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J Med Ethics 2005;31:39-47
© 2005 BMJ Publishing Group Ltd & Institute of Medical Ethics


RESEARCH ETHICS

HIV prevention research and global inequality: steps towards improved standards of care*

K Shapiro1, S R Benatar2

1 Family Health International, PO Box 13951, Research Triangle Park, NC, USA
2 Department of Medicine and Bioethics Centre, University of Cape Town Observatory, 7925, Cape, South Africa

Correspondence to:
S R Benatar
Department of Medicine & Bioethics Centre, University of Cape Town Observatory, 7925, Cape, South Africa; sbenatar{at}uctgsh1.uct.ac.za Intensification of poverty and degradation of health infrastructure over recent decades in countries most affected by HIV/AIDS present formidable challenges to clinical research. This paper addresses the overall standard of health care (SOC) that should be provided to research participants in developing countries, rather than the narrow definition of SOC that has characterised the international debate on standards of health care. It argues that contributing to sustainable improvements in health by progressively ratcheting the standard of care upwards for research participants and their communities is an ethical obligation of those in resource-rich countries who sponsor and implement research in poorer ones.


Keywords: global inequality; HIV; moral progress; prevention research; standard of care




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