Einstein Research Unit "Technologies in Global Health (ERU-TeGH)", Ethical monitoring of research processes (Work Package Ethics (WPe): Navigating Ethics - Guiding research processes and rationales in collaboration between researchers and users)

Global health technologies, such as vaccines, diagnostic tools and antibiotics, have shaped the last century of medical advances, leading to globally increased life expectancy and crucial improvements in quality of life. Technologies continue to develop at breath-taking speed and redraw the boundaries between life and death. However, in practice many technological advances cannot unfold their full potential due to limitations in availability and uptake. Technologies are embedded in a dense web of legal, ethical, infrastructural and societal requirements meant to ensure their utility and safe use. In the global health context, however, technologies are often needed in regions with weak infrastructures, governance and regulatory institutions, exposing them to the risks of misguided use and poor integration into health systems and everyday practices of health-seeking behaviors. The key challenge, then, is to identify who or what can safeguard, guide and foster the use of (new) technologies when these are often only loosely embedded in commercial and regulatory forces of markets, governmental bodies and consumer attitudes. The Einstein Research Unit (ERU) entitled “Technologies in Global Health” (TeGH) takes this challenge as a starting point and proposes to focus on the users of global health technologies. Putting users (end users, regulatory, governmental, commercial) center stage will allow to close the gap between the (imagined) potentials of novel technologies and the particularities of different contexts of use.
We propose a conceptual structure that focuses on the technology life-cycle, consisting of research & development (R&D), prototyping and implementation. In order to better understand users and their impact on the transferability of health technologies into new contexts for each of these building blocks, we have assembled a large, interdisciplinary team of academics. Together, we undertake three inter-and transdisciplinary, multi-sited case studies within the themes of vaccinology, anti-microbial resistance (AMR) and mental health. These have been co-created with co-principal investigators based at African research institutions. The scientific program of this ERU therefore conceptualizes user-technology relations in a finegrained manner, zooming in on the different stages of the life cycle of technological innovations in order to portray and compare various forms of user-involvements and user-requirements in the global health context. Working between the disciplines of sociology, medicine, engineering, immunology, microbiology, psychology, pharmacology, anthropology, health economics, policy and ethics, we develop innovative approaches using a repertoire of mixed-methods. Through this work, the ERU-TeGH will establish a new framework for user involvement in global health related programs.