Ethics and health research priority setting: a narrative review.

ABSTRACT

This narrative review aims to describe current practice and ongoing discussions in the academic literature regarding ethics and health research priority setting. It begins with some preliminary distinctions regarding types of research priority setting. It then gives some background on current practice with respect to formal research priority setting exercises, including summaries of The Ad Hoc Committee on Health Research method, the Child Health and Nutrition Research Initiative (CHNRI) method, the Combined Approach Matrix (CAM), the Delphi method, the Essential National Health Research (ENHR) strategy for priority setting, and the James Lind Alliance (JLA) framework. The majority of the paper reports the results of a literature review covering specifically ethical issues under the thematic headings of process criteria, substantive criteria, global justice, the obligations of specific actors, and research topics. It closes with some summary thoughts about apparent gaps and directions for future investigation.

More health research is needed to develop new treatment and prevention options for many diseases. But there are limited resources available to support health research. This means that difficult decisions must be made about how to allocate those resources among competing important projects. Making these decisions is called priority setting. Dr. Joseph Millum reviewed what has been published on the ethics of health research priority setting. First, he compared different methods that have already been developed to help organizations and governments set priorities. Second, he identified themes in the current discussions about ethics and priority setting. Some important themes included how stakeholders should be included in priority setting exercises; what would be a fair allocation of research resources; global disparities in health research; and how different types of funder should think about their obligations. The results of this review will inform guidance from the World Health Organization on how to incorporate ethics into health research priority setting.