (LMICs) for public health purposes. The aim of our study is to explore the ethical, legal and societal issues related to the development, conduct and reporting of mobile phone surveys in LMICs. Our study focuses mainly on the use of mobile phone surveys to identify non-communicable disease (NCD) risk factors.

We are asking you to participate in this study because of your experience with mHealth and/or the oversight of research or public health practice in LMICs.

If you are willing to complete this anonymous online survey, please continue by following the link below. It will take about 15–20 minutes to complete. We do not anticipate any risks to you from participation. You can skip questions that you do not wish to answer and may stop at any time.

While it is unlikely that you will benefit personally from completing the survey, we hope the survey will increase global understanding of the various emerging issues in this area. Our goal is to help future stakeholders navigate some of the unsettled ethical, legal and societal questions that arise when conducting mobile phone surveys in LMICs.

If you complete the survey, you will have the option of entering a drawing to receive a $50 gift card sent to you by email.  Twenty (20) people who respond to this survey will be selected randomly to receive a gift card. We will also be happy to share the findings of this survey with you.

Please click or copy and paste this link into your browser to begin the survey:


The survey will close in approximately 3 weeks. We greatly appreciate your taking the time to respond to the questions.

Kind regards,

Joseph Ali, JD

Alain Labrique, MHS MS PhD

Dustin Gibson, MS PhD

George Pariyo, MBChB PhD

Saifuddin Ahmed, PhD

Adnan A. Hyder, MD MPH PhD

Johns Hopkins Bloomberg School of Public Health

Johns Hopkins Berman Institute of Bioethics

Note: Questions related to the survey can be sent to jali@jhu.edu

Apr 04

WHO issues ethics guidance to protect rights of TB patients on World TB Day

WHO issues ethics guidance to protect rights of TB patients

World TB Day 2017 – Unite efforts to leave no one behind

Geneva ¦ 23 March 2017 – New tuberculosis (TB) ethics guidance, launched today by the World Health Organization (WHO), aims to help ensure that countries implementing the End TB Strategy adhere to sound ethical standards to protect the rights of all those affected.

TB, the world’s top infectious disease killer, claims 5000 lives each day. The heaviest burden is carried by communities which already face socio-economic challenges: migrants, refugees, prisoners, ethnic minorities, miners and others working and living in risk-prone settings, and marginalized women, children and older people.

“TB strikes some of the world’s poorest people hardest,” said Dr Margaret Chan, WHO Director-General. “WHO is determined to overcome the stigma, discrimination, and other barriers that prevent so many of these people from obtaining the services they so badly need.”

Poverty, malnutrition, poor housing and sanitation, compounded by other risk factors such as HIV, tobacco, alcohol use and diabetes, can put people at heightened risk of TB and make it harder for them to access care.  More than a third (4.3 million) of people with TB go undiagnosed or unreported, some receive no care at all and others access care of questionable quality.

The new WHO ethics guidance addresses contentious issues such as, the isolation of contagious patients, the rights of TB patients in prison, discriminatory policies against migrants affected by TB, among others. It emphasizes five key ethical obligations for governments, health workers, care providers, nongovernmental organizations, researchers and other stakeholders to:

  • provide patients with the social support they need to fulfil their responsibilities
  • refrain from isolating TB patients before  exhausting all options to enable treatment adherence  and only under very specific conditions
  • enable “key populations” to access same standard of care offered to other citizens
  • ensure all health workers operate in a safe environment
  • rapidly share evidence from  research to inform national and global TB policy updates.

From guidance to action
Protecting human rights, ethics and equity are principles which underpin WHO’s End TB Strategy. But it is not easy to apply these principles on the ground. Patients, communities, health workers, policy makers and other stakeholders frequently face conflicts and ethical dilemmas. The current multidrug-resistant TB (MDR-TB) crisis and the health security threat it poses accentuate the situation even further.

“Only when evidence-based, effective interventions are informed by a sound ethical framework, and respect for human rights, will we be successful in reaching our ambitious goals of ending the TB epidemic and achieving universal health coverage. The SDG aspiration of leaving no one behind is centred on this,” said Dr Mario Raviglione, Director, WHO Global TB Programme.

“The guidance we have released today aims to identify the ethical predicaments faced in TB care delivery, and highlights key actions that can be taken to address them,” he added.

World TB Day is an opportunity to mobilize political and social commitment for further progress in efforts to end TB. This year, World TB Day signals new momentum at the highest levels with the announcement of the first ever Global Ministerial Conference on Ending TB, which will be held in Moscow in November 2017.

“The Global Ministerial Conference will highlight the need for an accelerated multisectoral response to TB in the context of the Sustainable Development Goals,” said Dr Ren Minghui, Assistant Director-General HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases. “It will emphasize that global action against antimicrobial resistance must include optimized care, surveillance and research to address MDR-TB urgently”.

The Conference will inform the UN General Assembly high-level meeting on TB which will be held in 2018.

For more information:

Ethics guidance for the implementation of the TB strategy

Fact sheet on Ethical issues in TB prevention, treatment and care

World Health Organization 
Global TB Programme
20, Avenue Appia,
Geneva, Switzerland
Tel: (+41) 22 791 4695
For more information please go to

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