Global health reciprocal innovation: ethical, legal and regulatory considerations

Abstract

Global health reciprocal innovation (GHRI) is a recent and more formalised approach to conducting research that recognises and develops innovations (eg, medicines, devices, methodologies) from low- and middle-income countries (LMICs). At present, studies using GHRI most commonly adapt innovations from LMICs for use in high-income countries (HICs), although some develop innovations in LMICs and HICs. In this paper, we propose that GHRI implicitly makes two ethical commitments: (1) to promote health innovations from LMICs, especially in HICs, and (2) to conduct studies on health innovations from LMICs in equitable partnerships between investigators in LMICs and HICs. We argue that these commitments take a significant step towards a more equal global health research enterprise while helping to ensure that populations and investigators in LMICs receive equitable benefits from studies using GHRI. However, studies using GHRI can raise potential ethical concerns and face legal and regulatory barriers. We propose ethical, legal and regulatory considerations to help address these concerns and barriers. We hope our recommendations will allow GHRI to move the global health research enterprise forward into an era where all people are treated equally as knowers and learners, while populations in both LMICs and HICs benefit equitably from studies using GHRI.

The case for global health reciprocal innovation

“…4 6 7 Rid et al explore ethical, legal and regulatory considerations involved in implementing GHRI, including GHRI's ethical commitment to equitable research partnerships as well as a concern that GHRI studies could displace funding for studies whose results have more immediate or significant benefits for populations in LMICs. 9 Dearing et al introduce the idea of reciprocal coproduction as a basis for the diffusion of global health innovations and provide the example, among many others, of how a Kenya-based texting platform that facilitates personalised patient-provider communication was redesigned and adapted to address HIV prevention needs and gaps in the USA. 4 Muddu et al describe the importance of training and informing the next generation of researchers on the use of GHRI through the unique pairing of domestic and global health training programmes.…”