Forms of benefit sharing in global health research undertaken in resource poor settings: a qualitative study of stakeholders' views in Kenya

We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups.The range of benefits articulated by stakeholders addresses both micro and macro level concerns for justice by for instance, seeking to engage with interests of those facilitating research, and the broader systemic issues that make resource poor settings vulnerable to exploitation. We interpret these views to suggest a need for global health research to engage with current crises that face people in these settings as well as the broader systemic issues that produce them.Global health research should provide benefits that address both the micro and macro level issues of justice in order to forestall exploitation. Embracing the two is however challenging in terms of how the various competing interests/needs should be balanced ethically, especially in the absence of structures to guide the process. This challenge should point to the need for greater dialogue to facilitate value clarification among stakeholders.The last decade has witnessed increased health related research in resource poor settings mainly in Africa, Asia and South America [1]. While this increase is a positive development in addressing neglected diseases [1-4], it also ushered in new concerns over potential for exploitation through unfair distribution of risks and benefits among the parties involved [5-10]. Several strategies to address these concerns have been promoted in the ethics literature including calls for universal standards of care [11-13], reasonable availability of proven interventions [14-18] and more recently, promotion of the overall social value of research [19]. Closely related to the idea of promoting the social value of research is the determinatio