Participation in medical research as a resource-seeking strategy in socio-economically vulnerable communities: call for research and action

The freedom to consent to participate in medical research is a complex subject, particularly in socio-economically vulnerable communities, where numerous factors may limit the efficacy of the informedconsent process. Informal consultation among members of the Switching the Poles Clinical ResearchNetwork coming from various sub-Saharan African countries, that is Burkina Faso, The Gambia,Rwanda, Ethiopia, the Democratic Republic of Congo (DRC) and Benin, seems to support thehypothesis that in socio-economical vulnerable communities with inadequate access to health care,the decision to participate in research is often taken irrespectively of the contents of the informedconsent interview, and it is largely driven by the opportunity to access free or better quality care andother indirect benefits. Populations’ vulnerability due to poverty and/or social exclusion shouldobviously not lead to exclusion from medical research, which is most often crucially needed toaddress their health problems. Nonetheless, to reduce the possibility of exploitation, there is the needto further investigate the complex links between socio-economical vulnerability, access to health careand individual freedom to decide on participation in medical research. This needs bringing togetherclinical researchers, social scientists and bioethicists in transdisciplinary collaborative research effortsthat require the collective input from researchers, research sponsors and funders