Florencia Luna

This response analyses the discussion by Parsa-Parsi et al on the 2024 revision of the Declaration of Helsinki (DoH). While their narrative reflections on some of the internal processes behind the revision are, for the most part, appropriately nuanced and illuminating, I argue that they underestimate the conceptual and practical significance of the new approach to the concept of vulnerability and how this approach connects to the Council for International Organizations of Medical Sciences (CIOMS) 2016 Guidelines. Drawing on the idea of ‘layers of vulnerability’, I highlight how vulnerability is often contextual, dynamic and cumulative, and how this view avoids essentialising entire groups (such as pregnant persons) while clarifying when and how people facing multiple vulnerabilities can be ethically included in research with appropriate protections. I further argue that there are similarities between DoH and CIOMS and that a closer alignment with CIOMS in the interpretation of the DoH offers a more coherent and practically useful framework for research ethics committees and researchers.

Global discussions around the risks, benefits and governance of solar radiation modification (SRM) in the climate change response portfolio are accelerating, but the topic remains nascent in Latin America and the Caribbean (LAC). In 2023, a US start-up (Make Sunsets) performed a small-scale, non-research deployment of SRM in Baja California, Mexico, without prior permission or community engagement. Their actions prompted Mexico to announce its intention to ban SRM experimentation, underscoring the need for governance to prevent irresponsible practices that could discredit legitimate research. We perform an empirical and ethical analysis of the landscape of academic discussions and media coverage on SRM in the LAC region, focusing on the Make Sunset case. Our analysis leads us to three conclusions: first, a lack of regulations in LAC that fosters mistrust, fuels perceptions of neo-colonialism and restricts potentially valuable and responsible research; second, we argue that the theatrical Make Sunsets case is not ethically justified in light of the diversity of risks associated with it; third, we offer foundational, participatory recommendations to promote effective, transparent and sustainable governance of SRM, including LAC in global conversations.

The equitable distribution of vaccines has emerged as a major issue in pandemic treaty negotiations following the COVID-19 pandemic. Failures in global procurement and distribution have been attributed to ineffective allocation mechanisms and a general lack of cooperation. More than four years after the onset of the pandemic, this article presents a perspective on how to achieve a more equitable global allocation of medical supplies for future pandemics, drawing on the distinction between "ideal" and "non-ideal" schemes of cooperation. We will consider two perspectives: first, improving solutions under current, non-ideal circumstances where non-cooperation dominates in the short and medium term, given the challenges of an uncooperative international landscape; and second, implementing long-term policies that aim at ideal proposals, assuming an increased level of cooperation in the future. This evaluation will address the past successes and shortcomings of the COVAX facility, and also the negotiations on a pandemic treaty led by the World Health Organizations, to better address future pandemics. We will discuss key issues that ought to be of central concern when moving towards more cooperative solutions in the future.

Ten years have passed since the last regional assessment of the state of Fogarty International Center-funded research ethics education and challenges facing research ethics in Latin America and the Caribbean basin. Program directors and faculty from four international research ethics education programs met in Spring 2024 to discuss their progress, challenges, and future priorities. The themes that emerged from these discussions were the structural difficulties faced by regional ethicists, the use of pedagogical innovations to mitigate different barriers faced by fellows, and the need to anticipate future challenges for the region including climate change.

Introdução ao Dossiê Justiça Pandêmica Global