Climate change and public health research ethics in low- and middle-income countries: A systematic literature review

IF 3.6

The journal of climate change and health Pub Date : 2026-05-01 Epub Date: 2026-04-29 DOI:10.1016/j.joclim.2026.100653

Majid Ali Tahir , Hafiz Suboor ul Hassan , Omera Naseer , Hassan Nawaz Lalee , Mumtaz Ali Khan , Nadia Nisar , Rabyia Zaheer , Wasay Munir , Shahbaz Ahmad Zakki , Ijaz ul Haq , Mazhar Nisar , Muhammad Ishaq , Izza Shuaib , Muhammad Salman

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Abstract

Background

Climate change poses significant public health challenges, particularly in low- and middle-income countries (LMICs), where ethical considerations are critical for equitable research. This systematic review synthesizes existing knowledge on climate change, public health, and research ethics in LMICs to identify key themes and research gaps.

Methods

A systematic search of PubMed and Medline (2001–2024) identified 643 articles, of which 86 met inclusion criteria. Studies were thematically synthesized, and keyword co-occurrence mapping and cluster analysis were used to explore associations between health and ethical themes. Data visualization, including keyword co-occurrence mapping and hierarchical clustering, was performed to highlight thematic associations and research gaps.

Results

Out of 86 studies 53.48 % were were published after the year 2022. Research is predominantly focused on mortality, outbreaks, and epidemics, mostly associated in ethical contextss such as community rights and beneficence. Associations were strongest between “Rights and Liberties” and “Community Rights.” However, ethical considerations were inconsistently integrated, with equity and justice particularly underrepresented in studies on non-communicable diseases and maternal health. Most of the studies relied on secondary data, reflecting gaps in localized, context-specific evidence. Geographically, South Asia and parts of Africa were represented, while Southeast Asia and Latin America were markedly underrepresented despite major climate-related health risks.

Conclusion

This review highlights increasing research interests in climate change and health but identifies gaps in ethical frameworks and LMIC representation. Strengthening research agendas with context-specific ethical considerations and prioritizing vulnerable populations is essential for equitable health responses towards climate change in resource-limited settings.

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中低收入国家的气候变化和公共卫生研究伦理：系统的文献综述

气候变化带来了重大的公共卫生挑战，特别是在低收入和中等收入国家（LMICs），在这些国家，伦理考虑对公平研究至关重要。本系统综述综合了关于中低收入国家气候变化、公共卫生和研究伦理的现有知识，以确定关键主题和研究差距。方法系统检索PubMed和Medline（2001-2024）数据库643篇文献，其中86篇符合纳入标准。研究按主题进行综合，使用关键词共现映射和聚类分析来探索健康和伦理主题之间的关联。数据可视化，包括关键词共现映射和分层聚类，以突出主题关联和研究差距。结果86篇文献中53.48%发表于2022年以后。研究主要集中在死亡率、疾病暴发和流行病方面，主要与社区权利和慈善等伦理背景有关。“权利与自由”和“社区权利”之间的联系最为紧密。然而，伦理方面的考虑不一致，在关于非传染性疾病和孕产妇保健的研究中，公平和正义的代表性特别不足。大多数研究依赖于二手数据，反映出局部的、特定背景的证据存在差距。从地理上看，南亚和非洲部分地区的代表人数较多，而东南亚和拉丁美洲的代表人数明显不足，尽管存在与气候有关的重大健康风险。本综述强调了气候变化与健康的研究兴趣日益增加，但指出了伦理框架和低收入和中等收入国家代表性方面的差距。加强具有具体背景的伦理考虑的研究议程并优先考虑弱势群体，对于在资源有限的情况下公平地对气候变化作出卫生反应至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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