Research & Innovation

FACE is actively engaged in research that explores and highlights the ethical dimensions of global health. Increasingly, barriers to progress are as much ethical as they are technical. But these two dimensions are inseparable. For example, new technology that can prevent adverse reactions associated with mass drug administration comes with an ethical obligation to use it – but how? Similarly, what is the ethical response when our global health interventions inadvertently cause harm? How do global health practitioners manage ethical challenges such as divided loyalties and moral distress? Some of our current research priorities are described below.

Please see our Publications for a comprehensive list of published materials related to this research. 

Neglected tropical diseases (NTDs) are diseases of neglected populations. A primary strategy to control or eliminate NTDs is periodic treatment of at-risk populations with single doses of medication, known as mass drug administration (MDA). MDA reaches more than 1 billion people each year. But to what extent does it reach those most in need? FACE is collaborating with colleagues at Stanford University, UC San Francisco, and the World Health Organization (WHO) to answer this question. Initial findings suggest that, in most countries, deworming is more common in children from wealthier families.

Many global health interventions yield massive, undeniable health benefits for populations. But they also sometimes result in harm to individuals. How do we weigh these benefits and risks? Who decides? When unintended harm does occur, who – if anyone – assumes responsibility? Our research on preventing and responding to unintended harm currently focuses on three main areas:

– Safety of mass drug administration for neglected tropical diseases

– How global health organizations acknowledge, respond to, and offer apology for unintended harm

– How “seeing the faces” of persons who have been harmed influences ethical decision-making.

Moral distress is an experience of serious moral compromise that occurs when we know the “right” thing to do but we are unable to act upon it, often for reasons related to organizational structure, role, or practices. Moral distress has been extensively studied in intensive care units of hospitals, but little is known about moral distress in global health. Our preliminary exploration of moral distress suggests that it affects global health practitioners at all levels – from community drug distributors to CEOs of major global health organizations.

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