Jerome Amir Singh

Grand challenges in global health : community engagement in research in developing countries.

The authors argue that there have been few systematic attempts to determine the effectiveness of community engagement in research.

XDR-TB in South Africa: No Time for Denial or Complacency

Singh and colleagues discuss the threat to regional and global public health posed by XDR-TB in KwaZulu-Natal, and propose new measures to control the outbreak.

International AIDS Society global scientific strategy: towards an HIV cure 2016

Antiretroviral therapy is not curative. Given the challenges in providing lifelong therapy to a global population of more than 35 million people living with HIV, there is intense interest in developing a cure for HIV infection. The International AIDS Society convened a group of international experts to develop a scientific strategy for research towards an HIV cure. This Perspective summarizes the groups strategy.

Research Ethics Review in Humanitarian Contexts: The Experience of the Independent Ethics Review Board of Médecins Sans Frontières

Doris Schopper and colleagues describe the functioning of the Médecins Sans Frontières independent ethics review board and the framework used for ethics review, and discuss challenging ethical issues encountered by the board since its inception.

Grand Challenges in Global Health: Engaging Civil Society Organizations in Biomedical Research in Developing Countries

The authors discuss the different types of civil society organizations, their role in biomedical research, and the advantages and challenges of working with them.

Research protocols: Waiving confidentiality for the greater good

Research protocols are usually kept confidential to protect intellectual and commercial interests. But secrecy can also hide deviations that affect the validity of results and threaten the integrity of medical research

Do human rights matter to health

Legal instruments and litigation as a way to enforce the rights to life and to health is a relatively new strategy that is increasingly common. We show how legal measures have been used to attain health and human rights with case examples from India and South Africa that resulted in large public-health benefits.

Enrolling adolescents in research on HIV and other sensitive issues: lessons from South Africa.

Jerome Singh and colleagues present the ethical and legal challenges surrounding the enrollment of adolescents in HIV observational studies and other types of sensitive research.

Designing research in vulnerable populations : lessons from HIV prevention trials that stopped early

Activist groups have been successful in promoting research and better treatment for people with HIV infection, but they can also stop trials if their views are not considered Methods to prevent HIV infection are one of the most urgent global public health needs.1 One novel method in clinical trials is pre-exposure prophylaxis with the antiretroviral drug tenofovir. The trials have, however, been criticised by activist groups, citing human rights, ethical concerns, and a lack of community involvement.2 This opposition and media coverage has stopped two trials in Cambodia and Cameroon and threatens the stability of planned and recruiting trials among intravenous drug users in Thailand and other developing nations. The issues raised by activists, academics, and the research community highlight the poor communication between these stakeholders and the need for mutual understanding of values. The differences threaten to undermine the progress of prevention trials and ultimately affect the most important stakeholders, those who are at risk.3 This protest at the 2004 International AIDS Society Conference helped stop the Cambodian tenofovir trialCredit: STR/AFP/GETTY IMAGES ### Cambodia The first randomised trial planned to assess the safety and efficacy of prophylactic tenofovir was in Phnom Penh, Cambodia. The study, funded by the US National Institutes of Health and the Bill and Melinda Gates Foundation, planned to recruit 960 sex workers and was led by researchers from the United States and Australia.3 In July 2004, activists mounted the first large demonstration against the trial at the Gilead booth at the International AIDS Society conference in Bangkok, a protest that captured the worlds media attention.4 This protest, as well as local remonstration to the Ministry of Health in Cambodia, resulted in the Cambodian prime minister closing the trial before recruitment. The government has provided no official reasons for its decision. The primary …

The Ethics of Nurse Poaching from the Developing World

Recruiting nurses from other countries is a long-standing practice. In recent years many countries in the developed world have more frequently recruited nurses from the developing world, causing an imbalance in the health services in often already impoverished countries. Despite guidelines and promises by developed countries that the practice should cease, it has largely failed to do so. A consortium of authors from countries that have experienced significant nurse poaching consider the ethical aspects behind this continuing practice.