Last month the World Conferences on Research Integrity (WCRI) Foundation released the Cape Town Statement on Fostering Research Integrity through Fairness and Equity. This was published with a Nature commentary on the importance of addressing unequal, unfair and sometimes even exploitative practices in research partnerships between institutions in high-income countries (HICs) with those in lower and-middle-income countries (LMICs).
“The Cape Town Statement is essentially a call-to-action that we hope will turn the global conversation on inequity and unfairness in research into changes in practice by all stakeholders,” says Dr Lyn Horn, director of UCT’s Office of Research Integrity (ORI), who played a leading role in the production of the statement. “It also places issues of inequity squarely on the research integrity agenda, making it more difficult for researchers to ignore.”
The statement was conceptualised and developed at the 7th World Conference on Research Integrity, co-hosted by the WCRI and the University of Cape Town (UCT), through ORI, and held in Cape Town last year.
“Three of the six prior WCRI events led to the publication of guidelines and principles around research integrity that have been taken seriously by the global research community, and we hope the Cape Town Statement will be no different.”
The statement, which was drawn from discussions involving 300 participants from 50 countries entails 20 recommendations to uphold values and achieve research integrity goals. The recommendations are grouped under values that were identified as critical at the 7th WCRI discussions on this topic. They include:
Why the Cape Town Statement matters
In 2014, health officials in West Africa were caught by surprise as the Ebola virus spread unchecked and killed at least 10 000 people in Liberia, Sierra Leone and Guinea. Before this outbreak it was believed that West Africa was not an area where Ebola occurred. But as Liberian scientists reviewed literature on Ebola surveillance in the aftermath of the epidemic, they were devastated to find a paper, written in 1982, in which a team of German scientists warned that Ebola was a possibility in Liberia – a possibility Liberian health centres should have been aware of and prepared for. These findings were not unique.
The Liberian scientists, quoted in an opinion piece published in the New York Times at the time, wrote: “Part of the problem is that none of these articles were co-written by a Liberian scientist. The investigators collected their samples, returned home and published the startling results in European medical journals. Few Liberians were then trained in laboratory or epidemiological methods. Even today, downloading one of the papers would cost a physician here [in Liberia] $45, [the equivalent of] half a week’s salary.”
“This is one of many examples of the real-world damage of extractive and exploitative research practices,” says Dr Horn. “This is known as helicopter research, where researchers fly in, gather data, and then fly out again, publishing their results for their own career advancement. Other practices include ethics dumping, which is when HIC researchers use different ethical standards in LMIC countries than they would in their own.”
She adds that many LMIC researchers have had negative experiences in research partnerships, from being completely left off the publication as an author, despite significant input into the work, to being unable to access data that they themself collected after a project closed.
But there are also more subtle ways in which these inequities creep in, for instance in failure by funders to pay for so-called indirect costs of research in LMICs, while this is common practice in HICs. Indirect costs are used, among other things, to build research management and administrative support and build capacity around these.
Professor Valerie Mizrahi, director of UCT’s Institute for Infectious Diseases and Molecular Medicine (IDM), says this is an issue that strongly resonates with her. It’s something she brings up whenever she gets an opportunity to speak to funders or other research stakeholders.
"We are building ways of knowledge creation that take African lives, experiences, thinking and dignity seriously."
“In my own experience, people have not deliberately adopted unfair practices,” she says. “There is much goodwill from researchers in HICs who genuinely want to see research (and researchers) in LMICs succeed. However, some simply don’t know how to interact with researchers here – they don’t understand the challenges faced. They don’t understand the context in which we operate.”
“This is why these recommendations are so important,” she adds. “They are the first step to helping stakeholders in HICs become aware of inequities, of the power asymmetries and ethically dubious practices. And then to shift the centre of gravity of research to where it is really needed, where scientists are on the frontlines.”
Diversity key in high-quality research
While there have been moves towards greater diversity in research for some time, including stipulations from funders that research proposals include partners from LMICs, these partnerships are often not authentic. They are a check-box exercise where often the LMIC researcher is relegated to junior status, despite the work being conducted in their own environments or communities.
For Associate Professor Jantina De Vries, director of UCT’s Ethics Lab in the Department of Medicine and the Neuroscience Institute, it is necessary to see genuine research leadership in LMICs which are usually on the frontlines of the challenges the research is trying to tackle. “It is these researchers who often have the insights into how to spend the funding in a way that will make the most difference,” she says.
Professor Mizrahi echoes this: “We need representation in research priority settings, [where decisions are made] on what to fund and who to fund. We need to see LMIC researchers sitting on funding panels. This representation brings topics of concern to the attention of funders. We also need to invest in people, to increase the diversity of investigators in LIMCs.”
This issue is a relevant one to many fields. Dr Christopher Trisos, senior researcher in UCT’s African Climate and Development Initiative (ACDI) and director of the Climate Risk Lab, has written extensively about decoloniality in ecology and the importance of building a more inclusive, creative and ethical field.
Dr Trisos has welcomed the Cape Town Statement, noting that these unequal power dynamics are rarely considered in science, but that greater opportunities for historically marginalised groups to set research agendas is an important way of redressing ongoing power imbalances.
“Increased diversity and fairness in research is essential because it can lead to a research future that disrupts, rather than entrenches dynamics of inequality and where research helps lead a just transition to a more sustainable world,” says Trisos.
Dr Divine Fuh, director of UCT’s Institute of Humanities Africa (HUMA), has been working, through the institute, to upend many of these entrenched inequalities in the research system. Dr Fuh has contributed to work around building South–South partnerships, collaborating with funders to set the agenda rather than purely responding to funding calls, and putting African knowledge creation front and centre through a process he calls epistemic disobedience.
“Epistemic disobedience means taking African ideas and turning them into intellectual concepts and tools. We are building ways of knowledge creation that take African lives, experiences, thinking and dignity seriously,” says Fuh. “It is about building a pluri-versal space for research, rather than a universal one.”
A UCT-led initiative
For Mizrahi and other researchers at UCT the fact that this statement and work was led by UCT’s Office of Research Integrity is a matter of incredible pride.
Mizrahi notes UCT also has a proud history of leading the way in addressing ethical issues in research, including the work of Professor Solomon Benatar who was the founding director of UCT’s Bioethics Centre. She says Horn would be the first to acknowledge that where this work is concerned, she stands on the shoulders of giants.
“Lyn Horn led the way globally in tackling this issue of research fairness and equity head-on,” says Mizrahi. “It is of immense pride for me that I work at an institution that has a dedicated Office of Research Integrity that goes above and beyond the standard expectations and work of such an office, to look at the global landscape, to identify the problems and lead the way in addressing them. It is a tremendous achievement.”
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