Health research funded by organizations from HICs and conducted in low- and middle-income countries has grown significantly since 1990. Power imbalances and inequities frequently (but not always) exist at each stage of the international research process. Unsurprisingly then, a variety of ethical concerns commonly arise in the context of international health research, such as inequities in funding, the semi-colonial nature of international research models, the brain drain of low- and middle-income country researchers, and inequities in partnerships between HIC and low- and middle-income country researchers. In this chapter, these (and other) ethical concerns are introduced and the following ethical concepts to address the concerns are then discussed: responsiveness, standard of care, benefit sharing, community engagement, and social value. Existing guidance and remaining debates about how to specify each of the concepts are summarized. The chapter concludes by highlighting the existence of epistemic injustices within the field of international research ethics.
Ending an HIV epidemic among persons who inject drugs (PWID) in a middle-income country
