Incorporating the Research Needs of the Global South Angus Dawson Centre for Professional Ethics Keele University, UK Joint Centre for Bioethics University of Toronto, Canada

Two Aims: Call attention to the need for more care in the way things are expressed Step back a little and expand the range of issues being discussed

Why? Language is important – it frames the debate The way that we talk about things both reflects the way that we conceptualise things but also re-enforces it E.g. drug ‘access’ – is this too passive? Parallel to access to a library

Incorporating… …the research needs of global south Why phrase it this way? Suggests only a ‘modification’ Perhaps: Responding to…? Partnerships? Collaboration? Re-orientation…

Research needs v needs The former is narrower than the latter …the need of GS for research… or conduct research into needs of GS? In the latter formulation we will have a much broader notion of ‘research’ (not just drugs but also qualitative & normative methods etc)

So why raise these issues? Suggest we can separate two different issues: 1. Once a drug is created…how do we assure those in need gain treatment? 2. How ought we frame the research agenda itself? (Not suggesting that one is more important than the other)

Q1: how do we assure ‘access’? Various impediments: Supply side: IP, university rewards etc Consumer side: poverty, distance, etc This been main focus of discussion so far – but I want to broaden things:

Q2: How ought we frame the research agenda? More than how to assure access to treatment Treatment important – but also need to focus on: Prevention Socio-determinants of health (TB) Consistent policy and funding (Yaws)

So suggesting that… …it’s important to ensure that the focus of research is not too narrow in universities and among research funders There is a danger of misunderstanding the need for a broader agenda by only talking of access to drugs

In addition… …there is a danger of focusing on drugs as the solution – this is not such a good idea due to resistance problems (e.g. TB, tamiflu etc)

Normative If, as I think is the case, the background normative commitment is to the idea of health equity (or at least meeting some minimal commitment in relation to the determinants of health) there may be other ways to achieve the same end more effectively

If you are committed to this… …then you are committed to more than self-interest Don’t confuse what might motivate people with what we ought to do No need to be pessimistic – public has a of support for such a policy (and parallel with environmental issues)

Conclusions Equal access to drug treatments a good end to pursue – but needs to be situated in a broader context It is necessary, but not sufficient for health equity Knowledge transfer/translation ought to be knowledge partnership with global south