Global Health Research in an Unequal World: Ethics Case Studies from Africa

This workbook is a collection of fictionalised case studies of everyday ethical dilemmas and challenges that are encountered in the process of conducting global health research in places where the effects of global, political, and economic inequality are particularly evident. It is a training tool to fill the gap between research ethics guidelines and their implementation "on the ground". The case studies, therefore, focus on "relational ethics": ethical actions and ideas that emerge through relations with others, rather than in regulations.

The first part of this book is a short introduction to relational ethics, followed by a collection of 42 training case studies for global health researchers. The collection is divided the collection into 4 sections, each with a brief introduction to the section theme. Each section focuses on the different types of relationships that characterise the practice of global health research:

1. Researcher - participant relationships [example case study topic: Fieldwork and Friendship: Working in Your Own Community]
2. Community and family relationships [example case study topic: Seeing Is Believing: Trial Regulations vs. Community Engagement in an Ebola Vaccine Trial]
3. Institutional relationships [example case study topic: Too Many People Have Turned Up! Addressing Stakeholders' Concerns]
4. Staff relationships [example case study topic: Who Are You?: Employment Issues and North-South Relationships]

Each training case study comprises: (i) an introductory sheet for the training facilitator, which includes a learning objective, keywords, and a commentary on the core ethical dilemmas that the story addresses; and (ii) a group handout, which includes the story, an illustration, questions to prompt discussion, and suggestions for further reading. Many of the case studies also include ideas for group activities.

The collection of case studies is followed by guidance on how to use the training case studies, including: detailed advice on group use; a template form to help facilitators prepare for a training session; and a list of additional resources such as key journals and websites. The authors also discuss insights from their experiences of piloting the case studies with different groups in Africa and Europe.

The second part of this book provides a more in-depth discussion of the key perspectives informing the approach, an analysis of the context of transnational medical research in Africa, and an outline of what anthropology and the social sciences can offer.