The APRU SDG Education for Global Citizenship (APRU SDG4GC) is an intercultural, transdisciplinary, and interactive programme that fosters global citizenship among students from 60 universities in 20 economies across the Pacific Rim. Co-designed by six core partner universities in collaboration with the United Nations (UN), the program builds knowledge of global issues and global literacy among students.
The 2024 APRU SDG4GC delves into various dimensions of well-being, encompassing social, cultural, emotional, spiritual, intellectual, mental, physical, and economic aspects. It spans a wide range of critical topics, such as mental health, health equity, health care systems and ethics, healthy ageing, and global health. By leveraging insights from multiple disciplines and practices, the programme aspires to cultivate a strong sense of global citizenship, contributing to the development of resilient global communities. The programme anticipates the participation of undergraduates from various APRU member Universities. The overarching theme of the APRU SDG4GC 2024 programme is “Shaping the Future of Health and Wellbeing”.
Under the APRU SDG4GC 2024 programme, a forum titled ‘Ethics in global health interventions’, was conducted at the Auditorium, Mercu Alam Bina, Universiti Malaya, on 24 July 2024 (Wednesday), from 2.00 pm to 4.30 pm. This forum was designed to delve into the complex ethical challenges in global health interventions. It aimed to shed light on the multifaceted ethical considerations crucial to the design and implementation of health initiatives across diverse cultural landscapes.
The forum fostered a comprehensive understanding among participants of the ethical quandaries faced in this field. Emphasis was placed on identifying ethical dilemmas, appreciating the variety of cultural perspectives, and promoting ethical practices that lead to equitable and sustainable health outcomes worldwide. Participants were encouraged to critically engage with these topics, sharing their reflections on culturally sensitive issues. The ultimate objective was to equip future global health leaders with the ethical insights and skills needed to effectively contribute to advancing global health equity, aligning with the Sustainable Development Goals (SDGs).
Agenda
| Time | Session |
| 2.00 pm – 2.10 pm | Opening remark: Welcome by moderator and introduction to the forum’s objectives and the significance of the day’s topic. |
| 2.10 pm – 2.50 pm | Keynote lecture Speaker: Dr Tharani Loganathan Topic: “Ethics of Vaccines in the Age of Global Health” |
| 2.50 pm – 2.55 pm | Break |
| 2.55 pm – 3.55 pm | Panel Discussion Brief introduction of panels by the moderator. Main Discussion: Each panellist presents their views on pre-defined topics related to the forum’s theme. Q&A Session: Audience members engage with panellists through questions and discussions. |
| 3.55 pm – 4.15 pm | Closing Remarks Summary of key insights from the discussion. Thank you note to panellists and participants. Information on follow-up materials or sessions, if any. |
| 4.15 pm – 4.30 pm | Networking |
| 4.30 pm | Adjourned |
The keynote lecture, “Ethics of Vaccines in the Age of Global Health,” centred on the COVID-19 pandemic as a case study for ethical issues in global health. It highlighted health inequity, with unequal vaccine availability, and the power dynamics between high-income and low- to middle-income countries. High-income countries engaged in bulk purchasing, while manufacturing hubs were limited, with examples like India producing vaccines, Africa lacking local manufacturers, and China producing its own vaccines. These points underscored the ethical complexities in global health interventions.
Panellists
Public Health Policymaker
Datuk Dr Kalaiarasu M. Peariasamy, Former Director, Institute for Clinical Research at National Institutes for Health, Malaysia. Dr Kalai boasts significant experience in community healthcare and public health initiatives. With a strong track record in tackling healthcare challenges, particularly among marginalised communities in Malaysia, Dr Kalaiarasu is a leading figure in the implementation and advocacy of accessible and equitable healthcare interventions.
His expertise provides invaluable insights into the practicalities of delivering health services to diverse populations, ensuring that the forum benefits from a comprehensive perspective on achieving health equity.
Advocator for Migrant and Refugee Population
Dr Susheela Balasundram, Associate Public Health Officer, United Nations High Commissioner for Refugees (UNHCR). Dr Susheela brings a profound depth of expertise in addressing health issues among the world’s most vulnerable populations. With her role at the UNHCR, Dr Susheela is at the forefront of developing and implementing health strategies that cater to refugees and asylum seekers, ensuring that these communities have access to essential healthcare services.
Her work, rooted in compassion and driven by ethical principles, focuses on creating sustainable health interventions that respect the dignity and rights of all individuals. Dr Susheela’s extensive experience in navigating the complex health challenges faced by displaced populations offers critical insights into the ethical considerations necessary for global health interventions.
Public Health Researcher
Associate Professor Dr Tharani Loganathan, Associate Professor at Universiti Malaya’s Faculty of Medicine, has 17 years of experience in Public Health and Health Economics, focusing on Primary Health Care and health policy. An experienced lecturer and a 2017 Equity Initiative Fellow, she specializes in health systems research, aiming to advance Universal Health Coverage.
Dr Tharani’s notable work includes economic evaluations of health interventions and advocating for migrant healthcare access in Malaysia. Her expertise in equitable health policies and interventions enriches her contribution to health equity discussions, particularly in Southeast Asia.
Moderator
The session was moderated by Dr Nishakanthi Gopalan. She is a Senior Lecturer with the Medical Humanities and Ethics Unit (MedHEU), Faculty of Medicine, Universiti Malaya (UM).
Relevant issues/topics for forum discussion.
The following issues and topics are relevant to the ethics of global health interventions, however in light of the limited time, we will focus on the first three which are key issues.
- Justice and equitable resource allocation
Equitable access to healthcare resources, treatments, and vaccines across different countries and among various populations within countries, especially marginalized and vulnerable groups. Ethical dilemmas often arise concerning the fair distribution of resources in global health interventions. Determining who receives access to healthcare resources, medications, or treatments raises questions of justice and fairness.
- Informed consent and autonomy
Respecting the autonomy of individuals and communities by ensuring that they have adequate information to make informed decisions about participating in health interventions. Addressing issues of informed consent is crucial. In global health interventions, especially in communities with varying literacy levels or different cultural perceptions of medical interventions, ensuring that individuals have a thorough understanding of the intervention and the right to accept or decline it is essential.
- Power dynamics and collaboration
Addressing power dynamics requires a concerted effort to foster genuine partnerships that respect the sovereignty and priorities of LMICs, ensuring that interventions are contextually relevant and co-created with local stakeholders. Ethical considerations involve equitable partnerships and power dynamics between international organizations, local governments, NGOs, and communities. Ensuring that interventions are collaborative and empower local communities rather than perpetuating dependency is vital.
- Long-term sustainability and impact
Ethical discussions should include considerations for the sustainability of interventions. Assessing whether interventions create lasting positive impacts or inadvertently harm the community in the long run, is crucial.
- Accountability and transparency
Global health interventions need accountability measures to ensure transparency in decision-making processes, resource allocation, and the reporting of results. Ethical standards require that organizations be transparent about their intentions, methodologies, and outcomes.
- Evaluation and ethical research practices
Ethical research practices encompass conducting evaluations with sensitivity to cultural beliefs, ensuring confidentiality, and respecting privacy rights. It also involves disseminating findings responsibly and considering potential impacts on communities.
- Navigating global and local health priorities
Ethical dilemmas can arise when global health agendas conflict with local health priorities. Balancing these priorities ethically involves engaging communities and aligning interventions with their needs and aspirations.
- Continuous ethical reflection and adaptation
Ethical considerations in global health interventions are dynamic. Encouraging continuous reflection, adaptation, and responsiveness to changing cultural, social, and political contexts is essential for ethical practice.
The above topics of discussion collectively address the ethical complexities inherent in global health interventions, emphasising equitable practices, community engagement, sustainability, and the continual reflection necessary for ethical decision-making and action.
This write-up was prepared by Associate Professor Dr Tharani Loganathan from the Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya.
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