Date Published: January 14, 2019
Publisher: The American Society of Tropical Medicine and Hygiene
Author(s): Elizabeth A. Bukusi, Yukari C. Manabe, Joseph R. Zunt.
Addressing ethical issues through mentorship is key to encouraging scientific integrity and increasing research capacity. Across the global health arena, mentorship requires helping mentees understand and negotiate the regulatory aspects of research—which can substantially differ even between countries with similar resources. Mentorship support spans across the research framework from obtaining ethical approval and ensuring scientific integrity, to determining authorship and disseminating study results—providing multiple opportunities to model ethical behavior for mentees. The power imbalances between the global north and south in accessing funding resources produce further challenges in setting the research agenda and for ensuring equity in the dissemination of research findings. Gender further complicates the aspiration for equity; the proportion of women in high administrative or research positions remains low. This study explores four specific mentoring case scenarios commonly encountered in the global health research field in low- and middle-income institutions.
The increasing globalization of commerce, education, and research has resulted in increasing collaboration across countries. One manifestation of increased collaboration in academia is the rise in number of scientific publications. Between 2003 and 2013, the number of scientific manuscripts published in any of the more than 17,000 peer-reviewed scientific journals monitored by SCOPUS increased from 1.1 million to nearly 2.2 million.1 Over this same timeframe, scientists from low- and middle-income country (LMIC) institutions increased their percentage of scientific and technical publications from 9.5% to 13.7%.1 In addition, between 1988 and 2013, coauthorship by authors from more than one country increased from 8% to 19% and U.S. and Chinese scientists have reached approximate parity in total number of publications, with each country contributing 18.8% and 18.2% of the world’s total science and engineering publications in 2013, respectively. With this increase in publications, has come increasing reports of scientific misconduct, as well as attention to how institutions and mentors can monitor for scientific misconduct and provide role modeling and training in the responsible conduct of research (RCR) to reduce misconduct in trainees, especially in countries that have limited infrastructure to detect, investigate, or penalize scientific misconduct.2
The World Medical Association developed the Declaration of Helsinki adopted by its assembly in Helsinki in 1964.5 This guide was specific for physicians regarding engagement of their patients in research. Subsequently, in 1982 the Council for International organizations in Medicine, using the Declaration of Helsinki as a reference, provided guidelines for the conduct of biomedical research involving humans conducted in LMIC settings, where greater disparities in health care are encountered than in more developed countries.6 Before the 1980s, few institutions in the United States had adopted institutional review boards (IRBs) to oversee research involving humans or animals to respond to concerns of scientific misconduct and had instead relied on independent monitoring and regulation of scientific activities. In the 1980s, the emergence of several cases of scientific misconduct in the press led to U.S. congressional hearings that resulted in the creation of federal and institutional standards to reduce scientific misconduct.7 In 1989, to ensure “that attention be directed toward scientific integrity in the conduct of research,” the U.S. National Institutes of Health (NIH) revised National Research Service Award institutional training grants “to require that a program in the principles of scientific integrity be an integral part of the proposed research training effort.”8 Since this revision, guidelines have been updated but some experts suggest that despite these guidelines, transgressions in scientific integrity continue to occur and consensus is lacking regarding how to teach RCR or measure the effectiveness of such teaching.9
The globalization of research and publishing has also resulted in increased awareness of the disparity of RCR training opportunities in many countries. With the advent of AIDS, the Fogarty International Center increased research training support for international scientists to build capacity to respond to epidemics through new programs, such as the AIDS International Research Training Program, first offered in 1988, and the international Research Ethics Education and Curriculum Development award, first offered in 2000. With the implementation of these international training programs came increased attention to strengthening didactic and interactive RCR education for trainees conducting research in different international settings. Although many of the early diaspora of Fogarty research training programs have risen to leadership positions and have facilitated increased availability of RCR training at their universities and institutions, successive generations of trainees continue to struggle with many of the same issues touching multiple facets of research—from design to implementation, analysis, and dissemination of results.