Showing posts with label global south. Show all posts
Showing posts with label global south. Show all posts

Monday, January 15, 2018

How can we ensure that the global south benefits from and contributes to the field of bioethics?



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 bioethics journals such as this, as well as contribute constructively to them.


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 bioethics journal 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.



It is fortuitous that the next World Congress of the International Association of Bioethics will be held in New Delhi 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.

















[1]Schuklenk U. 2015. Fighting Imaginary Enemies in Bioethics Publishing. Bioethics 29(8): ii-iii. Schuklenk U, Magnus D. 2017. Justice and Bioethics: Who Should Finance Bioethics Publishing? AJOB 17(10): 1-2.
[2] http://www.gfbr.global/about-the-gfbr/ [Accessed 28 November 2017].
[3] http://www.gfbr.global/forum-meetings/ [Accessed 28 November 2017].
[4] http://www.iab2018.org [Accessed 28 November 2017]

Tuesday, August 11, 2015

Fighting Imaginary Enemies in Bioethics Publishing

The Australia based Journal of Bioethical Inquiry has recently published two papers[1],[2] by the same group of authors. One of these papers was a Letter to the Editor, hence it is not entirely clear whether or not it was peer reviewed. Let’s call this paper Paper One. It was published in 2013. Another paper was published in 2015, the journal mentions that this paper was externally peer reviewed. Let’s call this paper Paper Two. Each of these papers targets editorial and commercial practices of major English language bioethics journals or their publishers. Both papers are Open Access at the time of writing, I encourage you to take the time to read them for context. 

This blog entry responds to both papers. My primary objective is to show that each paper fails in each mission.

Let us start with Paper One. The authors aimed here to investigate whether bioethics journals are variously ‘institutionally racist’ or ‘editorially biased’. They tried to achieve this by using the following method. They investigated the composition of major journals’ Editorial Boards – no content analysis was undertaken as part of this research project. The authors of this paper then grouped Editorial Board members into various categories according to where they live in terms of their countries’ rankings in the Human Development Index.  Surprisingly – and evidently unjustifiably so - this paper then proceeded to grouping the Editorial Board members into three categories (the HDI offers four[3]). It grouped Editorial Board members into Very High and High HDI, Medium HDI and Low HDI. The paper then notes indignantly that the vast majority of Editorial Board members belong into the first group of HDI countries. It turns out, by grouping Very High and High HDI countries into one category, these authors created arguably artificially the result required for their scathing critique. Unsurprisingly they found that the vast majority of Editorial Board member hail from countries that are either Very High or High HDI. However, a closer look into these categories reveals that the following countries can be found in their amalgamated first category: Germany and Libya, Mexico and Switzerland, Iran and the United States, Sri Lanka and Liechtenstein, and so on and so forth. Quite clearly, many countries belonging to the global south were unjustifiably folded into the global north category to achieve the desired outcome, namely blameworthy bioethics journals having an insufficient number of Editorial Board members hailing from the global south.

As mentioned already, Paper One also failed to undertake an actual content analysis. Bioethics established some 15 years ago its own specialised developing world focused companion journal called Developing World Bioethics. In case you wonder whether that meant shunting articles aside into a global south niche category, nothing could be further from the truth.  Developing World Bioethics has currently the second highest Impact Factor of bona fide bioethics journals, as measured by the Institute for Scientific Information. All of this escaped the authors of this paper, because they were primarily concerned with the composition of the Editorial Board of Developing World Bioethics, an Editorial Board they happily castigated for having insufficient representation from the global south, because by these authors’ definition, for instance the journal's Mexican and Sri Lankan Editorial Board members don’t quite count as representatives of countries of the global south.

Paper Two proceeds in this methodological vein. The focus is on purportedly greedy publishers and general bioethical imperialism. Like in the first paper, hyperbole remains a strong selling point of these authors. The target this time are paywalls. Most journals in our field are subscription based journals, which is partly a function of the fact that most authors publishing in bioethics journals do not have access to the funds required to publish in pay-for-play Open Access journals. That also means that access to the content we publish is restricted to subscribers, typically subscribing university libraries. Individual articles are available for sale to people interested in purchasing them. Paper Two then proceeds to investigate the question of whether mainstream or leading bioethics journals are available to academics working in the global south. This actually is an important issue and as an Editor of Bioethics and Developing World Bioethics I have always cared passionately about affordable or complimentary access for academics working in the global south. Leading academic publishers, including Wiley-Blackwell, the publisher of Bioethics, are founding members of myriad access schemes aimed at ensuring that academics in the global south have access to the content we publish. Knowledge is power after all. Among these schemes is HINARI, a scheme administered by the World Health Organisation. There are other schemes, AGORA and OARE among them.  

The authors of Paper Two apparently investigated whether leading English language bioethics journals are available via HINARI. That is a fair enough approach, HINARI covers health related research outputs, so Bioethics and Developing World Bioethics should be available thru HINARI, if at all. Paper Two reports erroneously that neither Bioethics nor Developing World Bioethics are available via HINARI. The authors make the same erroneous claim about other major journals in the field, including but not limited to ajob – American Journal of Bioethics, jme – Journal of Medical Ethics, Journal of Clinical Ethics, Cambridge Quarterly of Healthcare Ethics, Journal of Law, Medicine and Ethics, Journal of Medicine and Philosophy, Journal of Bioethical Inquiry.

It is worth noting here that the authors of Paper Two did not bother confirming with me or my fellow editors, or with our publishers, whether these journals are really not made available free of charge or at very low cost to academic institutions in LMIC countries. Apparently, confirming with the editors of these journals, or their publishers, that these bioethics journals really are not available free of charge to authors in the global south was too onerous for the campaigning authors of Paper Two.  It turns out, not only are Bioethics and Developing World Bioethics available via HINARI, but so are our esteemed competitors, namely all of the journals I mentioned above.[4] There is some irony in the fact that the current Editors of the Journal of Bioethical Inquiry were unaware of the availability of their very own journal via HINARI. It is doubtful that they meant to stand idle by while authors slander their journal in the pages of their own publication.

In light of these facts, I strongly encourage you to read Paper Two again. The anti-imperialist emperors look pretty naked to me. It’s a good example for the view that good intentions are not good enough. This research output reportedly underwent peer review, which goes to show that while peer review might be the best quality control mechanism there is, it is far from perfect. Paper Two goes on at great length about the purported profit motives of greedy publishers and how that impacts access to scientific information for researchers in the global south, alas its starting premise turns out to be false.
One would hope the Editors of the Journal of Bioethical Inquiry retract this particular peer reviewed output at their earliest possible convenience.

UDO SCHUKLENK




[1] Subrata Chattopadhyay , Catherine Myser and Raymond De Vries. 2013. Bioethics and Its Gatekeepers: Does Institutional Racism Exist in Leading Bioethics Journals? Journal of Bioethical Inquiry DOI: 10.1007/s11673-012-9424-5 [Paper One]
[2] Subrata Chattopadhyay, Catherine Myser, and Raymond De Vries. 2015. Imperialism in Bioethics: How Policies of Profit Negate Engagement of Developing World Bioethicists and Undermine Global Bioethics. Journal of Bioethical Inquiry DOI: 10.1007/s11673-015-9654-4 [Paper Two]
 [3] UNDP. 2014. Human Development Report 2014.  http://hdr.undp.org/en/content/human-development-report-2014 - The interested reader might find these graphics displayed at Wikipedia informative. https://en.wikipedia.org/wiki/List_of_countries_by_Human_Development_Index [Accessed August 11, 2015]
[4] A complete list of accessible journals can be found here, http://extranet.who.int/hinari/en/journalList_print.php?all=true . [Accessed August 11, 2015] Consider saving the large file as a CSV file (follow the link offering that option). You will then download a MS Excel file that can easily be searched for journal titles that you are interested in.

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