Considering Risks to Researchers and Staff in Low-Resource Settings during Public Health Crises: A Proposed Conceptual Model

Human subjects research protections have historically focused on mitigating risk of harm and promoting benefits for research participants. In many low-resource settings (LRS), complex and often severe challenges in daily living, poverty, geopolitical uprisings, sociopolitical, economic, and climate crises increase the burdens of even minimal risk research. While there has been important work to explore the scope of ethical responsibilities of researchers and research teams to respond to these wider challenges and hidden burdens in global health research, less attention has been given to the ethical dilemmas and risk experienced by frontline researcher staff as they perform research-related activities in LRS. Risks such as job insecurity, moral distress, infection, or physical harm can be exacerbated during public health crises, as recently highlighted by the COVID-19 pandemic. We highlight the layers of risk research staff face in LRS and present a conceptual model to characterize drivers of this risk, with particular attention to public health crises. A framework by which funders, institutions, principal investigators, and/or research team leaders can systematically consider these additional layers of risk to researchers and frontline staff is an important and needed addition to routine research proposals and protocol review.

Automated summary

Human subjects research protections primarily focus on minimizing harm and maximizing benefits for participants. However, in low-resource settings, complex challenges such as poverty, geopolitical unrest, and climate crises increase the burdens of research. While there has been attention given to ethical responsibilities in global health research, less consideration has been given to the risks faced by frontline research staff in these settings, especially during public health crises. This article highlights these risks and proposes a framework for systematically addressing them in research proposals and protocol reviews, involving funders, institutions, principal investigators, and research team leaders.