What are the ethics of working in global health? Here is a reminder of the need to cultivate an ‘ethical sensibility’ as global health workers. Read more in the Personal Stories and have your say on the Forum.
Ethics is often not a big consideration when preparing for work in global health, with the assumption that global health is by definition ‘good’. However, there is an increasing recognition that it should be – especially since working in global health frequently involves enormous differentials in power, wealth and knowledge and huge potential for its abuse!

Ask anyone who has been involved in global health and you will hear stories of well-intentioned but over-zealous people getting themselves in trouble. Some mistakes are relatively benign, but others cause great damage – injuring patients, destroying community trust and undermining the goals of global health itself. Mistakes will happen to us all, but adhering to some simple ethical guidelines can go a long way to getting us by!
In 2010, the Global Health Gateway developed a set of ‘Ten Principles’. Here they are, let us know what you think.
1. Recognise that patients’ rights are universal.
Patients’ rights are based on the concept of fundamental human rights - as articulated in the 1948 Declaration of Human Rights and enshrined in international law. The World Health Organization (WHO) has achieved international consensus on a minimum standard: “that all patients have a right to privacy, to the confidentiality of their medical information, to consent to or to refuse treatment, and to be informed about relevant risk to them of medical procedures”.
2. Put your host community’s interests first.
Ultimately it is your hosts that invite you to practise in their community. It is they who should define your role, and it is essential that you ask a few key questions before you undertake professional activity: What are the community’s needs? Is there a gap that needs filling? Practising in this way will make your work abroad meaningful for both you and your hosts.
3. Give local trainees, practitioners and researchers priority.
Health workers have a huge opportunity to use and develop their skills in a global health context, however this should never be at the expense of local trainees. For researchers, involve local staff in as much of the research as possible, giving them ownership over the process from planning to publication (and always cite their contributions appropriately).
4. Emphasise education.
Frequently the biggest contribution that can be made by health workers is in leaving their skills behind. Make an effort to work with local staff to identify, and then fill, skills and information gaps. There should be an educational and capacity-building element to all of your professional activities.
5. Think long-term sustainability.
Just as you will take new knowledge and skills home, there will be opportunities for you to have an impact on your host community beyond your departure. Think about ‘big picture’ issues (eg, prescribing choices, clinical decision-making, resource management, staff recruitment and training and data collection) and how, based on your Australian experience, you can empower local staff to create enduring structural change. Whatever your role, consider how you can promote local ownership and self-reliance.