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The PLoS Medicine Debate The PLOS Medicine Debate discusses important but controversial issues in clinical practice, public health policy, or health in general. Debates will be commissioned from two or more authors with differing points of view.

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Should Data from Demographic Surveillance Systems Be Made More Widely Available to Researchers?

  • Daniel Chandramohan,
  • Kenji Shibuya,
  • Philip Setel,
  • Sandy Cairncross,
  • Alan D Lopez,
  • Christopher J. L Murray,
  • Basia Żaba,
  • Robert W Snow,
  • Fred Binka
  • Published: February 26, 2008
  • DOI: 10.1371/journal.pmed.0050057

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Colonialism, dispossession and the moral argument for sharing DSS data?

Posted by plosmedicine on 31 Mar 2009 at 00:22 GMT

Author: Daniel Reidpath
Position: Professor of Public Health
Institution: Centre for Public Health Research, Brunel University
E-mail: daniel.reidpath@brunel.ac.uk
Additional Authors: Pascale Allotey
Submitted Date: February 29, 2008
Published Date: March 4, 2008
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

When a group possesses a resource which they do not have the capacity to exploit, there are essentially three paths available. The first path is to let the resource lie idle until the group naturally acquires the capacity to exploit it. This path is unacceptable when the technology for exploiting the resource is well known, and the public good that would flow from exploitation would be widely received. The second path is for the group to be closely supported by others, so that they can actively develop the capacity to exploit the resource themselves. The last path is for others to assert a moral right to the resource and try and seize it. This moral right is based on the identification of (i) the public good associated with the exploitation of the resource, and (ii) the original owner's lack of capacity to exploit the resource. This last line of reasoning epitomises colonialism. Variations of it have been used successfully over the last 500 years to justify dispossession. The argument for dispossession may appear particularly disingenuous if it is a moral one, and substantial competing interests are undeclared.

The DSS data are rich; the kinds of questions that can be answered with them are interesting, important, and their potential value to population health is substantial. Properly exploited, these data are likely drive the science, not simply respond to existing science. In academic circles they are as much a bountiful resource as they are a public good. Grant money will flow to institutions seeking to analyse the data; and there are significant opportunities to dominate areas of international health if one were well positioned to exploit access. We know from the way that grant money flows that this means that Northern institutions will receive by far the greatest rewards from data “sharing”.

Chandramohan et al. have explained that the DSS sites are not able to exploit their own data. The argument for seizure has been advanced. The second path, of serious engagement in a process of capacity building was given, at best, muted discussion. The reality is that no benefits to population health will derive simply from the sharing of the data. The benefits occur when the data are appropriately analysed and the results disseminated. This does not require data sharing, it could work just as well on the basis of capacity building: within the DSS sites, INDEPTH, and the local academic communities. In other areas there have been serious attempts to advance models of shared engagement and collaboration between North and South [1]. The WHO intergovernmental working group on public health, innovation and intellectual property stressed the importance of promoting the active participation of developing countries in research priority setting and innovation [2]. Colonial arguments for resource exploitation are probably not the best way to advance this. The arguments for data sharing would also be stronger if everyone was happy to share their data [3], rather than holding one small group up for public shame. Although most like the idea of sharing data, most have also been guilty of not publicly archiving it. Indeed it has required major intervention on the part of funding agencies to ensure the archiving of data. That requirement is also predicated on substantial ongoing support to research institutions.

Alluvial data such as the DSS are extremely attractive to researchers. Mining it will realise nuggets of gold for some, and with luck the refined products will benefit populations, particularly those populations that have literally given of their blood to create the data. This call for the sharing of DSS data is about power and money in global health and the use of a moral argument to advance this goal is highly suspect. If capacity strengthening were supported within the DSS sites, the public benefit of the data would be realised – but perhaps not by us in the North, except as colleagues.

[1] Centre for Public Heath Research (2007). Applied social sciences for public health (ASSPH): Higher degree training for implementation research on tropical diseases. Report of the Special Programme for Research & Training in Tropical Diseases (TDR) Report No. TDR/RCS/07.1. Geneva: World Health Organization.
http://www.who.int/tdr/pu...

[2] IGWIG (2007). Draft global strategy and plan of action on public health, innovation and intellectual property. Report No. A/PHI/IGWG/2/2 Add.1. Geneva: World Health Organization http://www.who.int/gb/phi...

[3] Reidpath DD, & Allotey P. (2001). Data sharing in medical research: an empirical investigation. Bioethics; 15(2):125-34.

Competing interests declared: We have a very strong interest in finding appropriate ways of engaging with DSS sites in the analysis of their demographic surveillance data.