The burdens and benefits of international research
Burdens | Benefits | |
---|---|---|
Participants | Risk to health—iatrogenic | Improved healthcare access |
Stigma and social harms | Improved health status | |
Time lost to visits | Increased knowledge about health | |
Risk of exploitation | Feeling of altruism | |
Increase in risk behaviour if mistaken belief that study is | Benefits of positive results if available | |
protective | ||
Community | Poor overall access to care in the presence of increased resources for research | Improved access to care if resources shared |
Dual SOC with access only to the lesser standard by non-participants | Increased knowledge about health | |
Stigma of identification with HIV infection | Benefits of positive results if available | |
Healthcare system | Diversion of scarce health resources to research: | New resources for health |
• health workers | Training for health workers | |
• clinic and hospital space | New clinic and hospital space | |
• materials | ||
Dual standards of care | ||
Increasing fragmentation of services | ||
Research priorities may dominate services | ||
Researchers from sponsoring country | High costs | Career advancement |
Operational complexities | Good salaries | |
Regulatory restrictions | Travel to interesting places | |
Cultural and social gaps in understanding population | Right livelihood, altruism | |
Researchers from host country | Sponsoring country researcher may set research agenda | Career advancement |
Cultural and social gaps in understanding | Altruism | |
Racism Divided loyalties between local and sponsoring institutions | Increased resources for research directed to local problems | |
Higher salary than if locally funded | ||
Sponsors | Failure to recover costs | High profit potential in drug research |
Potential for external problems stalling project | Less stringent ethical oversight | |
Operational complexities | Lower operating costs | |
Regulatory complexities | Improved public profile of company or organisation |