In the realm of biomedical ethics, there is certainly no shortage of topics to be discussed. It is true that we could converse, debate, and conclude until we were blue in the face. In many instances, certainly in the United States, domestic issues abound such that conversation less often wanders to issues beyond our borders. Faced with controversy over stem cell research funding, gene patents, and the like, we must not become so absorbed in our own debates that we fail to acknowledge and address the ethical concerns arising from research on foreign soil. So let's take a moment and turn our eyes towards the African continent.
In fact, all eyes have been directed towards Africa in the past couple weeks, as the National Institutes of Health in the U.S. and the Wellcome Trust, a U.K.-based global charity, have announced a partnership to fund a new research initiative in Africa. (Alternatively, perhaps your interest in Africa these past few weeks has had to do more with a little soccer tournament that's in progress...) The project is named Human Heredity and Health in Africa, or simply H3Africa for short. With the goal of developing large-scale population-based genome studies in Africa, the H3Africa project diverges from the traditional Western approach to research in Africa, namely that the research doesn't actually occur in Africa.
Due to the high infection rates of various communicable diseases, African countries have long been regarded by Western biomedical scientists as fertile resources for research. Yet, the traditional approach of "you give us samples and participants, we give you treatments and cures" is, in actuality, often a less-than-equitable quid pro quo, with Africans at the losing end. In one example, if the biological samples from African participants ultimately guide researchers to a course of treatment that the participants cannot afford, then it's not really much of a trade, is it? Furthermore, the viewpoint that Africa is merely a storehouse of biological samples for Western researchers to fly in, collect, and whisk off to their laboratories abroad is not only a demonstration of dubious ethics, but it is a practice that is incredibly detrimental to the African continent.
The only way to truly combat the diseases that ravage African countries is to invest in research within those countries. Foreign researchers should stop using African populations solely as tools for their own research and should rather seek to build collaborations with African researchers. In order to do so, we need agencies to fund the construction of a research infrastructure within African countries, thereby providing African researchers with the tools to conduct the necessary studies themselves. That is exactly what is promised by the H3Africa project, which is why this forward-thinking endeavor should be embraced and applauded by the scientific community.
Granted, the features of the H3Africa project, which include developing research capacity in Africa, eventually creating a repository in Africa for biological samples collected from African populations, and providing study participants with medical examinations and screening tests, do not address all of the ethical concerns related to the conduct of research on African populations. (For instance, there is the issue of informed consent. People may choose to participate in research studies only because they are unable to afford any medical care at all, or they may be unaware that they will not be receiving treatment, as is the case in scenarios involving placebos.)
Yet, the H3Africa project is definitely a step in the right direction. As we empower African researchers and construct the infrastructure to allow true collaborations between countries, we move farther away from the scenario of one population taking advantage of another. The paradigm set forth by the H3Africa project is not only more ethical than research paradigms in the past, but it also offers the promise of unprecedented innovation and cross-cultural exchange in the future.