Developing World Bioethics最新文献

{"title":"The Storm We Chose: Bundibugyo Virus, Preparedness Injustice, and the Pathogens We Decline to Fight.","authors":"Harpreet Dhillon, Shibu Sasidharan","doi":"10.1111/dewb.70058","DOIUrl":"https://doi.org/10.1111/dewb.70058","url":null,"abstract":"<p><p>The 2026 Ebola disease outbreak in the Democratic Republic of the Congo and Uganda is caused by Bundibugyo virus, a species for which, unlike Zaire ebolavirus, no licensed vaccine and no approved therapeutic exist. This commentary argues that this absence is not a misfortune of virology but a structurally produced injustice. Bundibugyo virus has been characterised since 2008, has caused lethal outbreaks, and was foreseeably capable of recurrence; more importantly, species-specific and cross-protective countermeasures were scientifically tractable more than a decade before, yet none reached licensure or field readiness. A recombinant vesicular stomatitis virus vaccine expressing the Bundibugyo glycoprotein - built on the same platform as the licensed Zaire vaccine - conferred complete protection in nonhuman primates in 2013; thirteen years later, no clinical-grade material existed when the outbreak began. The gap, we argue, lay not in what science could build but in what the system chose to finish, because preparedness investment concentrated on the species that threatened wealthier and more connected populations. Drawing on the framework of structural injustice and on the authors' prior field experience of concurrent epidemics in the DRC, we distinguish tragic scarcity from produced scarcity, answer the feasibility objection, and argue that closing the gap is an obligation rather than a charity.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ecological Adverse Selection Theory: A Structural Framework for Understanding Health System Inequity.","authors":"George Rugare Chingarande","doi":"10.1111/dewb.70064","DOIUrl":"https://doi.org/10.1111/dewb.70064","url":null,"abstract":"<p><p>The inverse care law-the persistent pattern whereby those with greatest health need receive the least care-has remained stubbornly intact for over fifty years. Despite universal health coverage commitments, health systems continue to concentrate disadvantage in hospitals and exclude the most vulnerable from effective care. This paper argues that we lack a mechanism-level explanation for why the inverse care law persists. It introduces Ecological Adverse Selection Theory (EAST) to fill this gap. Drawing on Akerlof's adverse selection framework, EAST argues that health systems are designed around implicit assumptions about patient capacities-stable housing, supportive caregivers, reliable transport-that are not universally held. When systems cannot distinguish patients who possess these capacities from those who do not, they inadvertently select for those who fit and select against those who do not. This process-structural sorting-operates in two dimensions: barriers to access for disadvantaged patients, and accumulation in hospitals when they do access care. EAST introduces three measurable constructs-Predictive Governance Intensity (PGI), Structural Scarcity Index (SSI), and Behavioural Diversity Distribution (BDD)-that enable empirical testing and accountability. Anchored throughout in a case from Manenberg, a Cape Town township where chronic gang violence and structural scarcity make visible the stakes of health system failure, the paper demonstrates how EAST contributes to structural approaches within public health ethics. The paper concludes by identifying the normative implications of EAST, including a capacities-first principle, and by situating EAST within the broader fields of public health ethics and global health ethics.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Research Participants' Perceptions and Attitudes Toward Research and Informed Consent in Myanmar.","authors":"Min Myat Thway, Haymun Oo, Aye Thida Win, Kyaw Swa Mya, Henry J Silverman","doi":"10.1111/dewb.70060","DOIUrl":"https://doi.org/10.1111/dewb.70060","url":null,"abstract":"<p><p>Informed consent is fundamental to ethical research involving human participants; however, little is known about the public's understanding of research participants' rights in Myanmar. This multicenter cross-sectional study examined patients' perceptions of medical research, attitudes toward information disclosure during the informed consent process, and recognition of participants' rights using a structured, self-administered questionnaire completed by 284 adult patients from three hospitals. Most respondents viewed medical research positively but demonstrated varying levels of trust and understanding of ethical protections. Higher educational attainment and household expenditure were associated with more favorable perceptions. Participants strongly supported transparent informed consent procedures and comprehensive information disclosure; however, awareness of complaint mechanisms and understanding of the rights to withdraw from research and confidentiality were limited. These findings identify priorities for strengthening ethics education, investigator communication, and institutional transparency to support meaningful informed consent and sustain public trust as health research continues to expand in Myanmar.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decolonizing Bioethics: A Normative Proposal for Contextual Universality.","authors":"Joshua Cedric Aquino Gundayao","doi":"10.1111/dewb.70057","DOIUrl":"https://doi.org/10.1111/dewb.70057","url":null,"abstract":"<p><p>Today, the call to decolonize bioethics is prominent, yet its meaning and practical implications remain contested. In this article, I distinguish between two models of decolonization-strong and soft-and offer a constructive path forward. Strong decolonization seeks to reject Western-rooted bioethical principles in favor of entirely local paradigms. Soft decolonization embraces a dialogical stance, critically engaging with universal principles rather than disregarding them. While this bridges universalism and relativism, it lacks a concrete normative framework, often resulting in paralysis. I fill this gap by proposing contextual universality as a necessary framework for soft decolonization. Contextual universality is ethical reasoning that sustains universality by grounding it in lived experiences and ethical traditions. By advancing this, this article articulates a principled ethical pluralism that avoids relativism and imperialism, reconstructing decolonization not as a rejection of universality but as a shared dialogical process of remaking it.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Consent and Compliance.","authors":"Carlos M Ardila","doi":"10.1111/dewb.70061","DOIUrl":"https://doi.org/10.1111/dewb.70061","url":null,"abstract":"","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distance, Disparity, and Duty: An Empirical Bioethical Analysis of Adolescent Sexual and Reproductive Health Access in Rural Uganda.","authors":"Noah Nyende","doi":"10.1111/dewb.70062","DOIUrl":"https://doi.org/10.1111/dewb.70062","url":null,"abstract":"<p><p>Disparities in adolescent sexual and reproductive health (SRH) access in rural Uganda are commonly attributed to geographic distance, resource scarcity, and service availability. These explanations, while important, remain ethically incomplete unless they also account for duty: the social and economic responsibilities that constrain adolescents' capacity to prioritise health needs. Drawing on empirical findings from a study of 408 adolescents aged 13-19 years in the Bugweri and Iganga districts of eastern Uganda, this paper integrates Rawlsian distributive justice and the capability approach to examine how distance, disparity, and duty interact to undermine adolescent reproductive agency. Structural equation modelling shows that positive health-seeking attitudes strongly predict anticipated future SRH utilisation; however, this relationship is attenuated among adolescents engaged in paid or subsistence work. Justice-oriented SRH policy must recognise duty as a structural moral burden and design work-sensitive interventions, such as mobile outreach and weekend clinics, that protect adolescents' capability for reproductive agency.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reciprocity and Narrative Agency in Index-Case Research: Ethical Reflections on Oropouche Vertical Transmission","authors":"Rui Bian,&nbsp;Weihao Cheng","doi":"10.1111/dewb.70018","DOIUrl":"10.1111/dewb.70018","url":null,"abstract":"","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"26 3","pages":"253-254"},"PeriodicalIF":1.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contributions of Community Advisory Board and Experience of Study Participants in TB/MDR-TB Clinical Trial Management in Addis Ababa, Ethiopia: A Qualitative Study","authors":"Yemisrach Seralegne,&nbsp;Abaraham G/Medihin,&nbsp;Ermiyas Hundito,&nbsp;Hawult Adane,&nbsp;Bizunesh Sintayehu","doi":"10.1111/dewb.70014","DOIUrl":"10.1111/dewb.70014","url":null,"abstract":"<div>\u0000 \u0000 <p>Community Advisory Boards (CABs), as a form of community engagement, provide an important mechanism to ensure that research aligns with community needs and priorities by representing broader community interests and guiding research accordingly. Tuberculosis (TB) and multidrug-resistant tuberculosis (MDR-TB) remain significant public health concerns, particularly due to resistance to key first-line anti-TB medications, and individuals affected by these conditions often face stigma and discrimination that hinder timely diagnosis and treatment adherence. Addressing these challenges requires community-driven strategies and improved access to health services, with CABs serving a central role in bridging gaps between researchers, healthcare providers, and affected communities. This study explored the contributions of CAB members in supporting TB/MDR-TB clinical trials, the challenges experienced by trial participants, and the strategies employed to address these challenges. Using an exploratory qualitative design, in-depth interviews were conducted with 17 stakeholders involved in TB/MDR-TB clinical trials, and data were analyzed using deductive thematic analysis. The findings highlight persistent stigma and discrimination, limited understanding of the role and functions of CABs, inconsistent budget allocation, reduced participation, and diminished CAB influence throughout the research process. The study underscores the essential role of CABs in enhancing community engagement in TB/MDR-TB clinical trials and emphasizes the need for greater awareness, advocacy, and institutional support to strengthen their contributions. Adequate and sustained funding, along with systematic planning and implementation, is critical for reinforcing CAB roles and promoting more ethical, inclusive, and responsive public health research practices in Ethiopia and other low- and middle-income countries.</p>\u0000 </div>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"26 3","pages":"164-171"},"PeriodicalIF":1.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Retractions Tell Us About Research Integrity in Mexican Academia","authors":"Karina Ordoñez-Torres,&nbsp;Sergio Litewka,&nbsp;Elizabeth Heitman","doi":"10.1111/dewb.70011","DOIUrl":"10.1111/dewb.70011","url":null,"abstract":"<div>\u0000 \u0000 <p>Research integrity remains a challenge to public trust in science around the world. Retracted scientific papers can erode the public's trust by raising doubt about the reliability of the published literature. This paper assesses article retractions involving Mexican authors through analysis of relevant data and retraction patterns. The study examines 55 retracted articles with Mexican corresponding authors, categorizing them by publication venue, article type, scientific area, reasons for retraction, and time between publication and retraction. The findings underscore core challenges to research integrity in Mexico and the need to strengthen both research training and research integrity initiatives in Mexican research institutions. The paper concludes with recommendations for contextually relevant strategies for Mexican academia to foster research integrity.</p>\u0000 </div>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"26 3","pages":"227-236"},"PeriodicalIF":1.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Affordability: The Bioethics of Inclusion and Justice in Advanced Therapies","authors":"Carlos M. Ardila,&nbsp;Anny Marcela Vivares-Builes,&nbsp;Eliana Pineda-Vélez","doi":"10.1111/dewb.70013","DOIUrl":"10.1111/dewb.70013","url":null,"abstract":"","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"26 3","pages":"249-250"},"PeriodicalIF":1.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}