Health & Ethics
THAT health is a fundamental right of the people is well-recognised. But
resource crunch comes in the way of providing health services to all people. A nation must
have a health service delivery system that is accessible and affordable to the poor. The
limited resources that we have must be utilised in the most optional manner. How to do
that is a question whose answer lies often in well-conducted health research. Health
scientists, public health experts and Nepal's health research body, the National Health
Research Council (NHRC), must direct their research skills into finding out the most
cost-effective system of health care delivery. That research is needed is indisputable.
But health research is not always a simple cut-and-dried research like some socio-economic
studies are. Health research works have to be guided, more than anything else, by a
stringent set of ethics. Nepal as yet does not have a national health research ethics. The
NHRC has been slow to recognise that the country needed to have such guidelines. It seems
it has woken up now. Currently, it is drawing up a National Ethical Guidelines for Health
Research. In order to discuss the draft of the guidelines, it started a four-day
consultative meeting Monday which was inaugurated by Prime Minister Girija Prasad Koirala
who cautioned that health research should be guided by certain ethical principles and that
research should do no harm to the people it aims to ultimately benefit. In the past, there
have been controversies kicked off by health research that were seen not to have been
designed with that "no harm" policy. Recently, a research conducted by a foreign
organisation with a local partner in Lalitpur district had to be ultimately stopped as
there were serious questions directed at the way the research was being conducted. Such
things should not happen. It is against this backdrop that a set of national guidelines
that guide would-be health researchers how to conduct research with ethics at the heart of
it was overdue. As a speaker at the start of the consultative meeting said, an ethically
sound research with human beings include adequate disclosure of information prior to
voluntary consent, a favourable benefit-risk ratio and a fair distribution of burden and
benefits of research. These parameters, it is hoped, would be adhered to in the future
health research in Nepal, according to the forthcoming guidelines, so that health research
is "healthy".
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