FACING ETHICAL CHALLENGES TOGETHER: Reflections on the Global Health Bioethics Network Summer School, 2022 By Tess Johnson

This past September, in Bangkok, Thailand, a group of around 40 researchers in bioethics came together for a brilliant set of presentations and discussions surrounding global health ethics and related topics. The occasion was the Global Health Bioethics Network Summer School, 2022. This was the GHBN's 11th Annual Summer School and the first time that researchers from the Wellcome Trust member sites across Kenya, Thailand-Laos, South Africa, Vietnam, Malawi, Nepal and the UK (the Ethox Centre, also partnering with the Brighton and Sussex Centre for Global Health Research) could gather again in person since the beginning of the COVID-19 pandemic. It was both celebration and investigation—a celebration of the immense amount of global health ethics work conducted across the sites recently, and an investigation into emerging issues in global health, and how the GHBN can best adapt to a rapidly changing ethical landscape.
 
For me, it was also my first week in a new postdoc role at the Ethox Centre, and a wonderful initiation into the GHBN’s own uniquely supportive and proactive approach to global research collaborations. It was a deep-dive into a world of inspiring research projects, on ethical issues ranging across antimicrobial resistance, policymaking during pandemics, public engagement and public involvement in research, vaccination, and justice and equity. On top of that, we had the opportunity to hear from various guest speakers, engage in a reading group, and participate in a live debate (not to mention the tours, shopping, dinners and boat cruise organised by our hosts at MORU).
 
For those less familiar with global health ethics, it may seem like the solutions to many of the above problems are already cut-and-dried. Perhaps it seems obvious that collecting genomic data from diverse communities for research is a good thing. Or, of course we should be offering vaccines to those who need them most. Or, surely we should promote and support the health information released by local ministries of health when conducting community engagement.But actually, none of these issues is as simple as that. In every session, we were confronted with the complexity of the ethical dilemmas that physicians, engagement officers, health researchers and members of the public are facing around the world. Collecting genomic data may only be the right thing to do if we ensure the benefits of the research are adequately shared with the groups who donate their data, as Allan Sudoi of the KEMRI-Wellcome Trust Research Programme suggested. Whether and how vaccines should be donated to individuals or countries in need depends on a number of factors surrounding the benefits from vaccination in a particular area, the motivations behind donation, and whether there are strings attached, as proposed by Primus Che Chi and Dorcas Kamuya of the KEMRI-Wellcome Trust Research Programme. And if there is a risk of misinformation concerning a disease being spread by health authorities in an area, perhaps research centres there should design their own public messaging instead of supporting that misinformation, as we explored in talks by Deborah Nyirenda of the Malawi-Liverpool Wellcome Trust and by Napat Khirikoekkong and Jarntrah Sappayabanphot of the Chiangrai Clinical Research Unit and Mahidol-Oxford Tropical Medicine Research Unit.
 
As bioethicists, we are faced with these challenges every day, and I believe our abilities to overcome them, separating out the values at stake and searching for a reasonable recommendation at the end, are enhanced by working together. With perspectives on these issues that pay attention to context-specific factors and that are informed by diverse ethical traditions, we can find alternative framings and solutions to ethical challenges. That’s what makes the summer school so valuable, and such a learning experience for those of us who are used to seeing ethical issues in a single (often high-income country) context and through the narrower lens of the dominant European ethical tradition.The general reaction to the summer school chimed with this idea of coming together. We were glad for the opportunities for discussion and exposure to new ideas, as Makhosi and Lerato say:
 
“For me, the workshop experience was a real learning one. I’ve gained other people to network with… I’ve gotten exposure to new things, new ideas.” - Makhosi Ntombela, Africa Health Research Institute, South Africa.
 
“As a basic scientist, this meeting was an eye-opener. Being exposed to a different form of research¬—I never thought about how valuable that is. This meeting … made me think about my position in the conversations we were having. Like, where do I want to place myself? I want to be more a part of it.” - Lerato Ndlovu, Africa Health Research Institute, South Africa.
 
We have the GHBN as a whole to thank for the brilliant Bangkok Summer School. As always, Mike Parker and Dinnah Rippon’s untiring leadership and dedicated work supported the summer school. And in particular, it would not have been possible without our fantastic hosts in the MORU group, with efforts led by Phaik Yeong Cheah and Rita Chanviriyavuth, supported by Supa-at Asarath (Ice) and Napat Khirikoekkong.
 
 
Tess Johnson
GLIDE Postdoctoral Researcher in the Ethics of Pandemic Preparedness, Response and Surveillance
Ethox Centre, University of Oxford

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