Ethics of health research: developing the COHRED Fairness Index

What is the COHRED

The Council on Health Research for Development (COHRED) (http://www.cohred.org/) is a global, not-for-profit organisation committed to the goal of transforming health research and research innovation to ensure the delivery of sustainable healthcare solutions informed by the dual axes of health and development. In its endeavour to contextualise healthcare solutions, the COHRED strives to help health research funders and the high income countries (HICs) to appreciate and understand the specificities and challenges besetting health research in low and middle income countries (LMICs). It also strives to provide the latter constituency with leadership and effective solutions to help them in their own research and innovation systems for health and development.

What is the COHRED Fairness Index?

The COHRED Fairness Index (CFI) is a concrete step towards integrating these missions and designing a material, palpable, utilisable output – an Index to help globally standardise research and innovations in health systems. The CFI hopes to offer certification and bring different stakeholders, from donors, grant recipients, contract organisations, and R&D institutions, to pharmaceutical companies, ministries/departments of health and international organisations, together on a common platform towards their shared goal of improving global health research. While not being a binding law, the CFI is expected to be adhered to as a gold standard, so that health research and systems innovations across countries will be made transparent, fair and ethical, thereby, becoming more relevant to the intended beneficiaries.

Why is such an Index important?

Recent statistics show (elaborated in the COHRED document) that there is a vast disparity between the subjects and contexts of health research, and the location of the studies. For instance, while an overwhelming volume of contemporary health research focuses on developing solutions for the different African contexts, these studies are frequently located outside the continent.Such disparities have come to become part of the norm in global health research, and these norms are what the CFI will help dissipate to bring about balance and parity. The CFI will help mainly systematise research and innovation, offer a distinct mechanism of regulation and monitoring of systems and their agents, and also set up a globally accredited standard for ensuring integrity in global health research.

How does it affect the IJME?

The Indian Journal of Medical Ethics (IJME) is resolutely committed to ethical health research, transparent dissemination of research and proactive systems development. Through its biennial forum – the National Bioethics Conference – the IJME has been an active voice speaking up against medical malpractice and corruption in healthcare; it has actively supported, and collaborated with, like-minded associations/organisations in demanding a Universal Healthcare Act in India, and has been advocating policies to make health research more relevant, user-sensitive and just. Having such an index as the CFI will strengthen the IJME and the FMES in their combined goal to make healthcare, health research and systems innovations ethical, transparent and beneficiary-oriented.

What can we do to contribute?

The documents and the various processes of developing the Index are in the open domain, and the COHRED has invited suggestions, comments and constructive criticisms. The Forum for Medical Ethics Society (FMES) has endorsed the Index (http://cfi.cohred.org/institutional-endorsements/) and is in touch with the COHRED Technical Group. As patrons of the IJME and believers in the cause of fair and equitable health research and innovation, you are invited to read the document and share your critical feedback with us ([email protected]), or if you wish to, directly with the COHRED team (the contact IDs are provided in the document). As stakeholders in the larger project of systematising and standardising health research across the globe, we are all part of this process, in varying ways and roles.

[The final Index is expected to be announced by October 2015. As of now, the following document http://cfi.cohred.org/get-involved/global-consultation/ details the objectives, goals and structure of the Index.]