There has been a legitimate debate going on for many years about the question of how
we can ensure that colleagues in the global south can both benefit from journals such
as this, as well as contribute constructively to it.
The issue of access to subscription‐based journals has been litigated ad nauseam and
I do think global publishers have done by and large a decent job in terms of implementing
with WHO and other agencies myriad access themes available to those countries too
resource‐constrained to afford regular subscriptions.
1
Some authors disagree, insisting that only Open Access journals, a supposedly superior
business model, can address the access problem adequately. And they are right, Open
Access journals, by definition, pose no access problems of the kind subscription‐based
journals pose. Sadly, having your cake and eating it too rarely works in the real
world, and so these authors, having resolved the access to academic research problem,
are faced with a different problem they did not have before. Open Access journals
can only survive as viable enterprises if a sufficiently high number of authors pay
what are often expensive article processing charges, or APCs. These journals often
offer their equivalent to the access schemes subscription‐based journals have put
in place, namely differential fees or fee waivers for those who absolutely cannot
afford to pay.
Short of asking academics to exploit themselves by volunteering to produce and disseminate
academic journals and their content, reliably, over decades,
someone will have to pay for the resource intensive production of journals and to ensure
the reliable availability of their content.
I have yet to see from those complaining about access problems
realistic solutions to this challenge. They mostly, and typically correctly identify the problem,
but beyond grandstanding they offer no answers. They expect
someone else to sort things out for them.
As I said, authors in the global south can access our content either by means of the
access schemes mentioned earlier, or by simply emailing the authors of content they
are interested in and by asking those authors for a complimentary electronic copy
of their article. Nobody would decline such a request.
I do think that a much greater challenge is to enable scholars from the global south
to participate in international conferences and workshops both to share their own
knowledge, but also to learn from colleagues and to network with a view to establishing
research partnerships and the like.
I suspect you will know Facebook. I posted a photo from a workshop I had organised
in the summer of 2017 in the UK, on the most recent version of the Council for International
Organizations of Medical Sciences (CIOMS) research ethics guidelines. Not unexpectedly
a colleague, located in an upmarket London‐based university, harangued me for the
lack of diversity, perhaps most significantly, the evident lack of attendees from
the global south. That colleague was right: only two of the 25 or so workshop delegates
came from the Caribbean, while everyone else came from countries of the global north.
Of course, I had virtually no funding to organise said workshop, and everyone who
travelled there paid their own way. Nobody's flight was covered by me. I did have
inquiries from various colleagues in the global south who would have loved to attend,
but quickly gave up on the idea due to lack of funds for their travel expenses. The
colleague who criticized me quite publicly, naturally, had no funds to offer either.
It is always easier to criticize than to contribute meaningfully to change. The same,
as I tried to show, holds true for academics who refuse to acknowledge the cost involved
in producing academic journals.
Some constructive attempts have been made to have a more globally representative group
of conference goers presenting at and attending international bioethics events. A
successful example of this is the Global Forum on Bioethics and Research. The GFBR
has been around for a longish time. It's funded mostly by the UK's Wellcome Trust,
the Gates Foundation, the US NIH Fogarty International Center and the UK's Medical
Research Council. I had a quick look at the GFBR's website, with a view to finding
out who governs it, and who decides on the composition of speakers and attendees of
its meetings, given that its funders reside essentially in the USA and the UK. It
seems to me as if the majority of those people are either staff members of these funding
organisations, or are past/current grant recipients.
2 There appear to be very few truly independent scholars from the global south among
those in charge of
organising these global events.
I don't think that this is the result of any kind of malicious intent. It's likely
a function of ‘who do we know who could serve on that steering committee who is from
Africa, Asia etc’, and who does one know? Well, the answer is likely to be: ‘someone
we have funded before’.
However, that alone does not address the question of whether or not the meetings are
failures when it comes to the question of participants from the global south. Here
are the criteria the GBFR uses to determine who among the applicants will be invited
3 :
- Country of origin: GFBR would like to ensure a representative distribution of delegates from different
regions;
- Background /current area of expertise: GFBR is aimed at anyone involved or interested in health research ethics, including
researchers, policy‐makers and community representatives. GFBR seeks representation
from many different disciplines;
- Membership of an IRB/REC: Membership of an Institutional Review Board / Research Ethics Committee is not a
prerequisite for attending GFBR, but may be taken into consideration;
- Experience of ethics: GFBR encourage s a mixture of ‘old’ and ‘new’ faces at each forum so that participants
can productively discuss issues of concern to them and gain from the perspectives
of others. Applicants need not be experts in ethics;
- Reasons for attending the meeting: GFBR seeks participants who will be able to actively contribute to the meeting and
who expect to impact on research ethics and/or pursue a career in research ethics
in their own country.
While there is the inevitable number of people who presumably just have to be at every
such meeting (let's call them ‘old’ faces), the GFBR has succeeded in terms of attracting
a fairly wide range of delegates from the global south to its meetings over the last
few years. It's a small (and expensive) meeting, designed to host about 80 delegates,
but it's probably a meeting as good as they come on the global bioethics scene. I
truly wish there were more such events on the global bioethics events’ calendar. I
do encourage you to give thought to how this sort of event can be replicated, for
other areas of bioethics, ie. not the typically well‐funded area of research ethics
but, say, for reproductive health, global health, and so on and so forth.
Let me end this editorial by encouraging you to attend the next World Congress of
the International Association of Bioethics. It will be held in Bangalore from 4–7
December 2018 under the theme
Health for all in an unequal world: obligations of global bioethics and is locally hosted by SAMA, the resource group for women's health, the Forum for
Medical Ethics Society, and, of course, the IAB.
4 With a bit of luck (and planning) there might be a plenary dedicated to figuring
out how to enable more delegates from the global south to attend such events. Why
don't you propose to organise such a plenary to the India‐based hosts of the event?
They might consider it quite seriously.
Ruth Chadwick and I managed to send a first rough draft of our textbook to Wiley to have it externally reviewed. It will need quite a bit more work, but we hope to get this done during the summer months.
I also, jointly with Justine Dembo and Jonathan Reggler have an Open Access paper in the Canadian Journal of Psychiatry on medical aid in dying and depression. You can find it here. 
There is also a completed book chapter to report in a Palgrave MacMillan handbook on, I think, political philosophy. I did that jointly with an undergraduate student at Queen's, Benjamin Zolf.
